Back on the Golf Course After Arthritis

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The Patient Profile

Many golfers face this same situation. Let’s call him Ed — a 70-year-old retired sales executive who played golf three times a week for 30 years. His 14 handicap was a source of quiet pride. Saturday morning foursomes with the same three friends were the highlight of his week.

Then both knees started failing him.

How Golf Slipped Away

Ed’s left knee had bothered him since his early 60s. He managed it with occasional cortisone shots and over-the-counter anti-inflammatories. He could still play 18 holes, even if the last few were uncomfortable.

When his right knee started hurting too, everything changed. Walking the course became impossible. Even with a cart, the act of swinging, crouching to read putts, and getting in and out of the cart left him sore for days.

He went from 18 holes three times a week to 9 holes once a week. Then he stopped altogether.

“Sitting in the clubhouse watching my friends play was worse than the pain,” patients in Ed’s situation often say.

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The Turning Point

Ed’s primary care doctor referred him to an orthopedic specialist. X-rays confirmed moderate osteoarthritis in both knees — grade 2 on the left, grade 3 on the right.

The doctor presented several options, from conservative management to eventual surgery. Ed was clear about his goal: he wanted to play golf again. Not pain-free golf — he was realistic about that. Just golf.

That specific goal shaped the treatment plan.

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A Three-Part Approach

Part 1: Viscosupplementation

Ed received hyaluronic acid injections in both knees, starting with the more painful right knee. His left knee was treated two weeks later.

The doctor used imaging guidance for precise placement — particularly important when treating bilateral joints, since the overall recovery period is longer when both knees are involved.

Treating both knees meant a longer total timeline before Ed felt the full benefit. That patience was important.

Part 2: Physical Therapy

While waiting for the injections to take full effect, Ed started a PT program designed specifically for golfers:

Lower body strengthening

• Quadriceps and hamstring exercises to stabilize both knees
• Hip strengthening to improve swing mechanics
• Calf work for walking endurance

Golf-specific mobility

• Rotational flexibility for the swing
• Balance exercises for uneven terrain
• Squatting mechanics for reading greens

Endurance building

• Walking on a treadmill, gradually increasing distance
• Stationary bike for low-impact cardio
• Swimming for overall conditioning

Part 3: Weight Loss

Ed’s doctor had a straightforward conversation with him. At 235 pounds on a 5’10” frame, every extra pound added roughly 4 pounds of force on his knees during walking.

Ed committed to losing weight — not through extreme dieting, but through steady changes:

• Smaller portions at meals
• Walking more as his knees allowed
• Cutting back on post-round beers (his words)
• Working with a dietitian on an anti-inflammatory eating pattern

Over six months, Ed lost 22 pounds. Research shows that even a 10-pound weight loss can reduce knee pain by up to 20% in people with osteoarthritis.

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The Return to Golf

Month 3: The Driving Range

Three months into treatment, Ed started hitting balls at the driving range. Short irons only, 50 balls maximum. He focused on smooth tempo rather than power.

His knees were sore afterward, but it was manageable soreness — not the sharp, stopping pain he’d felt before.

Month 4: Nine Holes with a Cart

Ed played 9 holes with his regular group. Cart only. He skipped any shots that required awkward stances on slopes. He putted from a slightly wider stance.

He shot 48 for the nine. Not his best. But it felt like winning the Masters.

Month 6: Back to Eighteen

Six months after his first injection, Ed played a full 18 holes. He rode in a cart. He took his time getting in and out. He stretched during waits between shots.

His score wasn’t what it used to be. He was rusty, and he couldn’t generate the same power through his legs. But he was out there — walking some holes, riding others, finishing all 18.

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What Made the Combination Work

No single treatment got Ed back on the course. It was the combination:

Gel injections reduced the pain baseline so he could exercise and play. Injections alone, without the supporting work, would have helped less.

Physical therapy built the muscle strength and flexibility his knees needed for golf-specific movements. Stronger muscles absorb more shock, reducing stress on the joint.

Weight loss reduced the mechanical load on both knees with every step. Twenty-two fewer pounds meant roughly 88 fewer pounds of force per step during his round.

Together, these three interventions worked better than any single treatment alone. Studies consistently show that multimodal approaches produce better outcomes for osteoarthritis than monotherapy.

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Adaptations That Helped

Ed made some practical changes to how he plays:

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Honest Assessment: What It’s Really Like

Ed doesn’t pretend everything is perfect. Here’s his honest take one year into treatment:

The good: He’s playing golf again. He’s with his friends. His handicap has come back from “non-existent” to about 18. He can walk 9 holes on good days.

The reality: Both knees still hurt. The gel injections wear off after 7-8 months, and the last month before retreatment is uncomfortable. He can’t walk 18 holes anymore. His swing is shorter and less powerful than it was.

The perspective: “I’m 70 with arthritis in both knees. I’m not going to feel like I did at 50. But I’m playing golf. A year ago, I thought that was over.”

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Frequently Asked Questions

Can you get gel injections in both knees at the same time?

Many doctors stagger bilateral injections by 1-2 weeks so they can monitor each knee’s response separately. Some doctors do treat both in one visit. Discuss the approach with your provider. Medicare covers treatment for both knees.

How does weight loss help knee arthritis?

Every pound of body weight translates to roughly 4 pounds of force on the knee during walking. Losing 10 pounds removes about 40 pounds of knee stress per step. That adds up to millions of pounds of reduced force over a golf season.

Is golf safe with knee osteoarthritis?

Golf is generally considered a knee-friendly sport compared to high-impact activities. The walking is low-impact, and the swing, while rotational, doesn’t involve the pounding of running or jumping. Using a cart, wearing supportive shoes, and modifying your swing can make it even safer.

How long do gel injections last for active golfers?

Duration varies by patient. Active patients sometimes report slightly shorter relief periods (6-8 months) compared to less active patients, likely because of higher joint demands. However, activity is also beneficial for joint health. The trade-off is usually worth it.

What if gel injections stop working over time?

Some patients find diminishing returns after several rounds of treatment. If that happens, your doctor can discuss alternatives including PRP injections, different HA formulations, bracing, or surgical options. Having a long-term treatment plan matters.

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This story is a composite narrative based on common patient experiences. It is not based on a single real patient. Individual results vary significantly. Always consult a qualified healthcare provider about your specific condition and treatment options. This article is for informational purposes only and does not constitute medical advice.

Last reviewed: March 2026