Here's a medical description of what went wrong, courtesy of the American Society for Surgery of the Hand.
A distinctive golf injury is fracture of the hook of the hamate, one of the small bones of the wrist. The hook is the particular part of that bone that protrudes toward your palm, and is vulnerable to injury from the club on a hard hit to the ground as the handle crosses right over the bony hook when gripping the club (see ASSH Figure 1, 1A).
Hook of the hamate fractures may cause pain in the heel of the little finger side of the palm. If it irritates the adjacent ulnar nerve, it may cause numbness and tingling in the ring and little fingers. The tendons that bend the ring and little fingers are also adjacent to the hook, and movement of these fingers may be painful and give a sensation of catching or clicking if these tendons are rubbing on the fractured bone.
Left untreated, the tendons can even gradually fray and rupture. In addition to physical examination, your doctor may obtain X-rays, but the fracture is often difficult to see on plain X-rays because of the overlap of the other small bones in the wrist. A CT scan is often used to visualize the area of the hamate hook in greater detail when a fracture is suspected (see Figure 2).
Treatment may consist of splinting or casting if the fracture is seen very early after injury. If seen late and there is continued pain, numbness and tingling, or tendon irritation, surgery is usually performed to remove the broken bone fragment.
From my experience, this kind of injury means more trouble for Tiger. What he is dealing with is a stress fracture that is caused through repetitive hitting.
It is very difficult to detect and the cure, like with all stress fractures is rest. Or, as the extract from the website explains, surgery to remove the bone fragment. Short term solutions include cortisone shots, anti-inflammatory medicine, ultra-sound treatments and other options that treat the pain. Unfortunately, treating the pain does not solve the problem.
Even trickier is the fact that it doesn't hurt on every shot. Hitting out of the rough will jar the hand enough to make it hurt. Hitting from hard ground is no good. This means we will see more of Tiger's winces at the British Open if it gets dry over there this summer. Punch shots are no good. Has anyone seen many "stingers" from Tiger lately?
It also depends on how he is gripping the club. I haven't followed Tiger's work with Sean Foley very closely, but this injury makes me wonder if he has made a change of his grip with the left hand -- even a minor grip change can create new stress to the hook of the hamate bone bone that has been weakened by years of pounding balls.
The biggest problem for Tiger is the fact that as this injury worsens, the pain can come at any moment and on any given shot. It is the anticipation of the pain that can make even the simplest shots very difficult to execute.
I think that this injury for Tiger is more problematic for his career than his knee injuries. His left hand will also become weak and he will not be able to trust his release. Simple shots flaring slightly to the right are not uncommon.
The next time Tiger winces and shakes his left hand after a shot, you can be sure that he is not faking it. I am almost certain that we will be seeing more of it this year.
Stephen Moskal is currently the Director of Instruction for Golf Swing Exchange, an innovative online coaching platform whose goal is to revolutionize the ability for people to learn golf. A former professional golfer in Europe, Moskal turned pro in 1993 as a member of the French National Circuit and also spent time on the United Kingdom Mastercard Tour and the European Challenge Tour. Following a seven-year professional career, Moskal turned to teaching full-time in 1999. A 1990 graduate of Furman University with a degree in philosophy, Moskal was a four year letter winner with the Paladins and was a member of the academic honor roll. Most recently, Stephen studied under Top 100 instructor Mitchell Spearman, best known for working with major champions Nick Faldo and Ian Baker Finch. Stephen is also the Head Golf Coach at Marymount University in Arlington, VA.
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