Injury and alopecia: Smallbone's story

Whilst 2020 represented his big breakthrough, scoring on his first-team debut, marking his territory in the Premier League and winning Saints’ Young Player of the Year award, the last 12 months have thrown up even more significant if less welcome hurdles to overcome.

It began with his first appearance of the new year at Leicester in January – Smallbone’s 13th in a Southampton shirt and the unluckiest by some distance.

Ever-willing, the 20-year-old was hunting down Timothy Castagne, cleanly dispossessing the Belgian international in a challenge that came at a considerable cost.

With Smallbone’s foot planted in the turf a split second after nicking the ball, Castagne’s knee innocuously collided with his opponent’s, leaving Saints’ Academy graduate in agony.

Whilst the midfielder was able to climb to his feet and, amazingly, continue playing until he was substituted, the damage was severe.

“It's never a good time to rupture your ACL,” he begins, modestly. “But especially for me, I'd got back in the team after a few quad injuries and then on my first start (since the opening game of the season) to do my ACL is not ideal. It was very tough.

“When you come through the Academy, obviously the end goal is to be in the first team. When you finally do get there, it's a weird feeling. You're so thankful and proud of everything you've done, but in a way your journey has just started. It's very special to get there, but to stay there is the aim.

“Even when the injury happened, I still didn't think it was as bad as it ended up being. I carried on playing. To get the scan results the following day, straight away you're thinking that's six to nine months that I can't play football. Just the day before I was excited about making a start and being back out there.

“It's such a hard thing to hear. On such a high the day before, to then be told that information was such a low the day after. Everything changes. From playing every day to realising that's now six months away. No news like that is ever good news.

“After the surgery, for six weeks I couldn't do anything for myself. Luckily my mum came down and lived with me, which she was buzzing about! I had her and my girlfriend to help me; they were both great in those tough times.”

But it was not just Smallbone’s knee that needed protection. His head, understandably scrambled by the setback, was losing hair at an alarming rate.

“Alopecia is something I've had to deal with alongside my injury,” he reveals. “I first had a really small patch of hair missing – no one would ever really notice.

“It was the Leicester game, where in a few photos you could see a bigger patch appearing. Now it's actually growing back… but to lose it all is very tough.”

Smallbone carries a defiant smile as he talks. Often seen sporting headwear in recent months, he’s comfortable conducting this interview and posing for photos without it.

“It’s just hair,” he shrugs, but it’s not an easy thing for any young person to deal with, least of all one in the public eye.

“Alongside such a big injury, it probably couldn't have happened at a worse time for me personally, to have both of these things going on.

“The doctors can't say if they are linked. Because of the injury and the stress of being out for so long, they can't say if that caused it, but the timings line up. It would make sense for them to coincide.

“Mine was a gradual, steady increase of how bad it was. It started off as a really small patch of hair I was missing, which slowly grew and then eventually just started falling out from all sides. The doctor's advice was just to shave it because eventually it was going to get to that anyway.

“When it first happened, it's a tough thing to deal with. But at the end of the day, it's just hair. I suppose I'm in a situation where I'm playing on TV, and there's kids watching who may have to deal with the same thing – it’s to show that it isn't the end of the world.

“Sometimes, in life, you have to get on with difficult things that are thrown at you.”

His outlook is remarkably mature for a young man still only 21 years of age. It’s evident that overcoming two such major obstacles at the same time has formed a level of resilience that will only serve him well in football and beyond, with his career still in its infancy.

Smallbone thanks his mum and his girlfriend, who never left his side, and everyone he would bump into at Staplewood through the week.

“The best thing people did was try not to treat me any differently or act like too much had changed. The best thing everyone did was to act normal around me,” he reflects.

“Obviously now everyone can make jokes, because I've come to terms with it, but no one ever made me feel like it was weird, or something to be ashamed of.”

The first to crack a joke was Smallbone himself, tweeting “New season new trim” alongside a photo of his new look at Saints’ club media day in the summer.

For the Irishman, it was his acceptance of the situation that helped him conquer the inevitable negative thoughts swirling through his mind.

“You just have to embrace it; obviously in life things are going to happen that you have no control over. In an ideal world, I would not have lost my hair, and no one would lose their hair to alopecia. But the best thing you can do is take it in your stride,” he says, keen to help others who have been affected by the condition.

“Have a good group of people around you to support you, because there will be times when you're down. Obviously it's not normal, but if you can be positive and think of all the other things going for you, in many ways there are people out there with things that are so much worse. The quicker you come to terms with it, the quicker you can get on and enjoy your life again.

“I'd be lying if I said I was always positive about my situation. It was such a shock. To go from having a full head of hair to having none in such a short space of time was quite a big thing to deal with. There were many down days, especially at the start. It's such a personal thing.

“You speak to other people about it, but they don't necessarily understand it because it hasn't happened to them. There were days where it was tough. I had such good support around me – my family and at the club – to just get on with it and use it as the next challenge to overcome.

“Now, to know that I can play a full game of football again is a great feeling.”

As for the injury, Smallbone made his comeback in the Papa John’s Trophy for a young Saints side at Charlton, and was given the B Team captaincy in games that helped him rediscover his fitness.

His long-awaited first-team return, 283 days since the Castagne collision, was an eventful one.

Introduced in the 77th minute against Chelsea in the Carabao Cup, Smallbone threatened to win Saints the tie with a late header that was saved by goalkeeper Kepa Arrizabalaga, before showing admirable courage to step up when the game was decided on penalties.

Alas, a fairy-tale return eluded him, as his spot-kick cleared the crossbar, but much more important is being back in contention to play and knowing he can count on the support of his manager and teammates for off-field matters that put football firmly into perspective.

“People say during rehab you always come out stronger, but in every sense of the word, I feel like I have come out stronger,” he says, purposefully.

“I feel like I've got to the lowest point I can get to, in terms of an injury. I can use that strength going forward.

“It makes you appreciate everything so much more when it's taken away from you in a split second. It's made me shift my mindset.

“Six months ago from now, I was just dreaming to be back on the pitch. To be here now, I take it with a pinch of salt in a way, because I’m back playing and I could only dream of that six months ago.

“It's been a long time for me since I've been on a football pitch. It feels especially sweet to be back out there.”