Aaron Rodgers returned to practice this week, 7 weeks after surgery for a throwing arm clavicle fracture. Rodgers is eligible to return from injured reserve to play in next weekend’s game against Cleveland. He has been seen throwing as early as 2 weeks ago and his teammates say he looks like his usual self in practice. But it has only been 7 weeks since his clavicle was put back together in an operating room, with a reported 2 plates and 13 screws – is returning this soon really a good idea?
The fact that Rodgers is throwing well and not complaining of pain is a good sign that his recovery is going as planned. He will likely have xrays and a CT scan in the next week to assess how well the bone is healing. Yes, I said heal-ING. Aaron Rodger’s clavicle is almost surely not fully healed. In fact, the healing process will continue for the next few months. But sometimes we accept nearly-healed bones with sturdy metal plates on 2 sides as stable enough to return to play.
There are some facts that we don’t have about Rodgers’ injury that could help assess the risk of him returning too soon. For example, it would help to know why he had surgery to begin with when many clavicle fractures are treated non-operatively. Was his surgery done for a simple mid-clavicular fracture in order to speed up the healing and return to play process? Or was it done out of necessity because of a multiple fragment, displaced fracture that needed to be stabilized to heal? I suspect it was the former (especially since 2 plates were used). A more simple fracture is more likely to heal enough in 6-8 weeks for a return to play, whereas a comminuted (multiple part) fracture can take a lot longer. This could affect his readiness to resume full contact play and his risk of re-injury.
There isn’t a great amount of data in the medical literature about NFL return to play after surgically repaired clavicle fractures. Small studies have shown that return to play is possible at 6-12 weeks with no increased risk of re-fracture, but those studies are not solely in NFL athletes or even football athletes. The data, however, is reassuring that an early return can be safe in the right situation.
If Rodgers’ imaging shows good healing and he is not experiencing pain with throwing, then I would say that there is a good chance we will see him return in the next 2 weeks. If his doctors are not satisfied with the amount of bone that has grown around the fracture site and plates, then he will likely be held back. There is some risk of re-fracture of the clavicle, either at the site of the previous fracture or at the end of the plate (similar to Rob Gronkowski’s second forearm fracture at the end of his plate). In the NFL, because of the hard contact, that risk is very real and something not to be overlooked. In the end, the decision of when to return will lie with Aaron Rodgers and will involve much more than just the results of a CT scan.
One thing to remember is that Rodgers’ injury is in his throwing shoulder. Studies have shown that throwing mechanics are affected by a clavicle injury – the shoulder joint moves differently to compensate for the new stiffness and sometimes new length of the clavicle. If Rodgers does return, there is a possibility that his throwing form may require some adjustment and lead to shoulder discomfort from a change in his throwing motion. Keep this in mind if we see him back on the field in the next couple of weeks.