Lance Armstrong will have surgery for a broken collarbone that will interrupt, but not necessarily derail, his preparation for the Tour de France this summer.
Armstrong was with the main pack of riders Monday afternoon, chasing a breakaway on a rough, narrow country road, when he got caught in a pileup near the end of Stage 1 of the Vuelta a Castilla y Leon, a minor five-day stage race in the countryside north of Madrid.
He landed heavily and sat cradling his right arm until an ambulance arrived to transport him to a local hospital. X-rays revealed a fractured middle third right collarbone, and Armstrong also suffered bruising on his hip and arm.
"Surgery in a couple of days," Armstrong wrote Monday in a Twitter update. "Thanks for all the well wishes."
Armstrong remained with the team on Monday night in Spain and planned to fly back to the United States on Tuesday.
Armstrong's spokesman, Mark Higgins, told ESPN.com the surgery would "most likely" take place in Austin, Texas, where Armstrong has lived for many years.
The 37-year-old Armstrong, who was pushing hard to regain a fitness level that would enable him to compete for the podium in both July's Tour de France and the Giro d'Italia in May, told reporters in Spain he was "miserable" as he left the hospital.
"It has never happened before, I'm very disappointed," he said, adding that his plans to start in Italy on May 9 had just become "very complicated."
Armstrong said it was too soon to tell how the injury could affect his plans to ride in the Giro.
"In 17 years as a pro, I have been lucky to avoid one of the most common cycling injuries," Armstrong said in an e-mailed statement. "The crash has put my upcoming calendar in jeopardy but the most important thing for me right now is to get back home and rest up and begin my rehab."
USA Cycling physician Eric Heiden, the quintuple speedskating Olympic gold medalist who is now an orthopedic surgeon in Salt Lake City, said modern treatment of broken collarbones has reduced average healing time from six weeks to four. Armstrong's particular kind of fracture is the most common, and the easiest to fix, he said.
Broken collarbones can mend on their own without surgical intervention, but Heiden, who also competed in elite cycling and started the 1986 Tour de France, said the current "treatment of choice" for cyclists with the injury is to insert a titanium plate that is 3/4 inch wide, 1/8 inch thick and can range from 2 1/2 to 6 inches long to "bridge" the fracture, held in place with screws.
The plate is specially molded to fit the collarbone, which has a unique curve, Heiden said. It's an outpatient procedure, and the plate generally is left in place rather than removed after healing.
"Then, it's just a matter of treating the soreness," he said.
With the plate stabilizing the fracture, riders can generally start training on a stationary bike in a week, Heiden said. He did not think Armstrong's age would be a factor in healing. The bigger issue is the detour from his racing program.
"In six weeks, there shouldn't be any residual problems from the collarbone," Heiden said. "It's just a matter of fitness. He's lacking race fitness. He'll probably have to change his calendar and his expectations. But Lance has surprised a lot of people."
Veteran U.S. rider and Astana teammate Levi Leipheimer said the news could have been worse.
"It's a bummer, certainly, but I don't think it's going to change his plans that much," said Leipheimer, who was riding ahead of the crash and was not involved in it. "If it's a clean break, it could be a matter of days, not weeks, before he's back on the bike training."
Leipheimer said the mishap was not surprising given the conditions.
"We were starting to race more intensely, and the road narrowed," said Leipheimer, who won the Tour of California last month for the third straight time. "There were 150 riders trying to be in a space where only 10 could go.
"The road was really rough, more so than normal. There were no lines. It hadn't been paved in a long time, and there was a lot of gravel as well."
Armstrong said the crash was a blur.
"At the end of the race, people started to get a bit excited to win the race,'' Armstrong said in the statement. "Everybody wanted to be in the front and couple of guys crashed in front of me, crossed the wheels and I hit them over the top. It happens quick when it happens. It could have been worse, I suppose.
"I have road rash abrasions on right hip and arm but the big problem is the broken collarbone," he added. "I never had this before. It is pretty painful. Now we have to see how it heals."
Bobby Julich, the recently retired American standout who rode with Armstrong on the Motorola teams of the mid-90s, was watching the race live on television from his home in Nice, France. He said he feared there might be a pileup when he saw the peloton bottle-necking on the course. He said it appeared that Armstrong was squeezed toward the back, where accidents are more likely to happen as riders jostle for position.
"That road looked like Paris-Roubaix -- potholes everywhere," Julich said. "I knew as soon as I saw him on the ground that his collarbone was broken."
Spanish television footage shot immediately after the crash showed Armstrong sitting in the grass on the cyclists' right side of the road, head down, wiping his eyes, supporting his right arm on his right leg and in obvious pain.
The Castilla y Leon race in northern Spain was small but much anticipated because it was to be the first time Armstrong and his younger, much-decorated Astana teammate Alberto Contador would be racing together.
Armstrong announced last fall he would come out of retirement three years after winning his record-setting seventh Tour de France victory. He joined the Astana team run by his longtime director Johan Bruyneel and led by the 26-year-old Contador, hands down the best stage racer to emerge in the post-Armstrong era.
Armstrong originally was supposed to spend this week training for a two-day classic race, the Criterium International, in France this weekend. In an interview with ESPN.com last week, he said he changed his plans in order to put more mileage into his legs and to defuse some of what he termed "tension and drama" building between himself and Contador, who are contending for the position of team leader at the Tour.
Contador won the 2007 Tour de France and added Giro d'Italia and Tour of Spain titles last year, thus capturing all three of cycling's crown jewels -- the three-week "Grand Tours" -- in a 14-month span.
Armstrong had planned to compete in perhaps one more race before the Giro. He committed to ride in the 100th edition of the Giro last October, well before he decided to ride the Tour. He initially said it might be his major goal for the season, but has backed off that assertion in recent weeks and made the Tour his priority.
He told reporters from the French sports daily newspaper L'Equipe last week that he intended to peak this season on July 4, the day the Tour de France starts in Monaco. Cycling's biggest race still means the most to him, and is the biggest platform for his global cancer awareness campaign -- although Italy is one of three countries (along with Mexico and South Africa) targeted by his eponymous foundation for special grassroots activities and high-level meetings with policy makers.
In an interview with ESPN.com last Thursday, Armstrong conceded he may have overestimated where he would be, conditioning-wise, at this point in the season, and added he was facing up to the athletic reality presented by back-to-back Grand Tours.
"Not to mention that the month in between is not going to be a cakewalk," he said, referring to the child expected by his girlfriend, Anna Hanson, in early June.
"Since [the Tour of] California, I've dropped a few pounds," he said. "I think we're getting to the magic intersection of power and weight. I think it's fair to say you can win the Giro with lower watts [power output] per kilo than the Tour. Will we be there May the ninth? We'll be close.
"The Tour field is deeper, faster and stronger. Everyone in cycling would agree: A guy wins the Giro, let's say he can replicate that form in France, that doesn't get him the yellow jersey."
Armstrong told ESPN.com last week that he would shoot for a top-10 finish at the Giro, with the podium a distinct possibility. Now it seems more likely that he would ride the Giro as a training race -- or possibly substitute other, shorter tuneup races later in the season. In his prime, he regularly rode in the Dauphine Libere race in the Alps in early June.
Julich said Armstrong obviously needs to race as much as possible to try to maintain the fitness base he has built up since coming out of retirement.
"I would have to doubt he would be able to start the Giro with the kinds of sensations he had hoped for, but maybe he'll use it to build up for the Tour now," Julich said. "This is Lance we're talking about. Anything is possible."
For Julich, as for many who have followed Armstrong's career through its various turns, the sight of the Texan helpless on the ground seemed incongruous. Armstrong's seven-year reign as Tour de France champion was remarkably untouched by major injury.
Luck played into the streak, but Armstrong, who continued to compete in the rugged sport of cyclocross in his spare time even at the height of his career, is also one of the best bike-handlers in the peloton. He often managed to escape unscathed in situations that would have undone other riders.
Perhaps the most famous example came in the Alps during the 2003 Tour, when he deftly steered through a hayfield to avoid Spanish rider Joseba Beloki, who was fishtailing ahead of him on a patch of melting road tar on a twisting descent.
Beloki's subsequent crash ruined his career; Armstrong's joyride through the field, in which he cut off a switchback, portaged his bike over a ditch and rejoined the race in progress less than a minute later -- simply added to his aura.
Bonnie D. Ford covers tennis and Olympic sports for ESPN.com. She can be reached at firstname.lastname@example.org.