A Stable C7 Fracture in a High School Quarterback: A Case of Clay Shoveler's Fracture

Fractures of the lower cervical spinous processes, also known as Clay Shoveler’s fractures, are uncommon injuries typically associated with high-impact trauma but may also occur in contact sports. These avulsion-type fractures result from one of several mechanisms, including forceful muscle contraction, hyperflexion-hyperextension, or direct trauma at the cervicothoracic junction. This study presents the case of an 18-year-old football player who presented to a sports medicine clinic four days after a game-related neck injury with gradually improving pain managed conservatively with over-the-counter medications and ice. Physical examination revealed focal tenderness over the cervical seven (C7) spinous process with preserved strength, sensation, and range of motion. Radiographs confirmed an isolated C7 spinous process fracture. The patient was managed nonoperatively with immobilization in a rigid cervical collar, rest, and nonsteroidal anti-inflammatory drugs, followed by gradual weaning of the collar in coordination with neurosurgery. This case highlights the importance of considering Clay Shoveler’s fractures in athletes with localized cervical tenderness after contact injury and reinforces the efficacy of conservative management and multidisciplinary follow-up in achieving full recovery.