PITTSBURGH (KDKA) – When a local doctor saw a replay of Pittsburgh Steelers quarterback Ben Roethlisberger’s elbow injury, he immediately knew it would be serious.

As someone who treats elbow injuries daily, it wasn’t hard for Dr. Gerson Florez at St. Clair Hospital to realize Roethlisberger suffered a serious injury after he saw the Steelers quarterback holding and shaking his elbow in Sunday’s game against the Seattle Seahawks.

The question is: which side of the elbow? Was it on the outside or on the inside?

According to reports, Roethlisberger complained about elbow inflammation after the season-opener against New England and during the week leading up to the Seattle game.

So far, the Steelers haven’t stated which side was injured.

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Dr. Florez says it could be on the outside.

“For the throwing athlete, like a quarterback or pitcher, the ulnar collateral ligament is actually vital to keep the elbow in the appropriate position when they’re cocking back and getting ready to release and throw,” he says.

“So that’s the concern, obviously, that everyone in the sports field right now has.”

He says bone to bone heals faster than ligament to bone, and that’s why surgery is required.

While he admits age is a factor, surgery is usually successful due to advances that allow for faster healing.

“Now we’re pushing those limits a little bit more, where you’re starting to see the throwing phase of therapy occur between the six and 12-week mark and the full return placed somewhere between the six and nine-month mark,” he says.

NFL Network’s Ian Rapoport tweeted more about Roethlisberger’s injury, saying the type of procedure Roethlisberger will be having won’t be Tommy John surgery.

Roethlisberger issued a statement on the injury Monday afternoon, calling the season-ending surgery “shocking and heartbreaking.”

He expressed that he understands the surgery is needed to play at the level he expects from himself.

He said in part:

“The Steelers committed three years to me this offseason and I fully intend to honor my contract and reward them with championship level play. I will do all I can to support Mason and the team this season to help win games. I love this game, my teammates, the Steelers organization and fans, and I feel in my heart I have a lot left to give.”