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00:00Let's go out to the River Islands guest line, it's time for Clear to Play, take you inside
00:03the tent, get you updated on the latest injuries in the Bay, proud to partner with UCSF Health
00:08on this segment, bring in professor of orthopedic surgery, Dr. Nirav Pandya, we checked the
00:14salaries match and Doc is allowed to come on the show.
00:18It does not mean we have equal salaries.
00:19Hi Doc, how are you?
00:20I'm doing good.
00:21How are you guys doing?
00:22We're good.
00:23Tell us about Isaac Garendo's foot, a foot sprain and then football four days later,
00:29your thoughts.
00:30And so I think in general, you know, the main things we worry about with a foot sprain,
00:34number one, you want to rule out the bad list, frank injuries, and you want to rule out the
00:37turf toes.
00:38And then if you rule those things out, typically it becomes a issue of how can you do in terms
00:43of pain relief?
00:44Is there any mobility issues?
00:46Is there any stiffness with a full week that typically most foot sprains can get better?
00:52But with, you know, 72 to 96 hours from Sunday to Thursday, the limiting factor may simply
00:57be, he's got too much soreness and pain and it's hard for him to be effective.
01:00Not that it's going to cause more injury, but he's just not going to be able to play
01:03at that position.
01:04I think it's part of the position in a short turnaround that makes it hard for him.
01:08What sort of a pain management from an injection standpoint could you use and utilize for Garendo
01:14in the foot?
01:15You know, if it's related to like a specific joint or there's maybe like one tendon or
01:20one particular ligament that may be, you know, in a very specific area, you could do some
01:23cortisone in that area, but if it's more global, like you've got multiple tendons
01:28and your foot just generally hurts, it's difficult.
01:30Then you talk about taping, bracing, and hopefully putting on a stiffer speaker would help.
01:35But hopefully if it is something more isolated to one particular area or a joint, but yeah,
01:39there are things that you can inject to help make the pain better without worrying about,
01:43you know, is there something structurally wrong?
01:46We'll see if Dre Greenlaw plays, if so, what is the right way to sort of reindoctrinate
01:53someone after an Achilles injury and what should fans expect in terms of his performance?
01:58I think in general, you would definitely limit the number of plays that he has.
02:01He just hasn't recreated that full explosiveness, unpredictable nature, you just can't do that
02:07in the practice setting.
02:08So I think number one, with someone who's coming off that type of injury, you'd probably
02:12limit the number of snaps.
02:13And number two, I think timing is going to be off.
02:15I think the biggest thing that people talk about when they come back from that Achilles
02:18is they suddenly have to make a sudden movement.
02:20They have to react very quickly and there's that fear that that's going to happen again.
02:24So it's going to take several plays for him to feel confident that that Achilles is not
02:28going to kind of have that issue again.
02:30That's what you commonly hear with these athletes.
02:31So I think maybe a little bit of timing issue, maybe a little less power, as he gets further
02:35along game after game, hopefully that confidence comes back, he's more comfortable coming off
02:40that surgery.
02:41Nick Bosa's missed a small handful of games with the oblique issue.
02:46What do you expect to see come Thursday as far as Nick Bosa being able to return or not?
02:52I think it's really just based on how he's feeling.
02:54And I think that he's had enough time for a general oblique injury to heal from a structural
02:59standpoint.
03:00I think the hard thing is that if he's having a little bit of soreness or can't twist or
03:05can't really kind of stabilize himself, then it's really a game-time decision for him.
03:09And even though things may be structurally healed, if there's a little bit of soreness
03:12or he just doesn't feel confident, then it's another week.
03:15So once again, how he feels leading up to Wednesday, Thursday, are really going to determine
03:19whether he plays or not.
03:20Doc, can we revisit something on Brock Purdy?
03:23I was just forever interested when you said that shoulder could be sort of related potentially
03:29to what happened to the elbow a couple of seasons ago.
03:35Now he reports, no, I feel fine.
03:38He looks good throwing the ball the other day.
03:40Does that kind of calm all of your fears, or is this something still to monitor?
03:45I think it does calm my fears.
03:46I mean, in general, he may have just simply could have been sore, could have taken some
03:50impact on that area.
03:51So I think the fact that he turned around and looked good and there's not any kind of
03:54lingering issues, you're not hearing about an MRI showing some rotator cuff or labral
03:58issue, I think it's a very good sign.
04:01And I think because he had that elbow injury, when you hear shoulder, you get a little bit
04:05more concerned.
04:06But let's just say he was another quarterback that didn't have an elbow issue and you heard
04:09shoulder soreness, you'd be like, oh, fine, not a big deal, let's just keep going.
04:12So the fact that he's turned it around as quickly as a positive sign, typically larger
04:16structural issues will continue to linger, just taking a couple weeks off wouldn't necessarily
04:20help that.
04:21Double short week here for the Rams and the Niners, but how much worse is it on the body
04:26to have a short week here in December as opposed to back in September?
04:31I think it's much worse.
04:32I mean, you typically need, as the season goes on, more and more time to get your body
04:37ready for a game.
04:38I mean, in general, even just muscle soreness, fatigue, the normal kind of aches and pains
04:42take 72 to 96 hours, and then you have these lingering injuries and things that these players
04:46have.
04:47So suddenly you're going from Sunday, turning around playing on Thursday.
04:49So really is, can people push through, how much discomfort do they have?
04:54And where you really see it is you don't necessarily see, and they've studied this, injuries on
04:57Thursday, but then you look at the next couple of weeks and then you start seeing people
05:01break down.
05:02So having a short turnaround at the end of the season is worrisome.
05:05Hopefully everyone comes out healthy and there aren't any major injuries leading in the next
05:09couple of weeks.
05:10Doc, what's your read on the Andrew Wiggins ankle situation?
05:13Yeah, this kind of diagnosis of ankle impingement, really what that is, is something, whether
05:19it's inflammation, it can be scar tissue, sometimes it can be bone spurs.
05:23It's kind of this grab bag term for, there's something in the ankle joint that's causing
05:26him to potentially have decreased mobility and have pain.
05:30The vast majority of athletes that usually comes from repetitively playing in these kind
05:34of, you know, that type of player, he's going to do that very explosive.
05:37The fact that they're kind of giving him a little spot rest makes me think this is probably
05:41more just an inflammation issue as opposed to there being a bone spur or something else
05:45that's causing that mobility to go down.
05:47So something to watch, I mean, it is, you know, a little bit worrisome that something
05:50like this is cropping up earlier in the season, but hopefully they're just being very cautious.
05:54They're using that term kind of more loosely and hopefully he'll be back.
05:57It has been such a critical part of the season and kind of going back to that 2022 performance
06:02that he had.
06:03Steph missed a game with the bilateral knee tendonitis, then he came back and looked pretty
06:08good.
06:09What's your concern level for Steph, not only in the short term, but throughout the year
06:13having to deal with this knee tendonitis?
06:15Yeah, not super concerned about it.
06:17I mean, I think for him, if there's any athlete that takes care of his body, understands the
06:22rehab process, understands how to kind of work on things like that, it's Curry.
06:26And you know, even though you put the ankle issues aside, cause that's more of a structural
06:29issue that became more chronic, besides having these random traumatic injuries were like,
06:33an MCL or a foot sprain, Curry really hasn't had those degenerative type issues that would
06:38crop up at this age.
06:39So the fact that this is kind of this really his first issue that comes with potentially
06:43playing a lot and kind of the wear and tear, it's a good sign.
06:46The good news is, is that for him at his position, not a lot of repetitive jumping, not banging
06:51in the pain a lot.
06:52I think it's going to be a lot of load management and him kind of managing this more than it
06:56being kind of a warning sign, like an Achilles tendonitis or something else that you get
07:00in someone who's younger, like a Christian McCaffrey.
07:02Doc, great stuff as always.
07:04And we thank you, my friend.
07:05No problem.
07:06Take care, guys.
07:07Have a good one.
07:08There he goes.
07:09Doc Pandia.
07:10The proceeding was sponsored by UCSF Health.