The San Francisco 49ers are in the playoff hunt, currently owning the sixth seed in the NFC playoff picture. With two games remaining, that could change. The Niners will be in if they can win their final two games. That begins on Sunday against the Houston Texans. A loss in Week 17, and the team could require some help to clinch a playoff berth.
The 49ers might have to push forward with rookie Trey Lance under center. Starter Jimmy Garoppolo suffered a thumb injury when Tennessee Titans defensive lineman Denico Autry sacked him in the second quarter of the team's 20-17 loss last Thursday night.
Garoppolo remained in the game, even leading a game-tying touchdown drive in the fourth quarter. He did not practice with his teammates on Monday, though.
"It didn't feel great today," head coach Kyle Shanahan said after Monday's practice. "He wasn't able to throw today, and we'll see how it is on Wednesday. Hopefully, it will get better."
Shanahan said Garoppolo suffered a thumb sprain. However, the truth is that the injury is probably more severe. Multiple reports later revealed that the 49ers quarterback sustained an ulnar collateral ligament (UCL) tear and a chipped bone in his thumb, making it more likely that Garoppolo misses time.
Maybe a good deal more time.
UCSF orthopedic surgeon Dr. Nirav Pandya told NBC Sports Bay Area that adrenaline likely allowed Garoppolo to remain in the Thursday-night game.
"Also, what happens is the finger itself can actually swell up, and that will give you a sense of stability so that you're not compromised that much," Dr. Pandya said. "So a lot of times, these injuries will manifest 24 to 36 hours later. The swelling goes down, and you're able to examine it a little more."
The fact that Garoppolo remained in the game leads Dr. Pandya to believe that the injury wasn't highly severe and that the thumb is not unusable. However, it could also mean that we've seen the last of Garoppolo in a 49ers uniform. That depends on the recovery path Garoppolo and the 49ers take.
"For Jimmy moving forward, if there is damage to both of those structures (ligament and bone), that can definitely be more of a five- to six-week recovery time with the likelihood of probably needing surgery," Dr. Pandya said.
With just two regular-season games remaining, that would mean Lance leading the 49ers for the remainder of the regular season and the team's potential playoff run.
Dr. Matt Provencher, an orthopedic shoulder and knee specialist, finds it hard to believe that the 49ers feel Garoppolo might play on Sunday after suffering such an injury. He recently told FOX Sports that the UCL is the most commonly injured area of the thumb.
"It helps to keep the thumb stable," Dr. Provencher said. "It is also known as a skier's thumb and can significantly affect grip, strength, and mobility of the thumb, which are obviously super important for his position of quarterback."
Dr. Provencher says whether the injury can heal on its own or requires surgery will impact the recovery time.
"We should expect to see a specialized form of custom-molded plastic or taped splint that Jimmy will wear on the thumb," Dr. Provencher continued, "but this may not allow him to grip and throw the ball as he needs. I would expect Jimmy to miss the Week 17 contest against the Texans, and perhaps even more time. But we'll have to see how this stabilizes over the next one to three weeks."
After this season, the 49ers are widely expected to part ways with Garoppolo and transition to his successor, Lance. San Francisco surrendered multiple first-round picks and a third-rounder this past offseason to trade up and draft Lance with the No. 3 overall pick.
Garoppolo is scheduled to earn a base salary of $24.2 million and have a salary-cap hit of $27 million next season. Lance's base salary will be $825,000 with a salary-cap hit of $7.75 million after his prorated and roster bonuses.