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Old 11-02-2015, 04:12 PM   #101
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I am willing to wager that his medical team knows/understands very little about the Neuromatrix and most certainly little about the entire right side, and processing circles of the diagram. The cognitive and emotion areas on the left side are likely being ignored as well.

As a golfer and someone that works with golfers in rehab, I would speculate that his 2009 defeat in the PGA Championship to little known (at that time) Y.E. Yang began a significant unraveling of things for Mr. Woods. The well covered events with his ex-wife, caddie, and others likely factor in to the stew as well.

The parallel to this is Andre Agassi...went from top 5 (tennis) to bottom and back after some various life changing issues. It took some time and the right "rehab" for that to happen.
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Old 11-02-2015, 06:38 PM   #102
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It seems as if Tiger's advisors are those who are still approaching his problems by considering his problem from a structural or psychological standpoint. It may not his muscles or his emotional approach undermining his performance--but his brain.

In discussing why some of the greatest golfers of all time were plagued with the "yips," while putting (like Ben Hogan), the late Chicago neurologist Dr. Harold Klawans noted the following in his book, Why Michael Couldn't Hit:

"So what happens in the brain? We do not yet have an answer. As far as we know the brains of patients with dystonias look normal when examined under a conventional microscope after the patient has died. All that means is that there is no anatomic abnormality; no particular group of cells has been injured, no collection of neurons has died. They can just no longer do what is demanded of them. Why is that? The answer may well be in that they weren't designed to perform like that in the first place, and after years of performing above and beyond the call of duty and function, they eventually no longer can do it. That's when dystonia rears its head, or more characteristically, rears a finger or a thumb."
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Old 11-02-2015, 06:58 PM   #103
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Quote:
Originally Posted by Ken Jakalski View Post
It seems as if Tiger's advisors are those who are still approaching his problems by considering his problem from a structural or psychological standpoint. It may not his muscles or his emotional approach undermining his performance--but his brain.

In discussing why some of the greatest golfers of all time were plagued with the "yips," while putting (like Ben Hogan), the late Chicago neurologist Dr. Harold Klawans noted the following in his book, Why Michael Couldn't Hit:

"So what happens in the brain? We do not yet have an answer. As far as we know the brains of patients with dystonias look normal when examined under a conventional microscope after the patient has died. All that means is that there is no anatomic abnormality; no particular group of cells has been injured, no collection of neurons has died. They can just no longer do what is demanded of them. Why is that? The answer may well be in that they weren't designed to perform like that in the first place, and after years of performing above and beyond the call of duty and function, they eventually no longer can do it. That's when dystonia rears its head, or more characteristically, rears a finger or a thumb."
Sort of like, they used up all their juice?
Another possibility is, the synaptic junctions have used up all theirs, and they can't inhibit properly anymore the surrounding neuronal array to limit movement to the desired target movement. True smudge-ification.
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Old 11-02-2015, 07:04 PM   #104
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I know very little about golf, but having worked in sport(s) on the performance enhancement side as well as management of injuries, I am sometimes asked to look at someone who is frustrated by appearance of the "yips". I do my usual CH and exam and usually it is just a case of helping them to become better embodied and the development of fascination with, as opposed to fear of, movement. As ever, the possibility of red flags is a consideration. One gentleman who was referred on was confirmed as having Parkinson's Disease.
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Old 11-02-2015, 07:09 PM   #105
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Ken,
That story reminds me of a similar one about the guitar prodigy, Billy McLaughlin. I watched him live in the early 90's, and I'd never seen someone play a guitar like that- unbelievable skill and creativity. In fact, I heard- don't know if it's true- that Eddie Van Halen was inspired to play on the fret board by Billy McLaughlin.

He developed focal dystonia in his right hand, and it nearly ended his career. He learned, however, to compensate in a spectacular way. Amazing story:
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Old 12-02-2015, 03:44 AM   #106
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That is beyond impressive
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Old 19-09-2015, 03:57 AM   #107
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Back under the knife...

http://abcnews.go.com/Sports/tiger-w...ry?id=33871448
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Old 19-09-2015, 05:36 AM   #108
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Is anyone going to lay odds on the theory that the disc fragment removal (ahem?) will "cure" Tiger of ongoing pain?
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Old 19-09-2015, 05:47 AM   #109
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Is Park City Utah well known for spinal neurosurgery centres of excellence? Genuine question from a curious Brit.
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Old 19-09-2015, 02:31 PM   #110
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Quote:
Originally Posted by nari View Post
Is anyone going to lay odds on the theory that the disc fragment removal (ahem?) will "cure" Tiger of ongoing pain?
...About as much as the first one...
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Old 20-09-2015, 03:45 AM   #111
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I read that it was successful???? Only guess(es) that I have as to what that means.

1. Tiger Woods did not die.
2. They removed whatever piece of tissue they were after.
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Old 20-09-2015, 08:11 PM   #112
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Quote:
Is anyone going to lay odds on the theory that the disc fragment removal (ahem?) will "cure" Tiger of ongoing pain?
Perhaps, but I'm doubtful that it will cure the downward spiral of his golf game.
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Old 20-09-2015, 08:45 PM   #113
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I think that location of symptoms is overrated in the case of painful output here.

And to think - Tiger can afford the best advice, but he doesn't take any of ours.
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Old 21-09-2015, 11:33 AM   #114
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article on the matter in BJSM here

I like the way this has been written by a world authority, I like the careful diplomatic language of what could be a very charged subject.

ANdy
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Old 21-10-2015, 08:32 PM   #115
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Like Tiger, this young lady too had "stuff" removed. Although a might more important piece of anatomy!
http://training-conditioning.com/con...ussion-horrors

"Surgery to remove scar tissue in the back of her head." Same results as Tiger too, Unfortunately.

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Old 31-10-2015, 02:00 AM   #116
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http://espn.go.com/golf/story/_/id/1...iscomfort-back
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Old 31-10-2015, 03:37 AM   #117
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https://soundcloud.com/bmjpodcasts/p...-strength/sets
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Old 02-12-2015, 05:59 AM   #118
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Was surprised to see him sort of suggesting it might be done...

http://mweb.cbssports.com/golf/eye-o...-end-of-career
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Old 02-12-2015, 12:44 PM   #119
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I'm curious how many microdiscetomies you can do to one location? He said he's had 3 to the same spot….


Steve Kerr

Mike Dunleavy
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Old 02-12-2015, 03:43 PM   #120
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how many micro's make a macro?

Maybe anything less than a full discectomy is a micro?

ANdy
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Old 02-12-2015, 04:57 PM   #121
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Quote:
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Sort of like, they used up all their juice?
Another possibility is, the synaptic junctions have used up all theirs, and they can't inhibit properly anymore the surrounding neuronal array to limit movement to the desired target movement. True smudge-ification.
I agree and have a slightly different take on it. Rather than the brain no longer inhibiting properly, the brain is facilitating/creating the dystonia. Not necessarily ascending/descending facilitation but the dystonia is purposeful, and obviously the brain is not "ready" to perform the desired movement. Could it be that there is an advantageous purpose of the dystonia but "we" just don't know what it is?
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Old 02-12-2015, 06:51 PM   #122
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I agree and have a slightly different take on it. Rather than the brain no longer inhibiting properly, the brain is facilitating/creating the dystonia. Not necessarily ascending/descending facilitation but the dystonia is purposeful, and obviously the brain is not "ready" to perform the desired movement. Could it be that there is an advantageous purpose of the dystonia but "we" just don't know what it is?
I doubt it.
I agree with removal of inhibition model.
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Old 02-12-2015, 07:31 PM   #123
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He is most likely depressed and I wonder if anyone has bothered to talk to him about this? or is the focus entirely on whatever is left of that unfortunate disc? I think he has been mismanaged but from a distance that would be hard to estimate.
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Old 23-02-2016, 01:55 AM   #124
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http://sports.yahoo.com/blogs/golf-d...2457-golf.html
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Old 24-02-2016, 12:36 AM   #125
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If only Tiger would fire surgeons like he fires caddies.
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Old 24-02-2016, 03:12 AM   #126
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His agent is saying these reports are false. Having seen many people with three or more back surgeries, I've yet to see any of them tolerate much more than a reclined position. I'm curious how long it will be until he undergoes a fusion.
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Old 20-04-2017, 10:51 PM   #127
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Tiger undergoes fusion.

Now, how long till they diagnose him with failed back syndrome?
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Old 20-04-2017, 11:41 PM   #128
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I hate when I'm right....
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Old 21-04-2017, 02:50 PM   #129
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There are so many things I think when looking at Tiger's initial on-set to now having four back surgeries. I can only say so much not having a true understanding of his symptoms and issues. That said I have a few questions to ask:

What if Tiger simply stayed away from formal "treatment" and went on feel i.e. let things calm and build back up?

What if he was given simple re-assurance and not provided "treatment" under the context of structural abnormality?

What if someone blatantly and truthfully told him the evidence for ineffectiveness of injections and back surgery?

What if he accepted his limitations, current situation, made amends and got on with a life outside of his sports career?

Am I the only one that needs to say "Tiger, I'm sorry, but you are a perfect example of every thing that's wrong with the treatment of low back pain. You've been provided with an outdated understanding of low back pain and an ineffective yet harmful surgery. I understand you have pain, but the treatments provided to you are ineffective for you concerns."

I'm sure what I've said can and will come under scrutiny. But I stand by this:

Those treating people with back pain would better serve people by NOT TREATING it. Those with back pain, may be better served by simply accepting and moving on with their life. Given the current state of low back pain treatment, I'd love to be proven wrong.
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Old 21-04-2017, 05:06 PM   #130
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Nothing surprising here and I agree with Johnny. It means very little if not a thing. I'm influential but not powerful. I think. I'm pretty sure.

I spent some time with one of the PTs "on tour" with the likes of other PGA golfers years ago. What he didn't know appalled me. Of course, I changed all of that.

Actually, I didn't change anything.

I think Tiger is a lesson for many of us, but, believe it or not, not vocal enough to say what the culture might hear. I'd say his celebrity wasn't large enough either. As big as he was, how many play golf or hear anything he says?

More money than he can spend, but he listens to someone aside from us.
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Old 21-04-2017, 06:42 PM   #131
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The crappy thing for these guys is that one missed putt costs them $500,000. One missed tournament can cost a million bucks. 5 missed seasons is millions and millions of dollars. If I were in his shoes and my choices were "do nothing and be reassured," and "lets try one more surgery," I would probably make the same choice. His career is over, as unfortunate as it is. I've worked with golfers before and it is one of those sports where the athlete can make an amazing amount of money, but one bad season will end a money stream. The other problem is these guys rarely have anything else to fall back on as an income stream that is anywhere close to the level that pro golf provides. Imagine if you had to take a 95% pay cut to be pain reduced.
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Old 21-04-2017, 06:43 PM   #132
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His narrative seems to be packed with so called dysfunctions and bogus diagnoses

It's a tragic industry.
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Old 21-04-2017, 09:40 PM   #133
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Maybe we aren't built to tolerate that kind of rotation? Of course, we seem not to be built for American football either. Woody Hayes always said that "God invented the knee before he invented football."

A great line.

Better we should just juggle, but I'm rather biased.
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Old 22-04-2017, 12:31 PM   #134
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The crappy thing for these guys is that one missed putt costs them $500,000. One missed tournament can cost a million bucks. 5 missed seasons is millions and millions of dollars. If I were in his shoes and my choices were "do nothing and be reassured," and "lets try one more surgery," I would probably make the same choice. His career is over, as unfortunate as it is. I've worked with golfers before and it is one of those sports where the athlete can make an amazing amount of money, but one bad season will end a money stream. The other problem is these guys rarely have anything else to fall back on as an income stream that is anywhere close to the level that pro golf provides. Imagine if you had to take a 95% pay cut to be pain reduced.
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Old 22-04-2017, 12:59 PM   #135
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Speaking of professional golfers as if they worried about things more than any other human being seems ridiculous to me.

They have chosen a path that requires regular practice, luck, good looks and talent. There are probably a few other things in there.

Anyway, the requirements sound familiar.
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Old 23-04-2017, 01:10 AM   #136
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Nomadic,

For some reason my message did not come through above.

I don't want to get into a discussion about money and someone that had the highest income amongst all world athletes time and time again. Money is no object for this particular person.

I echo Barrett's comment. What difference does it make if its a construction worker or Tiger? Are there things one can do? They could pursue other occupations but most don't. I see countless individuals 50 and above struggling to continue as brick masons, roofers, landscapers, laborers. I continue rehabbing them after a knee meniscectomy, shoulder arthroscopy and lumbar procedures. They all have something in common.

Some things are not well suited for an aging population. Some occupations require a physical capacity of 100%. Anything less may result in one's inability to compete (professional sports) or complete (physical occupations).

If one is not ready or willing to accept their limitations and alter their path, then healthcare will be happy to step in. Unfortunately for Tiger, and many of the aging workforce I see, the results are what John W called in a recent thread, a tragedy.

So who do we call out. The distressed, suffering individual not willing to accept or alter their lifestyle, occupation, etc?

Or

Healthcare willing to provide "treatment" without benefit, countless harms and a likely path toward disability?

What a mess...
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Old 23-04-2017, 02:59 AM   #137
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Deadpool....perfect anti-pseudoscience superhero there Johnny.
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Old 23-04-2017, 12:09 PM   #138
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There's a long thread on Facebook about the failure of Tiger's treatment. It's on the Explaining Pain Science page.

I'm of the notion that human bodies aren't built for that kind of rotation and that the ones in charge of Tiger's treatment don't know what they might. I assume that the therapists think that pain is an input.

It's not possible to change that belief and it begins before neuroscience discovered otherwise.
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Old 23-04-2017, 12:27 PM   #139
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John's post #105 is about someone dealing with focal dystonia. Though not painful, it is one of those things addressed by Ramachandran in the '90s (yes, during the last century) and reported on at an APTA convention I attended.

When I worked and taught in the teens of this century none of the therapists I encountered had heard of either Ramachandran or the mirror box and procedures he proposed. They were too busy "helping others" to learn anything they had found adequate.
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