Roethlisberger's injury is the biggest of the Steelers' concerns after Monday's win, not their only one.
The Steelers gave up 10 unanswered points in the first 16 minutes, allowing the Chiefs their first lead of the season and had to struggle to keep up. They couldn't run the ball with the skill they displayed over the past three weeks, nor could they stop the run.
And as if to put icing on a seemingly spoiled cake, quarterback Ben Roethlisberger left the game in the late third quarter with a right shoulder injury, the extent of which has been highly speculated about but is still ultimately unknown.
Roethlisberger was hurt when sacked by Chiefs linebacker Justin Houston; he was replaced by backup Byron Leftwich, who managed to make the right plays at the right time to drive the Steelers to a fourth-quarter field goal that gave the Steelers a brief, 13-10 lead.
The Chiefs tied the game with a field goal of their own and the game headed into a short overtime period that resulted in Pittsburgh's win. This win came courtesy of an overtime interception of Chiefs quarterback Matt Cassel by Steelers linebacker Lawrence Timmons, which led to Shaun Suisham's field goal after 55 seconds of play.
In the rain, cold and wind, passing wasn't an easy venture for either the Steelers or the Chiefs. Before his injury, Roethlisberger was just 9-of-18, for 84 yards and an impressive Mike Wallace touchdown catch; Leftwich went 7-of-14 for 73 yards in relief of Roethlisberger, and Cassel ended his day 11-of-26, for 154 yards and that aforementioned interception.
Running, unfortunately, wasn't complying with the Steelers' will, either. Isaac Redman, who got the start, had just 21 yards on eight carries—a 2.6 yards-per-carry average—and found himself somewhat in the doghouse after an early fumble. Jonathan Dwyer didn't fare much better, however, with just 2.9 yards per carry on average, rushing 19 times for 56 yards.
The Chiefs, however, ran the ball masterfully.
They run the ball more than just three other teams in the league, and for more yards per game than two; though Pittsburgh's defense was giving up just over 80 yards per game on the ground, Kansas City running back Jamaal Charles ended his day with 100 yards and a touchdown on 23 carries. The Chiefs as a whole netted 142 rushing yards.
Luckily for Pittsburgh, a combination of poor Chiefs decisions and six penalties for a costly 76 yards saved their day, as well as that overtime Timmons interception. The Chiefs had turned the ball over a total of 29 times headed into this week but hadn't given the ball away to the Steelers in regulation despite a number of opportunities to intercept Cassel.
But the real story here is Roethlisberger's injury and how this may affect the Steelers' immediate and long-term futures.
There are a number of reports about the possible severity of the injury, though a clear picture won't likely come until Tuesday morning. Roethlisberger is confirmed (h/t Mark Kaboly, Pittsburgh Tribune-Review) to have left Heinz Field, en route to a hospital to have his shoulder examined (h/t Rick Reilly, ESPN).
CBS Sports' Jason LaCanfora says the hospital trip was for an MRI, and a source close to the quarterback told LaCanfora that "it does not look good." Yahoo!'s Jason Cole reports it's a shoulder separation, an "unusual" injury according to his source, while ESPN's Adam Schefter says the Steelers camp is officially calling it a shoulder sprain, not a separation, until more information is available, and ESPN itself is running with that claim. As of this writing, Roethlisberger is at home and sprain is the word until the MRI results are available Tuesday, also according to LaCanfora.
Regardless, it doesn't look good for Roethlisberger's chances to play this upcoming Sunday night against the Baltimore Ravens, the Steelers' first of two meetings with their rivals over the next three weeks.
Unless the injury is far less severe than what the rumor mill has been whispering, Roethlisberger could miss at least one week and up to the rest of the season, potentially leaving the Steelers with some significant decisions to make.
Unquestionably, Leftwich would be the starter during any time Roethlisberger misses, with Charlie Batch his backup. However, Lefwich is 32 and Batch 37 (and 38 next month), and it may behoove Pittsburgh to take a look at younger free agents to pad their ranks if Ben's to miss much time. First on the list should be Jerrod Johnson, most recent of the Steelers' practice squad.
This game was ugly, but it resulted in a Steelers win, something they can live with. But with two contests against the Ravens ahead (not to mention two against the Cleveland Browns and one against the Cincinnati Bengals), what becomes of Roethlisberger and his shoulder could ultimately determine if the Steelers can continue their win streak and potentially take over the AFC North title.
There's much for the Steelers to be concerned with after this win—their propensity to play down to so-called "lesser" opponents; the rushing yardage they allowed while regressing in their own run game; the problems with dropped passes and missed interception opportunities—but the biggest issue right now, the one that will make or break the rest of their season, is what Roethlisberger's injury, and thus playing status, is going forward.
Without Roethlisberger, the ugliness or prettiness of Monday's win matters little; until they know his future, they cannot even work toward fixing their other issues, because there's no quarterback context in which it can be framed. The Steelers were trending upward before Week 10, and now they may instead have an uphill battle ahead.