On September 30, 2018,  Seattle Seahawks star safety Earl Thomas injured his left leg during the fourth quarter against the Arizona Cardinals. The injury occurred as Thomas dove across the end zone in an attempt to break up a 22-yard touchdown pass. His leg collided with another player as both players dove for the ball. Thomas was noticeably in pain as he tried to put weight on the leg. Thomas was carted off the field and straight to the locker room for x-rays. He was later diagnosed with a lower left leg fracture.  Reports state that Thomas is expected to undergo surgery, but that he has not decided between surgery and another cast.

Thomas previously fractured his left tibia in 2016. It healed with a cast. Thomas will miss the rest of the season, but reports indicate that he is expected to be healthy in time for free agency.

Many tibia shaft fractures can heal without surgery, particularly if they are just a crack or are aligned well.  Internal fixation–usually with an intramedullary rod–can speed weight bearing, improve healing in fractures that are more out of place, and improve alignment for deformed fractures. But surgery has risks and can be associated with knee pain. With or without surgery 100% strength of the bone takes 1 year.  It’s reasonable to return to risky activities sooner, but it involves some risk.