Dougherty: Aaron Rodgers' return in uncharted waters

If you’re still wondering why general manager Ted Thompson and team doctor Patrick McKenzie needed almost two full days before clearing Aaron Rodgers to play this week, we might have the answer.

It appears Rodgers is making NFL history.

By starting for the Green Bay Packers on Sunday, Rodgers very well might be the first NFL quarterback to break his collarbone on his throwing side and return the same season.

At least that’s the case as far as I can tell after a thorough search on Google and contacting two doctors this past week who work or have worked in the NFL.

Best as I could find and the doctors knew, Charlie Batch of the Pittsburgh Steelers was the first NFL quarterback to have surgery after breaking his collarbone on his throwing side, in 2008. He went on injured reserve but had no throwing issues the rest of his career.

Nine years later, Rodgers appears to be the first to have the surgery and return in the same season. He’ll take the field at Carolina’s Bank of America Stadium exactly nine weeks after breaking his collarbone and 8 ½ weeks since having two plates and 13 screws implanted surgically to repair it.

No wonder McKenzie spent two days consulting other experts, and Thompson went deep into Tuesday night before giving the OK.

“I was the example that people used, can you do surgery on a collarbone on the throwing side?” Batch said this past week. “And Aaron will be the guy, ‘Yes, you can and you can bring him back.’ So he will be the test case. Can you wait on somebody (to get healthy during the season)? Ultimately, it depends on how he plays.”

Broken collarbones aren’t uncommon in football, but in researching recent history of the injury I could find only five NFL quarterbacks from the past 20 years who broke the collarbone on their throwing side besides Rodgers: Batch, Matt Leinart (twice), Jason Campbell and Josh McCown. All missed the rest of the season.

Leinart didn’t have surgery the first time (2007) but did the second (2011). Neither Campbell (2011) nor McCown (’15) had surgery. McCown, incidentally, broke his non-throwing collarbone last year.

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The broken collarbone you might have heard most about was Tony Romo’s – he actually broke his three times, including twice in one season (2015). But all were on the left (non-throwing) side. He didn’t have surgery until the third time and opted for a Mumford procedure – the shaving down of the bone near the shoulder to reduce pressure on the shoulder – rather than the more common plate and screws that Rodgers, Batch and Leinart had. Romo’s opting for that procedure suggests his original fracture healed out of alignment.

I did find one college quarterback who broke his collarbone on his throwing side and returned that season, Anthony Boone of Duke in 2013. He didn’t have surgery but somehow played five weeks after the break and finished out the season. He told the Chicago Tribune that year that he felt a click in his shoulder every time he threw.

But Boone never made it in the NFL.

Batch, as far as he and his doctors knew, was the first NFL quarterback to have a plate and screws inserted on the throwing side. He broke his collarbone in the ’08 preseason, and the Steelers didn’t want to risk going six games or more with a fifth-round rookie (Dennis Dixon) as their No. 2. So they signed veteran Byron Leftwich and put Batch on IR. There was no designation for return at the time, so Batch’s season was finished.

Batch had consulted a couple of doctors who recommended letting the break heal on its own. But the Steelers’ orthopedist suggested surgery even though it would be the first for an NFL quarterback on his throwing side. The thinking was, be sure the fracture heals well aligned so the length of Batch’s collarbone and his throwing motion don’t change.

Batch, who was 33 at the time, played four more seasons.

“There were no case studies,” Batch said. “That’s why it was too uncertain (when I’d return). … No issues (after that) and I played a lot through that time.”

Because Batch was on IR, there was no need to push his recovery, so he doesn’t know how quickly he could have been ready to play. Rodgers is trying to show what’s possible.

The decision to clear Rodgers clearly was in the gray area – the threshold to consider bringing a player back from a broken collarbone is 80 percent healed, and that’s reportedly about where Rodgers’ CT scan showed him Monday.

But this is a premier quarterback who at age 34 could have anywhere from six to eight more good seasons left and figures to be in line for a huge contract extension this offseason. Though it’s uncommon, collarbone fractures can damage nerves in the shoulder, which would weaken a quarterback’s throwing arm. So the risk of re-injury is not something to take lightly.

“With that combination of the plate, screws and 80 percent (healed), I’d say he’s relatively safe,” said Dr. Luga Podesta, regenerative orthopedic specialist at Bluetail Medical Group in Naples, Fla., and a former training camp medical consultant with the Dallas Cowboys and New Orleans Saints.

“But you don’t know. If he gets thrown onto that shoulder again, depending on the way the forces are driven across the shoulder, there’s always the possibility he could fracture around the plate. I doubt he’ll fracture through the fracture site again, but he can fracture around that plate and have more problems than he had originally.”

Thompson, McKenzie and Rodgers have made their decision. All that’s left is to see what happens Sunday. Rodgers is returning for a huge game – if the Packers win at Carolina, their playoff hopes will skyrocket with only two games to play.

But how will he play after two months from game action? And will he survive?

I find it hard to believe he won’t have some rust, though he’ll also have a run game that was only starting to emerge when he got hurt. The rust matters, because he’ll need to play well to beat 9-4 Carolina.

“Honestly, I don’t know,” Batch said of the layoff. “Yeah, he may miss some throws as far as accuracy. But I think everything else will flow to him.”

Carolina surely will hit him as much as it can, though the officials could be wild card. Maybe they’ll be extra-protective of him on anything even resembling a late hit. Rodgers is one of the NFL’s most valuable commodities.

“If you’re Carolina, your goal every week is to hit the quarterback,” Batch said, “but in this case even if you don’t get a shot on him you’re at least going to push him down to make him get up and think about it a little bit."