Mario Manningham injury: Truly assessing the recovery

Fooch's Note: We've got a new writer! socalisteph is a big Bay Area sports fan and will be providing a fairly broad mix of analysis for us. The first part of this article is her introduction, and the second part is her Manningham article. You can follow her on Twitter @socalisteph.

The 49ers were the first professional-sports franchise based in San Francisco. My parents, Bay Area Natives, were among the first fans when the team started up. In my family, sports fandom was part of our daily life. We didn't watch regular television shows or series like other families. We watched sports. We went to games. We spent hours playing outside with KNBR live in the background. Other than the occasional hunting show, or perhaps news expose, I grew up with the 49ers.

When it came to the 49ers, I was not given a choice. Even my gender was of no consequence. Rooting for another city would not have been tolerated. My parents were die-hard 49er fans, even my mother. I know some women claim to be hard core, but my mom was the real deal. She could explain a blocking scheme or defensive sequence better than most men. It was pretty cool.

One of my earliest memories is of my mom jumped up screaming. Then, my dad grabbed my sister and me in his arms. We hugged so tightly. I remember not being able to breathe. I remember tears coming down the side of my mom's face. And, I recall my dad's smile and his persistent kisses on my forehead. Oh, and so many high fives. My parents later explained the memory as, "The Catch" - Dwight Clark's incredible grab in the back of the end zone to beat the Cowboys, which effectively began the 49ers dynasty.

Looking back, I was spoiled in a sports-sense. From that memory on, I went on to watch my team win five championships. Maybe good things are wasted on youth. Those were glorious times. Following the 90s, it was pretty rough. I still cannot really talk about it much. But, no true fan abandons her roots. I could never change my loyalty. I am so proud of my sports heritage. My parents were amazing teachers and encouraged everything they loved. And, they really loved the San Francisco 49ers.

At present, I reside in beautiful San Diego, California. I still follow the 49ers with extreme passion year after toiling year. Instead of hugging my family and friends in Northern California, I hug total strangers in bars. It is still awesome.
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Attempting to win a championship is difficult enough without having to manage season-ending injuries. The 49ers withstood a series of injuries last year and fans continue to debate the riskiness of whether guys on the roster should return next season.

Mario Manningham tore both the anterior cruciate and posterior cruciate ligaments (ACL and PCL) in his left knee. Without a medical degree, most fans do not blink when comparing all ligament injuries to Adrian Peterson. Yes, the way an injury is repaired and rehabilitated has come a long way and prognoses are getting better and faster. Peterson gave the public a recovery baseline and a pseudo-bar has been set.

Many are optimistic Manningham will return based on the newly-formed AP baseline. However, many aspects of the rehabilitation process are not measurable and are subjective in nature.

The ACL and PCL function of wide receivers require quad and hamstring strength be at the maximum level. Manningham didn't just tear the ACL, like Williams, but two of the four ligaments that run inside the knee. In rudimentary terms, these are the two major ligaments that crisscross and connect the tibia to the femur. Manningham's rehabilitation entails strengthening both ligaments at the same time and both sides must be equally strong. If one side is stronger, it causes improper range of motion and risks further injury. ACL and PCL rehabilitation is double the work.

Even if Manningham has full range of motion and equal strength on both sides of the knee, we have to consider what wide receivers do. Imagine a few routes: run 15-yards, a stop, a slant, a fade, deceleration, a twist, random cuts and jumps. You get the idea. Additionally, Manningham was used in the slot because of his agility. His duties, in particular, demand more from his knees than the average wide receiver. When he goes to camp, his involvement will be guarded by the 49ers medical staff and his confidence in his strength will take some time. But, as his confidence grows, so will his ability.

The psychological component is something most do not consider when it comes to recovery. Two players can suffer the same injury and undergo the same procedure. But, if a player has never been hurt, rehabilitation can be overwhelming. A player's psyche is as important to the rehabilitation process as the physical aspect. In fact, it is not uncommon when a person is physically capable of doing everything he had done before, but doesn't think he is "strong enough" or "fast enough." So, where is Mario Manningham's headspace in all of this?

The restructured contract gives us a glimpse. According to Jay Hurley, the prior contract provided Manningham a $1.6 million guarantee. He basically waived the guarantee to stay and have a shot with the team in 2013. Under the new contract, Manningham has a $1.8 million base, with $1.25 million guaranteed for injury. The $1.8 million salary only becomes guaranteed if he is on week one of the roster. Alternatively, the $1.25 million is only guaranteed if the Niners cut him due to injury. Once Manningham is healthy, he can be cut at any time and he is on his own. Yes, the restructure saved the Niners precious cap space and the team is mitigating its risks, but what would motivate Manningham to agree to this one-sided deal?

The deal illustrates what kind of player he is. If Manningham didn't restructure, he most likely would've been cut. The new deal is a financial risk for him, but it's clear he wants to play. He believes he'll be on the team's roster for week one. And, that shows a level of confidence, the kind required to play in the NFL long-term.

To really gauge whether or not a player will return, we have to stop pretending we understand complicated medical procedures, making canned comparisons or assuming he restructured due to his inability to perform. Manningham has provided us the very best insight. He exhibits the physical and emotional wherewithal to get back on the field.