Seamus Coleman could be running again in five months - sports injury expert
Seamus Coleman could be back running in five months and must take encouragement from others who have recovered from broken legs, according to a lower-limb sports injury specialist.
The Republic of Ireland captain is beginning his long road to recovery after his fibula and tibia were shattered by a challenge from Wales' Neil Taylor during Friday's World Cup qualifier in Dublin.
Coleman underwent successful surgery the following morning, though medics have put no time-frame on when they expect the 28-year-old Everton full-back to return.
Doctor Sam Oussedik, an orthopaedic surgeon at HCA UK based in London, admits that will depend on a variety of factors but an average recovery rate would see Coleman running again by August.
"The rate of recovery will be determined by a couple of things," Dr Oussedik told Press Association Sport.
"The amount of soft-tissue damage - the muscles, tendons, sinews around the area all need to heal. That is a process that takes four, six, eight weeks for the swelling to come out of the leg, then the focus is on how rapidly the bone is going to heal.
"Before you can put him through his paces that bone needs to heal quite firmly. Estimates vary; it depends on the severity of the injury.
"Probably an average break will take somewhere around 15, 16 weeks to heal. Anything up to five months would probably be average. You would need to heal that much before you can certainly run on it.
"There are ways people try to speed up that process - pulsed ultrasound, cells injected - but none of them have been really shown to effectively speed up that recovery."
The graphic nature of Coleman's injury was such that television broadcasters elected not to show a replay of the incident, yet still images of the Irishman's leg bent at an unnatural angle later circulated on social media.
Dr Oussedik insists such deformity is commonplace when the tibia is fractured and the concept of a double-leg break, with the smaller fibula bone broken too, does not equate to twice as severe.
He also believes Coleman should be heartened by the statistics concerning other athletes' comebacks from similar injuries.
"With NFL injuries, over 90 per cent of players with a tibia fracture operated on get back to the NFL," Dr Oussedik added.
"Across sports participation in general, over 90 per cent of people get back after a tibia fracture. The figures are relatively good.
"The things that hold you back and stop you getting there are complications, pressure problems, associated injuries to other parts of the leg and ligaments.
"If the injury is straightforward, there's a reasonably proven route back to full action; that's the key thing psychologically to hold on to.
"Yes, it's going to be hard work but all of these guys are used to putting in the hours in the gym. Knowing there's every chance you will get back to that high level of performance - I think that's the thing to hold on to and see him through that difficult process."
The rehabilitation route Coleman is embarking on will not just centre around his broken bones, but also the muscles in his leg to prevent too much wastage, known as 'disuse atrophy'.
"One of the things they will try to get him doing relatively early is to start using those muscles in the leg to avoid too much disuse atrophy," Dr Oussedik said.
"There are all manner of exercises that you can do that load specific muscles without putting a great deal of load through the tibia.
"You can exercise your quads, alter-gravity training, run in the pool, things that reduce that impact at the fracture sight but still allow you to train those muscles so o nce the bone does allow you to go through impact again, the rest of your muscles are in relatively good knick to get back to that level."
:: Dr Sam Oussedik is a consultant trauma and orthopaedic surgeon at HCA UK at the Institute of Sport, Exercise and Health, The Princess Grace Hospital and The Lister Hospital. He specialises in knee surgery for both sports injuries and degenerative conditions, as well as all forms of trauma surgery.