Great golf after hip or knee replacement

By Golf Fitness MagazineMarch 10, 2009, 4:00 pm
By Erin Hurley-Booker
 
As a physical therapist I often hear the question, Can I play golf again? Regardless of age, skill level or gender, everyone ' especially here in Florida, where we can, fortunately, enjoy golf year-round ' is eager to return to the sport. Many times these patients are recent recipients of hip or knee replacements.
 
Recent statistics reveal that each year more than half a million people undergo hip or knee replacement surgery. In my research, I have found that every surgeon encourages his or her patient to resume golfing following the procedure. And, in fact, more than 90 percent of patients successfully return to playing golf.
 
The face of those opting for hip and knee replacements is changing. Men and women who are younger and more active are choosing to have the surgery sooner. As with every procedure, the surgeons are refining techniques that advancing technology continues to improve.
 
This allows many patients to return to golf sooner than would have been possible 10 or 20 years ago. However, it is imperative that the new joints are ready to take on the tolls of returning to the game of golf.
 
Immediately After Replacement Surgery
 
Knee replacements-
Early range of motion (ROM) is the key. You will want to discuss with your surgeon the plan for immediate post-operative ROM. Quite often surgeons will prescribe continuous passive motion (CPM) machines or similar devices to allow you to start stretching the ROM immediately. Also, most surgeons recommend that you start Physical Therapy in the hospital and continue after discharge ' either at home, in a rehabilitation center or in an outpatient facility ' to maximize your motion gains.
 
Hip replacements-
This procedure is often accompanied with post-operative motion restrictions to protect the integrity of the new joint. The movements that are restricted depend on the technique that your surgeon uses. Most commonly, bending forward at the waist (hip flexion) and twisting the foot (hip internal or external rotation) are limited. Your surgeon and the technique he or she uses will determine the length of time for the restrictions. Once these restrictions are lifted, it is often easy to regain full ROM.
 
The amount of weight that you can place through the leg that has the joint replaced varies. Often times you can place as much weight through the leg as you can tolerate, but again, your surgeon determines this. You will have to use a walker or crutches immediately after the surgery, and then usually progress to the use of a cane prior to walking normally.
 
Strengthening the muscles around the joint should begin as soon as possible. Most surgeons will let you begin walking and light strengthening exercises the day after surgery. Your Physical Therapist will progress your exercises from simple movements to more complex, functional movements that mimic daily and even golf-related activities as you recover.
 
Most surgeons and physical therapists recommend returning to golf three to nine months after the surgery, depending on the progress of your recovery. Once you are cleared to return to golf, you will want to continue to progress the exercises you learned in rehab to ensure that your new joint is ready to face the challenges of a golf swing. In addition, follow these suggestions in your return to the links:
 
1) Use a golf cart
Although walking is a great form of exercise, a golf cart is advised as you return to playing, to decrease the stress on the new joint. Walking an 18-hole course is too strenuous for the new hip or knee joint, especially as you are first returning to the game.
 
2) Wear spikeless shoes
Shoes with spikes ' even soft spikes ' can create torque or rotational stress at the knee and hip joints. Following replacement surgery, we want to avoid any unnecessary stress or torque throughout the joint. Spikeless golf shoes are usually available at golf outfitters. Cross-training sneakers are also a good option. Additionally, your golf professional may be able to help you achieve a swing utilizing a step-through method, which also helps to minimize rotational stress throughout the leg.
 
3) Start slow and build up gradually
As with returning from any injury or time away from the golf game, it is important to start off with an easy, partial swing and gradually work up to a full swing. I always advise my patients to take only their wedges and short irons to the driving range the first few times they go. This helps to eliminate the urge to test out the new joint. I have them start in the chipping areas, progressively working up to a full swing with their pitching wedge or 9-iron at the range. After a few days of this, the patient is usually ready, both physically and mentally, to start swinging again with a driver and the longer irons.
 
4) Stretching
Stretching is always important, particularly with hip and knee replacements. It is good to stretch your thigh, hamstring and calf muscles before playing golf to ensure optimum flexibility and reduced stress around the new joint. Another important stretch is for rotation, which is often restricted after hip replacement surgery. To perform this exercise, lay down on your stomach, with the surgically repaired knee bent to about 90 degrees, or a right angle, the bottom of your foot pointed toward the ceiling. You may want to place a pillow under your stomach to decrease stress on your low back. Keeping your back relaxed and still, slowly rotate your hip by turning the lower leg to the inside (external hip rotation) and then to the outside (internal hip rotation). Do not allow your torso to move. Hold for three to five seconds in each position and repeat 10-15 times on each leg. This exercise will not only loosen up the hip rotator muscles, but also help to strengthen them.
 
5) Strengthening
There are many available exercises to perform after hip and knee replacements. Your Physical Therapist will help you determine the best exercises to continue to maintain strength for golf. One of the most important strengthening exercises is the step-down. This exercise will help you gain and then maintain the strength necessary to climb up and down small hills and bunkers, as well as improving balance.
 
To perform step-down, stand on a small (approximately four inch) step with a railing or wall for hand support. A phone book can be substituted if there is not a small step available. Stand with your surgical leg on the step, and your other leg raised slightly in front of you. Without leaning in any direction, slowly lower down until your other heel touches the ground. Slowly rise back up. Focus on controlling the downward movement of lowering your other leg to the ground. Start with two sets of five repetitions, working up to two sets of 10 reps. When you can easily control the knee during the step-down exercise for two sets of 10 repetitions, you may increase the step to six inches to increase the challenge.
 
With increased hip and knee replacements, and post-operative golfers staying active longer, we are inevitably going to see more golfers on the course. These tips are key elements in protecting that new hip or knee joint, and ensuring its stability through many rounds of golf. If you are contemplating a hip or knee replacement surgery, visit your orthopedic surgeon and physical therapist in preparation for your eventual return to golf. It is never too late or too early to improve your strength and flexibility!
 
Erin Hurley-Booker, MPT, MTC, CSCS, is a GFM Advisory Team Member and Clinic Director for Physiotherapy Associates in Ocoee, Fla. For further information on Erin, log onto www.golffitnessmagazine.com/advisoryteam
 

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Murray fixes swing flaw, recovers momentum

By Associated PressApril 20, 2018, 2:24 am

SAN ANTONIO - Grayson Murray fixed a flaw in his swing and hit the ball well enough that blustery conditions weren't an issue for him Thursday in the Valero Texas Open.

Coming off a missed cut at Hilton Head last week, Murray made seven birdies for a 5-under 67 and a one-shot lead. His only mistake was a double bogey from a greenside bunker on the par-3 seventh hole.

''Just the fact I did give myself enough opportunities today for birdie, it took a lot of pressure off,'' Murray said.

Of the five players at 68, only Chesson Hadley played in the morning side of the draw, and he called it among his best rounds of the year because of gusts. The wind died in the afternoon and scoring improved slightly on the AT&T Oaks Course at the TPC San Antonio. Keegan Bradley, Ryan Moore, Billy Horschel and Matt Atkins each posted 68. Horschel and Moore played bogey-free.

''Struck the ball really well, something that we've been working hard on,'' Horschel said. ''Could have been better, yeah. I didn't really make anything out there today. But I'm happy with it.''

Sergio Garcia, who consulted Greg Norman on the design of the course, played the Texas Open for the first time since 2010 and shot a 74. Adam Scott failed to make a birdie in his round of 75. Scott is at No. 59 in the world and needs to stay in the top 60 by May 21 to be exempt for the U.S. Open.

Harris English was in the group at 69, while two-time Texas Open champion Zach Johnson, Nick Watney and Brandt Snedeker were among those at 70. Johnson saved his round by going 5 under over his final five holes, starting with a 12-foot eagle putt on the par-5 14th hole. He birdied the last three.


Full-field scores from the Valero Texas Open

Valero Texas Open: Articles, photos and videos


Murray was coming off a pair of top 15s at Bay Hill and the Houston Open when his game got away from him last week in the RBC Heritage, and he shot 74-70 to miss the cut. He got that sorted out in the five days between teeing it up in San Antonio.

He said he was coming down too steep, which meant he would flip his hands and hit a sharp draw or pull out of it and hit it short and right.

''I was hitting each club 10 yards shorter than I normally do, and you can't play like that because your caddie is trying to give you a number and a club, and you keep hitting these bad shots or keep coming up short,'' Murray said. ''I got back to the basics with the setup and the takeaway, got my club in a better position at the top, which kind of frees my downswing. Then I can start going at it.''

Even so, Murray thought he wasted his good start - three birdies in his first six holes - when his bunker shot at No. 7 came out with no spin and rolled off the green into a deep swale. He hit his third short to about 7 feet, but missed the putt and took double bogey.

''I would have loved to limit that to a bogey because bogeys don't really kill you - doubles are the ones that now you've got to have an eagle or two birdies to come back with, and out here it's kind of tough to make birdies,'' Murray said. ''But I kept my head. My caddie keeps me very positive out there, that's why I think we could finish 4 under the last nine holes.''

Only 34 players in the 156-man field managed to break par.

Horschel missed four birdie chances inside 18 feet on the back nine. What pleased him the most was the way he struck the ball, particularly after his tie for fifth last week at the RBC Heritage. Horschel was one shot behind going into the last round and closed with a 72.

But he's all about momentum, and he can only hope this is the start of one of his runs. Horschel won the FedEx Cup in 2014 when he finished second and won the final two playoff events.

''I'm a big momentum player. I've got to get the train moving forward,'' he said. ''I've always been a guy who gets on a little roll, get that train moving and jump in that winner's circle.''

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LPGA back in L.A.: Inbee Park leads by 1

By Associated PressApril 20, 2018, 1:53 am

LOS ANGELES - Inbee Park's flirtation with retirement is in the rear-view mirror.

Backed by a large contingent of South Korean fans, Park shot a 5-under 66 for a one-shot lead Thursday in the opening round of the HUGEL-JTBC LA Open in the LPGA's return to Los Angeles after a 13-year absence.

Showers ended shortly before Park's threesome, including second-ranked Lexi Thompson, teed off at windy Wilshire Country Club just south of Hollywood.

Using a new putter, Park birdied four consecutive holes on the back nine before a bogey on the par-4 17th. She quickly recovered and rolled in birdie putts on the second and fifth holes to finish off her round.

''I never played a tournament outside Korea having this much Korean supporters out,'' Park said. ''I almost feel like I'm playing back home. It's almost like a little Korea.''

That applies to the food, too, with nearby Koreatown's restaurants beckoning.

''Too many,'' Park said.

The third-ranked Park banished the blade-style putter she used in her Founders Cup victory last month in Phoenix, a playoff loss in the ANA Inspiration and a tie for third last week in Hawaii. She went back to one that feels more comfortable and has brought her success in the past.

''Last week was just an awkward week where I missed a lot of short ones and I just wasn't really comfortable with the putter,'' Park said, ''so I just wanted to have a different look.''

The 29-year-old Hall of Famer recently said she was 50-50 about retiring before returning to the tour in early March after a six-month break. Momentum has been going her way ever since.

Marina Alex was second. Thompson was one of seven players at 68 in partly sunny and unseasonable temperatures in the low 60s.


Full-field scores from the Hugel-JTBC Open


Alex tied Park with a birdie on No. 11. The American dropped a stroke with a bogey on the par-5 13th before rallying with a birdie on No. 14 to share the lead.

Alex found trouble on the par-4 17th. Her ball crossed over a winding creek, bounced and then rolled into the water, leaving Alex looking for it. Eventually, she salvaged a bogey to drop a shot behind Park. After a bad tee shot on 18, Alex managed a par to close at 67.

''I made a lot of the putts that I shouldn't, I wouldn't have expected to make,'' she said. ''I made two great saves on 17 and 18. Kind of got away with some not-so-solid golf shots in the beginning, and I capitalized on some great putts.''

Thompson returned from a two-week break after finishing tied for 20th at the ANA Inspiration, the year's first major.

She bogeyed her second hole, the par-4, 401-yard 11th, before settling down and birdieing four of the next eight holes, including the 14th, 15th and 16th.

''I changed a little thing that slipped my mind that I was working on earlier in the year,'' said Thompson, declining to share the change in her putting technique. ''I don't want to jinx it.''

ANA winner Pernilla Lundberg was among those in the logjam after a 68.

Natalie Gulbis was among five players tied for 10th at 69. Playing sparingly the last two years, Gulbis put together a round that included four birdies and two bogeys.

Top-ranked Shanshan Feng struggled to a 74 with five bogeys and two birdies.

The venerable course with views of the Hollywood sign and Griffith Observatory wasn't any kinder to eighth-ranked Cristie Kerr and Michelle Wie.

Both had up-and-down rounds that included three bogeys and a double-bogey on No. 10 for Kerr and five bogeys, including three in a row, for Wie. Wie, ranked 14th, had a few putts that lipped out.

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Horschel (68) builds on momentum at Valero

By Will GrayApril 20, 2018, 12:32 am

Billy Horschel only ever needs to see a faint glimmer of light at the end of the tunnel.

While some players require a slow ascent from missed cuts to contending on the weekend, Horschel's switches between the two can often be drastic. Last year he missed three straight cuts before defeating Jason Day in a playoff to win the AT&T Byron Nelson, a turnaround that Horschel said "still shocks me to this day."

The veteran is at it again, having missed five of six cuts prior to last week's RBC Heritage. But a few tweaks quickly produced results, as Horschel tied for fifth at Harbour Town. He wasted no time in building on that momentum with a bogey-free, 4-under 68 to open the Valero Texas Open that left him one shot behind Grayson Murray.

"I'm a big momentum player. I've got to get the train moving forward," Horschel told reporters Thursday. "I've always been a guy who gets on a little roll, get that train moving and jump into the winner's circle. So yeah, it would have been great to win last week, but it was just nice to play four really good rounds of golf."


Full-field scores from the Valero Texas Open

Valero Texas Open: Articles, photos and videos


Many big names tend to skip this week's stop at TPC San Antonio, but Horschel has managed to thrive on the difficult layout in recent years. He finished third in both 2013 and 2015, and tied for fourth in 2016.

With a return next week to the Zurich Classic of New Orleans where he notched his first career win in 2013 and a title defense in Dallas on the horizon, Horschel believes he's turning things around at just the right time.

"Gets the momentum going, carry it into this week, next week, which I've had a lot of success at," Horschel said. "Really the rest of the year, from here on in I have a lot of really good events I've played well in."

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Three years later, PXG launches new iron

By Golf Channel DigitalApril 19, 2018, 11:22 pm

Three years is a long time between launches of club lines, but Bob Parsons, founder and CEO of PXG, says his company had a very good reason for waiting that long to introduce its second-generation irons.

“Three years ago, when we introduced our first generation 0311 iron, we made a commitment that we would not release a product unless it was significantly better than our existing product,” Parsons said. “:Our GEN2 irons are better than our GEN1 irons in every respect. We believe it’s the best iron ever made, and the second-best iron ever made is our GEN1 iron.”

PXG’s 0311 GEN2 irons, which officially went on sale today, feature what the company says is the world’s thinnest clubface. They have a forged 8620 soft carbon steel body and PXG’s signature weighting technology. The hollow clubheads are filled with a new polymer material that PXG says not only dampens vibration, but also produces higher ball speeds and thus more distance.

The irons come in four “collections” – Tour Performance, Players, Xtreme Forgiveness and Super Game Improvement.

Cost is $400 per iron, or $500 for PXG’s “Extreme Dark” finish. Price includes custom fitting. For more information, visit www.pxg.com.