The 49ers have been dealt the short hand of the stick when it comes to injuries in 2024, with Christian McCaffrey being the biggest blow. But after seeing an assortment of specialists, it appears CMC’s return this season is still in play.
The San Francisco 49ers star running back has been nursing achilles tendinitis stemming from a calf strain since training camp. Looking to make it to gameday as soon as possible, McCaffrey instead had setbacks, forcing him to be placed on injured reserve prior to Week 2.
Now a few weeks on ice, the player has returned from an overseas trip to Germany will seemingly positive injury news. At least in the sense that surgery is not required, as the 49ers hope to hit his ramp-up harder following Week 4.
“Yeah, we’d like to start hitting his rehab here harder on Monday,” 49ers coach Kyle Shanahan said Friday.
McCaffrey has been dealing with this same calf/achilles issue since late in the 2023 regular season. He would miss Week 18 in a effort to preserve his body for a would-be lengthy playoff run to Super Bowl LVIII. Then, he spent all offseason managing it, working both recovery and training in a very precise manner to keep it at bay.
But even still, the problem returned. And after his biggest setback during that Thursday practice almost a month ago, the 49ers had no choice but to shut down their star player.
“We needed to quiet it down. The plan was to give it the time to do that and then at some point in a thoughtful way to ramp him back up,” 49ers general manager John Lynch said on KNBR this week. “What he does and where he goes, he’s got people who work on his body and have for a long time… Now he’s back here and we’ll have to hit certain markers and try the ramp up. God willing, the thing has quieted down and we can build him up in a smart thoughtful way.”
While we may never know what exact treatments were done in Germany, we have a hunch.
In an article by Eric Branch of the San Francisco Chronicle, Dr. Kenton Fibel, a sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, broke down what regenerative medical treatments Christian McCaffrey may have received. Those include both stem-cell therapy, and/or platelet-rich plasma injections, targeting the regrowth of tissue surrounding the player’s achilles.
But while the treatments and scans may have gone to plan, don’t expect CMC to bounce back in rapid fashion, needing more rest and rehab over an extended time following treatment.
“I think it more suggests this is an injury that they think they are going to need something more to augment his healing that may require weeks or a couple months rather than a week or two,” Dr. Fibel said about Christian McCaffrey. “This may be something where you realize the pathology is a little bit more serious and reserve a way to allow him to return this season, even if it does take a month or two with him needing a longer recovery.
“Usually whenever you’re having some sort of a biologic procedure for a tendon, particularly an Achilles tendon, typically that’s going to require you to have enough time to rest and protect the tendon after the procedure,” he continued. “And then start to progress things forward while the tissue has a chance to biologically start to heal and restructure…With some of these more important weight-bearing tendons, it’s pretty safe to say that they’re not returning within the first four weeks of the procedure.”
Should those prognosis wind up being accurate, McCaffrey has more of the wait-and-see approach ahead of him. The expectation that he can return prior to the 49ers’ Week 9 bye week is available, but they won’t rush him back whatsoever. That could mean an even longer stay on IR into the holiday season, we really don’t know. It all gems down to how CMC’s achilles inflammation responses to treatment.
But one thing does seem clear: The 49ers expect Christian McCaffrey to be available at some point this season.
“I think we’ll get a better idea in the next couple of weeks. We’ve let him rest a couple of weeks. He’s seen as many specialists as he can. We’ll test it out here, sooner than later,” Shanahan shared on KNBR.
