Assessing Kevin White’s Recovery from Shin Surgery
By Mike Curran
The Bears are looking to continue to make steps towards becoming a playoff caliber team. A lot of the hope for improvement revolves around the play of guys who were not starters at the beginning of last season. Jeremy Langford, Bobbie Massie, Hroniss Grasu, Cody Whitehair, and Charles Leno will all have key roles in the success of this season’s offensive productivity. But more than all of them, hopes and expectations are very high for Kevin White who missed all of last season due to injury. Let’s take a deeper look at the injury, surgery, and prognosis for Chicago’s first round pick from a year ago.
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Kevin White was diagnosed with a stress fracture in the larger bone (tibia) of his left shin last preseason. When news of this injury became public there was a lot of outcry from jaded fans. Questions and comments of all kinds started popping up on social media. Some thought that Kevin White was not completely honest about his injury status prior to the draft. Others were angry at the possible incompetence of the medical staff that missed the injury during evaluations. And yet even more questioned how this injury might affect the long-term ability of the first round draft pick.
The difficulty with stress fractures of the tibia is that they are very easily confused with the more common injury known as shin splints which is a muscle inflammation problem. Stress fractures, like shin splints, come on slowly and gradually with increasingly sharper pain during activity. Both injuries also occur for the same reasons, participation in a new exercise regimen that involves high intensity activity that your body hasn’t been able to adapt to. This being said, it’s surprising we don’t see more rookies with stress fractures.
The NFL combine is essentially a track and field competition with some football drills mixed in. Most of the top college football prospects start training at high intensity strength and performance clinics in the months leading up to the NFL’s pre-draft final exam. These preparatory workout programs focus specifically on doing well in combine drills like the 40 yard dash, the long jump, the vertical jump, 3 cone drill, shuttle run, etc. These workouts can be grueling and significantly different than a typical football practice. But since the salary difference between a top 10 pick and a top 30 pick is in the millions you can’t really blame them for the effort.
More than likely it was this extreme change in workout style and intensity that lead to White’s tibial stress fracture. Unfortunately a stress fracture feels very much like really bad shin splints and most athletes decide to continue training and push through the discomfort. This confusion with shin splints is also probably the reason why it never showed up on the combine medical evaluations. My guess is that when White started team workouts with the Bears he probably asked to get treatment for his aching shins and that’s when the medical staff saw enough evidence to order the x-ray or bone scan that found the stress fracture.
It’s important to remember that stress fractures are different from the garden variety “I fell off a ladder, landed on an outstretched arm, and felt my collarbone snap” kind of fracture. Stress fractures start off as a small crack in the bone like you might see on a sidewalk or a car windshield, and then over time the crack slowly lengthens and deepens. The more active you are, the more you do with that limb, the quicker the crack widens and deepens. For Kevin White who was doing nothing but explosive running, jumping, and cutting that stress fracture could have gotten out of control very quickly.
The average healing time for a fracture is approximately 8-10 weeks as long as the ends of the broken bone are in proper position and make good contact. In a fracture where the broken ends no longer make contact or have been knocked out of their proper position a doctor is required to re-position and align the bones. Following the correction the doctor will place the limb in a brace or cast to keep the bones in proper position throughout the healing process. Because stress fractures are cracks in a bone they don’t typically need to be re-positioned or casted. Sometimes a brace of some type will be used to take some of the strain off the healing bones but the standard treatment is just rest. If a guy rests for the 8-10 weeks the bone should be just fine. In exceptional cases, like White’s, the crack widens so much that the space is to large for the bone to heal properly without surgery.
There’s a couple of different surgical techniques that are used on fractures and stress fractures. Before I go too in depth, it’s important for me to state up front that orthopedic surgeons are the carpenters of the body. They are not gentle when they do their work and many of the tools they use in the operating room look like things you would find in Home Depot. The difference is that everything they use is sterile and safe for use in the human body. The point being you may want to skip ahead two paragraphs if surgery stuff creeps you out.
The goal of fracture surgery is the same as a cast, but surgery is used when a cast won’t work. The surgeon will take the two, or more, pieces of a broken bone, put them back together in the correct position (like a jigsaw puzzle) and then use plates and screws to keep them in proper position the heal. If the two bone fragments are small then sometimes a surgeon will only need to screw them back together with a surgical screw (looks an awful lot like a Home Depot screw) and you are done. If the bone is bigger then more hardware will be necessary to keep the fragments together. Surgeons will realign and stabilize bones with the use of a metal plate (or two) across the area of the break and then use screws to hold the plate in position.
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However, none of these surgical techniques were done on Kevin White. A surgical technique that is more commonly performed with a compound fracture (a bone break in which the fragments are displaced and forced through the skin) of the tibia called intramedullary nailing was done with White. Intramedullary nailing, even the name is horrible, sounds like one the tortures Ramsey Bolton did to Theon Greyjoy in Game of Thrones. During this surgery the physician drills a hole into the tibia and then inserts a sterile surgical nail that is the length of the shin down through the center of the tibia. This nail (also called a rod) is then held in place with screws to keep it from shifting position. This means that if you looked at an X-ray of his shin you would see a massive metal rod all the way down the center of his tibia. It also means he has no chance of making it through an airport metal detector.
However, despite the heavy metal hardware used in this surgery, early outcomes are pretty good. The rod is very effective at stabilizing the break and the chance of a recurring injury are low. In fact most of the impairments come from not being able to use the leg while the patient is recovering from healing. This forced sedentary lifestyle can cause a reduction of strength in the muscles of the injured leg. For an elite athlete like Kevin White, as long as he stayed true to his rehabilitation recovering that strength should not be a problem. The perfect example is Bears punt returner/ wide receiver Marc Mariani who had the same surgery in 2012. He has stated that he has had no difficulties since he fully recovered from his surgery. This unhappy speed bump is only that, a speed bump, a temporary obstacle. Bears fans can still keep hopes high for their new marquee player. The arrow is definitely pointing up for Kevin White and the Chicago Bears offense.