San Francisco 49ers

Why the 49ers new medical staff has a lot of work to do

From left, San Francisco 49ers General Manager John Lynch, Kwon Alexander, Dee Ford and coach Kyle Shanahan stand for a photo following an NFL news conference Thursday, March 14, 2019, in Santa Clara, Calif. (AP Photo/Ben Margot)
From left, San Francisco 49ers General Manager John Lynch, Kwon Alexander, Dee Ford and coach Kyle Shanahan stand for a photo following an NFL news conference Thursday, March 14, 2019, in Santa Clara, Calif. (AP Photo/Ben Margot) AP

The 49ers are taking an optimistic approach when it comes to a number of decisions they’ve made during the first two weeks of the 2019 league year. But that optimism comes with an obvious caveat.

Can these players stay healthy?

San Francisco brought in a slew of players to compete for roles in the coming season that have dealt with injuries in the past. Linebacker Kwon Alexander was given a four-year, $45 million contract despite tearing an ACL Oct. 21. Defensive back Jimmie Ward was re-signed on a one-year contract despite ending four his five seasons on injured reserve with fractured bones.

Corner Jason Verrett was signed to a modest one-year agreement despite appearing in five games over the past three seasons – which included missing all of 2018 because of a torn Achilles suffered last summer. Receiver Jordan Matthews has struggled to be productive the past two seasons due to, in part, a laundry list of injuries. He also signed a one-year contract.

The trend of signing players with ailments in their pasts is a surprising development. Injuries have been a prominent theme throughout coach Kyle Shanahan’s two years at the helm and contributed to going 10-22 since getting hired.

The team used injured reserve 45 times over the past two seasons, according to Spotrac. That was near the top of the league over that span. It led to Shanahan and GM John Lynch revamping the club’s medical and training staffs heading into 2019.

“It’s been too big of a deal for two years,” Shanahan said Dec. 31. “Injuries are pretty random, but it’s also affected us huge. So, that’s something that we definitely have to sit back and really look at it from all angles and put a lot of time into.”

San Francisco fired head athletic trainer Jeff Ferguson and strength coach Ray Wright. A new position was created titled “Head of Player Health and Performance,” which was filled by Ben Peterson, 34, who brings with him an extensive background in sports science after spending the past two seasons with Philadelphia Flyers of the NHL.

Dustin Perry was hired to become the new head of strength and conditioning after working under Wright last season and Dustin Little, formerly of the Denver Broncos, will take over as head athletic trainer.

“We haven’t had a lot of guys available and that’s something we’re looking into hard,” Lynch said. “It’s been ongoing. We’ll continue to do that because it’s something that needs to change and I don’t think anyone’s to blame. We have been studying it. We’ll continue to, and try to get a handle on that.”

The biggest injury during Shanahan’s tenure was suffered by franchise quarterback Jimmy Garoppolo, who tore his ACL Sept. 23 in Kansas City, just three games into his five-year, $137.5 million contract he signed the previous February. Garoppolo is expected to be cleared for full-team drills in training camp.

Whether running back Jerick McKinnon has the same prognosis is unclear, despite suffering his ACL tear just over three weeks before Garoppolo. The team might use more caution with McKinnon given the nature of playing running back versus a quarterback, who is far more stationary.

Which goes back to the questions facing Alexander. He sustained his injury Oct. 21 trying to chase Baker Mayfield during a win over the Browns. It came nearly a month after Garoppolo went down and more than seven weeks after McKinnon.

No time table has been given on Alexander’s return, though he was moving without a noticeable limp during his introductory press conference with the 49ers March 14.

“I’m just taking it day by day,” Alexander said. “I’ve been grinding, working hard, and just pushing myself to get back.”

Alexander’s contract is far more team friendly than the initial figures indicate. He’s expected to earn $14.25 million during the first year of the contract, with only $3 million in true guarantees over the final three years of the deal. Alexander will have $11.25 million guaranteed on April 1 of 2020 if he remains on the roster.

But making Alexander one of the NFL’s highest paid linebackers this season will be a dubious proposition if struggles to return to his pre-injury form or if it takes a while to get back on the field. After all, San Francisco elected to give him a big dollar figure for 2019 rather than pay for a free agent safety as Earl Thomas, Tyrann Mathieu or Lemarcus Joyner. The 49ers started eight different combinations of safeties in 2018 and, so far, have decided to return with their previous group.

The 49ers are bringing back Ward on a $4.6 million deal after breaking his forearm in back-to-back seasons. He appears to be the team’s top free safety currently on the roster, though the club could still add a safety in the upcoming NFL Draft.

The risk in injured players will ultimately result in how much the team relies on them.

Verrett, for example, will be competing for a starting job. But if he doesn’t produce or gets injured again, the 49ers have back-to-back third-round draft picks Ahkello Witherspoon and Tarvarius Moore in the mix, and they could add another cornerback in the draft.

The same goes for Matthews. He’s expected to compete with Kendrick Bourne and perhaps a highly-drafted receiver to fill the void vacated by the release of veteran Pierre Garçon. And only Alexander comes with any real financial risk.

The combined upside is considerable between Alexander (a former Pro-Bowler who led the NFL in tackles in 2016), Verrett (a Pro-Bowler and first-round draft choice in 2014), Ward (a 2014 first-round draft pick) and Matthews (a second-round selection in 2014 who averaged 891 yards his first three seasons).

But they must stay healthy, which is a substantial question mark given the 49ers’ recent history.