Dr. Jung says 49ers’ Star Running Back may be dealing with high odds of a season-ending injury.
Article: 49ers sitting Christian McCaffrey reflects season-ending injury danger (sfchronicle.com)
Why 49ers sitting Christian McCaffrey reflects danger of season-ending injury
By Eric Branch
San Francisco 49ers head coach Kyle Shanahan revealed Tuesday that Christian McCaffrey had Achilles tendinitis, which the team “has to be very careful about.”
The 49ers exercised caution with the All-Pro running back, making him inactive for Monday’s season-opening win against the Jets, after Shanahan indicated he was involved in medical discussions about the risks involved with McCaffrey playing.
“When you hear that type of stuff — and it’s not a playoff game, it’s Week 1 — and especially when you’re dealing with the lower extremities like that, it was a tough decision,” Shanahan said. “But hearing all the words — in the long run, it made it easy.”
Two words that, ultimately, likely made sitting the 2023 Offensive Player of the Year an easy call: torn Achilles.
That’s according to Dr. Kenneth Jung, a foot and ankle surgeon who is a consultant to the Los Angeles Rams. Jung, of course, isn’t privy to McCaffrey’s medical file. But he noted more serious cases of Achilles tendinitis, an overuse injury that causes inflammation, can involve microscopic degeneration, small tears in the fibers in the middle of the tendon that can increase the odds of a season-ending injury.
“You’re talking about possibly rupturing your Achilles,” said Jung, who works at the Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “There’s obviously a lot of load and dynamic motion associated with being a running back. And there are different grades where you can have partial tearing of the tissue. And if it’s a small tear, combined with explosive activity, you have a higher chance of having further damage to the tendon.”
McCaffrey, 28, ranks fifth among active players in career touches (1,806) and is coming off a season in which he had an NFL-high 339. He suffered a strained calf last season in Week 17, forcing him to miss the regular-season finale, and he strained his calf during training camp in early August.
At the time, Shanahan did not mention that McCaffrey had an Achilles issue and he said his calf strain would sideline him for “a couple of weeks.” The 49ers continue to list McCaffrey’s injury as “calf, Achilles,” but the fact that the injury has lingered suggests Achilles tendinitis is the biggest impediment to him playing, Jung said.
On Monday, Shanahan said McCaffrey’s injury was bothering to him to some extent during practices last week, sessions in which McCaffrey was limited. But Shanahan noted McCaffrey’s discomfort waxed and waned, saying, “Sometimes it goes away, sometimes it comes back.”
The best treatment for Achilles tendinitis, even in more severe cases, involves rest and physical therapy.
“If this is more of a degenerative type of picture, then that would be more likely get flared up again — to be recurrent,” Jung said. “Even if it’s something (less severe), the hard part is that it’s always a little difficult to treat during the season because it’s not like you can shut down entirely. He’s probably still working out and doing things to maintain his fitness. And that may aggravate things.”
McCaffrey returned to the field Sept. 3 and has since been a limited participant in each practice. Shanahan was asked Wednesday, given how McCaffrey’s injury has lingered, whether the 49ers have considered placing him on injured reserve, which would sideline him for at least four games.
Shanahan said that has not been discussed, but he also suggested he doesn’t know how long it will take for McCaffrey to return. Asked whether he agreed that it was a good sign that McCaffrey was continuing to practice, Shanahan noted his opinion didn’t mean much.
“I do agree,” Shanahan said, “but I’m not a doctor.”
