Miami Dolphins quarterback Tua Tagovailoa sustained a painful-looking chest injury after a sack against the Buffalo Bills yesterday. In a new video on his YouTube channel, sports medicine specialist Dr. Brian Sutterer shares his professional opinion on the footage from the game and a prognosis based on the information available.

“There was really not much, I don’t think, to the hit itself,” he says. “It was really more when Tua was driven into the ground here… The Bills defender didn’t even fall on him, I think it was more just the force that Tua hit the ground with, landing kind of on that left side, a little more on the upper back part of his back.”

While the footage of Tagovailoa clutching the left side of his chest led many to speculate about a fractured rib, that may not have been instantly diagnosable at the game. “Unless it’s a severe, displaced—meaning the bones are out of alignment—rib fracture, you’re probably not going to see anything on the X-ray,” says Sutterer. “You’re going to have to rely on your physical exam.”

Sutterer also explains that a sudden impact to the chest or thorax can result in a whole range of different injuries, like a pneumothorax, or collapsed lung. “Depending on if that rib fracture leads to any trauma in that lining surrounding the lung, you can lose that vacuum space in there, air accumulates, and the lung collapses,” he says. “That’s definitely going to be a no-return-to-play sort of situation.”

Other potential injuries include damage to the spleen, which sits just below where Tagovailoa was hit, as well as the kidneys. “We have to make sure we look beyond just the bone when we chest trauma like this,” says Sutterer.

If Tagovailoa has sustained a rib fracture but no other injuries, then Sutterer speculates that he may be able to return to the field within a matter of weeks, as no surgery is required, and it all depends on how long it takes for the pain to subside. “You don’t need full healing on the fracture, it’s just once they’re no longer having soreness there, they can breathe comfortably without pain, and they can do their football activities, that you let them return,” he says.

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