Nick Saban Reflects on Tightrope Surgery as Miami WR Faces Season-Altering Injury

One of the biggest storylines in college football this week broke Wednesday when it was announced that Miami receiver Malachi Toney would undergo surgery this week, ending his hopes of playing in one of the biggest games of the year: No. 1 Miami at No. 11 Notre Dame.

Toney's ankle injury appears to be one he could recover from in time to return for the Hurricanes’ title push, and one former Alabama head coach Nick Saban is quite familiar with.

In 2018, Alabama’s star quarterback Tua Tagovailoa suffered a high ankle sprain against Tennessee, and Saban turned to a relatively unknown medical innovation called “the tightrope.”

“Well, we had a great medical staff,” Saban said on the Pat McAfee show on Friday. “Dr. Andrews and Dr. Kane were our medical staff out of Birmingham, and they do a lot of stuff for NFL guys through the years, but they came up with this procedure; at least, they were the ones that told me about it.”

The tightrope offered an alternative to traditional treatment methods: rest and rehabilitation, or inserting screws into the tibia and fibula and bonding them like a pair of two-by-fours with a nail.

In tightrope fixation, surgeons slip a high-strength suture through small holes in the bone, fasten it with small metal buttons, and then tighten it as you would a zip tie.

Saban, much to the shock of the hosts on the show, went full Grey’s Anatomy in his explanation of the procedure.

“You know, a high ankle sprain is when the two bones where they come together in your ankle are tied together with a ligament, and those bones separate when you have a high ankle sprain,” he said. “So they just said, ‘Ok, let’s wire them together, and we don’t need the ligament.’ Take a couple weeks to fix it, but it won’t take six weeks to come back so that you can play.”

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Saban then cited an example from his time at Alabama in which he saw the whole cycle completed in an unfathomable period of time.

“We had Cam Robinson, who was a great left tackle for us, had a high ankle at Tennessee; we had a bye week, he played at LSU two weeks later and played well,” he said.

The procedure then became extremely common throughout Saban’s coaching tenure.

“And then we used it over and over and over with high ankle sprains, which is a tough injury to rehab from if you don’t have this surgery.”

Now, the surgery that once was marveled at just under a decade ago is saving the seasons of players like Toney, who could come back and help lead his team on a championship run, much like Tagovailoa did.

“It was like, of course, Saban just created something new just to beat football,” McAfee joked on the show. “Because sprained ankles have been taking out football [players] forever, and then it just so happens to come from this little West Virginia coal miner’s brain in an operation down there.”

“Another full of s—t moment there,” Saban said while laughing in response.

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