ST KILDA midfielder Paddy Dow is facing a delayed start to the 2025 season after spending close to three weeks in hospital over Christmas due to a traumatic infection that required three bouts of knee surgery.

The 25-year-old was one of the best trainers at Moorabbin across the first block of the summer program before he reported a fever to veteran club doctor Tim Barbour on leave on December 18, the day after the Saints went on leave.

Dow missed the first few months of 2024 due to severe bone bruising in his knee following a training mishap and the same knee swelled up again on December 19. It required draining at RSEA Park the following morning, where 120ml of greenish brown liquid was removed and signalled an alarm.

By that afternoon, Dow was in the emergency department of the Epworth Hospital in Richmond undergoing arthroscopic surgery.  

Dow required two more rounds of surgery on Christmas Eve and December 28 from one of the AFL's go-to ACL surgeons, Professor Tim Whitehead, where he went under a general anaesthetic and had water pumped through the knee joint to eradicate the bacteria. 

Finally, after nearly three weeks in hospital, Dow was discharged on January 6.

But his road to recovery is unclear. He is currently restricted to work on an elliptical machine and is aiming to be back on a bike next month. Running will be the next target, with a return to play in the first half of the season the aim, but no guarantee.

"I had blisters like every player, but that night after our last session they were pretty bad. On the Thursday I started getting a bit sick, felt feverish and the knee then blew up that night," Dow explained to AFL.com.au.

"I got a scan the next morning. 'Barbs' [Barbour] wanted to have a look and when he drained it the fluid was greenish brown. Usually if you drain a knee that's had an injury it is light blood or clear fluid; this was brown and he drained 120ml.

"It was good knowing that because it explained why I felt so crook. I didn't know what was going on.

"I started to decline pretty quick that day. That afternoon I got taken to emergency and it went from there. On the Friday night, I had the first washout to try and get rid of all the bacteria and started the antibiotics. 

"I thought I was leaving on the 24th and then I thought I was leaving on the 27th and they just ended up keeping me. After the third washout on the 28th, things started to get better. They weren't getting any worse, it started to plateau and then three or four days later it started to feel good. I was in hospital for three or four days at the end where I felt fine and thought I could have left."

Dow was planning to return to Swan Hill for Christmas and spend most of the break at home. Instead, his mum, Janine, moved to Melbourne for the duration of her son's hospital stint, although the timing wasn't ideal for his father, Richard, given the farmer was in the middle of harvest.

Enter the club. High performance boss Alex Sakadjian spent Christmas Eve and New Year's Eve by Dow's bedside with his son. Then St Kilda coach Ross Lyon spent two hours on Christmas morning in the Epworth with Dow in a sign of just how important the people are at St Kilda.

While most of the playing group weren't aware of the severity of the situation, St Kilda's football department were across every update. General manager David Misson rang every day to check-in, leaning on his past experience as a high performance boss. Midfield coach Robert Harvey monitored the situation closely, as did long-time player development manager Tony Brown, who is renowned across the industry for his relationships with families. Head physio Ben Shipperd also visited on New Year's Day with his two daughters.

"The club has been incredible," Dow said. "This helped me a lot, I reckon. Misso was calling me every day. Alex was talking to me a lot and came in Christmas Eve. He bought me a good book to read.

"Ross was great at reassuring me that I needed to only focus on my health and that I couldn't rush this. All the doctors were good with that because I was so keen to do stuff, but they have kept reminding me that if I rush this, I am more susceptible for a few months."

Misson praised the action of the football department at RSEA Park during the only window on the calendar where the industry has the opportunity to properly unplug for three weeks.

"I'm really proud of the club and the way it has been handled. Paddy went downhill pretty quickly the day he went into hospital. Everyone got involved," Misson said.

"Ross went in, Alex and his son went a couple of times, 'Shippo' was there New Year's Day. I made sure I spoke to him every day. 'Harvs' was there, the psychs were checking in regularly, so was Tony Brown, not just with Paddy, but his mum, Janine, who spent the whole time in Melbourne.

"It was an interesting time for the family. They've got the farm in Swan Hill and it was harvest time for his dad. It was a really tough time for the family, so as a club we were really conscious of that and wanted to really wrap our arms around the Dow family and provide as much support as possible.

"Tim Barbour was amazing coordinating the whole thing from infectious disease experts to Tim Whitehead, the surgeon, to everyone he knew in the hospital. He was just incredible, to be honest."

Dow was administered antibiotics via an intravenous drip for the first fortnight after being discharged but is now only taking oral treatment. He is back around the club and hopeful he can still play a meaningful role in 2025.

St Kilda doesn't yet have a clear timeframe around his return but are confident he will play a block of games before the club's mid-season bye in round 13.

"He is improving nearly every day from the IV and oral antibiotics. The range in his knee is the key thing and that's getting better every day. We are just waiting until the doctors give the green light to increase the load.

"He knows he has a reasonably long road ahead. He's got his head around that, so have we as a football club and coaching staff. It is going to be an extended period in rehab for him. There are going to be milestones along the way for him to try and tick off and all things going well, we expect him to play in the first half of the year. But it's hard to provide real clarity at this time."

Dow sought a trade from Carlton at the end of 2023 after playing only 14 games across the previous two seasons under Michael Voss, despite dominating in the VFL. And things haven't gone to plan just yet at the Saints; he didn't play until round 10 last year due to the pre-season knee injury and only managed 10 appearances for the season.

But the Geelong Grammar product has dealt with adversity before and knows this is only part of his story, although this setback is difficult to stomach given its nature and the fact he had banked a monster pre-season block to launch into 2025.

Seldom are players infected from a blister. More often it has occurred after reconstructions. Hawthorn defender James Blanck and Carlton forward Jack Silvagni both suffered multiple infections after major knee surgery in 2024.

"What helped last year was being able to play a few games and play some good games that I could show the club what I could do; that definitely helped," Dow said.

"I was keen to have a full pre-season here – and that was going well – but this is just the hand I've been dealt. You have to take it in your stride."