Great golf after hip or knee replacement
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
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.
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.
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.
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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Haas nearly shoots age in taking Champions playoff opener lead
RICHMOND, Va. -- Jay Haas shot a 7-under 65 - missing his age by a stroke - to take a two-shot lead Saturday in the PGA Tour Champions' playoff-opening Dominion Energy Charity Classic.
Trying to become the oldest winner in tour history, the 64-year-old Haas birdied the par-5 16th and 18th holes to get to 11-under 133 on The Country Club of Virginia's James River Course.
''I've been out here too long to know that I can learn to expect anything,'' Haas said. ''While I'm hopeful every day and I've been playing OK, the last couple weeks have not been very good, but this week has been much better. I love this golf course and it looks good to my eye. Most of the holes look like I'm going to hit a good shot, so I enjoy playing here.''
Mike Fetchick set the age record of 63 years to the day in the 1985 Hilton Head event. Haas is second on the list, taking the 2016 Toshiba Classic at 62 years, 10 months, 7 days for his 18th senior title.
''That's a good way to say I'm old, 'experience,''' Haas said. ''I think I'm very nervous most of the time when I play and today was no exception, but I continued to hit good shots and, hopefully, I can put one foot in front of the other, one shot at a time, do what I tell my son to do every time, you know? See if I can put some of those adages to work tomorrow.''
Stephen Ames and Scott Dunlap were tied for second after the round that started in light rain. Ames had a 67, and Dunlap shot 68.
Defending champion Bernhard Langer had a 66 to join Billy Mayfair (67) and Woody Austin (68) at 9 under. Langer won the SAS Championship last week in North Carolina to take the season points lead. The 61-year-old German star has two victories this year and 38 overall on the 50-and-over tour.
The top 72 players qualified for the Charles Schwab Cup Playoffs opener. The top 54 on Sunday will get spots next week in the Invesco QQQ Championship in Thousand Oaks, California, and the top 36 after that will advance to the season-ending Charles Schwab Cup Championship in Phoenix.
Miguel Angel Jimenez, second in the standings, was tied for 23rd at 4 under after a 71.
Sergio leads by 4 entering final round at Valderrama
Sergio Garcia closed with three straight birdies to shoot a 7-under 64 on Saturday, taking a four-shot lead into the third and final round of the Andalusia Valderrama Masters.
The tournament, which Garcia has won twice (2017, 2011), was reduced to 54 holes because of numerous weather-related delays.
With his bogey-free round, Garcia moved to 10 under, four shots clear of Englishman Ashley Chesters, who shot a 1-under 70.
"Hopefully we'll be able to play well tomorrow and get another win at Valderrama," Garcia said. "Hopefully I can finish it in style."
Chesters, however, is conceding nothing. "There's always a chance," he said. "There's not a lot of pressure on me."
Ciganda, S.Y. Kim share lead in Shanghai
SHANGHAI - Carlota Ciganda of Spain shot a 5-under 67 Saturday to share the lead with Sei Young Kim after the third round of the LPGA Shanghai.
Ciganda carded her fifth birdie of the day on the par-4 18th to finish tied with overnight leader Kim at 11-under 205. Kim shot a 71 with four bogeys and five birdies.
Ciganda is attempting to win her third LPGA title and first since the 2016 season, when she won two tournaments in a one-month span. Kim is chasing her eighth career LPGA win and second title of the 2018 season.
''I want to win because I didn't win last year,'' Ciganda said. ''I love playing in Asia. It's good for long hitters, playing quite long, so I'm quite comfortable.''
Angel Yin also birdied the final hole for a 68 and was a further stroke back with Brittany Altomare (69), Danielle Kang (71) and Ariya Jutanugarn (71).
Yin and Altomare have yet to break through for their first LPGA win. A win in Shanghai would make either player the ninth first-time winner of the 2018 season, which would tie 2016 for the third highest number of first-time winners in a season in LPGA history.
''I love competing,'' Yin said. ''That's why I'm playing, right? I'm excited to be in contention again going into Sunday.''
Local favorite Yu Liu was seventh after offsetting a lone bogey with four birdies for a 69.
Paula Creamer also shot a 69 and shared eighth at 8 under with Minjee Lee (70) and Bronte Law (71).
The tournament is the second of five being played in South Korea, Japan, China and Taiwan in the LPGA's annual Asian swing.
Koepka's pursuers have no illusions about catching him
Ahead by four, wielding his driver like Thor's hammer, Brooks Koepka is 18 holes from his third victory in five months and his first ascent to the top of the Official World Golf Ranking.
The tournament isn't over. No one is handing him the trophy and updating the OWGR website just yet. But it will likely take some combination of a meltdown and low round from someone in the chase pack to prevent a Koepka coronation Sunday in South Korea.
Thirteen under for the week, the three-time major champion will start the final round four shots ahead of his playing partners, Ian Poulter and Scott Piercy, and five ahead of six more players at minus-8.
As is his nature, Poulter figures to be undaunted. The 42-year-old is fresh off a Sunday singles victory over Dustin Johnson at the Ryder Cup and in the midst of a career renaissance, having broken a five-year winless drought earlier this year. In one sense, it's Europe vs. the United States again, but this isn't match play, and Koepka, a guy who doesn't need a head start, has spotted himself a four-shot advantage.
"Tomorrow I'm going to need to make a few birdies. Obviously Brooks is in cruise control right now and obviously going to need a shoot a low one," Poulter conceded. "Do what I'm doing, just enjoy [it]. Obviously try and make as many birdies as I can and see how close we get."
Perez, in the group at 8 under par, isn't giving up, but like Poulter, he's aware of the reality of his situation.
"We're chasing Brooks, who of course obviously is playing phenomenally," he said. "A lot of the long hitters now when they get in contention, they hit that driver and they're really hard to catch. I'm not worried about it too much. It's going to be harder for me tomorrow than him, so I'm going to try and go out and just do my thing, hit some shots, hopefully hit some close and make some putts and we'll see. I don't expect him to come backwards, but hopefully I can try to go catch him."
Gary Woodland, also 8 under par, summed up the predicament best when he alluded to Koepka's perhaps advantageously aloof demeanor.
"You obviously want to get off to a good start and put pressure on him as soon as you can," he said. "You know, Brooks doesn't seem like he cares too much, and he's playing so good, so you're going to have to go out and post a number."