Back to top

When will Alex Smith be back?

Many of us saw the gruesome footage of the leg break that Redskins, Alex Smith sustained in Sunday night’s game. As a physical therapist, I couldn't help but immediately launch into considering the challenges faced by Alex in returning to football and competing for the Redskins. The bones that he broke are the Tibia and the Fibula, the two bones of the lower leg. The recovery for a break of this severity has a lot of variables. 

The best case scenario for Alex Smith and the Washington Redskins is a clean break. If it’s a nice clean bone break without other major tissue damage, then recovery is straight forward. A normal person would require six to nine months to return to walking and daily activities, but would require longer for a return to sports. Normal people must fit in recovery between other activities, such as a job, maybe kids, and a hectic commute around DC. In comparison, the Redskins are predicting that Alex Smith will return to the field within eight to nine months, well ahead of the expectations of a normal, amateur athlete.


Click the arrow in the title area to see our interview with ABC7 news reporter Tom Roussey.

For a professional athlete like Alex Smith the recovery would be much faster for a number of reasons. Starting out, Alex Smith is one of the top quarterbacks in the NFL and is therefore in excellent physical condition—a great advantage. His entire job has now become rehabilitation, and he has access to the right professionals for fater healing. For faster healing, professionals who are experts in Active Release Techniques (ART), Graston, Trigger Point Dry Needling (TDN), and other specialties can accelerate healing dramatically. This is because quality is almost always more important than quantity in medical care—doing the right care, rather than just a bunch of exercises—is essential to getting Alex Smith back out on the field. So Alex will likely seek out experts rather than go to whoever is convenient, and this is a big lesson that amateur athletes can learn from serious rehabilitation programs like this one.

If the break is complicated the healing time could be much longer. The more surfaces of bone need to be knitted together, the longer healing takes. For example, if the bone is shattered, or if the surgery is more complicated by vascular, nerve or other damage, the healing time will be longer. It’s also possible that if there is enough bone fragmentation that the broken leg could heal shorter than the other leg, and this could generate long term effects. Redskins great Joe Theismann, who suffered a similar break on same day of the year in 1985, indicates that his career ended due to the broken leg healing shorter. While there are ways to fix this with Alex Smith’s surgeon, the time frame for recovery would be substantially longer due to many of these procedures.

If the break is accompanied by a lot of tissue damage, either muscular or vascular, this too would prolong the healing time and possibly end an NFL career. Complications of muscle atrophy, nerve damage, and compromised circulation in the lower leg would all influence a less than optimal outcome and longer time to recovery.

The bottom line is that no matter what, this is a terrible injury for anyone to sustain. It’s unusually gruesome even for NFL football. We at Rose Physical Therapy Group all have our fingers crossed for a successful recovery and return to football for Alex Smith!