team source has told ESPN's Ed Werder that San Francisco 49ers starting quarterback Alex Smith is seeking a second opinion from Dr. James Andrews after preliminary MRI results indicated he appears to have suffered a serious injury to tendons in his right shoulder in Sunday's game.
If the diagnosis performed at Stanford is confirmed by Andrews, the source said that it is expected Smith would opt to have corrective surgery immediately even though he would likely miss the rest of the season.
The 49ers have reported Smith's injury as a grade three shoulder separation that would not require surgery but would sideline him indefinitely.
On Monday, Smith was cautiously optimistic.
"They wouldn't put an exact date on it, but yeah, a few weeks," Smith said when asked to estimate his return. "Having the bye week helps, but I'll just push it as hard as I can and try to get back as soon as possible."
Smith had taken every snap for the 49ers over the past two seasons until Rocky Bernard, the Seahawks' 308-pound defensive tackle, landed squarely on him during a sack. The Niners lost 23-3 to fall to 2-2.
The former No. 1 overall draft pick struggled along with the San Francisco offense so far this season, going 43-of-84 for 461 yards with one touchdown and a meager 66.4 passer rating.
On Monday, Smith said he completely tore both of the ligaments that connect his shoulder blade to his collarbone. He knew he was seriously hurt as soon as he hit the ground underneath Bernard.
"I've taken lots and lots of sacks like that, and if you fall a fraction of a way different, you get up and you're fine," Smith said Monday.
With pain shooting through his body, he attempted one practice throw on the sideline during Monday's practice before heading to the locker room.
"It didn't go very far," he said with a grimace. "I'd like to think I have a little bit of pain tolerance, but I knew something was wrong there."
With Smith out, the 49ers will turn over their struggling offense to veteran Trent Dilfer, who went 12-of-33 for 128 yards Sunday in his first game action since 2005. He'll get his first start for the 49ers against the Ravens on Sunday, the team Dilfer led to its only Super Bowl victory.
Dilfer has started 107 games for four NFL teams during his 14-year career, but didn't play a snap last season or in the first three games this year. He has focused on being a mentor to Smith and a help to the offensive coaching staff while still staying ready to play.
"Not a whole lot changes except the repetition in practice," the 35-year-old Dilfer said on Monday. "I get to work on timing like we did back in training camp, and I think that will help our execution. We're obviously going to have to execute better on Sunday."
