QBs not the same after injury, surgery

ATLANTA -- He is roughly 1,000 miles removed from Chad Pennington, and his only familiarity with the ailing passer comes from a big-screen television, but former Green Bay Packers quarterback Don Majkowski can certainly commiserate with the famously sore-shouldered New York Jets star.

"Last year, just watching him try to play through [a rotator cuff injury], yeah, I could feel his pain," said Majkowski, who's now nine years into retirement, a decade and a half after rotator cuff surgery sent his promising NFL career into a downward spiral. "A second tear, though, if that's what he's got, man, I couldn't even imagine it. I can relate to why he's doing everything he can to avoid another [surgery]. Living with the pain is pretty much unbearable. Surviving through the [rehabilitation] is almost as bad."

There are no current players, former players or orthopedic surgeons -- at least among the dozen or so people interviewed by ESPN.com this week -- who could readily identify a quarterback who has even undergone two rotator cuff procedures, let alone come back from them. There is, as ESPN colleague Chris Mortensen noted in one of several reports this week on Pennington's situation, no celebrated case studies relating to multiple rotator surgeries on NFL quarterbacks. Pennington, if he requires surgery this time around -- a second invasive procedure on his shoulder in less than a year -- could become the stuff of medical and orthopedic journals.

It will, however, be a painful journal entry.

On the other hand, there is a painfully lengthy litany of professional and college-level quarterbacks whose football careers were either ended by rotator cuff surgery, or whose performance diminished dramatically following the procedure.

Majkowski, who led the Packers to a 10-6 record in 1989 with all manner of legendary derring-do and was second in the NFL MVP balloting that year before suffering a rotator cuff injury the following season, is one of them. Others include Hall of Fame quarterback Bob Griese, Jim McMahon, Gary Danielson, Greg Cook, Jim Miller and Tim Couch. And that's just scratching the surface of the quarterbacks who discovered rotator cuff injures to be the bane of their professional existence.

Said Danielson, now a college football analyst, in describing the injury: "A rotator cuff [injury], to a throwing athlete, is like cancer."

There might be a bit of hyperbole there, but for athletes who earn a paycheck throwing a ball from an over-the-head motion, rotator cuff damage is probably viewed as being just as insidious as a tumor.

Certainly the pain, as described by several quarterbacks who spoke with ESPN.com, is incredibly debilitating.

Earlier this summer, Couch, the former Cleveland Browns starter and the first overall pick in the '99 draft, detailed how the pain in his right shoulder was so bad last summer when he was in training camp with the Packers, that he didn't have sufficient strength at one point to even toss the bed sheets off himself on a warm night in the dormitory. A friend of Couch recalled getting a phone call from the quarterback, who needed assistance because his right arm was shaking so violently that he couldn't grip the steering wheel of his truck. Majkowski said that his shoulder was so bad he couldn't change the channels on his car radio. Miller said stories about people with rotator cuff injuries (some say they couldn't even lift their arms high enough to comb their hair) are "more truth than fiction, believe me."

Currently a free agent, but healthy again after having been released this spring by the New York Giants because of surgery to repair a labrum in his hip, Miller basically played the entire 2002 season for the Chicago Bears with a torn rotator cuff. It was one year after Miller piloted Chicago to a 13-3 mark, its first division championship since 1990, earning himself a handsome contract extension. It was also, Miller recalled, easily the worst season of his itinerant career.

"It was the most miserable time of my life and there's really no other word to describe it," Miller said. "Unless you've been there, it's hard to explain, really. But you keep telling yourself: 'I owe it to the team. They're paying me to go out and play. I've got to go out there and try it.' And all you really do is make it worse, to be honest. Worse for yourself. Worse for the team. Worse for everybody. There's just no relief from it."

Miller underwent rotator cuff surgery following the 2002 season, and then admittedly hurried back far too soon. It has taken three subsequent shoulder operations (none of them to the rotator cuff), and pink slips from three different franchises, but he is finally pain free. In fact, some team with a need for a veteran backup could do worse than to audition Miller. He is healthier than at any point in the past three years, feeling pretty spry and anxious to resume his career, even if it means the No. 3 spot on a depth chart. Most important, he's able to gun the football 65 yards again without fear of his arm falling off.

The message that Miller, Majkowski, Danielson, Couch and Buffalo Bills backup Kelly Holcomb would have for Pennington, if they were asked to counsel him: Take your time in recovering and don't try to play again until 100 percent rehabilitated. No matter how long and frustrating a process that entails.

"Those are small, tedious muscles and they take a long time to heal," Miller said. "I mean, I'm no doctor, but I think I know a little bit about shoulders now, right? Smaller muscle groups, while it might sound [wrong], take more time. That's just how it is. My guess is that, if [Pennington] needs another surgery, he's not going to start feeling well again until sometime around the first month or so of next season. This is a year-long rehab, and I'm not saying he rushed back, because that's not my call. But my bet would be he doesn't get back on the field until about the sixth game next year."

Majkowski, the beloved "Majik Man," whose trademark blond locks and late-game heroics made him the stuff of lore for a few seasons in Green Bay until some kid named Favre came along, actually played six seasons in the league following his rotator cuff repair. But he lost his job to Brett Favre in '92 and then, after two seasons each in Indianapolis and Detroit, retired following the 1996 campaign.

Now 41 years old, Majkowski is a partner in a suburban Atlanta real estate investment firm. He is moving into the media end of things, with a growing network of Wisconsin radio stations for which he provides NFL analysis and commentary, and he has his own Web site, Majiknetwork.net, which is flourishing.

But these days, his primary athletic endeavor is playing in the ultra-competitive ALTA tennis league that is so pervasive in the Atlanta area. He is also the quarterback of a flag football team, and his stiffest competition at the position is Atlanta Braves pitcher John Smoltz. He can still throw a football better than the former Cy Young winner and ace of the Braves staff. There are times, though, when he hits a backhand on something other than the sweet spot of his racket, when he recalls all the pain he endured with his damaged rotator cuff.

"It's by far the most grueling, torturous thing I've ever been through," Majkowski said. "I mean, it's excruciating. People don't understand, maybe, unless they've had it. But the shoulder is the biggest range-of-motion part of anyone's body. Bigger than the knee even. Just to get back that range of motion -- to get it to the point where you can just function, and I'm not even talking about the football part, but more like everyday stuff -- takes an enormous amount of work and pain."

The sobering truth is, some guys never get the football part back, and end up out of the game prematurely. Cook, who led the NFL in passer efficiency rating as a rookie in 1969 with the Cincinnati Bengals, was a brilliant touch passer. His future was bright but his career brief, a rotator cuff injury ending his tenure after he threw just three more passes in five years. Couch is seven months removed from surgery that included rotator cuff repair. Despite some interest from teams, he isn't quite ready to fully cut loose yet. Danielson went from player in ascent to backup after a rotator cuff injury in 1986. McMahon, who led the colorful Bears team to a Super Bowl XX title, won just one playoff game after enduring rotator cuff problems.

"So you really don't know what's going to happen [to Pennington]," Danielson said. "No matter how hard he works to come back, there aren't any guarantees."

At the outset of his rehabilitation, Majkowski could throw only a Nerf ball, and not even all the way across a living room, and he struggled to lift a one-pound dumbbell. Weeks into his rehabilitation regimen, he developed soreness in the posterior portion of his shoulder. Months into the grueling program, even after regaining some strength, it was obvious that Majkowski had lost the quick release that was a huge element of his throwing motion.

Trying to compensate mechanically, Majkowski altered his motion and release point, and that led to a build-up of scar tissue and eventually elbow tendinitis. He never did recover his previous throwing motion or arm strength. And he questions whether Pennington will really be able to come back all the way from severe shoulder problems in consecutive seasons.

Like Miller, the candid Majkowski wonders whether Pennington pushed things this spring and summer and got back on the football field too soon. No one who spoke with ESPN.com questioned the wisdom of the Jets or their handling of Pennington and his rehabilitation. The consensus, particularly from those who know a little about the Jets quarterback and his competitive nature, figure Pennington pushed himself. He is, after all, a player who noted last week that the team "would have to cut off [his] arm to keep him from playing this week." That was, course, before he knew the extent of the latest injury.

One quarterback who underwent rotator cuff surgery several years ago, but who asked not to be identified for this story, noted the Pennington comment of last week. Reacting to it, he said: "You know what? If someone told me I had to go through [rotator cuff] surgery again, and all the [stuff] it takes to come back from it, hell, I might have to tell them to amputate, too."

There is, Majkowski and Miller concurred, no shortcut that Pennington can take now as he embarks on a second rehabilitation in nine months. Miller, who recently had a plumber install an industrial grade ice machine in his basement, said that Pennington will have to ice his shoulder every day for the rest of his career, and perhaps beyond. And Majkowski noted that Pennington, no matter what transpires as far as surgery in the coming weeks, had better get accustomed to a chilling reality.

"Even if he sits out and doesn't play until next year, no matter how diligent Pennington is with the rehabilitation, a rotator cuff is like a lifetime thing," Majkowski said. "That's just how it is. I mean, for a guy who makes a living throwing a ball, it's an absolute nightmare."

Len Pasquarelli is a senior NFL writer for ESPN.com. To check out Len's chat archive, click hereInsider.