Babb: Cassel’s pain tolerance will determine whether he plays

[Tribal Warfare]

Cassel’s pain tolerance will determine whether he plays
By KENT BABB
The Kansas City Star

Matt Cassel’s upcoming week, and the short-term outlook of the Chiefs, could rely on something as unpredictable as a sneeze.

Cassel, the Chiefs’ starting quarterback, has an injured rib, and twisting or straining could send a shot of pain through him that could keep him out of this week’s regular-season opener against Buffalo — or perhaps render him ineffective.

A strong laugh could aggravate the injury, received last Friday when Cassel was sacked by Green Bay nose tackle Howard Green. So could a cough or turning over the wrong way in his sleep.

Still, on Monday, Cassel declared that he’d be fine; ready to go in six days to start for the Chiefs.

“I’m ready to roll,” he said.

David Geier is an orthopedic surgeon who has worked with the St. Louis Rams. He said Tuesday that Cassel’s luck, and his ability to tolerate the pain that comes from everyday twitches and movements, will determine whether he’ll actually play and be effective Sunday.

“Different twisting motions are going to pull on those ribs,” Geier said. “It’ll cause pain, and he just won’t be as strong as he normally is until that area has healed a little bit better.”

Chiefs coach Todd Haley wouldn’t discuss Cassel’s injury Monday, leaving a question of whether Cassel suffered a bruise or a fracture. Geier said the injury’s severity would determine whether Cassel is healthy in “a matter of days versus weeks,” speculating that Cassel’s pain threshold would influence whether he starts against the Bills.

“To a certain extent,” Geier said, “this will be his call.”

Cassel has a history of displaying toughness, starting a game at St. Louis last season only 11 days after undergoing an emergency appendectomy. He threw for 184 yards and was sacked three times in that game, which the Chiefs won 27-13, a week before clinching the AFC West championship.

Haley and the team’s medical staff will make the final decision, which might not come until Sunday morning. Geier said the good news is that rib injuries don’t typically require surgery or a cast; mobility and throwing strength would be affected only by the pain caused by the twisting the body does when throwing. He said treatment would be the same for a bruise or a fracture.

Geier said the Chiefs are likely to keep Cassel off-limits from contact this week, and he also could wear a bone-stimulating device or be subject to anti-inflammatory injections to curb the pain. Cassel wore a protective vest during the team’s practice Monday.

Another factor could play into the decision, though. Last year, Philadelphia quarterback Michael Vick missed three weeks after suffering what was described as a rib-cartilage injury. The Eagles turned to backup Kevin Kolb, the team’s former starter, and Kolb averaged 270 yards in three starts. Philadelphia went 2-1 before Vick returned.

The Chiefs don’t have the luxury of a proven backup. Their No. 2 quarterback, Tyler Palko, has never started an NFL game, and he struggled throughout the preseason, throwing two interceptions and fumbling twice. Coaches would have to decide whether a healthy Palko gives the Chiefs a better chance to win than an injured Cassel.

“Even if he’s 70 percent,” Geier said, “is that 70 percent still better than somebody who’s completely healthy but who might not be as good?”

Geier said he expected the Chiefs to evaluate Cassel every day, giving him a light load in practice and in the weight room — and hoping Cassel avoids violent sneezes and other movements that could intensify his pain.

“He can be as tough as he wants,” Geier said, “but if it hurts so bad that he’s not going to get good velocity on his throws, if he’s not able to avoid the pass rush and do what he wants to do on there, he’s not going to be much good.”