Alex Smith Talks Spread Offense, Mentoring Patrick Mahomes, and the Ultimate Resilience

If there's one thing we know about quarterback development, it's that it never happens on a perfect linear scale.

Alex Smith could tell you that better than anybody.

The Utah grad was selected by the San Francisco 49ers with the first overall pick in the 2005 NFL Draft, and to say that things were rough to start would be an understatement. From 2005-2010, he threw more interceptions (53) than touchdowns (51), and his passer rating of 72.1 ranked 34th of 35th among the quarterbacks with at least 1,000 attempts during that time.

Then, Jim Harbaugh became the 49ers' head coach in 2011, and everything changed for Smith. Freed from the organizational dysfunction that had him progressing in reverse with misfit offensive coordinator after misfit offensive coordinator, Smith became the quarterback everybody hoped he could be. In 2011 and 2012 combined, he threw 30 touchdown passes to 10 interceptions, and his passer rating of 95.1 ranked ninth in the NFL.

Things became even better for Smith when he was traded to the Kansas City Chiefs before the 2013 season, and he fell under the tutelage of Andy Reid. That's when Smith made all three of his Pro Bowl nods, and he appeared to be the Chiefs' quarterback of the future... until some guy named Patrick Mahomes got himself drafted with the 10th overall pick in 2017.

Traded again to Washington before the 2018 season, Smith was still on a tear until he suffered a gruesome leg injury that almost cost him most of his right leg, and all of his life, before doctors were able to make things better. Smith returned for the 2020 season before deciding to retire, putting quite the NFL career to bed.

Now, Smith is working with global health leader Abbott in their Dream Team initiative, which helps young athletes prepare to meet their dreams despite any obstacles that may be in their way.

Because if there's one NFL player who understands how to take on those obstacles and come out winning on the other side, it's Alex Smith.

Doug Farrar: You're joining us on behalf of global health leader Abbott. You're in Kansas City today, helping mentor athletes vying for an opportunity with the Abbott Dream Team. A partnership with Real Madrid. And you're sharing your own stories of resilience, which you certainly have in buckets. So, how much have you been enjoying this whole experience?

Alex Smith: Yeah, I'm excited. I mean, first off, a chance to come back to Kansas City, a community that's obviously so very near and dear to my heart. And any chance I get to come back here, I usually jump at. And then, partnering with Abbott, the global health leader, and what they're doing here with Real Madrid and this Abbott Dream Team, is scouting and giving a chance to 16 kids across the country to get to go on an all-expenses-paid trip to Madrid and train at Real Madrid.

DF: Hey, I'll do that. Sign me up. That sounds fun.

AS: And the piece that I'm really into is obviously Abbott bringing all their nutritional expertise, and their top health experts. They're going to obviously dial in all these young kids. And this not only will help them optimize on the field, but just help them for the rest of their lives. I think back to how much things changed from when I was an 18-year-old to now, or the end of my career, and how much I had learned about nutrition and wish I could have gone back and learned at a younger age. And so, I'm excited for that piece. I think these are kids with big aspirations, big dreams. And some are going to be lucky enough to win this amazing life opportunity, and some won't. It's not linear for everybody.

And I'm such a great example of that in my career. As an 18- or 19-year-old, it was not obvious that I would be the No. 1 pick, and be a starting quarterback in the NFL for 16 years. And so I think it's important sometimes to just keep that active as these kids are going about trying to reach their potential. There's going to be bumps in the road, and sometimes it's okay to be grateful for those bumps because they make you better.

DF: Going back to your time at Utah, and I've always wanted to ask you this: You were running a spread offense before spread offenses were cool.

AS: That's right.

DF: Can you summarize the design of that at Utah? Because when people say spread offense, it's like West Coast offense. There are 100 different iterations. What was the design of that Utah offense, and how ahead of your time were you in that regard?

AS: I mean, I was so lucky. Looking back, the timing of everything, you know, when Urban [Meyer] came to Utah with this offense... at that point, it was really called 'gimmicky.' I was in shotgun every single play, and it was really this spread option, right? The run game was really unique. Not only were we spreading people out and trying to isolate match-ups and stretch the field, but this run game was really evolved around QB-driven runs. We read somebody on every single play, whether it was running speed option or obviously just good old-fashioned [option] read plays where we're not blocking the defensive end, and all of a sudden, I had to incorporate myself into the run game.

And so, it was really the combination of both those things - this dynamic QB-driven run game out of the shotgun, and then in combination with spreading the field. You know, we didn't really play with a tight end. We had no one with their hand in the dirt, right? It was five wide [receivers]. That combination is effective, and I think we've seen it change college football. It's even integrated into the NFL.

The schemes that I was running 20-plus years ago, it's insane to think at that point how radical it was, and how much of that has changed in college football and professionally. I just think about professional football now and what we've seen from QB-driven run and so much of that going back to, again, how lucky I was as a young 18-, 19-year-old to get to run that crazy system. But it's funny. When I came out and I got drafted, right, that was almost like the knock on me, right, that I had run the offense, and I couldn't play from under – I couldn't play professional quarterback from under center, and that was certainly the thing that I had to – the narrative I had to kind of combat.

DF: And that's my follow-up. Someone you know well, [former 49ers general manager] Scot McCloughan. I asked him [about spread offenses in the NFL] at the 2007 Combine, and he was the first NFL guy who told me, 'Yeah, we're trying to implement some of these spread concepts.'

You're the first overall pick in 2005. Back then, like you said, it was verboten. I mean, Buddy Ryan called the Run-and-Shoot the 'Chuck-and-Duck' in the early 1990s, and people still thought that way [in 2005]. If you came out of college today, I mean, my gosh, how much easier would it have been if you were going to make that transition? It seems like it would have been a completely different deal.

AS: Yeah, I think the transition would have been much different. [At San Francisco], I went to playing in this very, very traditional West Coast offense my first year. I had to ask permission to even get into shotgun on third down. Think about that. All of a sudden, I was playing with a fullback and maybe two tight ends, and the boxes – just, like, the entire picture looked different than what I had grown accustomed to in college, right? Like, seeing the field from shotgun spread out, what does a – you know, what do these things – these defenses look like from that perspective? And now, all of a sudden, I'm under center. I've got a tight end, a fullback. I'm running I formation, you know, kind of old analog run game, you know, and it just was – that transition was hard.

You compare that to... I was a 20-year-old kid when I got drafted, and it just made the learning curve really steep for several years. It wasn't until I started playing for Jim Harbaugh [in 2011], which is year seven or eight of my career, when I finally felt like I was given the license to run the ball again, right? It took a lot of quarterbacks to help change that narrative. It took Cam Newton to come in help change that. Russell Wilson, and certainly there's been a bunch of quarterbacks since then.

DF: You played with one in Colin Kaepernick, too.

AS: Yeah, totally. You can do this at that level, be dynamic, and still be safe, right? And so it was funny. For something that was such a big strength of mine in college, to be a 1,000-yard rusher, and then all of a sudden feel like that was taken away from me as a young professional was hard. But then to get it back in the entire back half of my career, I felt like it was something that I loved in key situations. I got to Kansas City, and it was third-and-3, and Andy [Reid] would ask me what I want. Call my number, right? Like, get me on the edge. Let me do something with my feet at times. And so it was funny to kind of see that evolution.

And obviously, when you look at the athletes playing quarterback now, it's gone to such a high level. To think about the guys at that position, and the things they can do, how dynamic they are. It's fun to watch, certainly, as a fan.

DF: Well, it's funny because Fernando Mendoza, the No. 1 overall pick 21 years after you, he had two snaps under center for Indiana last season, and he had the NCAA's most RPO snaps of any quarterback. It's funny how things change, and yet they don't.

What is your best Jim Harbaugh story? Because I've talked to Jim a lot over the years, and he's a pretty interesting guy. He's a different breed of cat.

AS: Oh, that's for sure. He's so interesting, and he's interesting because he is different, right? I'm not sure there's any two guys on the planet like Jim. He's one of one. He's a guy who changed my career. I watched him play quarterback when he played for the Chargers. I grew up in San Diego and watched him play as a kid, and then all of a sudden to get to play for him, he still has such an amazing perspective towards the game. He has such gratefulness towards the game.

And I know that can almost sound hokey, but for me, as the No. 1 pick, there's a lot of weight that comes with the expectations. All of a sudden, being around him, I felt that gratefulness that he had. There's a guy who still wished in some ways that he could still play and was so happy that I had the opportunity to go do that. I loved that. I mean, he was like a kid - from the things he told us before we ran out for games - play as hard as you can, as fast as you can, for as long as you can, and don't worry. The last words the head coach told the team before they ran on the field was 'Don't worry.' I think this is a guy who understood the weight that players have.

I'll never forget the birth of my first child during the [2011] lockout. Jim had gotten permission from the league to pop up at the hospital. We weren't supposed to be having any contact. But all of a sudden, he pops up with flowers just to say hello and obviously tell me congratulations. He just had this amazing perspective on life... almost like a real-life Ted Lasso.

DF: Actually, that's a really good comparison.

AS: He made the game simple, and eliminated distractions at a point in my life when the game was heavy because of all the expectations that I was dealing with.

DF: You had almost a decade in San Francisco, then you went to Kansas City in 2013, and made all three of your Pro Bowls there. You were quite successful under Andy Reid. The Chiefs had come off a 2-14 record the year before. Then in 2013, you went 11-5 and had that... I'm not going to bring up too much about that Colts wild-card game [the Chiefs lost, 45-44], but that was one of the craziest games. If you weren't involved on the wrong side, it was probably a lot more fun.

But what did you learn from Andy? Because like [former 49ers offensive coordinator Greg Roman], he was talking to [Nevada head coach and inventor of the pistol formation] Chris Ault, and he was bringing in Brad Childress as a spread game coordinator. He's always been open to new ideas. What did you learn from Andy during your time in Kansas City? And what insight did you get into why he's been so successful?

AS: I think a few things. One, I think that Andy is... there are very few late-in-life learners in general, and Andy is one of them. He's a guy that just continues to grow, and evolve, and adapt. I look back at what the offense was like early on in my first few years, even at the end of my time in Kansas City, even what it looks like now, right? If you think about all the quarterbacks that Andy's coached, they all have such different skill sets, right? But Andy has adapted the offenses to them and their strengths, and I think that's such a sign of a great coach.

I think back to every spring ball, we never just practiced the same old stuff. He was looking at all this college tape, so he saw all these new college concepts, and we'd be trying them out in the spring. Just crazy stuff, and he was always willing to grow and get better and learn.

And then I think the other thing is just how even-keel he is. In a game that's so stressful and there's so much depending on it - you only have 17 games. Each win and loss is so magnified. But Andy's just so even-keel with the ups and downs. The one year we were 1-5, and we thought the sky was falling, and then we rattled off 11 in a row and won the first playoff game in, like, 30 years in Kansas City.

He just never changed, and I don't think that happens without Andy Reid. He is just so the same, and he never did these drastic, dramatic things, and we all just got to be a little better. It was these unsexy messages, but it worked. And I think guys just appreciated their ability to focus on football. Especially with the NFL, there can be so many exterior distractions, and Andy just did such a nice job of really focusing the team and insulating the team.

DF: So in 2017, they take some guy named Patrick Mahomes with the 10th overall pick, and this is another thing I've always wanted to ask you. You've been widely praised over the years for how you mentored him. I mean, you were in that spot. You made the Pro Bowl in 2017. They bring in Mahomes, and you really took your ego out of the equation, and helped him so much to develop. I watched tape with Patrick about a month before he was drafted, so I kind of had a good bead on where he was, but I love the stories about you helping him develop. What did you help him with?

AS: Oh, man. I mean, I think this kind of goes to a bigger question of what mentoring is, right? I'll tell you what it's not. It wasn't like I was sitting in the meeting rooms whispering the secrets to quarterbacking into his ear. That's just not the case. I think the proximity is the big deal. It was made from the moment Patrick was drafted. It was made very clear, right?

Like, 'Hey, Alex, this is your team this year, and Patrick, like, you're the two. You've got to get ready to play, and by the way, you're going to go everywhere Alex goes.' That was just the way the quarterback room was involved. Tyler Bray was our three, but, like, we did everything together. I never watched a minute of film by myself. The quarterback room had become that in Kansas City.

You do everything together. You live together. You rehab together. You go to dinner together with your wives and girlfriends. Like, everything is together. And so, for an entire year, he got an up-close view. I was in year 13.

I didn't learn from an old veteran quarterback. I played Week 3 of my rookie year. I was barely 21 years old. The quarterbacks in the quarterback room had a combined one NFL start. I didn't even know what it looked like to be an NFL quarterback. I didn't know how to watch film. I spent a lot of lonely nights trying to figure it out, unsuccessfully. And so you fast-forward to 13 years later. I had really dialed in my schedule.

I had three kids. I knew down to the minute, every day of the week, what I needed to get done on a month to his schedule going forward. And again, I think that mentor piece, too... you give respect, you get respect. And I think that was such a key element from the jump with Patrick. This is a guy that had grown up in locker rooms. He's competed his entire life. I think he has such a healthy perspective of competing. There weren't sharp elbows between me and him. Patrick's trying to be the best he can be. I'm trying to be the best I can be. And those two things don't have to conflict I also don't think it's a coincidence that I had my career year that year. I do think great competition can bring the best out of you.

I remember feeling so alone as a young quarterback, and remember thinking how crummy that was.

DF: Well, yeah. And it's great that you decided to pay it forward instead.

AS: I think there's so many things that are out of your control when you play as an NFL player. It's this amazing life. But you don't - if they draft you, you go. You don't get to say where you go. Patrick and I had no say in that situation, and I think it's important to remember that. You can be great teammates too, especially at the quarterback position where only one guy gets to play. It's unique in that situation. I think that was critical.

Andy Reid and [former Chiefs offensive coordinator] Matt Nagy had big hands also in creating that culture. And I think it was a great thing for the team to see.

DF: So, the Chiefs trade you to Washington before the 2018 season. And things look good until they don't. Obviously, the sack against the Texans and your injury - a spiral fracture to your right tibia and fibula. And I don't know that people - I mean, the Project 11 documentary was really important, but I don't think people understand what you went through with that. You almost lost your right leg.

AS: I almost died, Doug. I went into septic shock in the hospital. It was very close to being as serious as it can get. Thankfully, the doctors were able to get it under control in time. But at that point, I'm [imagining] missing half my leg. It's been amputated because of the infection, and the seriousness of it. I still have this severe break. And it obviously sent me down this crazy journey that... certainly when you play pro sports, you never expect, right? Not be in the situation where they're talking about cutting off my leg.

My health had been something I was always able to depend on. And now all of a sudden, I can't. And then these things are going to look very different. The rest of my life is going to look very different. Being a dad and a husband is going to be very different for me. And so it just is – obviously, again, it was this – you know, I'm so thankful for it looking back, the journey. But obviously, it was so incredibly tough for a long time.

DF: Well, certainly no one ever deserved Comeback Player of the Year more than you did in 2020 when you won it. My goodness. Alex Smith, thanks for taking the time, man.

AS: Thanks for having me on, and we'll do it again for sure.

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This story was originally published June 4, 2026 at 4:55 AM.