The path to the big question hovering over No. 2 LSU vs. No. 3 Alabama began in Ireland in 1990 with a water-skiing accident on a lake the Irish call Lough Gowna, even if a dull American ear might need that repeated and spelled.

As Brian Thornes told it by phone Thursday from Dublin, it began while Thornes was a first-year medical student when, he said, “I was run over by a speedboat” that was piloted by his father. A mean wind shoved it until a propeller cut Thornes’s ankle, costing him both a year of his beloved rugby and some feeling in his foot.

He made lemonade of it. Ankles became “always an interest thereafter,” he said.

By 2000, Thornes had invented an innovative device for ankle surgery. By 2003, he had licensed it to a Florida company, Arthrex. By the late 2010s, the “TightRope” surgery had joined college football chatter because of how Alabama players have found recovery hastened relative to the primitive days of yore.

If maestro quarterback Tua Tagovailoa plays and thrives for Alabama on Saturday, the major variable in the game’s loud run-up, the shape of the entire national college football season would have derived at least something from that cruel incident on that Irish lake. As the country’s football-minded amateur orthopedic surgeons know, Tagovailoa surely has become among the first to twice undergo the TightRope procedure, which involves tying things together rather than bolting things with screws. He had it last December for his right high ankle sprain and last month for his left high ankle sprain.

Concerning the right side, he rebounded from a game injury Dec. 1 to game activity Dec. 28. Concerning the left, he has rebounded from a game injury Oct. 19 to a game-time decision Saturday. In the process, he has helped usher the football-minded to reading such phrases as “syndesmotic ligament,” “flexible stitch” and “sturdy suture.”

While Thornes, still just 49, had not heard Tagovailoa’s name before and had heard only ripples of chatter about the injury, he pronounces himself “shocked” to see athletes return in three or four weeks from an injury long known to require double that. “It’s very humbling,” he said. “When you’re a surgeon, you can see what you do for patients that are in front of you. But when you’ve invented something and thousands of people around the world use it, you don’t see it until these stories coming out. It gives me great pride.”

In turn, it gives Alabamians great hope.

As former NFL quarterback and CBS analyst Gary Danielson described, Alabama can beat all but five or 10 college football teams with any of its quarterbacks. It bulldozed Arkansas, 48-7, on Oct. 26 with Mac Jones at the helm and Tagovailoa as a knowledgeable spectator.

“It’s with those five to 10 teams that can play with Alabama,” Danielson said, “where Tua can make a difference.”

“This Alabama team is built around the skills of how Tua plays quarterback,” Danielson said, soon adding, “They need the high-level play from the quarterback. They’re not built to have a game manager,” especially while LSU is freshly built to outscore one, and the Crimson Tide is buttressed with a fearsome quartet of wide receivers: Devonta Smith (43 catches, nine touchdowns), Jerry Jeudy (52, eight), Henry Ruggs III (26, six), Jaylen Waddle (21, one).

When Danielson studies Tagovailoa, the sensation who flattered Alabama by seeking it out all the way from Honolulu, he sees three rarefied qualities. He mentions Joe Montana, Tom Brady, Aaron Rodgers and Drew Brees when he says, “I believe that there are some god-given talents that some quarterbacks have that are unteachable.”

He recalls his days with the Cleveland Browns, when teammate Bernie Kosar would report from having worked with Dan Marino and saying, “Dan went from what he saw to the ball being released without any inhibitions in between. It was just automatic. Nothing clouded his thought processes whatsoever.”

He thinks Tagovailoa views space more keenly than other quarterbacks: “I think people see barriers. They see the picket fence. And these guys see the open spaces between the fence.”

And he spots Tagovailoa’s “innate ability to handle situations,” saying that with these rare quarterbacks, “The more stimuli they get, the better they seem to be calmed by it.”

Alabama should need all of that given LSU’s caliber, so it’s significant that Danielson and Alabama Coach Nick Saban, two former players born seven weeks apart in 1951, can marvel at life in the year 2019.

As Saban told reporters in Tuscaloosa, “Maybe [Jacksonville Jaguars offensive tackle] Cam Robinson might have been one of the first guys to get it, probably three or four years ago. I mean, he got a high ankle sprain in the Tennessee game and played LSU in two weeks, and you know, he played every play in the game. Little different for an offensive lineman as it might be for a skill guy, but it really has enhanced the ability of our guys to come back, and they haven’t had any issues or problems in the future. So I mean, it’s amazing to me all the things that they can do in medicine now that I know back when I played, none of these things were available.”

An ankle sprain ailed Danielson in the first six or seven games of his senior year of high school, but he persisted while mindful of college recruiters who might be looking. He wonders whether this innovation might end up resembling another revolutionary surgery. “Tommy John surgery used to be: ‘Oh my goodness. Can that guy ever pitch again?’ ” Danielson said. “Now they say, ‘You can come back even stronger.’ ”

While some still find the procedure unproven, Saban sounded like an orthopedist when he cautioned that he’s “no doctor” but said, “This is a ligament issue, you know, the two bones, where they come together in your ankle, there’s a ligament that holds them together, and that stretches, so when you tie it together, the ligament actually has a chance to heal because one of the biggest issues is it’s a rotation injury, so every time you turn a little bit on your foot, all right, those bones move, so it affects healing. So if you hold the bones together, the healing process is much quicker.”

Twenty years earlier, something kept bugging a young surgical resident across the ocean. “I was learning arthroscopic surgery,” Thornes said, “and I realized that the standard treatment of putting in a screw usually necessitated two operations. And for a very simple injury and surgery, why did you have to bring someone back in?”

He kept reading all the literature about all the variables related to the screws. Then, finally: “I kind of scratched my head and thought, ‘The problem is the screw, not the permutations of it,’ ” he said.

Now he finds himself in discussions of American football, this guy who learned of the game only as did so many on the right side of the Atlantic — through NFL highlights in the 1980s on Britain’s Channel 4, thus through the Chicago Bears of Walter Payton and especially William “The Refrigerator” Perry. Well, he has seen the Seahawks in Seattle. He has even been to Alabama, in 1993, while on a medical elective in Meridian, Miss.

He just never could have foreseen this when he had a “brain wave” while, he said, “I was in bed. Nothing more exciting than that. Just one of those things you think about when you can’t get to sleep, and you’re trying to solve all the problems of the world.”

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