Brandt Snedeker appears to have finally found the cause of his recurring rib fractures: a condition known as low bone turnover.
“I had everything tested and they found this one anomaly in my DNA,” Snedeker, 32, told Golf Magazine in an interview last week. “What it boils down to is that my ribs are just really brittle compared to the rest of my bones. So I’m on this medication that is supposed to strengthen your bones and keep this stuff from happening.”
The medication, Forteo, is an anabolic osteoporosis treatment designed to increase bone mineral density.
Snedeker, the world’s fifth-ranked player, said he has been injecting the drug daily for the last two months and that it conforms to the PGA Tour’s drug policy. “I made sure it’s okay to take,” he said. “It’s a drug that’s going to help me keep my bones from being less than brittle to being up to par.”
He said that the medication can take up to two years to “make a big difference,” and that he has encountered some side effects, including nausea and dizzy spells at night.
“But hopefully in the grand scheme of things, it will be worth the investment,” he said.
Bone turnover, or remodeling, is a natural process by which the body, in very basic terms, sheds mature bone and replaces it with new, supple bone, according to the A.D.A.M. Medical Encyclopedia. (Adults remodel about 10 percent of their bone tissue annually.) If, as in Snedeker’s case, the turnover rate is too slow, it can lead to brittle bone structure.
The condition is highly unusual for a man of Snedeker’s age, said Dr. Donald A. Bergman, a New York City-based specialist and past president of the American Association of Clinical Endocrinologists.
“It’s generally seen in the elderly, because as you get older, you have fewer and fewer of these bone-forming cells,” he said.
Snedeker has cracked four ribs in the last six years, most recently during the 2012 RBC Heritage at Harbour Town. (He also has had two hip surgeries, most recently in November 2011, and has twice strained a muscle in his rib cage, most recently during his winning week at the AT&T Pebble Beach National Pro-Am in February.) Snedeker had been seeking an explanation for his fragile ribs for years, visiting more doctors than he could count, but always to no avail. He was diagnosed with low bone turnover shortly after his win at Pebble, when more than a dozen doctors and specialists ran Snedeker through a battery of tests at the Mayo Clinic in Rochester, Minn.
“I had a few specialists look at me, and I said, ‘This is not normal. I shouldn’t be breaking [bones] at this point. I’m having these injuries all the time, and they’re from no contact whatsoever; they’re just from playing golf,’ ” Snedeker said.
“I said, ‘Where I am right now is not okay. We’ve got to do something to increase [my bone strength].’ They said, ‘Well, we can give you some medicine to keep you where you are.’ I said, ‘Where I am now is not working. I need to get better. I need to get back to where I can do what I want to do without any injuries.’ ”
Snedeker’s injury at Pebble was an intercostal strain on the left side of his rib cage that grew progressively more uncomfortable through the week. By Sunday afternoon, Snedeker said, each swing induced severe pain.
“I hit a drive on 14, the par 5, and looked at my caddie and said, “That’s it, man. I’ve got nothing else. I feel like I’ve been stabbed,’ ” Snedeker recalled. “I could get [the club] back okay, but on the way through it just felt like I was pulling the bone away from the sternum or something.”
Snedeker credited his caddie, Scott Vail, for shepherding him through the ordeal.
“It got the point where Scott said, ‘Hey, I just need 12 swings out of you. Just 12 more,’ ” Snedeker said. “He started putting it like that, and I was like, ‘You know what? I swear to God, I can bite my damn fingernails and get through 12 more swings.’ ”
Snedeker made it look easy. With a steady diet of three-quarter swings and low-risk approach shots to the fat parts of the greens, he posted a 7-under-par 65 to win by two. He took off six weeks to recuperate, then missed the cut in his first two starts back, at Bay Hill and in Houston. Since then, he has rebounded with strong finishes at both the Masters (T6) and the Players Championship (T8).
Snedeker’s manager, Jimmy Johnston, said he doesn’t believe Snedeker’s disorder is major cause for alarm. “What we have to do going forward is control his schedule a little bit better, and if he’s feeling tired, maybe be more proactive and pull out of a tournament or two,” Johnston said.
Snedeker is vacationing with his wife and two children in Florida this week. His next start is the Memorial Tournament, in Dublin, Ohio, at the end of the month.