Surgery won't wait

The 49ers aren't going to waste any time taking care of Tim Rattay's forearm problem. Since he's already out for San Francisco's final two games due to his latest injury – a partially torn plantar fascia – Rattay will have surgery on his problematic throwing arm Tuesday as he attempts to get a head start on being healthy for 2005, something he never was this year.

The forearm injury – and does anybody really know exactly what it is? – hampered Rattay's season before it even got started and has followed him around ominously since the beginning of training camp.

Rattay missed three weeks of summer practices with swelling in the forearm, then the mysterious injury surfaced again – this time, in a different area of the forearm – six weeks into the season. Rattay's passing got the 49ers out to a 14-0 lead against the New York Jets on Oct. 17 while he played through the pain. But – even after resting during the bye week that followed – Rattay couldn't answer the bell two weeks later against the Chicago Bears, a game the Niners would have won if Rattay had played instead of Ken Dorsey, who also was nursing some injuries of his own that week.

Rattay returned to the starting lineup the next week against Seattle, and it was around that time in early November that he first broached the subject of surgery to repair the forearm ailment that had baffled team doctors and other medical specialists.

Rattay indicated then that rehabilitation after surgery would force him to miss the rest of the season, so – with half a season still remaining – he opted to hold off on the operation until after the season was completed, since he was able to play through the injury.

Of course, Rattay wasn't counting on yet another injury. He suffered a partially torn plantar fascia during San Francisco's loss in St. Louis on Dec. 5 – the fifth significant injury to hit the fifth-year veteran since May. If Rattay returned and suffered further injury to the underside of his foot, it might set back his conditioning program six months.

So, with San Francisco going nowhere in a 2-12 season, the next move for Rattay became obvious: Surgery.

Not on his foot. That injury will heal on its own. But the forearm condition needs some surgical help.

"The procedure will help release compartment pressure in his forearm which will allow the muscle to expand," 49ers trainer Todd Lazenby said Thursday. "Since there is no rush to get Tim back on the field this season, he will immediately rest his forearm and begin rehabilitation at a later date."

It's the right thing for the 49ers to do, looking ahead to 2005 with Rattay before the 2004 season is even over. The poor guy has never had a chance to establish himself this year because of his multiple injuries, and he actually has shown some promising signs while playing hurt.

And – we must stress – Rattay has been hurt all season. In fact, he hasn't been completely healthy at any point this year.

He had surgery in May after tearing a groin tendon during San Francisco's first spring minicamp practice, an injury the 49ers believe has led to his other setbacks this season.

Rattay's forearm injury first surfaced in August, when swelling near his wrist forced him to miss almost three weeks of summer practices. Then he suffered a separated throwing shoulder in San Francisco's Sept. 12 season opener that forced him to miss the next two games. After returning to start three games, Rattay missed the Oct. 31 game at Chicago after swelling spread to a different area of his forearm.

He returned the next week and started four games. Then came the foot injury, which ultimately will keep out of San Francisco's final four games.

"I believe that the injury in minicamp, which we thought was going to be healed, totally influenced everything that happened to him," 49ers coach Dennis Erickson said. "Tim was hurt all year. I don't think he was physically at his best to perform."

You better believe he wasn't. There's no reason not to give Rattay a chance to get there in 2005 as soon as possible.

SPEAKING OF NAGGING INJURIES and surgeries …. Lazenby said defensive end Andre Carter will be able to begin rehabilitation in January after having a cyst removed from his lower back Wednesday for the second time in three months.

That's good news for Carter, since doctors weren't actually sure what was causing the new problem in his back when they went in to take another look. Carter had a MRI exam Sunday that revealed the problem was originating in a different area of his back. He'd had surgery Oct. 4 to remove the first cyst from his back.

That surgery came in the middle of a span during which Carter missed six games. He returned to start five games after his first surgery, but he woke up in the morning before last Saturday's game against Washington experiencing pain again in his back. The MRI then told doctors more surgery would be necessary. "Dr. Scott Wacchorst performed surgery on Andre Carter to remove a synovial cyst that was pressing on his L-5 nerve root," Lazenby said. "He will rest up to four weeks and then start light rehabilitation work."

So now Carter – who, like several other 49ers, has had pretty much a lost 2004 season – can begin pointing toward 2005, too. Erickson said Carter's latest back problem is not a career-threatening condition.

AND LAST BUT NOT LEAST on the injury front … As you probably already know by now, linebacker Jamie Winborn sustained his third consecutive season-ending injury last week when he broke his right shoulder blade against the Redskins.

And we thought this would be the year Winborn finally would make it through an entire season healthy.

He missed two games to injury as a rookie in 2001, then saw his sophomore NFL season end after just three games due to a knee injury. After establishing himself as a key cog in the San Francisco defense last year, his season ended abruptly after nine game when doctors discovered Winborn had a career-threatening neck condition.

After having surgery to fuse together his C-5 and C-6 vertebrae a year ago, Winborn returned stronger than ever this season to become one of San Francisco's top defensive playmakers. He finished the season with 104 tackles, 4.5 sacks and three forced fumbles.

Winborn, as you may recall, didn't join the starting lineup until the middle of October after All-Pro linebacker Julian Peterson suffered his season-ending torn Achilles tendon.

Winborn is the sixth defensive starter this year to suffer a season-ending injury. Peterson, Carter, cornerbacks Ahmed Plummer and Mike Rumph and defensive end Brandon Whiting already are on injured reserve.

Rattay and Winborn likely will join them there before Sunday's game after team management determins how it will replace them on the roster.

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