Preseason quarterback evaluation is often shaped less by the final score than by how quickly an offense loses its structure when the depth chart is tested. The 49ers faced that problem Thursday night against the Titans, when Kurtis Rourke left their preseason opener with a rib injury and was later taken to the hospital after struggling to breathe.
San Francisco announced Friday morning that Rourke was checked out and released from the hospital Thursday night. Initial X-rays at Levi’s Stadium did not show a broken rib, and coach Kyle Shanahan said the team sent him for further imaging out of caution rather than because it believed the injury was serious.
“They said ribs, he was struggling to breathe so they took him to the hospital just to check on him and make sure he’s alright,” Shanahan said. “X-rays in here didn’t show it was broken. They just wanted to get more imaging and find out, so they weren’t too concerned. I don’t want to downplay it but I don’t want to overplay it either.”
The medical update matters because Rourke had been operating efficiently before he left the game. The rookie completed 12 of 14 passes for 101 yards after starting Thursday night, and Shanahan’s assessment focused on the elements that define quarterback play within a scripted preseason offense: decision-making, placement and maintaining the intended rhythm of the call.
“He looked good,” Shanahan said. “Got the ball to the right spot, played well.”
Rourke’s exit came after Patrick Taylor’s 1-yard touchdown run with 8:38 left in the first half. Shanahan said the 49ers believe Rourke hurt himself on a quarterback draw near the goal line, while another report said he may have been injured two plays earlier on a 3-yard run. Either way, the sequence exposed the narrow margin within San Francisco’s available quarterback deployment for the night.
The 49ers had four quarterbacks on the roster but dressed only Rourke and Adrian Martinez, with Brock Purdy and Mac Jones getting the night off. Martinez took over after Rourke departed and completed 16 of 30 passes for 159 yards. The transition was not merely a matter of changing passers, it altered the team’s contingency planning at a position where every offensive formation begins with one player able to receive the snap and execute the exchange.
Shanahan said the 49ers were teaching tight end Brayden Willis how to take a snap and hand the ball off at halftime. Had Martinez been injured, Willis would have played quarterback and San Francisco would have called only handoffs. That plan underlined how the available personnel would have reduced the offense from a full menu of dropbacks, movement throws and quarterback runs to its most basic backfield operation.
Rourke entered the game after a rookie season spent on the non-football injury list while recovering from a torn ACL suffered in his final season at Indiana. Thursday’s performance offered a brief but productive opportunity to show he could direct the offense and deliver the ball where it was designed to go. The hospital release removes the immediate uncertainty surrounding the rib injury, but his next availability will determine how quickly the 49ers can resume evaluating him within a quarterback room that kept only two passers in uniform against Tennessee.
