NFL Week 2 Injury Spotlight: Kansas City Chiefs Isiah Pacheo Fractured Fibula

Week 2 has finished up and we had several key injuries, however one of the most notable injuries occurred to the Kansas City Chiefs running back Isiah Pacheo. Pacheo sustained a fractured fibula after colliding with Patrick Mahomes after an interception by the Bengals defense. The Chiefs ended up winning the game 26-25 but lost one of their top offensive weapons in running back Isiah Pacheo.

After further evaluation and x-rays to confirm the fractured fibula, Pacheo has been scheduled for surgery mid-week. He will be undergoing an open reduction and internal fixation (ORIF) to repair the fractured fibula. This surgery starts with the reduction in which the surgeon will bring the broken bone pieces back into the right place. Then the fixation begins where the pieces of bone are secured in place with screws, metal plates, nails, wires, or pins. After the surgery is over the leg and ankle are immobilized to protect the surgery. He will then be released home to begin his recovery process.

A major part of a successful recovery after an ORIF surgery to repair the fibula will be physical therapy. He will begin treatment typically within two weeks and his weightbearing status is surgeon dependent, but typically will be non-weightbearing for the first few weeks. Now you may wonder what will a patient do in PT if they can’t weight bear? Well, there is quite a bit that we do with patients when they are non-weightbearing.

First, we will begin focusing on decreasing swelling in the joint in order to improve mobility and decrease pain and restrictions. This is done with gentle massage and icing. We will also focus on regaining range of motion in the joint so that the joint will be less stiff. This has to be done gradually in order to maintain proper healing and not cause a flare up of pain or inflammation. Strength training of the hip and knee is also something that we tackle right away in order to maintain current strength and decrease the loss of muscle. We can accomplish non-weightbearing strength training with a variety of exercises on a treatment table to continue challenging the hip and knee.

Once the patient can resume weightbearing we begin to focus on gait training. It’s important for a patient to have proper mechanics while walking to decrease further injury or injury to other areas of the body. When a patient is immobilized for a period of time their joints stiffen which makes walking challenging, but since we have been working on the patient’s joint mobility the transition to gait training is much smoother, highlighting the importance of starting treatment as soon as possible. We also begin to focus on functional strength training like squats, lunges, step ups, and much more. It’s also imperative to incorporate balance training to dynamically strengthen and improve proprioception for return to agility type exercises. Balance training incorporates a wide variety of activities that are geared towards improving and restoring a patient’s balance tolerance.

The final stage of the rehabilitation process is the return to sport training. For Isiah Pacheo his training will involve incredibly high-level exercises and activities to restore his NFL running back stamina and skillset. Here he will go through a variety of agility and plyometric training to restore his speed and power in his football movements. It’s important that he has reached appropriate levels of strength and motor control prior to returning to full active status to reduce the risk of reinjury.

At this point Chief’s fans will be eagerly waiting for the outcome of Pacheo’s surgery to find out when he will be returning to the field. He will be participating in rigorous physical therapy to rehabilitate his ankle and get back out on the field in the best shape.

Don’t forget to give Portsmouth PT a call if you run into any injuries so we can help you get Back to Sports, Back to Work, and Back to Life!