After Arik Armstead’s presence desperately was missed in the 49ers’ Week 3 loss to the Denver Broncos, the team is hoping he will return for their Monday Night Football showdown against the Los Angeles Rams next week.
That possibility essentially will come down to one thing: the amount of pressure he can put on his foot while dealing with planar fasciitis.
Stanford Medicine’s Dr. David Oji spoke to NBC Sports Bay Area 49ers reporter Jennifer Lee Chan about some of the expectations with Armstead’s recovery. Dr. Oji also cleared up any misconception of Armstead’s size affecting the process.
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“Fortunately, plantar fasciitis is a common injury, even in a very large person and heavyweight,” Dr. Oji said. “It still has excellent potential to heal. Many things could be done including custom inserts, supportive footwear and obviously rest. He should still do very well from a non-operating standpoint.”
That’s promising news for the veteran lineman, who stands 6-foot-7 and weighs 280 pounds.
Armstead’s first missed game since 2017 gave him some time to rest his foot throughout the week. Still, he hasn’t shown he’s been able to push off with his right foot enough to be cleared -- yet -- for the Rams.
But he’s close.
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Dr. Oji anticipates that if he’s making steady progress but that push-off is the one thing holding him back, he could be nearing a return as soon as next week. But there’s no guarantee.
“Yeah. Again, without knowing the exact situation and where he is in the rehab process, it’s hard to kind of speculate on when he’ll be able to return to play,” Dr. Oji said. “But hopefully he’s on the healing track and hopefully he’ll get back on the field soon.”
Plantar fasciitis is one of the most common causes of heel pain. It is a really strong band of tissue that supports the arch in the bottom of the foot and runs from the forefoot all the way to the hind.
As Dr. Oji explained, for people who are very active and on their feet for a long time like Armstead is, it can get extremely inflamed and irritated.
Luckily, Dr. Oji said, the body’s capacity to heal is very good. And doing things like resting and stretching allows it to heal, typically, without needing surgery.
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"Physical therapy has also shown to be helpful in cases where it’s not progressing as well," Dr. Oji explained. "That’s when we start to do other things like inserts, some types of steroid injections, some other treatments that a little bit more, not the mainstream, would be platelet-rich plasma injections, or shock way therapy, and typically those are not covered by typical insurances so they’re a little bit more expensive. But they can also help in cases where it’s not responding to the usual treatments."
Armstead has a few days to do the things Dr. Oji mentioned, and we'll see if 49ers coach Kyle Shanahan decides to use one of his top defensive weapons in the divisional dogfight or whether he'll play it safe.
Either way, if Armstead doesn't take the field next Monday, he's expected to make a comeback soon.