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00:00And I think before we even bring Doc Feeley on, we should let everybody hear a little
00:04bit about what Kyle Shanahan said on the conference call today.
00:07That's a good idea.
00:08Right?
00:09Because we're all looking for more information on how did we get here and where do we go
00:13from here.
00:14So Kyle Shanahan, why was Christian inactive?
00:18Just the same stuff that was bothering him all week.
00:19There was a little too much today.
00:21Game time decision.
00:22He came in, just talking to him about it.
00:24It was still there.
00:25Thought it was going to be smart to keep him out and glad we did.
00:28Okay.
00:29And that is from last night after the game.
00:32Conference call today.
00:33Update on CMC's calf.
00:34Well, yes.
00:35I believe they're similar.
00:36I know it was a calf then and it's a calf now.
00:38You guys could ask Christian more on that.
00:40Definitely.
00:41I believe if it was a playoff game, he would have played.
00:45You know, but when you, you know, it's not just the calf, it's the Achilles and, you
00:49know, the Achilles is tendonitis and that stuff comes and goes.
00:52And when it is acting up, somebody's got to be very careful about, Christian's very diligent
00:56about that stuff.
00:57And if it was a playoff game, you know, he made it very clear to me that he believed
01:03he could go.
01:04But when you hear that type of stuff and it's not a playoff game and it's week one, and
01:08especially when you're dealing with the lower extremities like that, it was a tough decision.
01:14But hearing all the words and stuff in the long run, it made it easy.
01:18Okay.
01:19Achilles tendonitis.
01:21That's not good.
01:22It's not good.
01:23And it's the first time we've heard that term, right?
01:26So let's dive into it.
01:28And we're, we're excited to, not about the injury, but, but to, to, to have this definition
01:35about it to the river islands, gas line cleared to play, take you inside the tent, get you
01:40updated on the latest injuries in the Bay and proud to partner with UCSF health on this
01:44segment and bring in Dr. Brian Feeley.
01:47Hey doc, how you doing?
01:48What's going on?
01:49Good.
01:50How are you guys?
01:51We're, we're, we're good.
01:53It's a, it's a victory Tuesday, but let's talk Achilles tendonitis.
01:57What does this mean for Kristen McCaffrey and the Niners?
02:01You know, I really don't think it means all that much different than what we were thinking
02:05the week before.
02:06If it was a calf strain, if you look at, I think the best comp for a backfield player
02:11for a calf strain was Joe, Joe burrow last year, he was out for the entire preseason.
02:16He came out and he started slow.
02:18When you have a calf strain that's kind of on the inside of your calf at the top part
02:24of your Achilles, when you have Achilles tendonitis, there's a whole spectrum of problems
02:29that that can be.
02:30It can be very mild to you can't put weight on it based on how he's been practicing.
02:36This is probably more on the mild side and they're being conservative on being able to
02:41keep him out knowing that they have a good back backup and he's got an incredibly long
02:45season.
02:46And I don't think it's honestly all that controversial to say that Jordan Mason might have been told
02:50he was a starter and that McCaffrey was probably hoping he was going to play up until the last
02:56minute and then the decision was made.
02:59He's not going to start.
03:00He's not going to play just out of an abundance of caution.
03:03And the abundance of caution does not necessarily indicate a severity of injury, right?
03:08Tendonitis does not necessarily portend to future traumatic injury.
03:14No, tendonitis in many ways the calf strain is going to be just as bad if not worse than
03:19the Achilles tendonitis.
03:21It really just depends on the severity of the tendonitis.
03:24All it really means is there's inflammation along the tendon, which as a 28 to 30 year
03:30old running back with a lot of mileage, it's kind of expected he's going to get that at
03:34some point during his career, if not this year, next year.
03:38So I don't think it's the big deal.
03:39He's going to get a lot of treatment for it.
03:41I think it's important for him to be able to limit his reps during the season.
03:45I think we've seen that in the last couple of years.
03:47He's somebody that does a great job at a certain number of reps.
03:51And then if we have a suitable backup, that's even better.
03:56Doc Feely is with us.
03:58If he's been dealing with this since late in the regular season last year, why has it
04:04not gotten better?
04:06How does it get better?
04:08Yeah, so the problem with any of the tendinopathies in the lower extremity, whether it's your
04:14quad tendonitis, patellar tendonitis, or Achilles tendonitis is once it's there, it tends to
04:20just kind of linger often up to one to two years.
04:24The reality is, is it does not seem to increase your risk of a traumatic injury.
04:28So it doesn't seem to increase the risk of getting an Achilles tendon rupture, which
04:32is really what you want to avoid.
04:34But it does make it annoying to plan.
04:36You cannot plant and push off quite as hard.
04:39You don't have quite the amount of explosive ability.
04:43The problem is there isn't a magic cure for it.
04:46It's not like you wear special shoes, there's no special injection.
04:49You essentially just have to do the stretching, the conditioning, and work your way through
04:54it.
04:55And if he's not feeling perfect, you hold him out.
04:58And part of that feeling, does it get exacerbated or made worse when you have to play on an
05:03artificial surface as opposed to grass?
05:06Yeah, I think that's a really good question.
05:09And I think we know we, Dr. Pandya and I just published a paper that showed that the lower
05:15extremity injury rate is higher on turf than it is on grass.
05:19And if I'm playing in on turf next week, early in the season, I'm probably going to be a
05:26little bit extra conservative because I think it is a little bit riskier and it hurts a
05:30little bit more.
05:31Grass is softer.
05:32Doc, I wonder this.
05:34I think Bay Area sports fans are really triggered by this because of Kevin Durant.
05:39Are we talking about a similar situation where this is a precursor to something serious or
05:44is it different?
05:46So there's no proof that this is a precursor to something serious.
05:50So when you look at the literature, does Achilles tendonitis lead to an Achilles tendon rupture?
05:55There's no proof for that.
05:57The problem is in the literature means you're looking at the average normal person with
06:02Achilles tendonitis and Achilles tendinopathy.
06:06We're not talking about people that are seven feet tall and jump for a living or six foot
06:12one, 195 pounds and run through a defensive line.
06:16So I think in general, we can assume that it's low risk that he's going to get a more
06:21serious injury, but we can't rule it out just because the demands on the professional athlete
06:26at this level are so much higher than what we typically understand for everyday people.
06:31Doc, I don't want to ask you to speculate, but based on everything we're talking about,
06:36what do you think the chances are that Christian McCaffrey, whether it's week two, week three,
06:43week four, whatever, when he gets going, what are the chances of him being a 25 touch per
06:50game player for the full season?
06:54Well, by definition, he's no longer for the full season, but I think he'll probably be
06:59able to for the rest of the season once he starts.
07:02I think when you look at his usage rate last year, he was 18 to 22 touches a game, maybe
07:08up to 25, 28 carries for Jordan Mason was the most Kyle Shanahan player has ever had
07:14in a game.
07:15So ideally you have them in the 15 to 20 and I think that's totally reasonable.
07:21I think the other nice thing is as soon as you put him out there, even if he's not the
07:25first, second or third option, he's a decoy because he's so good.
07:29So I think once he gets out there, he will play.
07:32I think the athletic training staff and the medical staff is doing everything right.
07:37You take it slow with him now, especially if you're going to win a couple of games with
07:41his backup.
07:42It's a long season.
07:43You know, it's hopefully is another season that goes well into February.
07:47You want them fresh and you want them feeling as good as possible.
07:50We know all these players don't feel a hundred percent by the end of the year.
07:53Do you want to conserve him as much as possible for the second half of the year and into the
07:57playoff?
07:58If you were sitting at a bar next to somebody who picks Christian McCaffrey, number one
08:03overall in their fantasy league, and they had a tear coming down their face, what would
08:08you say to him?
08:09This is why I don't draft 49ers in my fantasy league.
08:13I hold them too close to my heart, man.
08:16There it is there.
08:17They're there, buddy.
08:18Okay.
08:19Hey, Doc, thank you very much.
08:21That was very, very informative.
08:23Yep.
08:24No problem, guys.
08:27Talk to you soon.
08:28The proceeding was sponsored by UCSF Health.