ProFootballDoc: Justin Herbert May Be “OK”But Rib Cartilage Injuries Linger

Everyone saw how much pain Justin Herbert was in. So much so, that he turned down a chance to walk to a first down on a key third and one. His head coach said he was “OK”, but there was no media availability for the tough as nails quarterback.

By video, Herbert appears to have a rib cartilage injury and those tend to linger longer than even a rib fracture.

X-rays were taken post game but there was no report of findings. But expect it to be negative, as rib cartilage injuries do not show up on that. OutKicks’ own Armando Seguro reported that an MRI is pending.

One can see where he was hurting, and it is in the lower rib cartilage area.

Signs are Good for Justin Hebert

This is good news as no fracture and little risk of a punctured lung as evidenced by his flying back to Los Angeles with the team. Based on two decades of NFL team physician experience, I doubt spleen or internal organ damage.

Rib cartilage takes longer to heal due to poor blood supply. It is very painful because of the attached intercostal, oblique and abdominal muscle. One has to twist the torso to throw and that can be quite painful.

Rib fractures are most painful in the first 2-4 weeks. Cartilage injuries can linger longer for 4-6 weeks or more.

I am not suggesting that Herbert will miss games. I am stating that it will effect his practice time. Even with 10 days before the next game, this will be a pain management issue in practice.

Based on his toughness, one does not expect Herbert to miss game time. Of course he can have a rib intercostal block injection to numb the pain on game day. The question is whether he chooses to have it given the local history.

Rib Block Injections are not perfect

Ironically, Herbert’s career was jump started early his rookie season by a rib block injection to starter Tyrod Taylor gone awry. There are ways to safely perform this intercostal nerve block. Philip Rivers had multiple occasions to need these for rib fractures in my NFL tenure and it helped him with his record ironman streak.

Indeed, Herbert will be OK, but the rib cartilage injury will be a management issue for the young star and team.

Written by Dr. David Chao

David Chao, MD -- known digitally as Pro Football Doc -- is an expert contributor for Outkick. Chao spent 17 seasons as the team doctor for the San Diego Chargers (1997-2013) and is part of the medical team at OASIS in San Diego where he treats and specializes in orthopedic sports injuries, working with high-profile professional athletes from the NFL, NBA, and MLB.

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