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at23steelers


Joined: 05 Mar 2011
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PostPosted: Thu Nov 15, 2012 11:54 am    Post subject: Reply with quote

If Mike Adams and Starks can somehow contain their pass rush, Leftwich will do great, but he needs time with his long delivery. His success is solely dependent on our pass-blocking and success of our running game.
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PacAttack04


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PostPosted: Thu Nov 15, 2012 4:14 pm    Post subject: Reply with quote

So let me ask, just from reading that part about the aorta, how much would this affect his overall playing career? Like, do you guys think he might have to retire earlier than would be expected, or do you think that he intentionally hangs it up if he fears this type of injury harming him in a more significant way? Is there any permanent damage?

With the way NFL teams hide information, the fact that this is called a "rare" injury makes me more cautious. The same type of news came out about Nick Collins and we didn't hear anything significant until the Packers actually released him, which clearly signaled the end of his career as no one else has signed him either.
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jebrick


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PostPosted: Thu Nov 15, 2012 4:27 pm    Post subject: Reply with quote

My understanding is that it just takes time for the ligaments to tighten back up and the rib to set in place. It could take a while because he moves and that moves the rib.
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SouthwestSteel


Joined: 08 Jan 2008
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PostPosted: Thu Nov 15, 2012 7:16 pm    Post subject: Reply with quote

I look forward to Treat's comments on this question with all his background and experience in the field.

What I can say from my more limited background is one way to look at Ben's rib injury is to consider the end of the rib as one side of a joint, and the sternum as the other end of the joint. If the ligaments holding the joint together are not too damaged, then in time the joint will regain a substantial amount of its structural integrity. Keep in mind that ligaments have a very limited blood supply and can heal very slowly.

But with any joint, if the ligaments are severely stretched and/or completely torn, then you have a problem. It is not that rare to meet individuals who have a joint where the ligaments were so severely stretched that the joint now has lost much of its stability, kind of like a rubber band that went past the point of no return. Perhaps some of us on this board have ligaments that were severely stretched, and joints that are now hyper-mobile and weak.

The details with Ben are sketchy regarding how much damage there is. I have not heard if it is a severe stretch and partial tearing of ligaments, like a second degree sprain, or a third degree, which is a completely torn ligament and usually requires surgery. I am guessing and hoping it is similar to a second degree sprain from the info available so far.


But it concerned me that he mentioned that when he was moving his arm the rib would sometimes pop out of place with much pain! At the least this sounds like a severe stretch, and it does make me wonder if the rib joint can heal fully with no surgical intervention, and as I understand it surgery is rarely performed with these rib injuries, kind of a rare specialty.


Last edited by SouthwestSteel on Thu Nov 15, 2012 8:23 pm; edited 1 time in total
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treat88


Joined: 03 Mar 2006
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PostPosted: Thu Nov 15, 2012 7:59 pm    Post subject: Reply with quote

I think you've got a good handle on it SWS.

The clavicle and the first rib attach closely to the superior portion of the sternum and are held in place by a very strong, fibrous series of ligaments which essentially form one common ligament. Individually they are the sternocostal and sternocalvicular ligaments, but anatomically connective tissue allows them to function in unison to stabilize the area of attachment.

From what I can gather, that ligament sounds like it was severely disrupted. It's shades of grey whether you want to classify it as 2nd/3rd degree. Regardless, some or most of the fibers that comprise that ligament have been torn, damaged, or stretched or some combination thereof to the point they no longer securely hold the clavicle/rib in place.

If the clavicle and rib are reduced (put into their normal anatomical position) and immobilized scar tissue will form in the damaged areas of the ligament and will eventually stabilize the joint so abnormal motion (rib popping out of position) no longer happens. Theoretically, the scar tissue is more dense and fibrous than the original ligamentous tissue and the joint will be held even more strongly in place than it originally was.

If the joint is not immobilized and abnormal motion occurs repetitively than the tissue that forms will be more elastic and allow continued abnormal movement of the rib/clavicle which in this case is apparently enough to threaten the vascular structures posterior to the sternum.

Surgery would be hugely unlikely as the joint is typically easily reduced by manual methods...so...Ben has to keep the shoulder and arm immobile for 4-6 weeks to allow the ligament to heal and then begin a strengthening/range of motion program to regain arm/shoulder movement while ensuring that no undue stress is put on the healing ligament. Once he has demonstrated that he can perform vigorous exercise and the joint remains stable, he can begin football activities.

Given the recent case study of Danny Amendola, I believe Ben could be cleared for contact at the 4 week point. His case sounds unique in that the entire breadth of the costal and clavicular fibers were damaged, so that may be optimistic, but it is Ben we are talking about. The question is how the joint responds to the stresses of throwing the football...which will depend on how strictly the arm is immobilized and how disrupted the ligament was initially, which we don't know.

I guess, I would adjust my expectations and err conservatively to plan on being without Ben for the remainder of the season based on what I have heard to date.
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lionslicer


Joined: 06 Nov 2010
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PostPosted: Fri Nov 16, 2012 2:45 am    Post subject: Reply with quote

PacAttack04 wrote:
So let me ask, just from reading that part about the aorta, how much would this affect his overall playing career? Like, do you guys think he might have to retire earlier than would be expected, or do you think that he intentionally hangs it up if he fears this type of injury harming him in a more significant way? Is there any permanent damage?

With the way NFL teams hide information, the fact that this is called a "rare" injury makes me more cautious. The same type of news came out about Nick Collins and we didn't hear anything significant until the Packers actually released him, which clearly signaled the end of his career as no one else has signed him either.


No, where the rib is dislocated, there is no permanent damage, it's just the rib that is dislocated happens to be on the top row of the rib cage and close to his aorta. Once it heals, he'll be fine.

As for the SC sprain, I don't know how serious it is, but from what I can gather, he will most likely heal fine, but there is a small chance he might have to get surgery to relocate the SC joint and repair damaged ligaments, which could in fact negatively effect his playing capability. It's not likely that will happen, but it is possible.
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The Curtain


Joined: 24 Sep 2012
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PostPosted: Fri Nov 16, 2012 9:08 am    Post subject: Reply with quote

Leftwich was slow in every way 5 years ago, let alone now. His throwing is slow, he moves slow, he's slow. It's hard to believe he can play in Haley's system. We're in a situation now where we have to run the ball and play defense, two things we have not been able to do well this year.

We're not beating teams with good QBs when we'll be lucky to put up 6 points half time.

Lets just say, it would be a helluva coaching performance to see this team finish strong and make the post season. We struggle to beat the terrible teams as it is, without Ben it just seems so much more impossible.
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MOSteelers56


Joined: 17 Jan 2008
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PostPosted: Fri Nov 16, 2012 6:51 pm    Post subject: Reply with quote

The Curtain wrote:
Leftwich was slow in every way 5 years ago, let alone now. His throwing is slow, he moves slow, he's slow. It's hard to believe he can play in Haley's system. We're in a situation now where we have to run the ball and play defense, two things we have not been able to do well this year.

We're not beating teams with good QBs when we'll be lucky to put up 6 points half time.

Lets just say, it would be a helluva coaching performance to see this team finish strong and make the post season. We struggle to beat the terrible teams as it is, without Ben it just seems so much more impossible.

We may play down to our opponents but we also play up to them, as well. I think we can keep the game close with our running game and keep Lefty in manageable down and distances.

The game plan will also be set up with Lefty's strengths and weaknesses in mind. I do agree that if we try and play the exact same style, we will lose horribly with Lefty.
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at23steelers


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PostPosted: Sun Nov 18, 2012 1:11 pm    Post subject: Reply with quote

http://espn.go.com/nfl/story/_/id/8648415/ben-roethlisberger-pittsburgh-steelers-likely-3-weeks-source

Not as bad as I expected. 3 weeks isn't too bad. I expect us to go 2-1 with Lefty.
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SouthwestSteel


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PostPosted: Mon Nov 19, 2012 2:32 pm    Post subject: Reply with quote

at23steelers wrote:
http://espn.go.com/nfl/story/_/id/8648415/ben-roethlisberger-pittsburgh-steelers-likely-3-weeks-source

Not as bad as I expected. 3 weeks isn't too bad. I expect us to go 2-1 with Lefty.


I have my doubts.
Quote:

I'm told Ben Roethlisberger still has pain with many simple movements, seven days after he suffered shoulder and first rib injuries in the Monday-nighter against Kansas City, and anyone forecasting a week for him to return is guessing. Roethlisberger has no sense when he'll be able to return. But according to Dr. Clark Fuller, the director of Thoracic Surgery at St. John's Health Center in Santa Monica, Calif., Roethlisberger has to be careful about returning too soon because of damage it can do to nerves in the right shoulder and arm, major blood vessels in the area, and, as Roethlisberger admitted last week, the aorta around the heart.

"This is not about being a tough guy,'' said Fuller, who has neither examined Roethlisberger nor seen his X-rays or scans. So he made it clear he was speaking generally about the dislocation of the first rib, which is connected to the breast bone on one side and the spine on the other. A throwing motion, he said, would not allow the rib to heal, and he would not recommend it any time soon. "Playing football with a dislocated first rib would put you at severe risk. There are many things to be concerned about, including destroying the nerves in the arm.''

Fuller said he thought Roethlisberger would miss a minimum of four weeks. "I do remember their coach, Mike Tomlin, not allowing that safety [Ryan Clark] to play in altitude in Denver because of his sickle-cell disease,'' Fuller said. "That is a good sign, to me. I believe he won't risk the health of Roethlisberger.


Read More: http://sportsillustrated.cnn.com/2012/writers/peter_king/11/19/week-11/index.html#ixzz2Ch8arGDC
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at23steelers


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PostPosted: Mon Nov 19, 2012 2:35 pm    Post subject: Reply with quote

The thing is though, many of our fans on here the first couple games were bashing Lebeau, saying the D is old and slow, and we're gonna pick in the top 15 come draft day. Where is everyone now who proclaimed that? The defense has been strong the last few games, but people will always find ways to doubt our team and never be satisfied. Pretend we have Charlie Batch for the rest of the year, which games would you expect us to lose?
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stefan52268


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PostPosted: Mon Nov 19, 2012 2:57 pm    Post subject: Reply with quote

at23steelers wrote:
The thing is though, many of our fans on here the first couple games were bashing Lebeau, saying the D is old and slow, and we're gonna pick in the top 15 come draft day. Where is everyone now who proclaimed that? The defense has been strong the last few games, but people will always find ways to doubt our team and never be satisfied. Pretend we have Charlie Batch for the rest of the year, which games would you expect us to lose?


Unlike a lot of people on here I'm a believer in Chuck Batch. I would not complain if he took over.

Of our 6 remaining games I could see us winning 3-5 games without Ben. Cleveland is playing decent ball right now but we can sweep them. San Diego is struggling, Cincinnati is do able at home and it depends on what Dallas team shows up. The Baltimore game on the road will be rough as they have a lot to prove.

Our D has to play pretty much like they did last night and create a few turnovers. Our running game stays on point and I can see us going 5-1 the rest of the way out. But in the same breath I could see us going 3-3 as well.

For the record I was not one of the Poster's bashing our D.

Smile
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pghinsomniac


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PostPosted: Wed Nov 21, 2012 11:22 am    Post subject: Reply with quote

'Quarterback Ben Roethlisberger is considered doubtful for Sunday, according to Tomlin. Roethlisberger missed his first game of the season on Sunday night with rib and shoulder injuries. "He had an additional test done today and all things are very positive in terms of where he is," Tomlin said. "We're encouraged about his status." '

from ESPN's AFC North blog.
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SteelProven


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PostPosted: Wed Nov 21, 2012 12:44 pm    Post subject: Reply with quote

It's being reported that Ben showed up today without his arm in a sling which is a good sign.
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pghinsomniac


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PostPosted: Wed Nov 21, 2012 2:29 pm    Post subject: Reply with quote

SteelProven wrote:
It's being reported that Ben showed up today without his arm in a sling which is a good sign.


There's no chance they'd let him do a thing if it endangered his aorta/heart/life...right? Neutral I mean, I'm ecstatic at the thought of him being "doubtful" and slingless at this stage, but the team will suffer unprecedented embarrassment/league discipline if Ben were to seriously (life-threatening/death) endanger himself.
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