Can Brooks Koepka Bounce Back from his Wrist Injury?

By Dr. Wyatt Kupperman

 

Shinnecock Hills, the site of the 2018 US Open. (Roger Rowlett/ShareAlike 2.5)

I am still celebrating the historic Washington Capitals Stanley Cup win.  I encourage everyone to watch some of the videos from the interwebs.  You will be highly entertained.  

But this week we shift gears towards another National Championship, the US Open, which is to be played out in the Hamptons at Shinnecock Hills.  The focus will be on Tiger since he commands significant coverage as it has been 10 years since that last US Open win defeating Rocco Mediate…..but this isn’t about Tiger.  

Defending champion Brooks Koepka, is a phenomenally talented under-30 player.  He also is the reigning US Open champion from Erin Hills in 2017 when he tied the record score at -16.  I had the privilege to attend and see his game, the guy can smash the ball. 

He also sustained a significant left wrist injury and was diagnosed with a “partially torn tendon” this past January.   He apparently hurt his wrist earlier than that in December 2017, and had an MRI that was “negative” then.  After the Sentry Tournament of Champions in Hawaii he was still bothered by his wrist.  Koepka was quoted in April in an interview with golf.com as saying “the tendon was barely hanging on.”  He then took more than 3 months off and returned for the Zurich Classic, missing the cut.  He apparently further exacerbated his injury while on the driving range at The Players recently, but he finished the tournament T11. 

The Golf Channel has a nice video from January explaining in basic terms the possible injury.

If I had to guess (which I am), he may have suffered an injury that included his extensor carpi ulnaris tendon, which runs on the back of the forearm and connects to the base of the hand and helps with extending the wrist.  However, given the long lay off and his own description of his injury, he may have had a tear to his triangular fibrocartilage complex. 

The TFCC, or Triangular Fibrocartilage Complex. (Elatmani S).

This “complex” stabilizes the ulna with the radius and the base of the hand.  According to Brukner and Khan, it can be injured with loading of the wrist as seen in golf and other sports.  They also state that the sensitivity of the MRI is about 60% (meaning 40% false negative rate, i.e. having an injury, but the scan comes up negative up to 40% of the time).  This could have been an explanation for the first negative MRI (aside from a not ideal scan).  The injury, if surgery is not performed, may take up to 12 weeks to improve, which seems to be consistent with Brooks’ timeline of play.  There was no mention of surgery, and given that he has played four full tournaments since Zurich and finished second in Fort Worth, he looks to have a strong defense this week.  I am eager to see how he does, and especially how the wrist handles the typical US Open rough. 

This week will certainly be a tough challenge for the world’s best golfers.  Happy Father’s Day to all the dads out there.

 

Thanks to Brukner and Khan’s Clinical Sports Medicine, Golf.com and The GolfChannel.