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Can Michael Crabtree return to pre-injury form?

Michael Crabtree has been activated off the Reserve/PUP and the 49ers anticipate he makes his 2013 debut on Sunday. We look at the Achilles rehabilitation process and the likelihood our wideout returns to form.

Win McNamee

Following the activation of wideout Michael Crabtree off the Reserve/PUP, many hope to see Crabtree on Sunday when the 49ers face the St. Louis Rams. Not only has Jim Harbaugh stated, "I anticipate that he's going to back this week," but is reporting the 49ers anticipate Michael Crabtree will make his 2013 debut on Sunday.

Honestly, for those of us familiar with Jim Harbaugh, we take almost everything he says with a grain of salt. We would be remiss not to. We are overly versed in his vague and ambiguous answers. Still, Harbaugh did not dance around this question. Needless to say, the cynic in me wonders why Harbaugh was so straightforward.

It is an exciting possibility, considering Crabtree emerged into a premiere wide receiver before his injury. His third-down stats alone were among the top five in the league. And, this is an area where the 49ers can use some help.

In any event, when Crabtree returns to the active roster, there is no sugarcoating the fact he is coming back from a complete rupture of his Achilles tendon. It is not a straightforward injury. It is difficult to say how Crabtree will perform, because all injuries and experiences are unique. However, I am very optimistic about Crabtree.

Crabtree ruptured his Achilles tendon in OTAs in May and underwent surgery immediately. He has made steady progress with his rehabilitation, but overall -- he is in line with the original 6-month projection of return. Earlier this month, Crabtree gave an interview and stated he had begun working on his sprinting and speed work 2-3 weeks prior to that interview. It was a great sign, because it showed he is well past the most difficult physical hurdles of an Achilles injury. And, his progress is ahead of the usual medical baseline.

The Achilles tendon is the thickest and strongest tendon in the body. It connects your calf muscle to your heel bone. When a person flexes the calf muscles, the Achilles tendon pulls on the heel. This is what allows us to stand, walk, run or jump on our toes.

After surgical repair, the Achilles is extremely malleable. It has to stay immobilized to repair itself and cannot be stretched. Once it is stretched, it causes irreversible damage. So, for years, doctors encouraged the tendon to be completely immobilized. Unfortunately, due to complete immobilization, the medical community realized tendons would shorten and could not move as fluidly. For that reason, rehabilitation of the Achilles evolved. Rehab specialists have embraced a more balanced approach and we are seeing better results.

During rehabilitation, the tendon also needs proper weight-bearing. An athlete will start weight-bearing as soon as possible (but without stretching it). It is a tedious and sometimes painful process. Yet, after athletes pass the initial three- to four-month period, Achilles tendons recover beautifully. The Achilles becomes very strong again.

I want to note muscles surrounding the tendon have memory. That is, after the injury, when the body approaches the position it was in when the initial injury occurred, the muscle will automatically retract. It is instinctive. It is why we see athletes limp immediately after an injury and why after the injury is healed, you will see certain athletes protect or guard an injury.

Because of muscle or movement memory, the Achilles tendon will never feel the same. It feels completely different, even after the injury is completely healed. Still, if no elongation or retraction of the tendon occurred, there is no reason a person cannot return to his former abilities. It should be noted a wide receiver puts more physical demands on his Achilles, but it is very possible to get there. Even athletes, like David Beckham (who arguably use the Achilles even more), have fully recovered and returned to form following a ruptured Achilles. But, a large part of it is mind over matter, which makes the prognosis extremely subjective in nature.

Athletes with over-the-top confidence really excel with these types of injuries. I do not have a crystal ball, but I will venture to say Crabtree has the quintessential attitude. The obvious challenge is he has not played a football game since the Super Bowl. I expect the 49ers will work Crabtree in slowly to get him comfortable. Shortly after he gets comfortable and if he can find a good headspace, I expect great things from Crabtree.