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Transcript
00:00it is time for clear to play where you take you inside the tent get you updated on the latest
00:03injuries in the bay proud to partner with UCSF health on this segment and bring in professor
00:08of orthopedic surgery Dr. Nirav Pandya. Hey doc what's up? How are you guys doing? Well we're
00:14doing fine and I think you know the number one question which is based on everything that you
00:20have read and heard and watched what do you think the danger level is of playing Christian McCaffrey
00:28on Sunday? I think that as long as they're good about not overusing him the danger level is pretty
00:36low and I know in the past when Kyle Shanahan's players coming off injury when they're 100 percent
00:41or you know their clarity says I'm going to use them full go and one of the issues with McCaffrey
00:45which I think probably led to this is kind of overused so I think that if they limit his carry
00:51using smartly that risk is pretty minimal and what you worry about is if he gets like a 25-30 touch
00:56game it's not necessarily what's going to happen during that game but what ends up happening when
01:01you are week two week three of his return and that's where you worry about new things creeping
01:05up so if they're safe not super worried about it. What is the connectivity between Achilles
01:11tendinitis and a dramatic Achilles injury? Yeah so in general that risk is about 10 percent for
01:19that you know Achilles tendinitis leading to a rupture and where you can manage that prevent
01:23that is that if a player as they're playing starts to get sore starts to get fatigued then
01:29you pull them out then you're less worried about that being an issue so a lot of this is going to
01:32be communication between McCaffrey the coaching staff the medical staff and saying hey I'm feeling
01:37good I keep pushing me but if I start feeling soreness that's where it happens it's very rare
01:42to suddenly be feeling great and boom next thing you know that Achilles rupture so there is a
01:46little bit of leeway with him as long as he's being honest about how he's feeling. Yeah and
01:51what would you sort of I mean I know you're not on the sideline obviously but the the expectation
01:56in terms of like sometimes I guess I don't know the difference between like okay you're healthy
02:01go play or let's kind of ease you into action and there's a ramp up that lasts two to three weeks
02:08what's your thought there? I think my thought because this is really the first week he's been
02:13out of practice I think this is really the ramp up period you know if you've been practicing for
02:18three to four weeks we're like okay when's he gonna play when's he gonna play and then suddenly
02:21it's week 14 and then you can say look just go all out go full speed but I think because this is
02:26really the first time we've seen him out there since his diagnosis on the field I really do
02:30think that this is going to be a ramp up where we're like let's give you some touches see how
02:34your body responds okay let's increase it up next week as opposed to 40 carries a game you know sort
02:40of sort of process. Is the risk of an Achilles injury mostly non-contact as opposed to a bone
02:47or ligament where contact can maybe cause the injury to be much more acute? Yeah the vast
02:54majority of Achilles ruptures occur from a non-contact situation because it's really
02:58that the muscles the tendon that area just gets overworked and eventually it just kind of just
03:03pops and very rarely do you get the Achilles rupture where someone like kicks you in your
03:07Achilles or something sharp kind of hits it from a cleat the vast majority of them have been building
03:12up over a period of time and that tendon's getting overworked micro tear micro tear micro tear next
03:16day you know it totally snaps so that's why it happens non-contact very rarely is it that
03:21one step that you take that causes it and you talk about great great green law that's necessarily
03:26probably him running off the sideline that probably was like that last step that finally
03:30led to him tearing it so most of these occur over a cumulative period of time it just so happens
03:35when you're out there running and no one hits you. Doc what what do you make of Dre at least
03:40sort of being out there and then also the organization you know we've talked about this
03:46before they would not put any kind of a timeline on it but now they they dip their toe in the water
03:51a little bit like creating some optimism over the next two three four weeks so what do you make of
03:57those comments right now? I think that typically means they're at the point where he's kind of
04:02passed all the physical tests you've you've got your strength back you got your mobility back
04:06you're able to do everything that you would need to do to return but now we're really in that period
04:11of time and this is hard for athletes coming off an Achilles is how do you feel do you feel
04:15confident can you get out on that field and do things the way that made him such a great player
04:20so that's where I think it's a little bit hard to predict and could it be a week it'd be in two
04:23weeks it's hard to say that's a lot of how Dre Greenlaw feels so I think they feel he's probably
04:28that physical return point but is that mental and confidence report return point there and that's
04:33where I think there's a little bit of uncertainty but assuming that everything goes well and he's
04:37out there and doing more full speed stuff I think that it's probably pretty soon within the next
04:42couple weeks that's exciting and to think about anything before December December would be
04:47basically 10 months so we're at almost the nine month point so for him to come back in the next
04:52couple of weeks for me would be ahead of schedule Jordan Mason has been hampered by the sprained
04:59AC joint what have you seen from him and how much can the two weeks off between games really help
05:04that thing heal I think that's really what's going to be key for him I associate with him
05:09being a very physical runner with certain running backs who are kind of you know doing more things
05:13that kind of outside the tackles you can avoid that contact over that joint which can cause it
05:17to get re-aggravated but for him just less opportunities to have that AC joint hit to run
05:22into the ground to be hit by alignment it's going to really allow those ligaments to calm down and
05:27with these with these kind of injuries very rarely do you have an AC joint injury that goes
05:31on to surgery where it's so severe what ends up happening you get a hit it gets hurt and then
05:35you're not willing to take contact it's just painful to play it so getting these two weeks
05:38to decrease inflammation where there's not constant contact is really what I think it's
05:42going to push him over the edge so that he's healthy for the rest last couple weeks typically
05:46these kind of minor AC sprains do take two to three weeks to get better so this gives them
05:50that time frame to heal from this and be back back with McCaffrey in the backfield doc how
05:54do you think Steph Curry looked last night you know the first the first kind of you know first
06:00quarter where he was kind of looking a little bit more tentative and kind of you know in the
06:03tunnel kind of warming up got a little bit worried there that maybe the maybe they came back a little
06:08bit quick but then he seemed in that second half he looks like Steph Curry of old so I think more
06:12than anything else it was a matter of kind of getting this kind of perineal muscle issue kind
06:16of warmed up maybe there was a little bit of stiffness maybe there's a little bit of a confidence
06:20kind of testing it out but he looks great and I doubt that this will be another issue it was
06:26interesting there was a comment where they asked him you know why how did this happen and he said
06:30look you know I sprained it the first time I probably should have taken time off and then I
06:34kind of sprained it again so I think it was just accumulation of inflammation in that area and
06:38hopefully he's doing better now and we'll have him nice and healthy for that Boston game tomorrow
06:42yeah it's a big one coming up tomorrow D'Anthony Melton won't be back most likely it hasn't been
06:48officially determined maybe it has with the back issue what do you think is the prognosis of a guy
06:54who came in with back issues and now is kind of still fighting it yeah you know I think at least
06:59based on what was reported for him last season and what they're saying right now there hasn't
07:03been any kind of major structural concern it looks like there's inflammation in the bone there wasn't
07:08a report of like a herniated disc or any kind of stress fracture so I think more than anything else
07:12they're just trying to manage pain because number one you don't want if there is irritation in the
07:16bone or something else going on to then lead to something large also with these back issues you
07:21just don't want him to get a secondary issue because his back is sore all the time so I think
07:24anytime you have an NBA player with a back issue it can become problematic very quickly we've seen
07:30players like Ben Simmons or other players who have these kind of issues so team's doing well
07:34there's not really a need for him to be in at this point of the season so I'd rather them be cautious
07:38get this under control so it can be healthy as opposed to having you know two weeks on and a
07:42week off and kind of have that cycle through the season doc great stuff as always there's
07:46such an important time with McCaffrey coming back so can't wait to talk to you again next
07:50week thank you as always no problem take care guys all right there he is doc pandia and the
07:55proceeding was sponsored by UCSF health