Witnessing human suffering draws out candid, emotional responses from all involved, and Louisville guard Kevin Ware's injury during Sunday's Elite Eight action brought tears to the eyes of many—including myself.
Medical students, doctors and athletic trainers never forget patients like him. No amount of training can prepare medical personnel for witnessing injuries like his firsthand, and even the best, most composed members of a medical team can get shaken to their cores.
After all, it didn't seem fair. Ware received no contact. He didn't dole any out, either. He merely did what he was supposed to do—contest a shot. Yet when he landed on the ground, his right leg buckled underneath his weight. As a result, he now faces a lengthy, complicated road to recovery.
According to CBS Sports, doctors diagnosed Ware with a broken leg, confirming what everyone already knew. Specifically, he appeared to suffer a compound fracture of his right tibia and possibly fibula—the two long bones of the lower leg. In other words, the broken bone became so displaced that it punctured through the skin.
Kevin Ware has been taken to a local hospital after suffering a broken leg. cbsprt.co/WareInjury— CBSSports.com (@CBSSports) March 31, 2013
Ware underwent surgery to repair the fracture within hours (via C.L. Brown of The Courier-Journal)—quick action is crucial to prevent serious, limb-threatening complications.
Kevin Ware has completed surgery; bone was reset & rod inserted in right tibia; will remain in Indy til at least Tues— C.L. Brown (@clbrown_cj) April 1, 2013
During surgery, surgeons realigned the tibia—and fibula, if it was also fractured—and inserted a metal rod into the bone to hold it in place as it heals. The rod will probably remain there for the rest of Ware's life. He will also receive antibiotics to combat infection, as bacteria normally present on the skin had ample opportunity to enter his leg.
After the dust settled and emotions calmed, many were left with one question: Just how did this happen? As is the case with many injuries, a perfect storm of biomechanics and bad luck is to blame.
When Ware landed, he placed 100 percent of his weight on his right leg. It also appeared to be entirely straight at impact, meaning he likely had his quadriceps and ankle muscles flexed when his right foot hit the ground. As such, Ware's knee and ankle had added support when compared to their relaxed state. He also appeared to be twisting to his left when his foot hit the floor, adding rotational stress into the equation.
As a result of all these variables, Ware's shin represented the weakest point in his leg at the time of impact, and that impact proved too much to bear.
Though this represents mere speculation, it is also possible Ware's shin was weaker due to an undiagnosed condition such as a stress reaction or stress fracture. Such injuries are very common in basketball players due to frequent jumping and can also remain hidden in many cases.
Fortunately, no news has yet surfaced regarding arterial or nerve damage. As in displaced fractures, the broken bone can sever the blood vessels and nerves that fuel and control the foot and ankle. Damage to either could prove devastating and even permanent.
Despite avoiding those complications, Ware still faces a long rehab process. The surgically implanted metal rod actually somewhat slows healing by disrupting the bone's blood supply, but it is a necessary evil. Without it, the tibia could reattach itself in an improper alignment or not at all.
Nevertheless, if Ware did, in fact, avoid any permanent damage—as it appears he did—he can absolutely make a full recovery. Current Chicago Bears running back Michael Bush returned from a similar injury he suffered in 2006. Bush immediately felt Ware's pain:
I can't even get myself together. I don't even wanna watch the rest of this game. His life just change— Michael Bush (@michaelbush29) March 31, 2013
The mental hurdle Ware faces may be even bigger than the physical one. After suffering an injury as gruesome as Ware's, many athletes are never the same.
Fortunately, University of Louisville athletic trainers and medical staff did their part to prevent psychological trauma as best they could, and they did so flawlessly. Rick Pitino helped his horrified team weather the storm, and training staff surrounded Ware immediately, covering the wound and attempting to calm him as he likely entered a state of shock and panic.
After all, that's their job. Yet as pediatrician and emergency room physician Dr. Jene Bramel told me via Twitter, sights like Sunday's can prove mentally taxing even for them:
@davemsiebert Never easy. Lots of things happen at once. Mental debriefing you go through afterward sometimes tougher than being in moment.— Jene Bramel (@JeneBramel) March 31, 2013
Now that his surgery is complete and the shock of the situation is beginning to subside, Ware can begin to focus on coming back. A number of variables can and will affect his prognosis in the weeks to come, but he could be sidelined for the rest of the calendar year.
In short, it's an uphill battle, but not an impossible one. Perhaps most importantly, Ware appears to be in the right mindset. Yahoo! Sports' Pat Forde wrote the following on the injury:
Yet in the midst of his agony, Ware did the most remarkable thing. Courageously, selflessly, he thought of his teammates.
The stoic, soft-spoken sophomore from outside Atlanta told coach Rick Pitino over and over, "Just win the game. I'm OK. Just win the game."
That mental resolve will be Ware's greatest ally in the months of physical therapy and rehab that are still to come. If he can keep his eyes on the end goal, he will get there, and he will certainly have the support of his teammates, his coaches and the entire college basketball community to draw upon.
Anyone watching could see the immediate, touching outpouring of support from his fellow Cardinals.
They cared—as he did for them.
The courage and strength Ware showed in the face of extreme adversity is enough to send chills down the spine. He is a special man and player—the kind that teammates will remember forever.
"Just win the game. I'm OK. Just win the game."
They obliged. Louisville will take the court in Saturday's Final Four matchup with Wichita State.
With good treatment and physical therapy next year, Ware could be joining them, and there isn't a single college basketball fan—or sports fan, for that matter—who won't be pulling for him.
Get well soon, Kevin.
Dave is a medical writer for Bleacher Report who will join the University of Washington as a Family Medicine resident physician in June. He plans to later pursue fellowship training in non-operative Sports Medicine. The medical information discussed above is based on his own knowledge.