The way Brendon Ayanbadejo remembers the first significant injury of his football career, it came on a routine play. It was the fourth quarter of a road game at New England early last season, and Patriots running back Sammy Morris had eluded one of Ayanbadejo's teammates.
When the Ravens linebacker went to bring Morris down, Ayanbadejo's left knee bent the wrong way under the added weight of a couple of other players helping with the sideline tackle. Ayanbadejo later learned that he had torn the quadriceps completely off the knee.
Given the fearless manner in which Ayanbadejo played throughout high school in Santa Cruz, Cal., college at UCLA and a pro career that included stops in the Canadian Football League and NFL Europe before he landed in the NFL with the Miami Dolphins in 2003, the odds had finally caught up with Ayanbadejo.
"I've always been a guy that's played full speed, from whistle to whistle," said Ayanbadejo. " I was a little surprised that I was hurt, but this is football and they say your chance of getting hurt in this sport is 100 percent. Guys who don't get hurt are an anomaly."
According to Ayanbadejo, Dr. James Andrews, the famed Birmingham, Ala., orthopedic surgeon who reattached the quad tendon to the kneecap, told him that it would take at least 10 months before he could get back on field.
Though Ayanbadejo thought he would be back in no more than eight months, he returned more than a year later. After coming off the physically-unable-to-perform list, Ayanbadejo, now 34, was in on 16 special teams plays of the Ravens' 37-34 overtime victory Sunday against the Buffalo Bills.
"I had some other stuff going on inside my knee that slowed up the process," Ayanbadejo said. "Even though it's healed, it still gets sore. The doctors erred on the side of conservatism. When they told me 10 months, I figured eight months because I'd heal fast. That was my mistake."
Aaron Santiso, a Fort Lauderdale-based physical therapist and sports enhancement specialist who supervised Ayanbadejo's rehabilitation process for the first seven months, said that the year-long rehab was partly due to the rigors of Ayanbadejo's profession — and his position as a reserve linebacker and special teams ace who was selected to the Pro Bowl three times.
"The difference is that a regular athlete's stress level [to the injury] is nowhere near the NFL player's stress level," Santiso said. "Someone who runs 10 miles or a marathon might have some stress from the impact to the ground, but it's not the same as filling a gap, taking on a fullback or a guard, changing directions at the drop of a dime, sprinting, backpedaling, turning, cutting, not to mention the impact of tackling."
Said Ayanbadejo, "We're like finely tuned Formula One racecars. The littlest thing happens to a Formula One and it can't compete with the other Formula Ones. If you're a normal person who's an athlete, it probably will help you to rehab better, but you don't have to be a Formula One race car. You can be a normal Corolla on the street."
Dr. Andrew Cosgarea, an orthopedist who serves as the team doctor for the Baltimore Orioles and the Johns Hopkins University athletic teams, said that extensive rehabilitation from a torn quadriceps is not unusual, even for a professional athlete who has access to a fulltime training and medical staff.
The injury is much less common than the torn anterior cruciate ligament, but potentially more difficult in terms of the rehab process, Cosgarea said. He added that torn quadriceps typically occur in people in their 50s, not their 30s.
"It's less predictable, it's a longer recovery and potentially a more serious injury," Cosgarea said, speaking in general terms about the injury and not specifically about Ayanbadejo's case.
Ayanbadejo began his rehab within hours of having the quadriceps reattached.
"Out of surgery I woke up and went at my first PT [ physical therapy] session later that afternoon," said Ayanbadejo.
Ayanbadejo called the initial rehab exercises "some Jane Fonda kind of stuff" because he was only asked to do a few leg raises. Much like a coach's game plan, Ayanbadejo followed a week-to-week physical therapy "script" put together by Andrews and coordinated by Santiso.
The months leading to Ayanbadejo's return were no different than if he had been preparing for a game. Long respected by his teammates and coaches for his work ethic, Ayanbadejo said he "was invigorated" each day for therapy and "attacked" it with the same passion as if tackling a kick returner or wide receiver.
"Brendon is up there as far as working as hard as anybody I've ever worked with," said Santiso, whose clients include Miami Dolphins running back Ricky Williams and Buffalo Bills wide receiver Lee Evans. "He was actually months ahead of his physical therapy his first few months; we had to slow him down a little bit because we didn't want him to think he was healing faster just to go out and do a bunch of crazy stuff."