How will cold weather affect Jimmy G's thumb, shoulder?

George Kittle isn't alone in saying it's a "dream come true" playing a night playoff game against the Green Bay Packers at Lambeau Field. Jimmy Garoppolo, a Chicago native, surely is in the same boat. At least mentally. 

Physically, not so much. 

The 49ers' starting quarterback now has not one but two injuries to his right throwing arm as San Francisco looks to keep its season alive this Saturday against Aaron Rodgers and the top-seeded Packers. What makes matters worse for him is the fact that it's predicted to be a freezing 15 degrees at kickoff and feel like 1 degree. No thanks.

That could be a big concern for Garoppolo's two injuries. 

"I think it's very difficult in general," Dr. Nirav Pandya of UCSF told NBC Sports Bay Area. 

Garoppolo is dealing with a torn UCL in his right thumb and a sprained right shoulder. Dr. Pandya says the two main issues with the QB's thumb injury is pain tolerance, which he has done well with, and grip of the ball. Since the injury, he has thrown five interceptions and fumbled once in a two-plus game span. 

However, Dr. Pandya also noted that the cold weather certainly could play a factor in how much Garoppolo's limited by the thumb injury alone. 

"I think now as he gets further along, the key issue with his thumb is how it's going to respond in the cold weather and that's the big thing with these ligament injuries," he said. "It impacts grip, and in cold weather it could potentially impact that as well."

As far as his shoulder goes, Dr. Pandya believes Garoppolo's velocity on his passes is what will be hurt most. He believes Garoppolo should be able to still throw short and intermediate passes, but it's the "30, 40-yard bombs" that can be more concerning. Luckily for Garoppolo and the 49ers' offense, that has been the plan all season long -- get the ball out of Garoppolo's hands quickly and get it to playmakers like Deebo Samuel. 

Everything in the body is connected, or so I've been told. That brought me to the question, could these two injuries be correlated? Well, somewhat.

Like the rest of us, Dr. Pandya noticed that on the play that Garoppolo hurt his shoulder against the Dallas Cowboys in the NFC Wild Card Game, he tried to avoid being thrown to the ground to protect his thumb. In return, he landed awkwardly on his elbow and that impacted his shoulder being hurt. That's the correlation, more than anything else.

"I think the connection is more 'I'm trying not to hurt my thumb,' and then you're landing a different way than you normally would," Dr. Pundya said. "Maybe three or four games ago if Jimmy landed on his hand, it wouldn't have impacted the shoulder. So I definitely think it's connected, whether it was something that happened over the course of the game and maybe irritated the shoulder a bit and then got thrown over the edge with that blow or it's something that's a little more subtle.

"So, absolutely. I think everything is connected with the throwing arm."

An advantage that Garoppolo could have is that he does have plenty of experience playing in the cold. He did so in high school, college and the start of his professional career with the New England Patriots. That makes Dr. Pandya feel a lot more confident when talking about Garoppolo. 

"Luckily for Jimmy, he grew up in Chicago, he played in New England, he played at Eastern Illinois -- so he's a player used to the cold weather," Dr. Pandya said. "So I think that's No. 1. A lot of it is how used to it your body is to playing in cold weather. I think the two things specifically for him that it'll impact, No. 1 there are studies that show when your fingers and hands are colder, grip strength is compromised. So, it's going to be harder to grip that ball, even if he had a normal thumb. I think that's the first thing we need to look for. And No. 2, everything just takes longer to warm up and that's where the shoulder comes into play. Can you keep those rotator cuff muscles nice and loose? How's it going to respond when it gets impacted?

"Absolutely I think that's going to place a little bit of a disadvantage at him. But he clearly has shown a lot of heart and toughness with the various injuries. With those things in consideration and his experience playing in the cold weather, I think he'll be able to overcome it.

"But once again, yeah, that definitely is going to be a bit of a factor he's going to have to work against, both with the hand and the shoulder."

Garoppolo isn't alone when it comes to having to stay loose and warm on the sidelines. Dr. Pandya brought up the point that this is the Frozen Tundra that we're talking about. Garoppolo, and every other player on both sides, won't be tackled on a pillow. This one's going to hurt. 

The quarterback always has the brightest spotlight on him. Garoppolo's right thumb and shoulder have taken center stage. Injuries overall this late in the season, and with weather like this, is a concern for all. 

"In general when it's colder outside, it's harder for your respiratory system to recover," Dr. Pandya explained. "In general, athletes are gonna have a little less time in terms of, are you gonna catch your breath? You're a little more tired, are your mechanics going to break down? Someone has that hamstring, that quad, other issues, it's hard enough already to warm it up. Then you're not having that time to recover on the sidelines, that's No. 1.

"And No. 2, there's actually been some studies that show that in cold weather, concussions actually increase as well too, just with the impact on the brain and the force that you're experiencing. Obviously everyone is concerned about Nick Bosa, with the concussion. I think in general, it's more of a general risk for a player on the sidelines. You're worried about that body warming up, you're worried about recovering and that concussion risk as well.

"So, it's tough to play in cold weather. Ideally, it would be a nice and warm day in sunny San Francisco, but everyone's playing on the same field and everyone's gonna have that same risk. We'll see how it all plays out over the weekend."

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All in all, Dr. Pandya made it clear that Garoppolo already has "exceeded a lot of what outside medical professionals thought he could do." He has been beyond impressed by his toughness and likes the fact that Garoppolo has experience in the cold. Despite the factors against him, Pandya is expecting a solid showing from San Francisco's signal-caller. 

Kittle and Garoppolo are just two people on a long list of 49ers, that also includes receiver Brandon Aiyuk and coach Kyle Shanahan, as those who have refused to use the cold weather as an excuse for their upcoming battle. The last time the 49ers faced the Packers in the playoffs, Garoppolo only needed to attempt eight passes to still come away with a win at Levi's Stadium. That likely won't be the case this time, but as he has done plenty of times in the past, Shanahan should have a plan to slice and dice the Packers' defense with a compromised QB. 

While players look at their own breath in one of football's most historic cathedrals this Saturday, keep a close watch on how the weather impacts not just Garoppolo, but all players on both sides as each team looks to continue their season.

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