Alex Smith leg injury, revisited: How former Commanders, Chiefs QB overcame devastating broken leg in 2018

Gilbert McGregor

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Alex Smith leg injury, revisited: How former Commanders, Chiefs QB overcame devastating broken leg in 2018 image

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Alex Smith enjoyed one of the more unlikely endings to a career in professional sports.

While he was a No. 1 overall pick and picked up many accolades during his prime years with the Kansas City Chiefs, Smith sustained a devastating leg injury during his first season with Washington. More than the injury itself, Smith nearly lost his leg due to complications, and doctors were concerned about his ability to lead a healthy life, let alone return to the gridiron.

Despite those issues, Smith was able to overcome seemingly insurmountable odds to get back to football less than two years after nearly losing his leg. As such, he was able to leave the game on his own terms, and his story lives on in NFL lore.

Here is a comprehensive look back at what Smith dealt with and how he beat the odds.

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Alex Smith leg injury date

  • Date:  Nov. 18, 2018

Alex Smith suffered a devastating leg injury against the Houston Texans during Week 11 of the 2018 NFL season. The game was played on Nov. 18, 2018.

Alex Smith leg injury, explained

Alex Smith sustained a leg injury after being sacked by Texans defensive back Kareem Jackson and defensive end J.J. Watt.

He suffered a spiral and compound fracture in multiple bones, meaning there was an open wound in the skin near the fractured bone. The injury required surgery, which led to complications.

Smith developed life-threatening necrotizing fasciitis, resulting in sepsis. Doctors suggested an amputation before performing skin grafts and transferring muscle from his left quadriceps to save the leg.

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Alex Smith leg injury play

The Texans sent an aggressive blitz on third-and-9, causing Smith to attempt to escape.

Smith had nowhere to escape and was met by both Kareem Jackson and J.J. Watt. He was tackled from behind by Jackson while Watt tackled him from the front. As the two brought Smith down, he rolled over, and the injury occurred because of the impact. Smith himself described the play as "routine," and there was no malicious contact or intent.

Upon realizing the nature of the injury, Smith rolled over, and training officials quickly ran to his aid.

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Alex Smith leg injury video

The video of Alex Smith's injury can be viewed here. Warning: the nature of the injury is graphic, and some may find it disturbing. 

What bones did Alex Smith break?

Alex Smith broke his tibia and fibula in his right leg.

How many surgeries did Alex Smith have?

Alex Smith underwent 18 surgeries after his injury.

His first surgery was what the broken bones necessitated. The next 17 surgeries were done because of the response to the infections he suffered in his leg. 

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Did Alex Smith play after injury?

Yes, Alex Smith miraculously played in eight NFL games (six starts) after the injury.

Alex Smith leg injury timeline

Nov. 18, 2018

Smith sustains a spiral and compound fracture of his tibia and fibula in his right leg. He underwent surgery within a day, and the team expected him to make a full recovery.

Late November, 2018

A bacterial infection in Smith's right leg causes doctors to consider amputation to save his life. This infection resulted in 17 more surgeries.

July 24, 2019

Smith is placed on the physically unable to perform (PUP) list. There is no plan for him to be taken off the list, and he is expected to miss the entirety of the 2019 NFL season.

Sept. 23, 2019

Ahead of Washington's meeting with the Chicago Bears, Smith is captured walking into the stadium without the aid of crutches.

Late July, 2020

Smith's medical team clears him to return to football activities, but he is again placed on the PUP days later.

Aug. 16, 2020

Washington activates Smith from the PUP, but plans to take a measured approach to his return-to-play process. His training camp participation is limited.

Oct. 11, 2020

Smith returns to the field for the first time as he is brought in to spell starter Kyle Allen. While Smith is sacked six times, he completed nine passes for 37 yards in a valiant and unlikely return. 

Nov. 15, 2020

After spelling the injured Allen in Week 9, Smith makes his first start nearly two years to the date of his injury. In a three-point loss to the Detroit Lions, Smith completes 38 passes for 390 yards.

Jan. 3, 2021

Smith plays in what would end up being his final NFL game. He completes 22 of his 32 pass attempts for 162 yards and throws two touchdowns as well as two interceptions.

After missing the 2019 season, Smith posts a 5-1 record over six games as a starter in 2020.

March 5, 2021

Washington waives Smith, ending a three-year tenure with the franchise.

April 19, 2021

Smith announces his retirement with a post shared to Instagram. In the video, Smith detailed his journey back to the field and explained what football meant to him and why he was at peace with his decision.

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When did Alex Smith return to the NFL?

Smith was cleared to resume football activities in July 2020 and returned to play in Week 5 of the 2020 season.

Alex Smith stats

Smith amassed over 35,000 passing yards and threw 199 touchdowns over 174 career games.

Here is a breakdown of his career:

SeasonTeamGamesYardsTDInt
200549ers9875111
200649ers162,8901616
200749ers791424
200849ersDNP———
200949ers112,3501812
201049ers112,3701410
201149ers163,144175
201249ers101,737135
2013Chiefs153,313237
2014Chiefs153,265186
2015Chiefs163,486207
2016Chiefs153,502158
2017Chiefs154,042265
2018Washington102,180105
2019WashingtonDNP———
2020Washington81,58268
Career 17435,650199109

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Was Alex Smith's comeback the greatest ever?

Alex Smith's comeback is indeed considered by many to be the greatest ever.

Because Smith nearly lost his leg and underwent nearly 20 surgeries, his return to play in eight NFL games is viewed as a nearly impossible task. He was named the NFL's Comeback Player of the Year for the 2020 season.

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