The likely death blow for the Dallas Cowboys' 2015 season was when Tony Romo re-injured his collarbone. Although there are many other issues for the team that also contributed to the unholy mess that things have become, that is the largest. The expectation was that this was the end of the season for Romo, but the staff elected not to put him back on injured reserve. In an interview, team owner/general manager/Energizer Bunny-style spokesman Jerry Jones explained the reasoning behind that.
"Let's just put it like this, we didn't deactivate Tony for a reason, and that is if we should get to the playoffs, then he would be available for us in the playoffs," Jones said. "I'm speaking for myself. Jason Garrett, of course, would be the ultimate decision-maker, but one of the reasons we thought using a roster spot is so that he could be available for the playoffs."
Given the way Romo broke down as a passer prior to being injured in the game against the Carolina Panthers, it is not a given that putting him in to replace Matt Cassel would be wise. It is especially questionable in light of the fact that Cassel would have had to lead the team in an historic comeback from 3-8 and also would have probably been involved in winning at least one playoff game by the time Romo was cleared to play again.
But it is also hard to argue with the value of having Romo as an option at that point, especially since Cassel is not invulnerable to injury himself. However, there are certainly questions about whether it is even feasible for Romo to be ready by sometime in January. I was given an opportunity to pose some questions to Dr. Joshua Dines, MD, a sports medicine surgeon at the Hospital for Special Surgery in New York City. While Dr. Dines emphasizes that he has never treated or examined Romo, he did offer some expert opinion on this kind of injury and the recovery process.
- Was he more susceptible to re-injure it after only eight weeks recovery?
Answer: Yes, with regards to bone healing after a fracture, most studies would support the contention that bones are not as strong as they are going to be after only 8 weeks of healing. if the bone is not at full strength and it is subjected to the hits that one takes as a quarterback in the NFL, I would say that it is fair to conclude that he was more susceptible to reinjuring his collarbone.
- Is it common for athletes that endure similar impacts game after game to reinjure their collarbone?
Answer: Given the amount of players in the NFL who see the same hits week in and week out combined with the fact that clavicle fractures do not occur too frequently, I would not say it is common. Again, though, I think this relates to the impacts the player was exposed to combined with the fact that the bone was not at 100%.
- Is there any future increased risk since he's had multiple injuries to the same bone?
Answer: Yes there is an increased risk in the future since the player now had multiple injuries in the same bone.
- What is the typical prognosis for this type of injury?
Answer: In most patients, these fractures heal very well with no significant functional deficits. Unfortunately, when the bone fractures in the same place multiple times it is possible that it will always be at increased risk for re-fracture, particularly without surgery. Along those lines though, it is safe to assume that if the fracture does not need surgery, it is not as severe and has an even better prognosis.
- How long before he will be fully healed?
Answer: While everyone heals differently, when I treat contact athletes with these fractures, I often recommend waiting 12-16 weeks before resuming contact sports. That said, there are many other variables that factor in return to play including what physicians see on the x-rays, which would show the degree of healing, as well as the exam of the patient. Typically, if a patient is experiencing pain, recovery time is extended. Please note: I have not examined Tony Romo nor have I seen his x-rays.
- Is there any limitation on mobility or strength that could linger because of his injury?
Answer: There is always a possibility of limitations to mobility and strength following an injury. However, usually an individual's shoulder strength and motion is not impacted by a clavicle fracture, particularly one not bad enough to warrant surgery.
- Is there a possible problem if he tries to favor or protect this particular part of his body in the future?
Answer: The good news is that this is not a bone that you would typically "favor" or protect as it is not a joint.
Dr. Dines certainly raises some more questions about just how ready Romo might be to play before the playoffs end, as well as whether the team might have been too aggressive in bringing him back to play after his first fracture of the season. There is no doubt that Romo is more than willing to get back on the field as soon as possible. He has played through a variety of injuries in the past, including a punctured lung. But being willing does not mean that returning to the field is truly wise.
All this is likely to be rendered moot, given the extremely long odds against the Cowboys managing to claw their way back to the top of the NFC East. However, they have not been eliminated yet, and the division is not exactly a high mountain to climb. It is more of a short pile of garbage this season. Still, Dallas has not exactly demonstrated the ability to get there, no matter how bad the rest of the division is.
What is encouraging is the prospect for Romo making a full recovery for next season. There is always going to be an increased risk of a fourth injury to his clavicle, but as long as he is able to take the field and compete, he will almost certainly make the effort. Still, the move by the Cowboys in keeping him active seems to be more wistful thinking than a real option - in more ways than one.