Now that New England Patriots quarterback Tom Brady has undergone surgery to repair a stress fracture in his right foot, an important part of his recovery will be managing his rehabilitation so the screw inserted in his foot does not break, two experts said.
In addition, the standard recovery time for surgeries to the navicular bone -- located at the arch at the middle of the foot -- gives Brady plenty of time to be ready for the start of training camp in late July, said the experts, who both were speaking without direct knowledge of Brady's condition.
"It's not a big ordeal, but it is a formidable recovery," ESPN medical analyst Dr. Michael Kaplan said. "You can't stress this area until it's done healing or prematurely load it because you don't want the screw to break. If you break the screw, it would be horrific."
Kaplan estimates Brady will wear a non-weight-bearing boot for about six weeks. The general plan likely would be to have Brady gradually increase the weight-bearing within the boot before starting an initial range-of-motion program. After there was evidence of healing, Brady could begin a strengthening regimen.
Dr. Nicholas DiNubile, a Pennsylvania-based orthopedic surgeon, estimates a four- to six-month time frame for the injury to fully heal.
"You have to turn down the volume on the foot," DiNubile said. "But that doesn't mean the whole body has to rest, so he could creatively design workouts for his upper body and core, such as water running."
DiNubile, who has consulted for the Philadelphia 76ers and Pennsylvania Ballet and is the author of the book "FrameWork: Your 7-Step Program for Healthy Muscles, Bones, and Joints," added that Brady could use a bone growth stimulator machine to speed the healing process.
"Stress fractures in the foot are a major issue with dancers; I've seen a lot over the years," DiNubile said. "The far majority do OK, but you can't keep pounding on it. You have to let the body do the healing and don't interfere with it. Sometimes the bone doesn't heal and it requires surgeries or multiple surgeries, and it can be career-threatening. But that's not typical."
Kaplan said one challenge in healing from fractures to the navicular bone is that blood supply is not as good as one would hope to that area of the foot. Kaplan has witnessed a more aggressive approach from athletes with stress fractures of late; he thinks that instead of opting for rest in hopes of recovery, more are undergoing surgery to ensure a more certain result.
Brady played through the stress fracture this season, first appearing on the Patriots' injury report Nov. 10, which was the time he started missing Wednesday practices. Kaplan said there is no way to support the foot adequately in a cleat.
"The stress he put on that midfoot makes it difficult to heal," Kaplan said. "So their interest is to get this [healing process] on its way, and the best method to do that is a compression screw across the fracture sight, pulling two ends of the bone together, securing it stable and giving it the best environment for healing."
Kaplan likened Brady's injury to a paperclip that continues to bend and ultimately breaks because of fatigue stress.
"All of this is timing," Kaplan said. "He'll have ample opportunity to heal, which gives him enough time to get well for next season."