KANSAS CITY, Mo. — In the distressing first few seconds after Patrick Mahomes went down late in the Chiefs’ Dec. 14 loss to the Chargers, he writhed on the field clutching his left knee with both hands.

It looked devastating and grim right away, especially when it comes to a resilient, rugged man who somehow keeps shrugging off seemingly debilitating injuries.

Remember when he suffered that dislocated kneecap in Denver ... but walked off the field to the locker room under his own power and somehow returned in mere weeks?

And how he willed away a mangled ankle in Super Bowl LVII to thrive down the stretch?

Along with any number of other wounds and afflictions, visible or unknown, he’s coped with over the years — including an underappreciated but instructive one we’ll come back to.

So whether the quarterback was in shock or denial — or just through overwhelming instinct after he was being helped up and off the field — Mahomes initially was inclined to return as the Chiefs trailed 16-13 and faced elimination from the playoff hunt.

He knew “something had happened,” he said last week via Zoom in his first interview since then. Once he was able to walk, though, he asked one of the doctors if he could be fitted with a brace and finish the game.

“But they wouldn’t let me,” he said with a slight smile and sounding somewhat wronged.

When he received the MRI results that evening and understood he’d require surgery for what turned out to be ACL (anterior cruciate ligament) and LCL (lateral collateral ligament injuries in his left knee, Mahomes rapidly fixed his focus on the horizon: what should be considered a quest to return as soon as Week 1 of the 2026 NFL season, starting with undergoing surgery in Dallas roughly 24 hours after the end of the game.

“It’s hard, but at the same time you’ve got to kind of flip the script fast knowing that it’s going to be a quick turnaround to get to this season,” he said. “Now it’s just been motivating trying to push myself … as much as they’ll let me push myself to be ready for next year.”

And that indomitable mindset we’ve seen play out over and over in Mahomes is both reassuring and the crux of any concern about his ambition to be on the field — “with no restrictions,” as he put it — to start the season.

Because there’s an emotional challenge between the urgency of returning vs. his long-term health, between being diligent and over-extending himself — as he could be apt to do, being the voracious competitor he is.

As he spoke about following the directions and protocols from surgeon Daniel Cooper through rehabilitation largely with Chiefs VP of sports medicine and performance Rick Burkholder, assistant athletic trainer Julie Frymyer and longtime personal trainer Bobby Stroupe, Mahomes used terms such as “they hold me back, because I always want to go a little further” and “as much as they’ll let me.”

When I asked him if he’s conscious of balancing the most immediate with the future, he nodded up and down and put it this way:

“Yeah, for sure. That’s something that I have to think of. I think the coaches, the organization all (have) to think of. But at the same time, that’s why they give me limits to where I can push it.

“Dr. Cooper described that to me … ‘I’ll give you the limits of where you can push it to, and then it’s up to you how far you want to push it to that limit.’ Knowing me, I’m going to push it to that exact limit every single day.

“There’s places you can’t go yet, which I want to but can’t go yet. But at the same time, they’re doing it for a reason.”

Not that he isn’t human and doesn’t need a nudge now and then.

“Some days I want to go in there and crush rehab, (and) some days I just want to get through it,” he said, smiling. “But (Frymyer) doesn’t let you have the get-through-it days. She pushes you to be the best every single day.”

Most often, though, Mahomes has to be held back.

Part of that is meant to help him mentally in a subtle way: to help keep him buoyant in the sense of feeling he’s capable of doing more than he’s being allowed to.

Beyond that, Mahomes’ mindset is understood to be about as healthy as it can be. Including that he appreciates that he’s got less to deal with than he might well have ... and that he even experienced a degree of good fortune in what befell his knee.

After all, it was in such a condition that there was no reason to at all delay the surgery. And it could have been worse.

“As bad as it was, it was as clean as it could be,” he said. “I found out there’s a lot of little things that can happen around that knee that I’ve never even known.

“So, I was lucky … (that) God blessed me enough to not do some of (the) things that could prolong the injury.”

It also figures to be reassuring to Mahomes, as well as the Chiefs and their fans, that he’s able to do upper-body, shoulder and core work that has left him looking lean.

Not to mention that other parts of his much-battered body are having the opportunity to heal in ways they haven’t for years.

At least five years, to be more precise, since the aforementioned unsung but at least partly telling return from his only previous surgery: to repair “turf toe,” a torn plantar plate, after the 2020 season.

Maybe that seemed less daunting because it was out of view in the offseason. And because only days before the February 2021 surgery Mahomes had scrambled a stupefying 497 yards behind the line of scrimmage before throwing the ball or being sacked in a 31-9 drubbing by Tampa Bay in Super Bowl LV.

But that surgery is understood to be delicate and involved. Rehabilitating from it was a slog, one that still had Mahomes in a walking boot two months later.

And for someone whose game is so strongly predicated on movement outside the pocket and even running the football, how quickly he could return — and return to form — was an open question that offseason.

However much he might have grappled with being held back through that process, the results indicate he approached it just right.

Mahomes enjoyed six of the top 15 quarterback ratings of his career that season. The Chiefs averaged 30.87 points in the first six games he was back. Then they scored 42 points in each of their first two postseason games before that wretched overtime AFC championship game loss — in which Mahomes struggled — to the Bengals.

This is its own injury, of course, and its own process.

But at least so far, and from the outside looking in, there’s every reason to think Mahomes is on trajectory. And that he understands, like Dirty Harry said, a man’s got to know his limitations.

“We have to let it all play out and kind of take it a day at a time,” he said. “Which has been hard for me. But at the same time it makes me get the best out of every single day.”

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