Over the past two seasons, Nicklas Backstrom faced conversations that frankly, he had no interest in having.
The Washington Capitals center's nagging left hip had deteriorated to the point where he had a hard time putting on his socks and shoes. He struggled to play with his kids (ages 9, 6 and 2). He walked around the team facility with a limp.
"I couldn't bend my left leg, I could barely bend over," Backstrom told ESPN. "It ached all the time, especially after games."
The daily pain was met with frustration.
"Yeah, I played," Backstrom said. "But I wasn't really effective out there."
Capitals GM Brian MacLellan had several chats with the 35-year-old, who is already a franchise legend.
"I told him, 'You've had a great career,'" MacLellan told ESPN. "Played 1,000 games, scored 1,000 points, won a Stanley Cup. You're at an age where, if you walked away, nobody would say anything."
Backstrom wouldn't entertain the thought. "He was adamant about keeping going," MacLellan said. "And so we thought it was important to support him."
This June, Backstrom flew to Belgium for an attempt to extend his career. He underwent hip resurfacing surgery, a type of artificial joint replacement designed for younger, more active patients who have worn down the cartilage surface but still have good overall bone quality. Surgery involves placing a metal ball on top of the head of the femur (thighbone), capping it like a tooth, then fitting the socket with a thin metal shell.
The first hip resurfacing surgery to be performed in the United States was in 2006. There is still not enough long-term data on several aspects of the surgery, and there's an unknown about what might happen when introducing a metal implant to the hip in a collision sport; not enough patients have tried that.
Only two active NHL players before have had their hips resurfaced. Defenseman Ed Jovanovski underwent 10 months of rehabilitation after his 2013 procedure, then played in 36 games before getting bought out and subsequently retiring; forward Ryan Kesler never played again after his hip resurfacing in 2019.
As Backstrom laid down on the operating table, he turned to his surgeon: "The last thing I said to him was, 'You better do this good. This is my last chance.'"
ACCORDING TO MacLELLAN, Backstrom is set to return to the Capitals' lineup within the week, which is remarkable in itself.
"I really thought he was going to be out the whole year," MacLellan said. "The optimistic case was six months. All of the doctors [we consulted] -- nobody was really going to commit to six months. Why push it, why not wait out the whole year? But he feels strong. He's pushing as hard as he can. The proof will be in the pudding."
Backstrom's return will be followed closely by other NHL teams and players. The center has two and a half seasons remaining on a five-year, $46 million contract he signed in 2020. Should Backstrom finish it out -- at an effective level -- he could chart a new path, or spark hope for those who have been told they've exhausted all options.
"Hip injuries are pretty common in hockey," Backstrom said. "Technique and medicine are so good today. Even if there is a metal thing in there, there's a chance to get back out there if you want. If it works for me, hopefully that can inspire a lot of guys too."
Backstrom has always clung on to hope, despite hip issues that span nearly a decade. He underwent arthroscopic surgery in 2015, a common and less invasive procedure. That quelled the discomfort, until three years ago when it started bothering him again. Backstrom took two months off to start the 2021-22 season, hoping rest and holistic treatments would help. It didn't. He rejected any suggestion of hip replacement surgery, believing that it would end his career completely.
One of the specialists Backstrom saw in New York mentioned hip resurfacing surgery as a last resort. Backstrom did his homework.
"It's an untested thing in hockey and in sports in general, but I did all that I could researching about this surgery and talking to a lot of athletes who went through it," Backstrom said.
He found two hockey players in Sweden who did it, as well as Isaiah Thomas of the NBA and Andy Murray in tennis. Murray was on the verge of retirement after the Australian Open in 2019, famously telling the crowd in what appeared to be his last match: "Maybe I'll see you again ... I'll do everything possible to try." Murray underwent hip resurfacing surgery shortly after, and is continuing to play professionally today.
Backstrom got in contact with them all.
"We all had the same issues. The joint was just too damaged, you couldn't do anything with it," Backstrom said. "You tried to do things to feel better, find solutions. All of the guys I talked to, they said one thing: 'I should have done this sooner.' I also heard, 'This is a life-changer,' and 'This is too good to be true.' I was like wow, this is pretty good feedback from guys that went back and played professionally."
The Swedish hockey players recommended Dr. Koen De Smet in Belgium, whose website says he has conducted more than 5,500 hip resurfacing surgeries.
"I talked to him directly, he was really positive about it," Backstrom said. "He said, 'You're actually going to feel better than before.' I felt so confident going in because he was so confident about it."
BACKSTROM WAS IN the pool swimming three days after surgery. He was able to walk without crutches within two weeks. Within two months, he was lifting weights. And within four months he was back on the ice.
"I felt good quicker than I thought," Backstrom said. "And when I stepped on the ice, it was a game-changer for me. I could turn, pivot with no hiccups."
Backstrom's X factor has always been his passing. His vision is elite, able to process opportunities before they develop. So even as he dealt with restrictions, he found ways to produce -- including six points in six playoff games last season.
"You noticed it most in his skating. His first couple strides weren't there," MacLellan said. "He's such a smart player that he could get away with it."
But for Backstrom, that wasn't enough.
"I love the game and I don't want to finish my career the way the last two years have been," he said. "It's been a battle to get out to practice, and getting through practice and games. I don't want to finish that way, that doesn't feel right. I feel I owe it to myself, my family, my organization, the fans, everyone that has supported me all of my years, to give it everything I have."
Backstrom's return comes at a critical time for the Capitals. The team got an emotional boost this week with the return of T.J. Oshie. That will be fortified when Backstrom and Tom Wilson return. Wilson, who had offseason ACL surgery, is also expected back next week.
Washington weathered a brutal injury storm early, and in a season punctuated by Alex Ovechkin's historic milestones, the band is back together for another run.
Backstrom wouldn't allow himself to envision a scenario where he retired.
"Thoughts like that, I tried to push them out of my head," he said. "I know it's easy to go that way when you've been through this, but my love of playing the game, I couldn't lose it. If there's a chance to get back, I'm going to stay there mentally, it's the only way."
Said MacLellan: "For a lot of people, I think they would say it's not worth it to go through all of that. But there's a stubbornness to Nick, that all stems from his love of the game. It's a good lesson in keep moving forward, keep finding a way."
Additional reporting by Stephania Bell.