What does the literature say about golf and prosthetics?
In 2007 members of the American Association for Hip and Knee Surgeons agreed that all low load activities were recommended after a knee or hip replacement surgery, including golf. This was an assumption and thus not scientifically validated. Which is why we went looking for some answers!
How long does it take before getting back on the green?
A case series showed that 57% of the patiënts with knee prosthetics returned to golf after 6 months. Other research had an even shorter return to golf of 18 weeks (Mallon & Callaghan, 1993). We recommend to start after you’ve talked with the physio and the doctor and to listen to your body. First of all, start with a 30 minute warm up at low to moderate intensity before you start swinging!! Not 5, not 10, but 30 minutes!. Not only does a prosthetic allow you to play golf more often or as much as before( 81%) but 83% had less pain. More importantly, 90% enjoyed golfing even more than before!
How high is the risk for complication?
More than 90% of golfers does not have more risk for complications than someone who doesn’t play golf. But biomechanical research (Hamai et al., 2008) has shown that a lot of rotational forces (20° inward rotation) can act upon the knee during the swing (especially back swing to end of follow through). The material (polyethyleen) of the knee prosthetic can wear down more rapidly. Although this reasearch group made a great study, they only took X-ray images of the leading knee (right handed golfers- left knee) during movement. The problem is that this technique only is accurate when the lower leg is fixed. But as you can see in the pictures below, the left foot leaves the ground making it possible to overestimate the rotational forces. For the trailing knee, not many complaints are noted during golf (Mallon & Callaghan, 1993).
It’s important to know, what type of swing is performed. In the next picture it is apparent that the leading foot leaves the ground during the backswing. Taking into account the possible overestimation of rotational forces on the leading knee during this type of swing, no advice is giving against this swing. Secondly you should think of the fact that adapting your swing can change forces on your knee.
Adapting your swing is not easy! Look at Tiger Woods. He’s probably the best example of swingadjustments because of injuries. But people can learn at any age. For those limited with a knee prosthetic, a good swing with enough club head speed an distance is still possible. Or you keep the knee’s almost still with more rotation at the hip and back. Or you can shorten your backswing and step through when during the follow through.
For more questions, don’t hesitate to contact us or your PRO. Happy Golfing!
What do you know? Leave a comment below!
Written by Pieter Van Bossuyt ©
ReferencesChatterji, U., Ashworth, M. J., Lewis, P. L., & Dobson, P. J. (2005). Effect of total knee arthroplasty on recreational and sporting activity. ANZ Journal of Surgery, 75(6), 405–8. D’Lima, D. D., Steklov, N., Patil, S., & Colwell, C. W. (2008). The Mark Coventry Award: in vivo knee forces during recreation and exercise after knee arthroplasty. Clinical Orthopaedics and Related Research, 466(11), 2605–11. Hamai, S., Miura, H., Higaki, H., Shimoto, T., Matsuda, S., Okazaki, K., & Iwamoto, Y. (2008). Three-dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty. Journal of Orthopaedic Research?: Official Publication of the Orthopaedic Research Society, 26(12), 1556–61. Jackson, J. D., Smith, J., Shah, J. P., Wisniewski, S. J., & Dahm, D. L. (2009). Golf after total knee arthroplasty: do patients return to walking the course? The American Journal of Sports Medicine, 37(11), 2201–4. Mallon, W. J., & Callaghan, J. J. (1993). Total knee arthroplasty in active golfers. The Journal of Arthroplasty, 8(3), 299–306. Swanson, E. a, Schmalzried, T. P., & Dorey, F. J. (2009). Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. The Journal of Arthroplasty, 24(6 Suppl), 120–6.