A Doctor’s Take On Kevin Ware’s Injury

We interview an orthopedic surgeon in sports medicine to explain what could have caused Ware's horrific bone break in last Sunday's game and when a realistic return could be.

Josh Helmuthby Josh Helmuth

Duke v Louisville

Louisville guard Kevin Ware sustained one of the most gruesome injuries every captured on live television last Sunday during the Regional Final when he snapped his tibia contesting a three-pointer against Duke. The injury stunned not only the entire crowd at Lucas Oil Stadium in Indianapolis and a national audience of television viewers, but even players and head coach Rick Pitino himself were wiping tears in the ten minutes Ware laid on the floor in agony, screaming to his teammates to "forget about me," and to just "win the game."

I couldn't get over my shock of seeing such a traumatic injury during a game, especially during a sport that isn't known for serious contact sustained injuries. After all, no one even touched Ward. How could such a strong and agile athlete fall victim to such a horrific injury simply by landing awkwardly? I contacted a specialist in Los Angeles who works with athletes to find out.

Dr. Christopher Lee is an orthopedic surgeon trained in sports medicine who has worked first hand with professional athletes which include USA volleyball and USA soccer. He explained to me how Ware could have suffered the compound fracture during the play, even though he went untouched.

"Looking at the video there's a few things that makes his injury unique. One, he lands on one foot and when he landed on one foot, his knee almost buckles. It looks like it almost locked up on him and when that happens there's almost zero shock absorption. If we jump and we land, we'll bend our knees at our ankle; we'll absorb that shock. But his knee literally almost buckled, and that basically transmits a ton of force into the bone or the joint. And a lot of studies have been done… it takes about 900 to 1,000 pounds of pressure to break a bone. When you think about how big, strong, fast our athletes are, you're seeing more and more of these kind of high, unusual, high velocity injuries. Certainly snapping a bone like that is rare."

Rare it is. However, Lee says he's actually seen this injury twice before in competitive sports; once with a volleyball player and once with a Division III college basketball player. He also says that this type of injury is very common on the ski slopes because it's so fast, once they fall, the twist and torque on the bone can cause it to easily to snap.

Still, while he may have seen this kind of injury several times, Lee himself said it was tough to watch the footage of Ware's injury. Being a surgeon, the EMTs usually have the leg set by the time he sees such a break in the emergency room and he's never actually seen such a break occur in live action.

900 to 1,000 pounds of pressure sounds like a lot, but Lee says simply walking up the stairs applies three to four times your body weight worth of pressure on your legs. For me that would be roughly 665 pounds. That perspective shows how landing awkwardly with so much force could be traumatic to Ware's leg.

"You have a guy that's running full speed, jumping, landing on one leg with zero shock absorption, there's just so much torque and force concentrated on one area," Lee said.

My first thought — and that of many it seems — was that Ware most likely had a bone deficiency. Lee says that's not necessarily the case.

"People have speculated, did he have a previous stress fracture? Did he have something like that? Those are all concerns. I think that's all speculation at this point. I saw a Rick Pitino interview where he said there were no preexisting conditions and no pain prior to his injury. My opinion; I think this is just a big, strong, fast guy jumping, landing on one leg with no shock absorption when he landed and it was just all this force transmitted to his bone and it broke on him."

In a nut shell, what Lee is saying is that it was simply bad luck — similar to when players tear their ACL in basketball, which isn't uncommon even while being untouched. Ware even mentioned that when he jumped in the air and was about to land, he was unaware of where he was on the floor, which caused his awkward land.

All everyone can wonder now is if Ware will ever play again, and if so, what's a realistic recovery time? Lee says the odds are tough to call, but if he sticks to the rehab program he could be back in about a year.

"Odds of ever playing again are tough. They're saying he'll be back in a year. I think if he is back, it will probably be about a year before he's back… If the surgeons did a good job, and it sounds like everything was done great…it's actually the soft tissue that needs to get rehabbed… He had an open fracture so the surrounding muscle gets injured, the swelling, the trauma itself.. all that muscle needs to get strong again. Because of this fracture, although they'll start weight bearing pretty early, he's going to have to get his hamstrings, quads, hips, core, all strong. So that rehab is going to be extensive. The other thing they have to do is watch closely for infection. He had bone sticking out so he'll need to be monitored very closely."

Lee went on to explain that there have been several athletes that have come back from this type of injury and have thrived professionally. While this injury is obviously serious and might threaten is career, it is certainly not 100 percent career ending.

"Leon Washington had this injury — he played for the Jets — and he came back and played great. On the other hand, Joe Theismann never played ever again… I don't think you can make an assessment on when he can play until when he starts getting through his rehab. It's almost impossible to predict right now. It's certainly a career threatening injury but it's not career ending. There are several athletes that have come back from this and have done well and played professional sports."

Attitude will obviously play a key part in coming back and Ware seems to have what it takes. Not only will his optimism be needed, but Lee also says he needs to follow the advice of his treating physician, physical therapist and dedicate himself to his rehab program, refusing to give up — all attitudes I'm sure he won't have any problem with considering his tremendous optimism thus far.

Ware and his Louisville Cardinals play Wichita State in the Final Four Saturday at 6:09 EST. The winner will play in the national championship game against either Syracuse or Michigan.

Josh Helmuth is the editor for CraveOnline Sports. You can follow him on Twitter @JHelmuth or subscribe at Facebook.com/CraveOnlineSports for the latest in sports on your newsfeed.

Photo Credit: Getty