It took just one imperceptible move at high speed to break Alexa Cathcart’s leg. When the tip of her ski hooked in the snow coming out of a chute and stopped, her leg above the boot kept going. The force caused a spiral fracture of Alexa’s tibia, snapped her fibula and sent her “pickle-flipping” down the mountain. The expert skier, both downhill and back country-style – the kind involving peaks and cliffs – finished her doomed run with a ski a patrol escort and toboggan ride.

At the time of the crash, Alexa was living a transitional kind of dream. A university grad, she gave up plans to attend law school and decided to consider her options while taking a ski year in Whistler, B.C. She made alpine living affordable by converting a short bus purchased at auction. Blissful independence was the norm until the accident, when Alexa’s mom rushed to pick up her daughter and get her to Seattle for treatment.

The next day Alexa underwent surgery at Virginia Mason Medical Center to stabilize her multiple lower-leg fractures. In a spiral tibia fracture, the bone breaks in a corkscrew pattern, usually from a forceful twisting-type injury. Orthopedic surgeon David Belfie, MD, inserted a specialized rod in Alexa’s tibia, secured with screws to support and align the broken bone. Dr. Belfie also discovered another hairline fracture in Alexa’s ankle during the operation that had been elusive on X-ray. It added up to what would become a long stretch of healing and downtime – inconceivable for someone used to conquering mountains.


“When you build your whole life around outdoor activities it’s very difficult to have that taken away,” says Alexa. “There was a mental aspect to that I didn’t anticipate. I had a list of peaks I wanted to ski, but then I couldn’t walk for three months.”

As her leg healed, Alexa discovered a silver lining: an opportunity to recharge in creative ways. She caught up on her reading and started painting. A friend surprised her with a guitar and Alexa taught herself how to play. After weekly physical therapy helped her gain some mobility, Alexa got on her bike.

“I would tie my crutches to my backpack and ride around,” says Alexa. “I couldn’t walk without the crutches, but I could bike because it’s non-weight bearing. I definitely got some funny looks. It helped me get my strength back and I was just so excited to be moving my body again.”

Just eight months later, Alexa ventured to Nevada with a friend to go rock climbing, another outdoor passion. Though her leg had healed well enough for climbing, the hardware used to support Alexa’s tibia didn’t flex like natural bone, making positioning herself on rock faces painful. She connected the pain to how it felt skiing, when pressure on her leg seemed to meet with resistance. Alexa knew many people kept their hardware after leg fractures with good results, so at first she was hesitant to report the discomfort.

“Saying the metal in my leg was preventing my bone from flexing sounded crazy, but Dr. Belfie confirmed what I was feeling was very real,” says Alexa. “He had gotten to know me and the activities I enjoyed, so he supported me in getting it removed.”

A year and a half after her initial injury, Alexa had surgery to remove the rod and all other hardware from her leg. Now when she’s back on the slopes carving her own lines, gone are the days of crying behind her goggles from the pain. The summer season will find Alexa leading expeditions for people summiting Mt. Shasta, as she prepares to someday become a backcountry ski guide – an aspiration that materialized during her recovery.

Alexa never doubted she’d make a comeback, crediting her care team for giving her the needed confidence. “That’s why I felt so lucky to have Dr. Belfie and the team, we were all in it together,” says Alexa. “I was excited when I’d make progress and they always shared that excitement with me. I never felt like I was in it alone.”