Eight days after the most extraordinary win of his career, Tiger underwent season-ending surgery at a clinic in Park City. A ligament was taken from his right hamstring and was used to reconstruct his left ACL. Afterward, he was told to remain off his left leg for two months.
“Can I do push-ups?” Tiger asked.
The answer was no.
“Sit-ups?”
No again.
“Upper-body stuff?”
Still no.
“What can I do?” Tiger insisted.
Dr. Rosenberg wanted him to rest, to give his body time to heal.
The next months were two of the most difficult of Tiger’s life. The deep, throbbing, aching pain never went away. He hated the post-surgery treatment because there was no adrenaline rush. He wanted to get back into the gym, but first he needed extensive rehab. Fortunately, Team Tiger knew exactly where to turn.
By the summer of 2008, the name Dr. Mark Lindsay was being passed among elite athletes searching for state-of-the-art recovery techniques and the realignment of their bodies. A Toronto-based chiropractor known for his “magic hands,” Lindsay had worked with hundreds of athletes, including tennis star Maria Sharapova, Olympic sprinter Donovan Bailey, and New York Yankees infielder Alex Rodriguez. Lindsay’s method was called ART, short for Active Release Technique, a controlled but aggressive combination of neuromuscular massage and stretching designed to stimulate and release the fascia tissue beneath the skin and thereby maximize recovery and athletic performance.
“It’s like playing an instrument,” Lindsay once told Canadian author Bob McKenzie. “You can be superbright, superintelligent, but it has to translate to tactile, to the hands. From my own experience, getting treatments, you can tell right away when someone gets it, when someone has the touch. . . . Sometimes I think, ‘This is cool—this is my job.’ ”
Woods had been introduced to Lindsay by professional volleyball star Gabby Reece, who had found her way to Lindsay through NFL linebacker Bill Romanowski, a four-time Super Bowl champion. In the late nineties, “Romo” was one of the first US athletes to put his faith—and career—in Lindsay’s hands. He would eventually go on to play a record 243 consecutive games at linebacker before retiring from the league in 2003.
“Bottom line, Tiger’s career was over if he didn’t have Mark,” said Romanowski. “Tiger was so locked up, his whole kinetic chain was messed up.”
About six weeks after the surgery, Lindsay sent Woods to Bill Knowles, a certified strength-and-conditioning specialist with two decades of experience working with world-class athletes. Knowles’s area of expertise was alpine skiing, so he knew a blown-out knee when he saw one, and what he saw with Woods was not pretty. “Let’s just say the surgery was a very big surgery,” Knowles recalled years later. “Not a straightforward surgery. It was a very big operation.”
Woods and Knowles worked together on rehab five days a week for about six straight months—gym and pool, gym and pool, twice a day, up to two hours at a time. As Knowles reconditioned Woods’s knee, he also worked on his body and mind.
In mid-October, Tiger was cleared to start swinging a golf club. Dr. Rosenberg suggested he take it slowly, but Tiger began swinging at thirty-five miles per hour. Within a month he was at sixty-five miles per hour and driving the ball 150 yards. He also stepped up his weight-lifting routine, especially for his lower body. By the end of 2008, he was doing Olympic-style lifts.
Tiger was on schedule to return to the Tour at the start of the 2009 season, but right around his thirty-third birthday, he injured his right Achilles tendon while working out. For the third time in a little over a year, one of the world’s best-conditioned athletes suffered a serious injury while training.
Psychologically, the Achilles injury was a huge setback. It threatened to derail Tiger’s return. Dr. Lindsay recommended bringing in another Toronto-based sports-medicine expert—Dr. Anthony Galea. Lindsay had first met Galea at the Winter Olympics in 1994, and they later shared office space for years. Galea was considered a pioneer in PRP—platelet-rich plasma therapy, a process whereby a small amount of blood is withdrawn from the injured athlete and then spun in a centrifuge, separating red blood cells from the platelets. The resultant protein-rich plasma is then injected directly into the injured area—tendon, muscle, or ligament—catalyzing the body’s instinct to repair itself and accelerating the healing process.
“It’s very effective,” Lindsay said. “It’s legal as long as you’re fixing a legitimate injury. There are growth factors in the platelets—it’s basically a form of stem cell, [but] it’s your own tissue—no drugs, no foreign substances. It works best for hamstring tears, Achilles tears, and groin tears. That’s why Tony and I worked so well together. Tony would treat the specific injury and I would work on the [body] system.”
Tiger agreed to see Galea, who had to be in Tampa to treat Pittsburgh Steelers receiver Hines Ward in the lead-up to Super Bowl XLIII. Galea went directly from Tampa to Tiger’s home in Isleworth.
Like Lindsay, Galea was, by 2009, seen as something of a miracle worker, the go-to guy among elite athletes for injury and recovery procedures outside the medical norm. Galea cut a dramatic figure, with his spiky black hair and feline features. His background was equally unusual. The son of a beautician and a bookkeeper, he had graduated with a medical degree from Canada’s McMaster University before establishing his own clinic, the Institute of Sports Medicine Health & Wellness Centre, just outside Toronto. At forty, he divorced the mother of his four children and married a tennis pro less than half his age and fathered three more children. Galea’s hobby was biblical archaeology, and he claimed to have had a spiritual awakening in an olive grove during one of his frequent trips to Jerusalem.
In their book Blood Sport, authors Tim Elfrink and Gus Garcia-Roberts detail how Galea “took a liking to the medical patents of a Miami-area doctor named Allan R. Dunn, whose off-label use of human growth hormone consisted of scraping away scar tissue from inflamed joints and refilling the area with HGH.” Galea had frequently cited Dunn in medical lectures, much to Dunn’s dismay. “I would like to tell him to get lost,” Dunn told Elfrink and Garcia-Roberts. “I don’t want any part of him.” But increasingly, some of the most elite athletes in the United States and Canada did.
Court documents suggest an extra incentive that Dr. Galea had available to get male athletes to seek his services—access to Viagra or Cialis, for free and without fear of detection. When traveling from Canada to the US, Dr. Galea would instruct his medical assistant to prepare a “checklist” of items to enable him to treat patients: IV bags, IV tubing, ATP (German), syringes, ginseng, Nutropin, Actovegin, centrifuge, Cialis/Viagra, Celebrex. Specifically, according to the US government’s 2009 indictment of Dr. Galea, he “instructed his [medical assistant] to take Viagra and Cialis out of their original packages and put them in nondescript pill bottles so as to make detection of them less likely during border inspections.” If asked by a patient, Dr. Galea would allegedly provide Viagra or Cialis free of charge and without a prescription. “Viagra was the hook,” said one athlete with direct knowledge of Galea’s method of operation. “The closer for athletes who didn’t want to go to a doctor for a prescription.”
When Galea started treating Tiger, he would go to his home in Isleworth and Tiger would lie down on a massage table in his family room. He winced as Galea placed a long needle directly into his injured Achilles tendon and injected platelet-rich plasma. The following day, Tiger’s Achilles felt better. The next time Galea returned to Tiger’s home, he injected his Achilles and his knee with PRP. The doctor was living up to his reputation as a miracle worker.
According to court records and other sources, Dr. Galea’s unique medical services centered around four treatments: PRP; anti-inflammatory IVs, which contained, among other things, Actovegin, an unapproved drug derived from calf’s blood; injections containing Actovegin; and “injections containing a mixture of substances including but not limited to Nutropin, a human growth hormone, injected into the knee and administered for the purpose of regenerating cartilage” and reducing joint inflammation.
At the end of 2009, Dr. Galea told the New York Times that his preferred treatment for knee or ACL injuries was platelet-rich plasma. In the Times article, Dr. Galea said he had treated Woods’s left knee solely with PRP using a centrifuge borrowed from an Orlando doctor—and not with unapproved Actovegin or any illegal performance-enhancing drug. He said he had treated Woods just four or five times—which turned out to be false.
According to records later obtained as part of a Florida Department of Health investigation, Galea actually made fourteen trips to treat Woods between January and August 2009, charging $3,500 per consultation plus expenses for first-class travel and lodging. Galea’s total invoices amounted to more than $76,000.
There’s a very good chance Galea’s work with Woods would not have become public if not for the events of September 14, 2009. On that day, Galea’s longtime medical assistant was crossing the Peace Bridge connecting Canada and Buffalo, New York, when she was stopped by a US Customs and Border Protection (CBP) officer and referred for a secondary inspection. During the inspection, CBP officers discovered, among other items, 111 syringes, a centrifuge machine, and a bag with twenty vials and seventy-six ampules of assorted substances and medications, including 10 mg of Nutropin (synthetic HGH) and 250 ml of Actovegin. The assistant told officers she was traveling to Washington, DC, for a medical conference, which turned out to be untrue. She was actually taking what she described as Dr. Galea’s “medical kit” to DC so he could treat an injured NFL player.
Faced with criminal charges, the assistant began cooperating with agents from Homeland Security, Immigration and Customs Enforcement, and the Food and Drug Administration. She eventually turned over her BlackBerry to investigators. A month later, on October 15, 2009, Canadian police raided Galea’s office, seizing an “NFL file folder” and a “professional players journal.”
Galea was subsequently indicted in the US by a federal grand jury on five counts, including possession of HGH with intent to distribute and introducing misbranded drugs into interstate commerce. As part of its case, the government charged Dr. Galea with unlawfully entering the US more than one hundred times between July 2007 and September 2009 to illegally provide drugs and medical services to more than twenty professional athletes, including Woods. Billings during this more than two-year period alone amounted to about $800,000. Galea later pled guilty to one count of introducing misbranded drugs into interstate commerce and was sentenced to one day in jail and a $275,000 fine.
In an affidavit filed as part of an FBI investigation, Dr. Galea’s longtime assistant appeared to contradict his assertion that PRP and Actovegin were the sole treatment options for knee injuries. She told the government, “Dr. Galea would at times inject a cocktail containing HGH into an athlete. The . . . HGH injections were designed to help regenerate cartilage growth.” She also told authorities that Galea had injected at least eight professional athletes—seven in the US and the other in Canada—with a mixture of substances that included human growth hormone. (In an email, an attorney for the assistant insisted that she had never witnessed Dr. Galea injecting HGH into Woods.)
A close inspection of the government’s case against Dr. Galea reveals what could be construed as an attempt to conceal the exact nature and history of his treatment of high-profile athletes. Invoices from Galea routinely described his services in vague terms—“Consultation” or “Consultation/IV/Injections.” Checks were written to Galea Investments Inc. and not to the doctor himself or to his health and wellness center.
In defending his use of HGH, which was legal in Canada but subject to extreme limitations in the US, Galea said he had injected the drug only in patients over forty years old as a way to improve their health and stamina. Galea admitted he had personally used HGH for ten years.
So was Woods getting some kind of pharmaceutical boost to speed his recovery from injury? One source with knowledge of Dr. Galea’s treatment of Woods had no doubt. “One hundred percent,” the source said. “No question.”
According to the source, Galea’s PRP injections into Woods’s injured knee and Achilles also contained what the source described as “minuscule” amounts of both testosterone and HGH. “All of those—the HGH, testosterone, and PRP—just work together really well to create healing at that localized place of injection,” said the source. “There’s just not enough [testosterone and HGH], and it’s so localized [that] there’s just no way it would show up in a drug test. It would have been out of his system in a day. Tiger may not have known exactly what Tony was putting in there.”
No question has hovered over Woods more than whether he used performance-enhancing drugs. In a 2010 survey conducted by Sports Illustrated, 24 percent of the seventy-one PGA Tour pros who responded said they thought Woods “used HGH or other performance-enhancing drugs.” Those suspecting he used PEDs, particularly testosterone, have pointed to the muscular development of his upper body and arms beginning in the early 2000s; the need to recover from his twice-daily two-hour workouts; and his unusual—at least for golf—string of ligament and tendon injuries. Victor Conte is one of those who suspects Woods used PEDs. Conte was the man in the middle of the 2003 BALCO steroid scandal. Now owner of a thriving nutritional supplement company (SNAC, Scientific Nutrition for Advanced Conditioning), he remains a knowledgeable resource on the current state and use of PEDs.
Conte said Woods’s injury history could be a sign of PEDs in the form of mineral depletion. “When you use anabolic steroids, it depletes the body of copper,” said Conte. “So while you’re simultaneously building your muscles with nitrogen and promoting protein synthesis from the use of steroids, you’re weakening connective tissue, ligaments, and tendons. So when you describe his [injury] history, could that possibly be a result of his using anabolic steroids, and the answer is yes.”
Woods has consistently and categorically denied the use of performance-enhancing drugs. “[Dr. Galea] did come to my house,” Woods said at a Masters press conference in 2010. “He never gave me HGH or PEDs. I’ve never taken that my entire life. I’ve never taken any illegal drug ever, for that matter.”
Dr. Galea also denies any suggestion that he was party to performance enhancement with Woods or any other athlete. “Dr. Galea at no time has ever been engaged in any performance-enhancement activity,” said Galea’s attorney, Brian H. Greenspan. “These sorts of innuendo of suspicion are absolutely, one hundred percent false.”
Greenspan insisted that Woods had gone to Galea because he was a pioneer of PRP at the time and that Galea was a healer, not a cheater. Asked specifically if Galea had ever injected a “cocktail of healing” containing testosterone and HGH into Woods, Greenspan said Dr. Galea was unable to respond. In an email, Greenspan cited Galea’s “positive regulatory obligation to maintain the confidentiality of his patients’ medical records, which cannot be disclosed without their express instructions in writing.”
Those who know the truth about Woods and whether he knowingly or otherwise used PEDs probably can be counted on the fingers of one hand. One of those people is almost certainly Dr. Mark Lindsay. Between September 15, 2008, and October 30, 2009, Lindsay treated Woods forty-nine times, charging $2,000 per day plus expenses, according to a Florida Department of Health investigation. He was paid a total of $118,979 for his services, including expenses. Lindsay has told friends his routine with Woods rarely varied. As soon as Tiger woke up, Lindsay would perform his specialized Active Release Techniques on him. Woods would then go to practice and work out for the next three hours and then return home for lunch, after which Lindsay would work on him again. When Tiger was preparing for a major, Lindsay would often bring his therapeutic table to the range, where he would work on Woods for an hour in between practice sessions that focused on swing mechanics.
“The goal was to create efficiency and elasticity of the complex movements using the forces generated from the ground,” Dr. Lindsay explained. “The efficacy of doing this on site and interchangeably with Tiger Woods’s golf swings was significant.”
Lindsay’s extensive treatment sessions with Woods provided unparalleled doctor-patient access during a time that some people suspect Tiger had gained an unfair advantage through PEDs. In a one-year span, from 2008 to 2009, Tiger underwent hundreds of hours of treatment at the hands of Dr. Lindsay. After initially declining to speak on the record, Dr. Lindsay—through his Toronto-based attorney, Timothy S. B. Danson—obtained a limited doctor-patient privilege waiver from Woods, authorizing him to disclose information about his treatment of the golfer and to provide his medical opinion on whether Woods used banned substances or performance-enhancing drugs. On December 17, 2017, Dr. Lindsay signed a four-page declaration witnessed by his attorney. With Tiger’s consent, Lindsay provided his declaration to the authors of this book. It is the most authoritative and definitive statement to date on the question of whether Tiger Woods used performance-enhancing drugs. It reads in part:
During this extended period of time, I was very close to Tiger. At no time during this intensive process did I ever witness Tiger Woods take, discuss, or ask for any banned or performance-enhancing substances, nor did he even indirectly hint about the subject matter of banned substances. Anyone suggesting or implying otherwise is misinformed and wrong. To the contrary, Tiger Woods was fully committed to a proper and highly disciplined rehabilitation process.
Tiger Woods is an exceptionally gifted, highly disciplined, and very spatially aware athlete. These qualities, along with his passion and single-minded commitment to be the best golfer of all time, are nothing short of breathtaking; they are what puts Tiger Woods in a very elite cohort of the best athletes in the history of sports. It is simply wrong and misconceived to apply normal standards of recovery and performance to world-class, elite athletes like Tiger Woods. The exceptional and unique qualities that made Tiger Woods the best elite athlete in his field are the same exceptional and unique qualities that he applied to his rehabilitation and comeback.
I have been in the practice of sports medicine for over twenty-seven years. I have treated hundreds of world-class athletes spanning eight Olympic Games and multiple professional sports disciplines. I know what muscle tone and tissue should feel like. This is critical to the proper treatment of a patient. I continue to be involved in research and stay current with the latest applicable medical literature. I understand body/muscle tone and tissue and the effects of certain drugs on tone and tissue. Tiger Woods’s body/muscle tone and tissue are completely consistent with what one would expect from an elite athlete free of any performance-enhancement drugs. Stated differently, there was no evidence of rigid, stiff, and hypertonic body/muscle tone or tissue during my multiple physical examinations of Tiger Woods, which one would expect if performance-enhancing drugs were being used.
With regard to my experience described above and my direct observations and treatment of Tiger Woods, it is my professional opinion that he has not taken any performance-enhancing substances, and that the notion of taking such substances would be abhorrent and repugnant to him. Tiger Woods is truly one of the most impressive, skilled, intense, and determined athletes I have ever worked with. These are the qualities and attributes that drive his rehabilitation and comeback.