David Chao, MD
2 min read • January 31, 2023
Posted in
After a seven-start win streak to propel the 49ers to an NFC Championship berth, rookie quarterback Brock Purdy is heading for surgery on the elbow injury he suffered in Sunday’s loss to the Philadelphia Eagles.
With the news of his full UCL tear, Purdy has two surgical options to get him back on the field, according to the Pro Football Docs. If the surgery consists of a repair, it’s not impossible he could be ready to throw fully six months from now. However, it’s far from a guarantee.
If Purdy requires a reconstruction – a graft to replace the damaged ligament – he would be out closer to a year and almost assuredly miss the entire regular season, according to the Pro Football Docs.
There is hope that’s not the case. Here’s why.
Throwing elbow injuries are entirely more common in baseball, where repeated stress on the ligament from throwing at high velocity wears out the ligament.
UCL injuries in football happen almost exclusively as a result of contact from a pass rusher during the throwing motion.
Quarterbacks do not make many “max effort” throws during a game, thus UCL injuries caused by repeated high-velocity torque on the elbow are fairly rare in the sport.
In-game, the Pro Football Docs detailed, by video, the worry for a UCL injury. The hope initially was for a sprain – a partial tear – similar to the one Bills quarterback Josh Allen suffered earlier during the regular season.
After the season, Allen revealed he had to adjust his throwing motion to adjust for the “pretty bothersome” pain from his Week 9 UCL sprain. The 26-year-old did not miss game time with the injury, but said he wasn’t fully healed until Wild Card weekend.
Former 49ers passer Nick Mullens suffered a similar UCL injury in Week 15, 2020. He required a repair – not a reconstruction – and became the first quarterback to return after undergoing an Internal Bracing procedure to aid his UCL recovery.
Mullens was able to begin throwing about three months after surgery and signed with the Eagles about five months after surgery. He has appeared in five games since undergoing the surgery in January 2021.
Former Panthers quarterback Jake Delhomme underwent Tommy John surgery in October 2007 following an injury in Week 3, 2007.
Delhomme said his arm was “better than ever” six months after the surgery and he started all 16 games in 2008, leading Carolina to a 12-4 record in the regular season.
Ben Roethlisberger, the retired Steelers quarterback, also returned from throwing elbow surgery. He was injured in mid-September 2019 and returned for the start of the 2020 season. Roethlisberger told reporters his surgery was similar to Tommy John surgery, but he also tore three flexor tendons off the bone that had to be repaired.
After the NFC Championship loss, Purdy talked about the sensation of electrical shocks up and down his forearm. That was because the ulnar nerve, located next to the UCL, was stretched by the impact from Eagles’ rusher Haason Reddick.
Marcus Mariota, currently on the Atlanta Falcons, experienced a similar injury while on the Titans, but did not require UCL surgery.
After losing three quarterbacks to season-ending injuries, San Francisco heads into the offseason with only Purdy and Trey Lance under contract.
Jimmy Garoppolo, who suffered a broken left foot in Week 13, will be an unrestricted free agent after his one-year, $7 million contract expires. It’s no guarantee Garoppolo will return, potentially leaving the team without two healthy quarterbacks for OTAs.
Lance suffered an ankle fracture dislocation in mid-September and, if everything goes right in his rehab, will likely be ready in time for OTAs.
Cowboys quarterback Dak Prescott suffered his ankle fracture dislocation in mid-October 2020 and was ready for OTAs. The hope is Lance and/or Purdy can do the same.
Written by David Chao, MD
