49ers Blog and Q&A

News, notes and reader questions about the San Francisco 49ers

October 1, 2007
Saints game more realistic for Smith's return

I just finished talking shoulders with Dr. Richard Marder, who knows a little about the subject considering he is the head of sports medicine at UC Davis Medical Center. In discussing Alex Smith’s separated shoulder, Marder explained that there are six degrees of separations that essentially look at the relation of a person’s clavicle with his acromion. This forms the AC joint you hear so much about. Grades IV-VI are usually associated with a high-impact trauma such as a car crash and require surgery.
A grade I separation means that there is no displacement between the two bones (clavicle and acromion), Marder said. Grade II separations mean there is some contact between the two bones and that one of the ligaments between the two might be torn. A grade III separation – which is what Smith has – means there is actual separation between the two bones, but that the clavicle is still stable. It also means that the ligaments connecting the two have been torn. The bad news is that it’s painful (Smith verified that today) and that the shoulder looks funny. Because the clavicle is no longer attached to the acromion, it looks like it’s sticking up in the air, and Smith said there appeared to be a big bump on his shoulder.
The good news, Marder said, is that the ligaments will scar and heal on their own and that Smith likely will not need surgery. In fact, Matrder said recent studies showed that 'throwing' athletes (quarterbacks, pitchers, etc.) tended to do better when surgery was not involved. Marder said it’s entirely possible that Smith could resume throwing in two weeks and be ready for action in four weeks. He said a full recovery is usually a four- to six-week process. Four weeks would put Smith on the field for the Oct. 28 home game against New Orleans. Six weeks means he’d be back for the Nov. 12 game against, gulp, Seattle.
-- Matt Barrows


Matt was born in Blacksburg, Va., and attended the University of Virginia. He graduated in 1995, went to Northwestern for a journalism degree a year later, and got his first job at a South Carolina daily in 1997. He joined The Bee as a Metro reporter in 1999 and started covering the 49ers in 2003. His favorite player of all time is Darrell Green.


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