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Clavicle Fracture in Athletes: Return to Play Guidelines

Athletes are no strangers to injuries, and one common injury that they may encounter is a clavicle fracture. The clavicle, also known as the collarbone, is a long bone that connects the shoulder blade to the sternum. It plays a crucial role in stabilizing the shoulder and facilitating arm movement. When an athlete suffers a clavicle fracture, it can significantly impact their ability to participate in sports. Therefore, it is essential to establish return to play guidelines that ensure a safe and effective recovery process.

Understanding Clavicle Fractures

A clavicle fracture occurs when the collarbone breaks due to direct trauma or indirect forces applied to the bone. It is a relatively common injury among athletes, particularly those involved in contact sports such as football, rugby, and martial arts. The fracture can range from a hairline crack to a complete break, and the severity of the injury will determine the treatment approach and recovery timeline.

There are three main types of clavicle fractures:

  • Midshaft fractures: These fractures occur in the middle portion of the clavicle and account for the majority of clavicle fractures.
  • Lateral fractures: These fractures occur near the shoulder joint.
  • Medial fractures: These fractures occur near the sternum.

The location and displacement of the fracture will influence the treatment options and the time it takes for an athlete to return to play.

Treatment Options for Clavicle Fractures

When an athlete sustains a clavicle fracture, the first step is to assess the severity of the injury through physical examination and imaging tests such as X-rays or CT scans. Based on the findings, the healthcare provider will determine the most appropriate treatment approach. The treatment options for clavicle fractures include:

  • Conservative treatment: In less severe cases, where the fracture is not displaced or significantly angulated, conservative treatment may be recommended. This typically involves immobilizing the shoulder and arm with a sling or brace to allow the bone to heal naturally over time.
  • Surgical intervention: If the fracture is displaced or significantly angulated, surgery may be necessary to realign the bone and ensure proper healing. During the surgery, the clavicle may be fixed with plates, screws, or pins to stabilize the fracture.

The choice between conservative treatment and surgery depends on various factors, including the athlete’s age, activity level, and the specific characteristics of the fracture. The healthcare provider will consider these factors to determine the most suitable treatment plan.

Factors Influencing Return to Play

Returning to sports after a clavicle fracture requires careful consideration of several factors. These factors play a crucial role in determining when an athlete can safely resume their activities. Some of the key factors influencing return to play include:

  • Fracture type and severity: The location, displacement, and angulation of the fracture will impact the recovery timeline. More severe fractures may require a longer period of rehabilitation before an athlete can return to play.
  • Healing progress: The healing process of a clavicle fracture typically takes around 6-8 weeks for non-surgical cases and may be longer for surgical cases. Regular follow-up appointments and imaging tests are necessary to monitor the healing progress and ensure that the bone is adequately healed before allowing the athlete to resume sports activities.
  • Pain and range of motion: Athletes must have sufficient pain control and regain their full range of motion before returning to play. Pain and limited range of motion can indicate that the bone has not fully healed or that there are complications that need to be addressed.
  • Strength and stability: The strength and stability of the shoulder and arm are crucial for athletes to perform at their best and reduce the risk of reinjury. Rehabilitation exercises focusing on strengthening the muscles around the clavicle and improving stability are essential before returning to sports.
  • Functional testing: Functional testing, such as specific movements and sport-specific drills, can help assess an athlete’s readiness to return to play. These tests evaluate the athlete’s ability to perform the required movements without pain or limitations.

It is important to note that each athlete’s recovery process is unique, and the timeline for return to play may vary. Rushing the return to sports without proper healing and rehabilitation can lead to reinjury and prolonged recovery.

Rehabilitation and Return to Play Guidelines

Rehabilitation plays a crucial role in the recovery process of clavicle fractures in athletes. It aims to restore strength, range of motion, and functional abilities to ensure a safe return to sports. The rehabilitation program should be tailored to the individual athlete’s needs and guided by healthcare professionals, such as physical therapists or sports medicine specialists. The following are general guidelines for rehabilitation and return to play:

  • Phase 1: Immobilization and pain management – In the initial phase, the athlete’s shoulder and arm are immobilized with a sling or brace to allow the bone to heal. Pain management techniques, such as medication and ice therapy, may be used to alleviate discomfort.
  • Phase 2: Range of motion exercises – Once the bone has adequately healed, range of motion exercises are gradually introduced to restore mobility in the shoulder and arm. These exercises may include pendulum swings, passive and active-assisted range of motion exercises, and gentle stretching.
  • Phase 3: Strengthening exercises – As the athlete gains more range of motion, strengthening exercises targeting the muscles around the clavicle, shoulder, and arm are incorporated. These exercises may include resistance band exercises, dumbbell exercises, and functional movements.
  • Phase 4: Sport-specific training – In this phase, the athlete progresses to sport-specific training, focusing on movements and skills required for their particular sport. The intensity and complexity of the training gradually increase to prepare the athlete for a safe return to play.
  • Phase 5: Return to play – Before allowing the athlete to return to competitive sports, they should undergo functional testing to ensure they can perform at their pre-injury level without pain or limitations. The decision to return to play should be made in collaboration with the healthcare provider and the athlete’s coach.

It is crucial to follow the rehabilitation program diligently and progress at a pace that allows for proper healing and strengthening. Rushing through the phases or neglecting rehabilitation exercises can increase the risk of reinjury and compromise the athlete’s long-term performance.


Clavicle fractures are common injuries among athletes, and returning to play after such an injury requires careful consideration and adherence to proper guidelines. The severity of the fracture, the healing progress, pain management, range of motion, strength, and functional abilities are all crucial factors that influence the return to play timeline. Rehabilitation plays a vital role in the recovery process, focusing on immobilization, pain management, range of motion exercises, strengthening exercises, sport-specific training, and functional testing. By following these guidelines and working closely with healthcare professionals, athletes can safely and effectively return to their sports activities after a clavicle fracture.

It is important to note that the information provided in this article is for informational purposes only and should not be considered as medical advice. Each athlete’s situation is unique, and it is essential to consult with a healthcare professional for proper diagnosis, treatment, and rehabilitation guidance.

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