Dr. York 'perfectly comfortable' with handling of Smith's concussion


Dr. York 'perfectly comfortable' with handling of Smith's concussion

Before there can be any quarterback controversy, 49ers quarterback Alex Smith must receive medical clearance to return to play after sustaining a concussion Nov. 11.

Smith was cleared to practice last week through Saturday, according to the 49ers' practice reports. His participation was listed as "limited." Even team owner Dr. John York said he was surprised when he learned that Smith would not be available Monday night to play against the Chicago Bears.

And under the NFL protocol on concussions, Smith would not be cleared to play Sunday against the New Orleans Saints unless his symptoms clear.

Coach Jim Harbaugh said after the 49ers' game Monday that Colin Kaepernick got all of the practice snaps on Saturday and Sunday, which seems to indicate Smith was experiencing symptoms over the weekend.

Teams are not required to provide an injury update on the day before a game, so the 49ers did not submit any notification of Smith's participation -- or lack thereof -- in Sunday's practice.
The 49ers made the call to start Kaepernick on Sunday before knowing if Smith would gain medical clearance to play, Harbaugh said."Yeah, (we) made the decision Sunday that Colin would start the game," Harbaugh said. "And then we found out Monday that Alex would be out. But that decision was made to start Colin on Sunday."Again, not a big mystery here. Just felt that Alex still had some symptoms on Sunday and we were going to make the decision to go with Colin."The 49ers announced Monday at 10:30 a.m. that Smith was declared out after being evaluated by team medical director, Dr. Dan Garza, one of the leading concussion researchers at Stanford.Dr. York is the chair of the NFL Owners Committee on Health and Safety. After the game, I spoke with him about his team's handling of Smith's situation:"The 49ers handled it according to the (NFL) protocol," York said. "That's what we're supposed to do, and that's what the other 31 teams are supposed to do. So I'm perfectly comfortable with how we handled it."At what point did Alex Smith begin experiencing symptoms?
Dr. York: "This is not avoiding your question, but I don't know the answer to that. That's between the doctors and Alex, so I don't get into that."If he were cleared to practice for four days, I'd assume that means he did not have any symptoms. Is that correct?
Dr. York: "Well, I don't know exactly because I wasn't here all week. You tell me the sequence of where Alex was."He took part in limited practice Wednesday -- well, unofficially Wednesday -- officially on the reports, Thursday, Friday and Saturday.
Dr. York: "So what that would mean to me is that he did not have symptoms at those times and that in meeting with the neurologist, which he had to do, that he was OK. He probably went through the neuropsychological testing and I don't know at what time he started to develop symptoms. But what you need to understand is if you have a concussion, you might not have symptoms right away. You may have them later. You may have symptoms now, they go away, and they come back. So trying to figure out whether or not he had symptoms on Wednesday or Thursday or Friday, obviously, he didn't have symptoms to the extent that the doctors knew it and Alex felt uncomfortable. I don't know when Alex felt those symptoms."Are you apprised of it as the chair of the committee?
Dr. York: "No. I'm not apprised of it from any other team, nor should I be from our team. I'm kept in the loop as the owner of the team."Do you believe everything is working league-wide as it pertains to the handling of concussions?
Dr. York: "It is far better than it has ever been. Can it improve? I think the answer is yes. But you have a situation where there is a big game between the Bears and the 49ers, and both quarterbacks had concussions. I personally thought that Alex was probably going to play. So I was surprised when he did not. But when I was told that he had symptoms and he was not going to be able to play, that's the protocol, I accept it. Jay Cutler, I don't know what happened to Jay because I'm not privy to that. But he's out. And my understanding is that Michael Vick was out. So you had three starting quarterbacks, all pretty high profile, and not one of them played. And to my knowledge, if they had passed all of the protocols, all three of them would have played."Is that a signal to you that it's working?
Dr. York: "I think it's a signal that people are following the protocols and if you don't clear, you don't play. So we've seen things where we thought we had things covered, and we do other things, such as putting the AT (athletic trainers) spotter in the video booth. There are going to be things that we're going to have to continue to do better and better. So we're going to be diligent about finding out what the protocols are, and that people are following them. And when things need to be changed or improved, we'll do that. But it won't come from me, it'll come from the physicians."

49ers begin final phase of offseason program

49ers begin final phase of offseason program

The 49ers have graduated back to the phase of the offseason when offense-vs.-defense drills are allowed.

Because of the hiring of Kyle Shanahan, the 49ers were allowed an additional “voluntary” minicamp before the NFL draft. That meant the 49ers were permitted to skip from the two-week conditioning phase of the offseason straight to what is allowed under Phase III.

But after the three-day minicamp in late-April, the 49ers were forced to retreat back to Phase II, when on-field drills but could not include offense vs. defense.

Beginning Monday – and over the next three weeks -- the 49ers can get back to conducting the standard one-on-one, 7-on-7, 9-on-7 and 11-on-11 "non-contact" drills. The 49ers have the maximum number of 10 organized team activities scheduled. The official offseason program concludes with a mandatory minicamp scheduled for June 13-15.

The real competition does not begin until the pads go on during training camp. but here’s a look at the team’s most notable offseason competitions (one position you will not find is quarterback, where the depth chart of Brian Hoyer, Matt Barkley and C.J. Beathard appears clearly set):

Running back: Carlos Hyde, entering the final year of his original four-year contract, has a lot of competition to hold onto his role as the featured back. He is coming off his most-productive season, finishing just 12 yards shy of the 1,000-yard mark when he sustained a knee injury with one game remaining. Shanahan and running backs coach Bobby Turner lobbied for Utah running back Joe Williams in the draft. They clearly see a fit for him within the system.

Pass-rush end: The 49ers’ pass rush was among the worst in the NFL the past two seasons. Arik Armstead will be given an opportunity to see if he can adapt to the “Leo” position. Aaron Lynch must earn the confidence of the coaching staff and front office. The 49ers added explosive, 243-pound pass Pita Taumoepenu in the sixth round.

Tight end: The 49ers confirmed Vance McDonald was available for a trade during the draft. After finding no takers, the 49ers brought back McDonald and he rejoins the competition among rookies George Kittle and Cole Hikutini, and veterans Logan Paulsen, Garrett Celek and Blake Bell.

Cornerback: Rashard Robinson is the obvious choice to start on one side. And assuming Jimmie Ward remains at free safety, the 49ers have no other player on the roster who has started a significant number of games at cornerback. Rookie Ahkello Witherspoon, a third-round draft pick, will have a legitimate opportunity to win a starting job, as long as he displays a willingness to stick his nose into the action and play with the requisite level of physicality. Dontae Johnson, Keith Reaser and Will Redmond should also be in the mix to replace Tramaine Brock, who was released shortly after his arrest after an alleged domestic incident last month.

Center: Jeremy Zuttah, a Pro Bowl performer, was added in the offseason via a trade with the Baltimore Ravens. Daniel Kilgore has been the 49ers’ center the past three seasons but injuries have limited him to just 23 starts over that period of time. Zuttah has position flexibility. The 49ers could determine the best thing for the offensive line is to move Zuttah to one of the guard positions – to challenge Zane Beadles or Joshua Garnett -- if he is not clearly better than Kilgore.

Weakside linebacker: The 49ers signed veteran Malcolm Smith on the first day of free agency, providing him with $11.5 million of fully guaranteed money. The 49ers ranked Alabama linebacker Reuben Foster as the No. 3 overall prospect in the draft. They traded up to select him at No. 31 overall. Assuming Foster is ready to compete at the beginning of training camp after undergoing offseason shoulder surgery, it appears likely he would line up in that position and compete with Smith. The 49ers’ medical staff does not believe Foster will require any additional surgery, and Foster said he expects to be cleared for the opening of camp.

Barkley continues work with personal coach of Brady, Ryan

Barkley continues work with personal coach of Brady, Ryan

Atlanta Falcons quarterback Matt Ryan spent last offseason working with Tom House and Adam Dedeaux on his throwing mechanics.

Ryan went on to set career-bests in completion percentage (69.9), yards passing (4,944), touchdowns (38), interceptions (7) and passer rating (117.1).

New 49ers quarterback Matt Barkley worked with House and Dedeaux for the fourth offseason in Southern California before reporting to Santa Clara for the team’s offseason program.

“Kyle (Shanhan) is on board with what House and those guys are doing – I think, really, because of the year Matt Ryan had,” Barkley said on “The 49ers Insider Podcast” on NBC Sports Bay Area.

“He’s a believer in that. He saw the benefits of what Matt did with some of his drops and the timing on routes, how he changed his feet on some things. So we’re kind of sticking with that plan. Everyone is a little different, but for the most part we’re all on the same page when it comes to what our drops are looking like, our footwork and how the ball is coming out.”

House is a former major league pitcher and pitching coach who founded the 3DQB training facility in Los Angeles. Dedeaux pitched at USC and is the grandson of USC baseball coaching legend Rod Dedeaux. Former NFL quarterback John Beck is a motion mechanics instructor.

Tom Brady, Drew Brees, Alex Smith and Carson Palmer are among the NFL quarterbacks who have worked with 3DQB.

“I believe in those guys and what they’re doing,” Barkley said. “They’re at the top of their game, working with Brady and a bunch of other guys. They’ve helped me.

“He won’t change your throwing motion or really tweak how the ball comes out, but he’s going to try to maximize velocity and ground force production and torque -- a lot of sports science terms. But, really, just maximizing efficiency with your motion and making sure you’re sequencing is right.”

Barkley had never played for Shanahan before signing a two-year contract with the 49ers on the first day of free agency. But there are two obvious connections. Barkley’s offensive coordinator last season with the Chicago Bears was Dowell Loggains, Shanahan’s quarterbacks coach in 2014 when Shanahan was the Cleveland Browns’ offensive coordinator. The other connection is House.

"It’s kind of funny, he worked with Atlanta’s staff all of last year, helped Matt Ryan, kind of build his base from the ground up and helped him a lot and he had an MVP year," Barkley said of House.

"There may have been talks down the pipeline, who knows. I don’t think that was the deciding factor by any means, but it never hurts.”