And, for the first time in awhile, Leftwich insists he's healthy. He missed all of 2011 when he broke his left arm while diving for yardage in an exhibition game last summer. The injury came on the heels of a knee injury he suffered in the final preseason game against Carolina in 2010 that prevented him from filling in while Roethlisberger served a four-game suspension for violating the league's personal conduct policy.
He's thrown all of seven passes in two years, though he looked like his usual steady self in a 24-23 loss to Philadelphia in the preseason opener last week.
Leftwich completed 3 of 5 passes for just 14 yards, one of them a 2-yard touchdown pass to Emmanuel Sanders.
More significant - for both Leftwich and the Steelers (No. 7 in the AP Pro32) - was the shot to the head he absorbed from Philadelphia defensive back Dominique Rodgers-Cromartie late in the first quarter. Leftwich was scrambling out of danger when he flipped the ball away just before Rodgers-Cromartie launched himself skyward.
"It looked worse than it did," Leftwich said. "It was a DB. I'd rather it be a DB rather than a lineman or a linebacker. I'm a pretty big guy myself. I feel like I can hold my own with certain types of things. To me that wasn't that big a hit."
Maybe, but the fact he took it and bounced back was the final step in a process that let Leftwich know he's back and ready if Roethlisberger runs into health trouble. Roethlisberger missed one start last season with an ankle injury and was limited in several others. The now 30-year-old quarterback is dealing with a slightly torn right rotator cuff and a bruised ankle after a teammate stepped on it during practice over the weekend.
Leftwich however knows it will take more than a bruise to keep Roethlisberger - whose tolerance for playing through pain is well-documented - off the field. If it happens, though, he's ready.
"Injuries that come with the position," Leftwich said. "Unfortunately for me it came back to back. I prepare myself the same way and just hope for the best."
Leftwich expects to get extended playing time on Sunday against Indianapolis and believes he and Roethlisberger are starting to get a handle on new offensive coordinator Todd Haley's versatile attack.
"It's like learning a new language," he said. "We've got the basics down now we need to see where we can go with it."