Ben Roethlisberger has played through injuries before, but the Pittsburgh Steelers quarterback could find himself sidelined for health reasons for the first time since 2009 at an inopportune time.
In a tight AFC playoff race, the Steelers could also be without linebacker James Harrison when they visit the postseason-bound San Francisco 49ers on Monday night.
Pittsburgh (10-3) has been idle since winning its fourth straight with a 14-3 victory over Cleveland on Dec. 8. The 10-day layoff due to a Thursday night game came at a good time for the Steelers, who hope to get Roethlisberger on the field after he sprained his left ankle against the Browns.
Roethlisberger left in the second quarter but returned in the second half, finishing 16 of 21 for 280 yards, two touchdowns and an interception. Veteran Charlie Batch relieved him and threw two incomplete passes.
Roethlisberger declined to talk to reporters Wednesday before walking out of the team's facility with a noticeable limp. Coach Mike Tomlin said the quarterback would be evaluated throughout the week before a decision is made, but that Roethlisberger wouldn't need to participate in a full practice in order to play.
"He can be ready to play on a limited number of snaps,'' Tomlin said. "We're going to take it day by day. We're always going to be optimistic when it comes to Ben."
Roethlisberger, who played through a broken thumb earlier this season, hasn't missed a start due to injury since a concussion sidelined him against Baltimore in 2009. He sat out the first four games of the 2010 season after violating the NFL's personal conduct policy. The Steelers went 3-1 in his absence with Dennis Dixon and Batch splitting the snaps.
"Those guys, they're not Ben,'' wide receiver Mike Wallace said. "They're great players, but Ben is something really special. So you have to change your game to what they do best."
The situation may be less optimistic for Harrison, who garnered a one-game suspension by the NFL following his helmet-to-facemask hit on Browns quarterback Colt McCoy.
Though Harrison hasn't been fined for a hit in more than a year, he was considered a repeat offender under the 2011 League Policies for Players manual, leading to the suspension.
Harrison filed an appeal, which was expected to be heard later this week.
"We're disappointed for James because we know how hard he's worked to play within the rules," Tomlin said. "We accept the judgment rendered by the league office and we'll move forward."
Harrison has eight sacks despite missing a month with a fractured right orbital bone and dealing with persistent back issues. The Steelers defense has given up 19 total points in the last three games, and Pittsburgh managed to go 4-0 during his earlier absence.
The 49ers (10-3) have clinched the NFC West, but have lost two of three and have some injury concerns of their own as they try to grab a first-round bye for the playoffs.
"You're the hunted now, you're not the hunter as much," coach Jim Harbaugh said. "You have a target on your back. That's raised. Not saying it wasn't like that before, but that expectation, that bar has raised."
After a 26-0 win over St. Louis on Dec. 4, they fell 21-19 at Arizona last Sunday. San Francisco had the ball inside the Cardinals 10-yard three times in the second quarter and came away with only field goals, then proceeded to blow a 12-point lead.
Alex Smith had one of his worst games of the season, completing 18 of 37 passes for 175 yards and no touchdowns.
Red-zone efficiency has been a problem all season for San Francisco, which is converting a league-worst 35.6 percent of its chances into touchdowns and has done so in just three of its last 19 trips.
Running back Frank Gore's struggles down the stretch could be worsening the red-zone difficulties. After averaging 126.8 yards in five straight victories between Oct. 2 and Nov. 6, he hasn't topped 88 yards in the five games since, averaging 54.4. Gore suffered a knee injury in a win over the New York Giants on Nov. 13, and coach Jim Harbaugh says his top rusher is "not 100 percent," without specifying further.
Gore had 72 yards, including a 37-yard touchdown run in the third quarter last Sunday, but had only three carries in the second half.
This is the first meeting between the teams since Pittsburgh's 37-16 home victory in 2007. They last played in San Francisco in 2003, a game won 30-14 by the 49ers.