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Dr. Mike Evans - Thursday Feb. 6, 2014 20:41

Why Steven Stamkos's broken tibia didn't heal in time for Sochi

A doctor's opinion on the Tampa Bay Lightning player's recovery

Steve-Stamkos-cbc-sports-injury-stub
Steve Stamkos suffered a gruesome injury, breaking his right tibia after colliding with the net. (Associated Press)

Steven Stamkos, who is usually filling nets, ran into one on Nov. 11 and fractured his tibia.

We just heard Wednesday that he's not able to make it to the Olympics despite a courageous try. Before we think about the nuances of his return lets review the anatomy.

There are two bones in your lower leg. The big weight-bearing bone is called your tibia. It extends from just under your knee down to the top of your ankle.

If somebody kicked you in the shin, it’s the tibia they are kicking.

The second bone in your lower leg is on the outside, is much more slender, and extends down to the outer part of your leg to your ankle and is called the fibula. The fibula is actually kind of famous in Olympic circles recently.

Oscar Pistorius was born without his and after consulting doctors his parents made the gut wrenching decision for an early amputation. Silken Laumann had her fibula fractured (and some of her leg muscles torn) in a terrible crash with another boat on May 15, 1992. She would ride her wheelchair to her boat to train, and incredibly came back to win the bronze medal in Barcelona, just three months later.

At the London Olympics, Manteo Mitchell ran the first leg of the heat for the 4x400m relay for the U.S. and had his fibula snap at the halfway mark. Despite this, he finished his lap to qualify his team for the final.

Titanium pin inserted

Adrenalin, a responsibility to his team, and the fact that the tibia does almost all the weight bearing, helped Manteo. Stamkos’s fibula was fine but his tibia is another story. The day after his fracture, Stamkos had a titanium pin literally nailed into the top of his tibia by an orthopaedic surgeon.

The nail extends right down the tibia and some screws are put in to lock the pin and stabilize the fracture. This procedure, called intramedullary nailing, “splints” Stamkos’s tibia from the inside.

It might take the guy in my beer league eight months to come back from a tibia fracture. But Stamkos is at the three-month mark and he has been practicing for a few weeks. Incredible. A testament to youth, hard work and athleticism.

What do I think is holding him back? Well I would make an educated guess and say at this point his bones are likely healing well, but its all the soft tissue and muscles around the tibia that need more time.

Elite athletes do heal faster but their requirements are also higher. Much of his excellence on the ice is tied to his mobility to get in the exact position for a quick release shot, and the strength and balance, as well as his elite acceleration and push off may still be compromised.

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