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The injury to QB Jimmy Garoppolo’s thumb shelved him for a game against the Texans, but...
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Hand surgeon explains how 49ers’ Jimmy Garoppolo could play vs. Rams
Niners head coach Kyle Shanahan said Monday that he’s hopeful quarterback Jimmy Garoppolo can practice Wednesday.
That should sound familiar.
That’s because Shanahan offered the same vague optimism the previous Monday about Garoppolo potentially practicing despite his thumb injury two days later.
But Garoppolo has yet to practice since he got hurt. In fact, as of Sunday, he hadn’t even thrown a pass since injured the thumb in a game at Tennessee on Dec. 23.
Shanahan’s ongoing talk about Garoppolo having a chance to play, along with Garoppolo’s inactivity, has to leave you wondering: Is Shanahan entering the second week of a smoke screen designed to mislead opponents about which of his QBs, Garoppolo or Trey Lance, will play when he knows Garoppolo will remain sidelined?
The answer: Possibly … but not necessarily.
The crux of the issue is whether Garoppolo can play against the Rams with a torn ulnar collateral ligament and an associated avulsion fracture of his thumb Sunday, which would be 17 days removed from his injury.
And, based on how Shanahan has described Garoppolo’s injury, it’s not unreasonable to believe he could return for Sunday’s regular-season finale.
That’s the opinion of Dr. David Hay, an orthopedic hand and wrist surgeon at Cedar-Sinai Kerlan-Jobe Institute in Los Angeles. Hay, a hand surgeon consultant to the NHL’s Anaheim Ducks, said the severity of such an injury is determined by the nature of the fracture at the base of the thumb.
Garoppolo’s avulsion fracture occurred when a small piece of his bone attached to his UCL ligament was pulled away from the bone. Shanahan has said only a “fleck” of his bone was removed, which is why it’s “stable.”
“It all depends on how bad the injury is,” Hay said. “You’ll see these sometimes and it’s a sprain and a little avulsion fragment. And the thumb is basically stable because it wasn’t completely torn off. And the guy’s like, ‘Hey, let’s tape it up and play.’”
Shanahan noted former Saints quarterback Drew Brees suffered a similar injury in 2019 that required surgery and forced him to miss five games because he had a displaced fracture.
“If you tear a little bone off it, and that bone is not particularly displaced, it tends to heal better and you can often avoid surgery,” Hay said. “It’s a little quicker timeline. …
“If his thumb is stable to stresses and isn’t particularly painful — or can be made stable to external stresses with taping or bracing in a manner that’s not particularly painful — then he could obviously play.”
Hay said Garoppolo is likely experiencing significantly less pain now that he’s nearly two weeks removed from the injury. However, he acknowledged such an injury is difficult for a QB given the nature of the position. An offensive lineman, for example, can play with a cast, but it can be challenging to stabilize the thumb on a QB’s throwing hand with a brace while not compromising his ability to grip and throw.
Shanahan maintained Monday that Garoppolo could avoid surgery when asked about an NFL Network report that an offseason procedure would likely be required.
“I’ve been made aware of that surgery is a possibility,” Shanahan said. “But as of right now, he would not need it.”
What could change that would necessitate offseason surgery? It’s not known if Shanahan was hinting at a scenario in which Garoppolo plays again this season and exacerbates his injury.
Hay said, “There’s the thought of, ‘Oh my gosh, am I going to make this worse? Turn this into surgery? Cause myself long-term problems? Or is the risk worth winning on Sunday?’”