Dr. Kharrazi lends perspective to the 49ers’ Injured Rookie.
Article Link: 49ers WR Ricky Pearsall’s injuries broken down by shoulder specialists (sfchronicle.com)
There’s a San Francisco 49ers wide receiver who played at Arizona State and is a first-round draft pick who may not be adequately prepared for the regular season.
No, not talking about him.
One of the summer stories that has been overshadowed by the story — Brandon Aiyuk’s just-resolved contract staredown that will leave him with four practices to prepare for the regular-season opener — is Ricky Pearsall’s injury-marred training camp.
Pearsall, the No. 31 pick who was teammates with Aiyuk at ASU, participated in six of 19 training-camp practices and missed all three preseason games due to hamstring and shoulder injuries, the latter of which sidelined him for 20 days. Pearsall returned to practice Monday, but his ailment appeared to be lingering: He was still wearing a non-contact jersey and a sleeve on his left shoulder during the final practice of the week Thursday.
During camp, Pearsall suffered a shoulder subluxation, a partial dislocation that occurs when the ball of the shoulder briefly pops out of place. It’s the same injury he suffered in the spring when the 49ers were conducting non-padded practices. Head coach Kyle Shanahan said Pearsall also had a shoulder subluxation in the latter stages of his college career, but he said partial dislocations are common football injuries while waving off concerns.
“About 50% of the people coming out of college do that,” Shanahan said, later adding: “It’s probably happened to 80% of the guys on our team at some time. It’s just a pretty normal thing.”
Two shoulder specialists agree with Shanahan that shoulder subluxations aren’t unusual among football players. However, they also addressed what Shanahan glossed over: It’s far less common to have Pearsall’s history with the injury.
Multiple partial dislocations can be evidence of recurrent anterior shoulder instability. The condition involves laxity or tears in the ligaments, tendons and muscles around the shoulder and often requires surgery.
“It’s correct to say this is a common football injury,” said Dr. Daniel Kharrazi, an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “A subluxation once? OK. But when it’s twice or three times where he has to sit out. … The reality is when you hear this is a recurring problem, the antenna goes up as to, ‘Is this something that needs to be addressed at some point?’”
Dr. Shahryar Ahmadi, an orthopedic surgeon at MemorialCare Long Beach Medical Center, said multiple subluxations often indicate a labral tear, or stretching of the soft tissue around the shoulder joint. Shanahan said Pearsall does not have a torn labrum.
Ahmadi said Pearsall’s rehab from his latest subluxation likely involved strengthening exercises that can increase stability, but he was dubious that it would provide a cure-all.
“He took some rest and that can help him, but it’s not going to solve the problem,” Ahmadi said. “Sometimes we can do some rehab and physical therapy for the patient and it will strengthen the muscles around the shoulder. And those muscles around the shoulder work like a barrier that helps the shoulder not to sublux or dislocate. That can be helpful.”
Pearsall didn’t miss a game in college, playing in all 55 in five seasons at ASU and Florida. But his two subluxations this offseason, injuries that occurred without him being tackled, raise questions about his ability to avoid a recurrence in a game.
“The shoulder has to be in a vulnerable position, usually,” Kharrazi said. “And that’s the position where he reaches up and away from his body to catch a ball. Imagine an off-target ball that he has to reach for. That’s a vulnerable position. And if someone hits him from the side or the back during that instance, that increases the chance of a potential subluxation.”
The 49ers had trade discussions with at least four teams involving Aiyuk before he signed his four-year, $120 million extension Thursday, and they were intent on getting back a receiver in any deal. Pearsall’s largely lost summer could have influenced those discussions. He’s probably not ready to become an immediate difference-maker in a wide receiver corps that, without Aiyuk, would have lacked proven options beyond Deebo Samuel and Jauan Jennings.
With Aiyuk’s new deal secured, the 49ers can afford to bring Pearsall along slowly during his rookie season, which, they hope, won’t mirror his offseason.
“You obviously really can’t decipher everything that’s happening (with his shoulder) from just that injury history,” Kharrazi said. “But the reality of it is — if this happens a fourth or a fifth time? It’s going to have to be addressed.”
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