PITTSBURGH - Sean Spence had to look. He didn't really have a choice if he wanted to move forward with the kind of healing that can't be addressed with a brace or a wad of tape.
Handed a photograph of the moment that changed his career and his life, the Pittsburgh Steelers linebacker tried not to get nauseous. He nearly failed.
"It was bad," Spence said. "I couldn't even believe my body made that movement."
Pittsburgh Steelers linebacker Sean Spence has had a long road back from a devastating knee injury.
That's because it's not supposed to.
The third-round pick out of Miami (Fla.) was wrapping up a spectacular training camp in August 2012 when he found himself chasing down Carolina Panthers backup quarterback Jimmy Clausen in the third quarter of the preseason finale. Spence was in the midst of reaching out for Clausen when the linebacker's left knee bent grotesquely underneath him.
In an instant, Spence's knee exploded. Ligaments shredded. His kneecap dislocated and turned 90 degrees. And that wasn't the worst of it. Spence severely damaged his peroneal nerve, the kind of injury from which athletes rarely recover.
Laying on the Heinz Field turf, tears in his eyes and agony coursing through his body, Spence wondered if he'd ever play again. He wasn't the only one.
"It was one of the few times I got emotional about seeing a player go down, a promising young player in camp," safety Ryan Clark said. "To see him hurt and the way he was, and to see him dealing with that injury on the field, it made me emotional."
And made the moment Spence donned a helmet and shoulder pads for the first time in 14 months all the more thrilling. After spending more than a year in a grueling rehab program that left Spence feeling "alienated," he worked with the scout team Wednesday in what he called a major milestone toward his eventual return.
The Steelers activated Spence off the physically unable to perform list Tuesday and have three weeks to decide whether to put him on the 53-man roster or put him on injured reserve.
There's little doubt which avenue Spence prefers, even if he knows he won't be available this weekend when the Steelers (1-4) play host to rival Baltimore (3-3).
"I'm definitely hoping (to play this season) but I'm not going to guarantee anything," Spence said. "I'm going to keep working at it and see how it goes."
The fact Spence is even at this point is no small miracle. In an era where knee surgery is commonplace, nerve issues are something else entirely. The peroneal nerve is located in the lower half of the leg and can affect everything from leg strength to the ability to move your foot up and down. For months there was no guarantee the peroneal nerve in Spence's left knee would repair itself.
Even now Spence only offers a brief "it's good" when asked to assess the nerve's progress. The truth is, he's not sure how any of this is going to go. While he appeared to pass his first brush with contact in 412 days with no problem, he cautioned "ask me (today) how I'm doing."
Hard to blame Spence for trying to temper his enthusiasm. He appeared more than NFL-ready during his first training camp, opening eyes with his speed and intelligence. And that was before he even knew what he was doing.
That confidence, however, evaporated in a flash. He's spent months learning to trust his body will do what he asks. Until that trust is restored, he knows he has no chance of donning his No. 51 jersey on Sundays.
"When you're on the field there's no thinking," Spence said. "When you're rehabbing there are certain landmarks and things like that, but when it comes down to playing ball, you just want go play."
Something that might have to wait until 2014. Spence will wait if he has to. So will the guys who have marveled at his perseverance and his intelligence.
"He's that much smarter now," outside linebacker Jason Worilds said. "Whereas a year ago, he was making plays but he was making plays off his natural ability. Now he's learned. It's going to be exciting."
Not to mention welcomed. Viewed as the eventual heir to Larry Foote at inside linebacker, Spence could only watch as Foote was lost for the year with a torn biceps and replacements Kion Wilson and Vince Williams struggled to get up to speed.
"You feel like you missed an opportunity, but I know things happened for a reason," Spence said. "If I have an opportunity to take advantage of it, I will."
Tackle Marcus Gilbert (quadriceps), DE Brett Keisel (abdomen) and LB LaMarr Woodley (knee) were limited in practice Wednesday ... LB Jarvis Jones did not practice due to a head injury. TE Heath Miller also sat out, though it was not injury related.