It didn't take long for the injury hypotheticals surrounding Ryan Mathews to turn into reality. In fact, it took just one carry. In the Chargers' first preseason game, Mathews left the game after being tackled on his first run and did not return. The grim news that Mathews suffered a broken clavicle, or collarbone, came soon afterward. He underwent surgery to repair the fracture Friday, and the team has issued a projected return of four to six weeks.
Broken clavicles are not uncommon in football as they typically occur when the shoulder is driven into the ground on a tackle or after a hard landing on the shoulder (the result is either a shoulder separation or a clavicle fracture, depending upon where the force is). They are common in offensive players, such as quarterbacks (Tony Romo, Matt Leinart), wide receivers (Marques Colston and Riley Cooper, who incidentally fractured his on July 28 of this year in camp, had surgery and is projected by the Eagles to miss six weeks) and running backs. (Adrian Peterson suffered this injury in his junior year of college, and it raised some concern about his durability before the draft. Of note, he did not have surgery, missed seven games, returned to play in the Fiesta Bowl and suffered another fracture. Ultimately that injury healed on its own.) Although Colston missed only three weeks after his injury, Romo's was season-ending -- he was injured in late October and missed eleven games -- and it was his non-throwing side. Colston had surgery; Romo did not.
Despite the relatively common occurrence of these injuries, the timetable to full health can vary greatly. Given that the clavicle does not always heal well, athletes in contact sports often undergo surgery nowadays to help stabilize the injury and promote quicker recovery. Factors that can influence the severity of the injury include the location of the fracture within the bone (the midshaft of the clavicle is more commonly broken and often less problematic than the end near the shoulder, for instance), whether the fracture was displaced (whether the bony ends remained in alignment or not), and whether there were multiple fragments (more often seen in high-speed accidents). None of this information has been made available regarding Mathews' injury.
Fracture healing typically is about six weeks, and, before a player is cleared to resume contact, there must be sufficient evidence of bony repair to alleviate concerns of reinjury. Every fall onto the shoulder, direct hit to the shoulder (especially if the player is hit from both sides simultaneously), even a stiff-arm move, will translate force through the collarbone area. For an athlete such as Mathews, who will incur contact through his clavicle (directly or indirectly) on virtually every play in which he carries the ball, the confidence that the bone will remain intact must be high before allowing him to compete.
Mathews should be able to maintain his cardiovascular conditioning but will be limited with respect to upper-extremity weights initially. This is not like a knee or ankle injury, in which his ability to perform well enough could be in jeopardy; once he is cleared to return, he should be able to pick up where he left off. Unfortunately for Mathews, this latest injury does nothing to increase confidence that he'll stay up once he picks back up.