Inside the pain and changes Justin Herbert faces playing with cast

This is not the optimal way – Justin Herbert completion Chargers season with a cast on a low-key hand – but it’s not unique either.

Herbert suffered a fracture in his left arm last Sunday when it collided with the helmet of a Las Vegas Raiders defender. The quarterback returned the kick with so little fanfare that television took notice only minutes after he scored a touchdown on the ensuing play.

He had surgery Monday to stabilize the fracture. and, barring any setbacks, was hell-bent on playing Monday night against the Philadelphia Eagles.

It's part of being a quarterback: the expectation of resilience and stoicism, and the confidence to improvise even when the arm is wrapped in a cast or a heavy cast.

“The doctors will tell you one sentence that will determine whether you're going to play: 'You can't hurt him any more,'” said former NFL quarterback Matt Hasselbeck, who played for 18 seasons despite all sorts of injuries. “That doesn't mean you won't be in excruciating pain. You probably will. It means you won't break it down further, and the medicine is still the medicine.”

The problem is not throwing the ball. Herbert is right-handed and does not need his left hand to pass. But it's about taking snaps under center — all of his remaining snaps against the Raiders were shotgun — and passing to his right that he would normally do left-handed.

“Usually you'll see a quarterback with a cast that extends both arms so he doesn't lose his grip,” said Rich Gannon, who had a broken arm while playing for the Oakland Raiders and wore a cast that folded up so he could take the snap. “You can't fool around with passing and change it on the fly. You have to practice it during the week.”

For other injuries, pain-relieving injections can be used to help get the player onto the field. Not so with a lot of hand injuries.

“You can't inject into that area,” Gannon said. “If you numb it, you won't be able to feel or hold the ball. Plus, there are so many ligaments and bones there that if you numb it, you can do even more damage without even knowing it. You just have to bear it, smile and bear it, and let the pain be your guide.”

Moreover, everyone knows about the injury. If it's an NFL quarterback and his arm, it's been a topic of discussion all week – not just among fans, but among opposing teams as well.

“The team you're playing against will say, 'He only has one arm. He can't handle the ball that well. Let's go down there with two strong arms and see if we can get this ball out,” Gannon said. “These guys are not stupid. “I'm not saying they're going to go out of their way to slap him, but if he gets in trouble, they're going to check on it.”

There's an axiom in football: if your quarterback isn't the toughest guy on the team, you're in trouble. The game requires such perseverance.

Hall of Fame quarterback Steve Young puts it a little differently.

“I'm not saying your quarterback is as tough as a defensive lineman,” he said. “But if your quarterback doesn't have that kind of stamina, he slowly starts to destroy the locker room.”

He said a quarterback sets the team's standard and creates a “sacred trust” that he will do whatever it takes to get on the field.

“The second your teammates think you're trying to dodge something, it allows other people to dodge and they feel righteous about it,” he said. “You build that trust so that when you really can't play, you can look them in the eye and say, 'I can't go.' And then they say, “Bro, we got it.”

“You require your linemen to go out every week and go to bat and put their bodies on the line and fight in anonymity. And as a quarterback, you make millions and millions of dollars. But I can tell you, no one is counting their money at the point of impact. … You have to want to meet the guy and feel like there's a purpose greater than yourself. That's what makes great locker rooms.”

When it comes to doing whatever it takes to stay on the field, Steve DeBerg was iconic.

He was playing quarterback for the Kansas City Chiefs in 1990 when, in a December game against the Houston Oilers, he found himself sandwiched between a pair of pass rushers as he released the ball. The two defenders slammed their helmets together, with DeBerg's left little finger caught between them. It was as if his finger had been crushed by bricks.

“The referee comes up to me and says, ‘Steve, Steve, you have to quit the game,’” DeBerg recalls. “I said, ‘No, I got up on time. [after the defenders hit him].' And he said, “You need to look at your left hand.” I looked down and saw that my little finger was turned to the side. Blood flowed from my finger with every heartbeat.”

He went to the locker room, took an x-ray and learned that his finger was broken in nine places. However, he wanted to keep playing, so the coaches put a splint on him that was essentially a Popsicle stick.

He tried to practice snapping on the sideline with center Mike Webster, and it was so painful that he remembers it vividly 35 years later. “It took me about five minutes to come to my senses after that,” he said.

DeBerg finished the game in shotgun. The next day he had surgery: three pins were implanted in his finger. Because of this, he no longer missed time and wore a cast that was cartoonish in size and shape. It was huge and resembled the bottom half of a lobster claw.

That cast member now sits in his home office with an autograph from his best friend and former Chiefs teammate, running back Christian Okoye, who wrote his name and a simple “Thank you.”

– Thank you for what? DeBerg teased him after reading it. “Thank you for missing a block and breaking my finger?”

During his senior year of college, Archie Manning fractured his left forearm, requiring three screws and a plate. He spent nearly a week in the hospital and missed the following week's game before returning to play with the cast now in Ole Miss' display case.

He got used to this cast, although it fixed his arm at a 90-degree angle. He wore it when he rushed for 95 yards and two touchdowns against Auburn in the 1971 Gator Bowl.

“I made one run, crossed the field twice and even made the same guy miss a couple times,” Manning said.

“I bet Justin will be fine. He should get the pass, but it won't affect his passing.”

Herbert isn't the only defenseman dealing with the cast right now. Pittsburgh's Aaron Rodgers suffered three fractures to his left wrist in a game against Cincinnati three weeks ago.

Hasselbeck suffered a similar injury in 2010 when he was a defensive end for the Seattle Seahawks. This happened in the match against Arizona, and his center Chris Spencer broke his thumb in the same game. As a result, the tandem never took a single snap in training until the end of the season.

“I had a cast on my left arm, he had a cast on my right arm,” Hasselbeck said. “We would just pretend to practice and then during the games they would cut the cast off my wrist and put a splint or brace on me.”

Another problem with these types of injuries, Hasselbeck says, is that you can't cushion the impact of a fall.

“Usually when you lay down on the ground, you kind of tense up, bringing your left arm down,” he said. “I saw Aaron Rodgers break his nose this week because when you fall, you basically end up with a belly flop. You can't stop a fall. I ended up getting away with other injuries because I couldn't protect myself when I fell to the ground. That's one of the hidden things you don't know about when you hurt your left arm.”

Hasselbeck had a hero in Sam Ramsden, who was then the Seahawks' head athletic trainer and now the club's vice president of player performance.

Ramsden, who studied under legendary Green Bay Packers coach Pepper Burruss, was something of a mad scientist with the casts and braces he crafted for Hasselbeck on a weekly basis.

“He’s a problem solver,” Hasselbeck said. “He developed the plaster and we tested it and it was phenomenal.”

For Ramsden, it was a new puzzle every week.

“No quarterback in NFL history has ever played 100 percent healthy,” the coach said. “Matt was a lot of fun. He made me a better athletic trainer because he challenged me in so many different ways.”

Depending on the size of the game and the difficulty of the challenge, Burruss named the lineup after a mountain peak and used a marker to label the lineup accordingly. So for a normal game, Burruss might call the cast “Rainier.” The Super Bowl the Seahawks didn't reach that season could have been the Everest.

In the playoff match against New Orleans, Hasselbeck got Kilimanjaro. This classic will forever be known in Seattle as the Beast Quake game, when Seahawks running back Marshawn Lynch broke nine tackles for a 67-yard touchdown. The reaction from Seattle fans was so loud that a nearby seismometer registered a magnitude of 2.0.

One of the behind-the-scenes details about this was that Hasselbeck winced in pain every time he drove a football into Lynch's stomach with his left hand. It was like putting your wounded hand into the mouth of a lion.

“His eyes look at the hole, he takes the ball and just moves towards it,” the defender said. “Your hands are supposed to slip out. Marshawn had some grippy gloves and they stuck to my bandage. That was the most painful thing.”

No complaints. It's all part of the job.

“I look at a guy like Baker Mayfield in Tampa,” Hasselbeck said. “He’s playing with a dislocated AC joint. [in his shoulder]. This means that on game day he will essentially have Novocaine injected into his shoulder and have it absorbed over the course of four hours. He will not feel pain, and after this he will have the most miserable night of his life.

“And that's what the locker room expects. You set the tone.”