Boublik’s assessment:
Nate comes in re-examination of his left foot. He states that his foot feels about the same. He continues to have some soreness along the medial proximal plantar aspect of the foot.
Left foot persistent symptoms in the region of the proximal medial plantar fascia. The patient is not improving with conservative treatment. We will obtain an MRI of his left foot to fully delineate the extent of his injury. Follow-up discussion of definitive treatment after MRI available.
ADDENDUM: I spoke with Dr. Crain by telephone today regarding Nate’s left foot MRI. Her verbal interpretation was plantar fasciitis with involvement primarily of the medial cord. . . . There is no defect, but there is a component of partial tearing. There is also some mild first MTP degenerative joint disease and mild sinus tarsi inflammation and mild cuboid edema.
I had already spoken earlier with the player regarding the possible role of a plantar fascia injection. We discussed the risks including the fact that the injection is somewhat painful, risk of infection, risk of rupture of the plantar fascia, and the risk that he may not get complete relief of his symptoms.
I shrug off the risks and accept the offer to inject, thus beginning my long relationship with the needle-as-savior approach to injury treatment. Toradol, Bextra, Kenalog, dexamethasone, Medrol, cortisone, Ketrax, PRP; the needle is the last resort when the pain is too much or progress is too slow.
Accompanying the injection is a new type of shoe insole: a hard, plastered orthotic. Greek imprinted my feet and sent away for it. A week later, orthotics specifically made for my feet arrived in the mail and I am told to use them in my shoes. They put my feet at an angle that science apparently finds pleasing but I find compromising. It feels like I’m standing on a pile of rocks.
—Man, Greek, these things don’t feel good.
—It takes a while to get used to them, Nate. Just give it a little time.
A few weeks later we play the Chargers in San Diego. The orthotics fill up my shoes and my feet feel like cinder blocks. On a ball intended for me in the end zone, I get tangled up with a cornerback. He falls sideways on one of my cinder blocks and I feel a crunch in my ankle. I try to walk it off. I don’t know it yet but my tibia is broken; a vertical fracture through the bottom bulbous part of the bone: a curious little break, everyone will agree.
After the game I limp onto the bus and call Alina, who’s staying at my apartment in Denver. Our long-distance relationship is coming to an end. She’s just been accepted to Denver University and has decided to transfer schools and move here. Her real-estate-savvy parents bought her a loft downtown. It’s official. They had just signed the paperwork that day and flown back to California. But Alina stayed at my place so we could have a few days together before she went back to Santa Barbara to finish her semester.
While I was breaking my leg in the north end zone of [Insert Corporate Logo Here] Stadium in San Diego, she was skimming through some files on my laptop. She came across a most unfortunate confessional I had written more than a year prior that outlined in detail a regrettable rendezvous I’d had with my downstairs neighbor shortly after moving to Denver. The night it happened, Alina was visited in her sleep by the phantom of my deviance. She called me in the morning and asked me if the phantom was real. No! I assured her, and rushed to my keyboard to repent, if only to myself.
When I call her from the bus she’s hysterical. She explains what she has read. I’m too weak to defend myself. I admit to the transgression, hang up, and sigh. My leg’s the least of my worries. I have four or five hours to prepare a concession speech. By the time the plane lands I can’t walk. I hop all the way to my front door on one leg. Sweating and whimpering, I swing open the door to find her sitting on the couch like a powder keg, ready to blow.
—C’mon, babe. I’m really hurting. Can we talk about this tomorrow?
—No we most certainly cannot.
Kaboom.
The next morning I’m happy to get out of the house for my MRI.
Results from the lab:
IMPRESSION:
Vertical to oblique fracture involving the distal media tibia extending from the metaphysis to the medial tibial plafond articular surface/base of the malleolus, with no displacement.
Old high grade sprains/tears of the lateral and deltoid ligaments but no acute ligament injury.
Moderate tibiotalar joint effusion, and two smaller posterior loose bodies and one small anterior loose body.
Mild degenerative changes of the tibiotalar joint with mild cartilage thinning, lateral talar dome, and osseous spurring, anteromedial talus.
Mild tenosynovitis of the posterior tibial tendon with prominent surrounding scar tissue.
Boublik’s transcription:
IMPRESSION: Left ankle non/minimally displaced vertical medial malleolar fracture with evidence of chronic ankle sprains and possible intra-articular loose bodies. No evidence of osteochondral injury.
PLAN: Natural history and operative and non-operative treatment for this type of injury were reviewed with the player today. This would be a season ending injury for the player whether it is treated operatively or non-operatively. The advantage of operative treatment would be to stabilize the fracture and allow more rapid rehabilitation. If we were to treat the patient surgically, then this would also give us a chance to arthroscope his ankle and potentially remove the loose bodies, if in fact they are loose. Prior to this injury of 12/5/2004, the player did not give a history of locking or catching or had a clinical examination that would be consistent with a loose body. Therefore, these loose bodies may be incidental and asymptomatic. There is always a chance of these becoming symptomatic in the future. The other treatment possibility would be to treat the patient conservatively with a boot, non-weight bearing, icing, elevation and repeat serial x-rays. The advantage of this would be that the patient would obviously avoid the risks of surgery. We would need to follow his x-rays closely for any evidence of displacement. If he were to displace, then our recommendation would change more strongly toward operative fixation. Patient is interested in being treated conservatively at present as above. We will clinically follow him closely as well with serial x-rays.
The split in my contract kicks in and I finish the season with my last four checks cut in half. I gimp around the facility like a ghost while the rest of my teammates make a playoff run. We sneak by the Colts late in the season and set up a rematch of the previous year’s wild-card game, in which we’d been disemboweled. Same result this time around. Peyton’s just too good.
5
Meat Sacks
(2005)
My shoes and orthotics go in the bin underneath my locker and I finish the last four games on injured reserve, and on crutches. A few months into my first real off-season, my rehab complete, Coach Shanahan calls me with a proposition:
—How would you feel about playing tight end?
He’s done this before. Our offense uses the tight end beautifully in the passing game, and having a skilled pass-catcher at the position puts defenses in a bind. Shannon Sharpe came into the league as a receiver and Coach turned him into a tight end: same with Byron Chamberlain and Jeb Putzier. Shannon and Byron are gone now but Jeb is still here. He’s our main receiving tight end. All I want is to run routes and catch passes. But I’m beginning to understand what NFL longevity requires: an ability to adapt.
—Sure, Coach. Absolutely.
I start eating like a fat man. When the off-season program starts a few weeks later, I lift heavier and harder. After workouts, I take Myoplex shakes home from the facility and refrigerate them. Every few hours I pour one in the blender and season it with a few eggs, ice cream, and chocolate sauce. The weight comes quickly. So do the bowel movements. I consider starting a band called “Two-Poop Morning,” decide otherwise. I go from 215 pounds to over 245 pounds in a few short months with Rich and Crime. By minicamps I’
ve taken on my new tight end body.
With the new body comes a new job description, and a new number, 89, the only number in the eighties that’s still available. Last year’s 89, Dwayne Carswell, a beloved longtime Bronco, is gone now. His nickname was “House.” Now that I’ve taken over his number, the guys are calling me “White House.” I approve this message.
The tight end position utilizes an entirely different set of techniques and terminology. I never realized it before, but tight ends need to know everything about the offense: pass plays, run plays, pass protections, offensive line calls, etc. Plus I have a new group of buddies and a new position coach. My days as a receiver are over. I shed a single tear. It evaporates immediately.
My new tight end coach is Tim Brewster. He had a standout college career at Illinois in the early 1980s and a cup of coffee with the Giants and the Eagles in 1984 and ’85. He’s a hard-nosed, tough-talking coach who keeps a dip in his lip and a scowl on his face; ever ready to drown out the sound on the field with a “What the fuck!” for whoever messes up. It’s his natural reaction to a mistake: nothing malicious, just his coaching style. But compared to Blade’s calm demeanor, Brew’s approach comes as a shock. Thankfully, he spares me the vitriol and focuses his attention on our newly acquired tight end Wesley Duke.
Wes was a college basketball player at Mercer University with freakish strength and athleticism but zero experience on the football field. They want to mold him into another Antonio Gates, the athletic model of the twenty-first-century tight end, one who can blow by linebackers and safeties and attack the football at its highest point. Brew was Gates’s coach in San Diego and helped turn him from a college basketball player to an NFL beast. Brew figures he’ll do the same with Wes. But it’s not an easy transition to go from the streets to the NFL, where technique is so maniacally stressed and the terminology is a foreign language. It takes years to train your body to master the tiniest movements. Still, Wes’s struggles infuriate Brew. There are five of us in the meeting room, but it may as well be just Brew and Wes.
—Wes, look at yourself here. First of all, look at your stance. If a stiff wind blew through here you’d be on your ass. You hear me? Widen your feet, Wes. And flatten your back. You gotta be in an athletic stance and ready to fucking pounce on someone. You hear me?
—Yes, sir.
—Second of all, look at this route. You look like you’re out for a little fucking stroll in the park, Wesley. Come off the ball violently and run your fucking route with a sense of urgency. Jesus, you’re going to give me a goddamn heart attack, Wesley. Do you even know what coverage they’re in?
Brew spends all of his energy on Wes, which allows me to work on my craft in relative peace. I have already learned a crucial lesson in the NFL: watch someone who knows what they’re doing and copy him. If you get tied up with nonsensical coaching tips then you get confused and you play like shit. I watched Rod for two years and tried to emulate him. Now that I’m a tight end, I tune out Brew and watch our newly acquired tight end Stephen Alexander, aka S.A. S.A. is from Chickasha, Oklahoma, and has the easy demeanor of a man who feels good in his skin. Six foot four, 250 pounds, he’s in his eighth year in the league and knows all the tricks. He carries himself smoothly and calmly, which in turn soothes my nerves. Technical improvement is a one-day-at-a-time thing, never mind the cliché. And run blocking relies on a technical checklist: stance, first step, head and hand placement, hips, feet width, etc. And in the passing game, a tight end must release through a herd of meat sacks, a process of “dipping and ripping” with a checklist of its own. S.A. will show me the way. Brew is on mute.
Minicamp gives me a soft opening for my new position. The running game is toned down because we don’t have any pads on and I get to use my receiver skills in the passing game. Running routes against a linebacker or a safety is easier than what I had been doing, locking up with Champ twenty times a day. But once we get to training camp and put on pads, I’m in for a rude awakening. I have to block behemoth defensive ends like Trevor Pryce, Courtney Brown, and Ebenezer Ekuban—guys who are roughly my height plus another fifty pounds. My technical improvement isn’t coming along fast enough to spare the daily ass beating they are handing me. Every day when I step onto the practice field, I have an “oh shit” moment when I look up to find that my blocking assignment is the size of my old Honda. I take a deep breath and swallow it. No time to be scared. Over and over, I throw my head into the car crash.
The violent intensity of practice obscures my surroundings. But as I stand drinking water one mid-training-camp morning, a rare moment of repose, I watch our new number 19 take a slant to the house as the crowd screams their approval. My childhood hero, forty-two-year-old Jerry Rice, is my new teammate. His rookie year was twenty-one years earlier. I was six years old and wearing my plastic Huff 49ers gear around my neighborhood. By the time I was ten, Jerry was a god and I was his disciple. Posters of him wallpapered my room. “Goldfingers” was my favorite. In it he stood on a runway in a black tuxedo with a gold bow tie holding up a football. His hands were painted gold. Behind him, a private jet was parked next to a red Ferrari: the spoils of his golden fingers. My friends and I played game after game in the street. When I scored a touchdown, my squeaky voice bounced off the garage doors and echoed through the trees. “Touchdown, 49ers!”
Like three years earlier at the 49ers’ facility, I’m caught now between a reverence for the legends who shaped my childhood dreams and an acceptance of my fate as a professional football player. What makes Jerry’s presence even harder to reckon with is that he’s on the decline. He played sixteen years in San Francisco and the previous three and a half before this in Oakland. Halfway through the 2004 season he requested a trade and went to Seattle. After the season, he signed with us. It’s his twenty-first NFL training camp.
Football is a young man’s game. Thirty is old in the NFL. Forty is unheard of. I marvel at his energy and work ethic. He comes out to practice early to work on footwork and stays late to catch balls. I rejoice inside every time he catches a pass. And I cringe every time Champ locks him down in man coverage. There are no fond farewells in the NFL. It is eat or be eaten: even if you’re dining on G.O.A.T.
I tell Jerry once and once only that I was a big fan growing up, but then I let him be. In the locker room we are all the same. You earn your keep or you get the fuck out. The best way for me to honor my hero is to follow his example on the field and leave him alone off of it. He is the greatest player to ever play the game of football, and he is confronting some real shit: this thing is almost over.
I’m dealing with a similar fear. My new body is struggling to keep pace with the demands of camp. During a particularly exhausting practice, I run a deep crossing route in the end zone and as I try to accelerate past one of our linebackers, he tugs my jersey, which yanks my hamstring. I feel it up high, right against my butt bone, and very deep.
The rehab is ice and electric stimulation, strengthening, stretching, and cardio right away. But after three or four days, the benchmark for noticing improvement, I notice none. In the morning, I limp into the training room to see Greek.
—Feeling better today?
—Uh, maybe a little but not really.
I say “a little” no matter what.
—It should be improving by now.
He has plugged me into his how-to-fix-a-broken-jock mainframe and is following the protocol step by step.
Twice a day I go through an extensive exercise program that attacks the injury. Lots of guys get hurt in training camp. Some guys get comfortable not practicing so they’re pushed back on the field. That’s done with verbal pressure in the training room, creating a timeline for return, and kicking his ass in the weight room, twice a day, so that an injured player would prefer to practice hurt than receive this isolated attention.
The pressure works, and I get back on the field in time to play the Houston Texans in a
preseason game. I have to prove I can hold my own in the trenches if I want to stick around. But during the game I reaggravate the injury. When we get back to Denver I get an MRI.
Lab results:
FINDINGS: There is a moderate strain of the proximal hamstring tendon complex with more focal partial tearing at the origin of the biceps femoris and semi tendinosis conjoined complex. There is associated surrounding soft-tissue edema and hemorrhage. No underlying bone edema. The majority of the hamstring complex at the ischial tuberosity is intact. There is also interstitial degeneration or partial tearing in the semimembranosus tendon just distal to the origin.
Translation to me: mild hamstring strain. I’m prescribed exercises, ice, meds, and modalities. We good, Nate? Yeah, I guess we’re good. But another week goes by and I make no progress. Greek lets me know that my progress isn’t jibing with the timeline that fits the protocol for “mild hamstring strain.” That gets me thinking, what’s wrong with me? Am I being a pussy, or what? Greek says I should be ready to go, so I know that’s what he’s telling Coach every day when he gives him the injury report.
So I get on the field again in time for the last preseason game in Arizona. I’m still thinking I need to prove myself a warrior to make the team. Brew tells me he wants to see me go in there and bite someone in the fucking neck. Before the game I use heat, pain pills, meditation, stretching, Icy Hot, back plaster (a patch that goes on the skin and heats up as your body warms it), and my own natural adrenaline. None of it works. I limp around and play badly.
Oh, and I reinjure my hamstring. I think I’m toast, for sure. But my phone doesn’t ring the next morning. Despite my poor training camp, I’ve made the team again. On the first day of the regular season they decide to ramp up the treatment plan.
Robert Williams, M.D.:
CHIEF COMPLAINT/HISTORY OF PRESENT ILLNESS: Nate is being seen for a proximal right hamstring strain. He tried to play on Friday and reinjured the hamstring. He does not have constant pain but feels as if the injury is similar to how his first injury felt approximately a week and a half after that injury. He does have some pain both proximally in the area of his origin of his hamstring, as well as some pain that he describes that radiates medially into his inner thigh.
Slow Getting Up: A Story of NFL Survival from the Bottom of the Pile Page 10