Football is a brutal business. One second you're fighting for a roster spot in the preseason, and the next, you're in the back of an ambulance speeding through Chicago traffic. That’s basically how the 2025 season ended before it even started for Alexander Mattison. It was August 10, 2025. Soldier Field. A 24-24 tie that nobody will remember, except for the moment Mattison went down.
The hit looked awkward, sure, but the fallout was a total shocker to the system.
The Alexander Mattison neck injury: A Sunday nightmare
Honestly, when it first happened against the Bears, most of us thought it might just be a stinger. Mattison had just hauled in a 21-yard catch from Quinn Ewers—moving the chains, looking like the veteran presence Miami paid for—when he got spun around. His helmet hit the turf hard. He actually walked off the field under his own power, which is usually a good sign in the NFL.
It wasn't.
By Sunday night, the narrative shifted from "neck and shoulder soreness" to "emergency surgery in a Chicago hospital." That’s a terrifying jump. One minute Mike McDaniel is telling reporters Mattison is "doing well," and the next, Adam Schefter is dropping the bomb that he’s out for the entire 2025 season.
Why the surgery happened so fast
People were scratching their heads about how a guy walks off the field but ends up under the knife a few hours later. When it comes to an Alexander Mattison neck injury, the concern is almost always stability. If there’s a fracture or a disk issue that threatens the spinal cord, you don't wait. You fix it.
💡 You might also like: Listen to Dodger Game: How to Catch Every Pitch Without a Cable Bill
Mattison later opened up about this on the Caps Off podcast in late 2025. He described it as a career-threatening moment. He didn't just "sore up"; he lost that feeling you never want to lose. The surgery was meant to stabilize the area immediately to prevent permanent damage.
The medical specifics were kept somewhat under wraps, but we know a few things for certain:
- It was a season-ending procedure.
- It happened in Chicago, not Miami.
- It involved a significant stabilization of the cervical area.
Life in Miami without Mattison
The Dolphins were kind of banking on Mattison to be the "thumper." You've got De'Von Achane, who is basically a human lightning bolt, but you need someone to run between the tackles when it’s 3rd and 2. When Mattison went to Injured Reserve (IR), it forced the team’s hand.
Suddenly, rookie Ollie Gordon II and Jaylen Wright were thrown into the deep end. Miami even brought in Jamaal Williams for a look because the depth chart looked paper-thin. It’s funny how one play in the fourth quarter of a meaningless preseason game can rewrite an entire team's offensive strategy for the year.
The contract situation
Mattison had signed a one-year, $1.38 million deal with the Dolphins. In the NFL, "one-year deal" is basically code for "prove it." Having that year stolen by a neck injury is a massive blow to a running back's career earnings. He spent 2025 on the sidelines, watching his teammates while he wore a neck brace and did grueling physical therapy.
📖 Related: LeBron James and Kobe Bryant: What Really Happened Behind the Scenes
What experts say about neck surgery recovery
Recovering from neck surgery as an NFL running back isn't like recovering from a broken arm. You're literally leading with your head and shoulders on every play. It’s about impact.
Medical experts often point to the "Chris Carson" comparison, which is the scary version. Carson had to retire early because of a similar "neck" label. But the word out of the Dolphins' camp—and from Mattison’s own camp—is much more optimistic. They’ve stressed that he has "full strength and motion."
That’s the key.
If he can keep his range of motion, there’s no reason he can’t be the same 220-pound back who averaged 3.9 yards per carry over his career. But the mental hurdle? That’s different. Getting hit for the first time after someone has operated on your spine takes a special kind of toughness.
Is 2026 the comeback year?
So, where does that leave us now? As we head into the 2026 off-season, Mattison is a free agent again. His contract with Miami expired while he was on IR.
👉 See also: Lawrence County High School Football: Why Friday Nights in Louisa Still Hit Different
The market for a 27-year-old running back coming off major neck surgery is... complicated. Some teams will see him as a low-risk, high-reward veteran. Others won't even give him a physical.
He’s been posting workout videos that look promising. The explosion seems to be back. The "thump" is still there. But until he’s in a jersey taking a hit from a 300-pound defensive tackle, the questions about the Alexander Mattison neck injury will linger.
Moving forward: What to watch for
If you’re a fan or a fantasy manager looking at 2026, don't write him off just yet. Modern medicine is wild. We've seen guys come back from things that used to be career-enders.
Keep an eye on these specific milestones:
- March Free Agency: Does a team sign him to a deal with significant guaranteed money? That tells you what their doctors saw in the medical records.
- OTA Participation: Is he wearing the "no-contact" red jersey, or is he mixing it up?
- The "Leverage" Test: In preseason games, watch how he finishes runs. If he’s ducking his head or playing timid, the injury is still winning.
The road back for Mattison is long, but he’s already beaten the odds by getting back to "full strength." Now, he just has to prove he can still be the hammer in a league full of nails.
Actionable Insights for Following the Recovery:
- Monitor the "Medical Clearance" reports: NFL insiders usually leak when a player has been "fully cleared for all football activities." This is the first major green light.
- Check the landing spots: Look for teams with a high-volume "lightning" back (like Miami had with Achane) that need a "thunder" counterpart. Mattison fits best in a committee where he isn't asked to carry the ball 25 times.
- Follow the beat writers: Local reporters in training camp see every rep. They’ll be the first to note if Mattison is losing his footing or looks hesitant during contact drills.