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00:00It is time for us to take you inside the tent, get you updated on the latest injuries in
00:04the Bay.
00:05Proud to partner with UCSF Health on this segment and bring in Professor of Orthopedic
00:08Surgery, Dr. Nirav Pandya.
00:10Hey, Doc, how we doing today?
00:12I'm doing good, how are you guys?
00:15We're doing fantastic.
00:16I think we wanted to start out by asking about Fred Warner with what's going on with the
00:2149ers.
00:22There are a lot of people that say, shut him down.
00:26And my response to that is, I don't know that that helps.
00:29You know, there's a fracture in the ankle.
00:33Is Fred Warner putting himself in danger by playing?
00:37You know, I think that the hard question is not knowing exactly what's fractured, but
00:40in general, anytime something is broken, you do want it to basically heal at some point.
00:45Now, the question is certain fractures you can play on, particularly if there's like
00:49a ligament or something attached to it and it's more of an avulsion, and you could say,
00:52look, this needs to get fixed in the off-season, versus, no, this is a weight-bearing part
00:56of your ankle, like you are causing more damage by playing on it.
00:59So a lot of it's in the details, but I think in general, with him playing through pain,
01:03with him clearly in discomfort and mentioning it, not only do you worry about that injury
01:07getting worse, but could he hurt an Achilles?
01:09Could he hurt his knee?
01:10Like, it's not normal to be able to play with that degree of pain and that much of structural
01:15of issues.
01:16So I think it's probably a good idea for him to shut it down, particularly how the season's
01:20going, just to make sure there isn't a more severe injury or something then becomes more
01:23of a chronic issue into next season.
01:25And the severe injury would be the fractured ankle gets more fractured and becomes completely
01:30broken?
01:31Or is there a risk of possibly some ligament damage in there if he was to roll his ankle
01:36again?
01:37I think a combination of both.
01:39You definitely worry about this fracture potentially becoming more and more, where then the pieces
01:43of bone may not necessarily be in the right place, if it's kind of more of a weight-bearing
01:46injury.
01:47Or yes, you do worry then, is there going to be more ligament damage?
01:50Is there going to start being cartilage damage?
01:52So I think all these things are definitely in play based on the position that he's playing
01:56and the intensity with which he's playing on the field.
01:58Doc, first of all, thank you for your text about Christian McCaffrey over a holiday weekend.
02:04So that was really good information.
02:07I know a lot of people wanted to know this.
02:10Is in any way what happened with the PCL potentially related to what he had been dealing with with
02:18the Achilles tendonitis over the last few months?
02:22Yeah I think they're completely unrelated.
02:24I mean, in general, the only way you really do injure your PCL is if you're in a car accident
02:29and the front part of your shin hits the dashboard or you have a direct blow on the knee on the
02:34ground like he had that game.
02:36So, highly unlikely for any kind of Achilles issue to be connected with that PCL.
02:41I think it was just bad luck who fell on it.
02:43I don't think there's anything that could have been done to prevent it besides not falling
02:46down on really hard ground in the cold.
02:49So just one of those unfortunate things that happens to a player and it happened to be
02:53that he had Achilles tendonitis as well too, but I think this would have happened regardless
02:56of whether he had Achilles tendonitis or not.
02:58And the word is no surgery for the PCL.
03:00Is that normal?
03:02Because you and I talked before about an ACL tear and you almost always go in there and
03:06repair it.
03:07Is the PCL injury one that can kind of heal itself or is it just dependent on the severity?
03:13The vast majority of PCLs actually don't need surgery.
03:16Unlike the ACL, there's less force across it and the vast majority of PCL injuries are
03:20usually these partial tears where the ligament may have pulled off the bone a little bit
03:23or kind of have this little tear in the middle of it.
03:26Typically, most of these are treated without surgery, usually a brace, potentially crutches
03:30to get that ligament to heal, unlike the ACL.
03:33The only time you really undergo PCL surgery is if your knee continues to feel bad after
03:38that period of six to eight weeks, it feels unstable, or you have a complete tear where
03:42that knee just kind of could totally flop it all over the place.
03:45I think the example we can look at is Steven Adams in the NBA had this PCL injury, tried
03:49to treat it nonoperatively and was still having discomfort, so then got it fixed, but he's
03:53more the exception than the norm.
03:55Lamar Jackson had something similar last year.
03:58Most people can get by six to eight weeks, don't need anything done, and are back on
04:01the field.
04:02Doc, you said some stuff with the Brock Purdy shoulder injury and missing Green Bay that
04:07maybe there was potential, you know, concern or, you know, that the Niners need to watch
04:14the fact that there's shoulder soreness after the reconstructive elbow surgery from the
04:20year before.
04:21Did the Niners have something to think about long-term here?
04:25You know, I think a lot will be based on what they potentially saw on that MRI.
04:30I know Kyle Shanahan talked about, oh, there was nothing concerning there, but I think
04:33if you kind of look at how he's playing this year, obviously, offensive strategy and scheme
04:37and wide receivers aside, there's not as many long passes, which obviously is a concern
04:41when you're thinking about someone having a shoulder issue, and any time that does crop
04:45up with that injury, you do have to worry about that, so I think really the next three
04:49to four games are really going to be telling in terms of how that shoulder's doing.
04:52You know, that Green Bay game, obviously, he's not playing, and then this last game
04:55you're playing in a blizzard, so you can't really make any kind of conclusions about
04:58how his shoulder's feeling, but if you see the next couple games where you just don't
05:01see those long passes or potentially there's a game off, then you do start worrying, is
05:06there something going on that needs to be addressed in the offseason, which is difficult
05:09because going into a contract year, that's where a lot of decisions for surgery can be
05:13made based on what that compensation may be and what exactly is on that MRI.
05:17And similarly, maybe at a lower price point, is Jordan Mason, who's going to be going into
05:21the market at the end of this year, and he's now out with a high ankle, and he was placed
05:25on injured reserve.
05:26The fact that they're putting him on ice for at least four weeks, does that indicate to
05:30you the severity of this high ankle sprain?
05:32Yeah, typically, kind of more, you're kind of right down the middle where you see it.
05:36Very rarely do you get someone who gets that high ankle and it's like one to two weeks
05:39and you're out.
05:40The fact that it mostly kind of lands four to five weeks and the position that he plays
05:44at running back, and he plays a very aggressive style of running, not surprising, so I don't
05:49think this necessarily means something for him next season.
05:51I think it's just kind of a combination of where they are in the season, how long this
05:55injury would take to heal, and if there are going to be more games down the road.
05:58Doc, real quick on Draymond Green with a calf strain, doubtful for tonight, but there is
06:03some speculation that maybe this is something that's going to cause them to sit him for
06:09a little while.
06:10What would you say about a calf strain for Draymond Green?
06:13I think it's not unexpected, just given the minute he's played, his size, all the things
06:17to wear and tear, I think we're going to see this with both Draymond and Steph moving forward.
06:21I think they have to be extra cautious, particularly in this early part of the season, make sure
06:25these things don't become more chronic.
06:28So early load management for these injuries, particularly for Draymond and Steph at their
06:32age, I think it's important, not super concerned about it, and hopefully we'll get this right
06:36and kind of keep them healthy for the second half of the season.
06:38Doc, I'm sorry we have so many questions, there are so many injuries.
06:44Not a problem, that's unfortunate news for the Bay Area right now.
06:47No joke, no joke.
06:48Thank you Doc, we'll talk to you next week.
06:51No problem, take care guys.
06:52Alright, take care, the proceeding was sponsored by UCSF Health.