There is a lot of information floating around in regards to Ben Roethlisberger and his injured shoulder. Sprained AC joint, torn ligaments and a lot of pain. The Pittsburgh Steelers will have some tough decisions to make, but I tracked down some real doctors to see exactly what Roethlisberger is facing when it comes to the injury itself, as well as what he might have to do to rehab the injury in time to play Sunday vs. the Denver Broncos.
David A. Wang, MD, a primary care sports medicine physician at Hospital for Special Surgery, the official hospital and team physicians for professional sports teams including the New York Giants, answered some questions I had about the injury and what it means for the team this weekend. Take a look at the interview:
Ben Roethlisberger reportedly has a sprained AC Joint, or a slight separation. In just a week's time, how much healing can actually be done to improve the performance at a position like QB?
A sprained AC joint, or "shoulder separation" can be graded from 1-6 depending on the severity of the injury. This ranges from a stretching of the ligaments at the AC joint to complete tears leading to damage of the surrounding shoulder structures. Depending on the grade of the injury (and as I am not treating the athlete, I am not aware of the extent of his injury), if there has been a high degree of ligament damage, the actual healing of the ligament will take much longer to heal. However, in a week's time, treatment can be done to address the acute inflammation, pain, and swelling that develop from the injury, which can allow better performance.
If Roethlisberger is able to play Sunday in Denver, will it simply be a pain tolerance issue, or is there are severe risk of further injury if he is hit again?
It depends on the severity of the injury. If there is a very low, grade one separation, pain control is a major determining factor for performance ability. Unfortunately, the risk of re-injury can never be eliminated, but this is less of a concern with a grade one injury. However, if there is a higher grade injury with a more significant amount of damage to the ligaments, this can increase the risk of re-injury until the ligaments have healed. In general, athletes with AC separations are cleared to return to play if they are pain free and have full range of motion and normal strength, which can vary from a period of a few days to a few months depending on the grade of injury.
When rehabilitating such an injury, is it smart to simply stop using it, or should there be exercises/light throwing done to help strengthen the joint?
When rehabbing from an AC separation, exercise is an important component of recovery. Range of motion exercises are generally started early in the recovery as soon as they can be tolerated, and this is followed by strengthening exercises. Once range of motion and strength has improved, sport specific activities can begin. Rest is generally only necessary initially during the acute phase of injury and this can vary from a few days to a few weeks depending on the degree of injury.
Roethlisberger has proven his toughness on more than one occasion, but would it be wise for him to sit out the game to avoid further damage to his throwing shoulder?
It is hard to say not knowing all of the details of his case as I have not treated the athlete. In general, as long as pain is controlled and there is full range of motion and strength in the shoulder, an athlete can play after an AC separation injury.
A big thanks to Dr. Wang from Hospital for Special Surgery, the nationally ranked #1 in orthopedics by U.S. News & World Report (2015-2016) and world leader in sports medicine performance and rehabilitation, who took the time to answer my questions.