 Welcome to our Western and Southern PFF studios, where it's time now for our weekly injury update with Dr. Stephen Pomerance of MRI Online and Dr. Pomerance. The names who were injured in week two of NFL action, they don't get any bigger than this, two Hall of Fame quarterbacks, Ben Rottlesberger and of course Drew Brees. But let's start with Big Ben up in Pittsburgh because all we had is that video of him holding the right elbow and then we're told that he needed season ending surgery. He's done for 2019. What could this injury possibly be? Well, just looking at the video, Sally, it's impossible to know what structure was injured, but the fact that they operated on him so quickly suggests that it is the thrower's injury known as a medial collateral ligament injury of the elbow. Now for the audience out there, most of you are familiar with this in baseball pitchers. They don't quite have the same motion as football quarterbacks. They turn the hand and the wrist a little more, but this was made famous by the surgery known as Tommy John surgery, which was developed out of the West Coast, I believe by the former eminent orthopedic surgeon who's now the C. Frank Job, a luminary in the field. And that surgery has not only been successful, occasionally you see baseball pitchers come back and they throw the ball even faster than they did before the surgery. So what they'll do is they'll take a ligament from somewhere else, a little bigger, a little stronger, a little fatter, and they'll put it in the bones on either side of that joint. So the opportunity for a full recovery in a pitcher is 100% in many cases if it comes out well and the patient does their rehabilitation. The opportunity for a full recovery similarly is very high in a quarterback who doesn't put quite the same amount of strain that even a baseball pitcher does. So if that is the injury, I'm very optimistic that Ben Roffelsberger will be his own self. He could even throw the ball harder. On the other hand, he has one thing working against him and that is father time. How fast do you heal from this? Occasionally you'll see people that do not come back the following season if they've had this Tommy John or Tommy John type of surgery. It's a little more fancy now, but sometimes it can take a year and a half for this thing to heal and allow them to throw with a full force. And I anticipate that if he desires to come back, that he will be able to do so and function at the prior level that he was functioning at. Yeah, if given the proper amount of time to heal, I've been told by baseball players that some of the things that you want is that Tommy John surgery because most of them do come back with their arm much stronger. Let's talk about the ageless Drew Brees with the New Orleans Saints, 19 seasons in the National Football League. He's already 40 years old. He has a thumb injury. We're not told exactly what it is, but we're also told that he's expected to be out four to six weeks, had a difficult time just trying to grip the football, Dr. Pomerance. Well, unfortunately, I've seen many of these injuries and that specific mechanism where the arm is coming and falling through over the head. And I've seen it a number of times where the helmet of another player hits the thumb. In this case, it looked like the hand of another player. And most importantly, it's on his throwing hand. I've witnessed several athletes that have had this on the throwing hand, but on the non-throwing hand, on the non-throwing hand, they can usually continue through the full season and just take the hand off in the opposite direction. They'll have to give the ball off in the opposite direction to the running back. So they can function with it on the non-throwing hand. On the throwing hand, it's impossible. You cannot grip the ball. So what is injured? There's a little ligament on the inside of your thumb called the ulnar collateral ligament. Some of your audience out there who's a little bit more medically oriented know it as skier's thumb. Occasionally it's given the name gamekeeper's thumb. It'll stick with skier's thumb since we're talking sports. So it's a similar type of ligament to the one that I described in the elbow. And I'm positing that this is the ligament that's injured. They'll often repair that ligament, or if it's really shredded, they'll take a ligament from somewhere else, like in the hand. You have a few extra ligaments to donate in your hand, and they'll take that ligament and they'll just dock it right in there and replace it. And the thumb will be as good as new. Now, it was reported that he would be back in six weeks. I don't know what kind of surgery he has had. That would be very surprising to me, Sully, if after a procedure and repair of a UCL, that he would have the ability and power to grip the ball and be the old Drew Brees in a six week timeframe. So that timeframe could be a lot longer. Of course, I know about that skier's thumb, and we can tell everyone that if you're skiing and you have that pole in your hand, you go to open that hand when you're falling, get rid of the pole first before trying to protect yourself from falling. Dr. Pomeranz, great information. We wanna thank you for taking the time to help us to understand what's going on with these two potential Hall of Fame quarterbacks, and we'll see you again next week.