The Ballad of Alex Smith
So when you forget your work at work, you get behind. Sorry to deviate from my diet posts but work has gotten busier lately and I left my draft about Ketogenic diets at the office. Don’t worry though, I have it almost ready to post and will continue talking about different diets and how they can relate to athletics and health. But I recently watched a show in ESPN and thought I’d talk about it.
A small documentary (E60) about Alex Smith came out on ESPN called “Project 11”, detailing his recent injury and subsequent recovery. To recap, in 2018 Alex Smith was the quarterback for the Washington Redskins and suffered a terrible leg injury after being sacked against the Houston Texans. The injury was bad enough he had to have multiple surgeries and almost lost his leg. However, it was saved and he is now in recovery and rehabbing, and even maybe return to the NFL. If he can do this, that would be amazing, almost a miracle, but I sure am rooting for him.
Not the game in question but this is a typical view from the sideline.
What would make this amazing is what happened to his leg, which is detailed throughout the show. He ended up with compound fractures of his tibia (shin bone) and fibula (smaller lower leg bone that run from lateral [outside] knee to the ankle), which means it was broken in several pieces. In the show, the x-rays appear shattered, pretty much. That will always require surgery to piece the bone together to heal. This type of injury alone can hinder any comeback and end careers. But it didn’t end there.
A very dangerous infection developed after that, called necrotizing fasciitis. That’s where skin bacteria get in the subcutaneous tissue (fascia- the silvery tissue between the skin and meat when you peel the skin off a chicken breast or leg.). There area usually doesn’t have bacteria there, so when it does happen to get in that potential space, they grow like gangbusters and the infection can spread very quickly. As the infections spreads, it causes necrosis (cell death by bursting open). The only way to deal with the infection is IV antibiotics and removing the diseased tissue. In this case, it seemed to spread almost to the point that his leg could have been amputated to try and corral the spread and save his life. However, he wanted to keep his leg and they were ultimately able to save it.
In saving his leg, much of the fascia and muscle tissue had to be removed. The muscles that had to be removed are primarily responsible to assist in dorsiflexion, where the foot and toes are lifted toward the face. This motion is very important to keep the toes from dragging in the dirt when walking or running. To offer some mobility, Smith had some of his Gastrocnemius (big calf muscle) transplanted to the front of his leg. In the show, they said his dorsiflexion was considerably hindered because of this. Not only is the muscle in the front of the shin not the original, but to be able to do this you must work with the nerves that will get injured as well and vessels in the region.
Of everything he had to endure, the one that would likely cause the most issues trying to return to the field would be his lack of dorsiflexion in the foot and ankle. One of the things that made Alex so good was his ability to scramble on the field and run outside of the pocket. To be able to do that he needs to have considerable strength and confidence in his leg, ankle, and foot, which just isn’t there. Is it impossible for him to come back?... No… but highly improbable. He has taken considerable strides in recovery and is seen running with his children and doing some drills, though when seeing him do it on camera, the leg just isn’t moving like it should to be as explosive as it needs to be to play football, especially in the NFL.
All that being said, Alex Smith has persevered and rising to the challenge several times in his career. The show does delve deep in to how he has been underestimated and you just can’t help but root for him throughout the episode. He really has done the best he can with the hand he has been dealt. I really do hope he is able to return to some sort of normalcy. It is definitely be a tribute to his drive and the skill of those medical professionals that cared for him in the hospital and his sport medicine team outside of the hospital. Yes, Smith does a lot, but you can bet there are sports medicine physicians, physical therapists, and athletic trainers there helping along the way.
I due recommend giving this episode a viewing on ESPN’s streaming service (I don’t get paid to tell you that though). There is some graphic images of the injury so do be mindful about that.
Watch out for a ketogenic diet post coming up soon!
Stay safe out there and keep moving! Remember to protect those ankles and keep the quarterback upright!