Smith seeks second opinion from Dr. Andrews

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 his right shoulder in Sunday's game.

The 49ers have reported Smith's injury as a grade three shoulder separation that would not require surgery but would sideline him indefinitely.

A source close to Smith told ESPN's Ed Werder that the quarterback intends to follow whatever recommendation Andrews makes even if it is surgery that would likely end his season.

The team said that once Andrews completes his review, its medical staff will meet with Smith and discuss his options. The 49ers say Smith was in their training room receiving treatment on his shoulder Wednesday morning.

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 Sunday'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."

Information from The Associated Press and ESPN's Ed Werder was used in this report.