What Alex Smith’s Broken Leg Means For His Future

By Dr. Ankur Verma

This past summer, after a multi-year soap opera with Kirk Cousins, the Washington Redskins let their franchise quarterback walk, unwilling to pay the cost it would take to keep him in DC.  Instead, they ended up paying a steep price for another quarterback to take his place, sending Kendall Fuller and a third-round pick to bring Alex Smith to the nation’s capital, and subsequently locking him up with a four-year contract extension that pays out $70 million in guaranteed money.  Though Smith was coming off one of his most successful seasons, it was a heavy investment in terms of assets and dollars for a 34-year-old quarterback.

Then on November 18, Kareem Jackson and JJ Watt decided to have a meet-‘n-greet in Washington’s backfield and Redskins fans likely saw their season blow-up before their eyes.

You’ve seen the clip by now (well…maybe).  In case you haven’t, this is what happened when Jackson and Watt had their get-together:

You don’t need to be a doctor to see that there was something wrong with Smith’s leg and that it was probably broken.  It’s also become cliché by now to point out that nearly the same thing happened to Joe Theismann 33 years ago to the day.

Let’s discuss what this injury is all about, what happened to other players with a similar injury, and whether we can predict what Smith will look like when (if?) he returns.

The Injury

Smith was carted off the field and had immediate surgery to fix what was initially reported as a broken tibia and fibula (prompting the now infamous Theismann tweet).  However, Dr. David Chao at ProFootballDoc, pointed out that Smith’s injury likely involved an ankle dislocation.  As you can see from the diagram below, that would mean it likely occurred further down the leg than it did for Theismann, whose injury didn’t involve the ankle and was more of a true tibia/fibula fracture.

The ankle joint is formed by the tibia, fibula, and the talus (the most superior foot bone). Alex Smith’s injury likely at least partly involved this region, while Joe Theismann’s was higher up on the leg.                                Source: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

In fact, I encourage you to read both of Dr. Chao’s articles to gain a further understanding of what Smith faces in the immediate aftermath of his surgery.  In summary: the large surface area of the fracture gives it a high chance of healing, but there may be associated muscle damage.  However, given proper rehab, stiffness and decreased motion should be something Smith is able to overcome (despite a likely initial 6 weeks of non-weightbearing).  This was also opined by ESPN’s Stephania Bell.  ESPN’s Adam Schefter reported that this was a compound (or open) fracture, which means the bone pierced the skin.  As Dr. Chao explains, this increases the infection risk, but that should have been assuaged by Smith’s prompt hospitalization and surgery.

Projecting Future Production

The question, then, lies in what we can expect from Smith if he is able to make it through rehab (likely 6-8 months from such a surgery) successfully.

Dr. Chao mentions that his injury is somewhere between a true tibia/fibula shaft fracture and the ankle fractures suffered in recent years by Derek Carr and Marcus Mariota.

So, if we view this as a true tibia/fibula shaft fracture and use Theismann as a comparison, we would be pessimistic about Smith’s chances because Theismann never played a down again.

But what if we look at this as an ankle fracture?  How did Carr and Mariota fare in their return from injury (after undergoing a similar period of rehab as Smith is projected to do)?  Let’s take a look:


Carr and Mariota Pre- and Post-Injury

 TD:INT (Pre-Injury)TD:INT (Post-Injury)ANY/A (Pre-Injury)ANY/A (Post-Injury)Rating (Pre-Injury)Rating (Post-Injury)Best Total QBR (Pre-Injury)Best Total QBR (Post-Injury)
Statistics per pro-football-reference.com

TD:INT = Touchdown to Interception Ratio (TD divided by INT)
ANY/A = Adjusted Net Yards Per Attempt (Yards per attempt with bonus given for TDs and penalties for Sacks and INT, a good approximation of QB value)
Rating = Traditional Quarterback Rating
Total QBR = ESPN's proprietary metric that measures the totality of a Quarterback's contributions to winning (this chart provides the QB's best QBR in a season pre- and post-injury)

Stats through Week 11 of 2018 NFL Season


There is a drop-off in the quality of play, especially with Mariota.  Of course, both quarterbacks have gone through coaching and scheme changes, and there’s the possibility that neither one may have been all that good to begin with.  However, one could make a reasonable argument that much of Smith’s value comes from his mobility, which is especially important in this instance given that this is a leg/ankle injury.  Mariota is a similarly mobile quarterback; how did he fare rushing-wise?

Well, some of this is baked into Mariota’s Total QBR.  But if we look a bit closer using ProFootballFocus, we can see that Mariota actually has improved as a runner after the injury.  For instance, PFF gives him higher grades for rushing for the two seasons after the injury (78.2, 79.6) than the two prior to the injury (60.2, 53.5).  While he is averaging nearly three fewer yards per scramble, he has made up for it by significantly increasing his yards after contract and avoidance of tackles per rush attempt, indicating his elusiveness and endurance are intact or better.  His explosive run rate (runs > 10 yards) and yards per designed run have held steady.

Of course, that’s just one example.  If we want to get some further approximation, we could examine running backs who have experienced an ankle fracture and how they fared in their mobility after the injury.  This list is gleaned from ProSportsTransactions, and a few may have slipped through the crack.  If I missed any players, let me know in the comments.


Running Backs with Ankle Fractures since 2010

 YPA (Pre-Injury)YPA (Post-Injury)Average PFF RUN Grade (Pre-Injury)Average PFF RUN Grade (Post-Injury)10+ yard runs/attempt (Pre-Injury)10+ yard runs/attempt (Post-Injury)Avoided Tackles/attempt (Pre-Injury)Avoided Tackles/season (Post-Injury)YCO/A (Pre-Injury)YCO/A (Post-Injury)
Zac Stacy3.8DNP64.1DNP0.03DNP0.03DNP2.39DNP
Thomas Rawls5.63.084.664.
Travaris Cadet3.7DNP53.9DNP0.08DNP0.04DNP1.98DNP
Mike James4.93.789.761.60.1300.
Chris Rainey3.9DNP73.6DNP0.08DNP0.15DNP2.50DNP
DeMarco Murray5.54.471.867.
Stats per pro-football-reference and ProFootballFocus

YPA = yards per attempt
Average PFF RUN Grade = Average ProFootballFocus Run Grade Per Season
YCO/A = Yards After Contact per attempt
DNP = Did Not Play


Well, that’s not pretty.  The caveat here is that the running backs other than Murray were largely replacement-level (and thus may have been weeded out because they weren’t all that good to begin with, rather than it directly being a function of their injuries) and Murray went on to play six more seasons after his injury.  With that said, for the backs who were able to return, there is still a general decline in statistics in all of the categories, except for the rate at which they avoided tackles.  Again, this generally points to the fact they were able to retain some degree of elusiveness.

The problem with this is that Smith has never been all that elusive.  He has only accumulated 18 total avoided tackles over his 12 seasons of play.  In addition, he has had only one season where he averaged at least two yards after contact, and that was during his career year last season.  You will find that he is generally lacking in explosive runs ( defined as >10 yards), as well.  The one thing he does well is scrambling, and this is the one category Mariota declined in.  Indeed, Smith’s PFF run grades have always tracked mediocre and it’s hard to see that improving with age after an injury (yes, Mariota improve his grades after the injury, but he was much younger).

Smith’s Future: The Bottom Line

Alex Smith. (Photo Credit: Keith Allison).

Alex Smith had his career best season in 2017.  While the price to acquire and sign him was steep, you couldn’t blame fans in DC for being excited that he was their new starter.  In fact, the Washington front office would likely have been ecstatic if he played even seventy-five percent as well as he did last season.

Unfortunately, this wasn’t the case even before the injury.  And now that Smith has been knocked out, the Redskins have to turn to Colt McCoy to preserve their division title run.  The list of QBs Washington has reportedly worked out (EJ Manuel, Kellen Clemens, Mark Sanchez, TJ Yates, Josh Johnson) is uninspiring to say the least and is a who’s who of below-average retreads that have a proven inability to win at this level.  It’s a bit of a strange tactic, given that the team is in the thick of the playoff hunt and has been trying to preserve its division lead.  Hey, Colin Kaepernick is still out there, I’m just sayin’….

While the above paints the picture that he will come back in some capacity (Carr and Mariota returned to play after all, and there have been advances in medicine since Theismann’s injury), it’s hard to get too excited about his capabilities.  Before the injury, Smith was recording his worst ANY/A since 2010, worst Total QBR since 2014, and an Air Yards Per attempt (courtesy Next Gen Stats) that placed him in the middle of the pack.  His injured quarterback predecessors have generally suffered in quarterback statistics upon their return.  Smith’s ability to scramble, a major strength, will be called into question given this is the one rushing measure that took a hit after Mariota’s injury.   As this is his age-34 season, it’s hard to see him improving after a devastating injury.  Thus, Washington needs to start thinking about the future of its quarterback situation.  However, given that Smith is guaranteed $31 million the next two seasons for injury and the soonest they can move on from him is 2021 (with a $10.8 million dead cap hit, hat tip to Spotrac), it appears they are stuck with him and, therefore, likely have the ceiling of a mediocre team for the next couple of seasons.


Thanks to Pro-Football-Reference for information.