October 6: According to ESPN’s Adam Schefter, the bilateral tendinitis is not regarded as a pressing concern, as the issue is mostly concentrated in just one of McCaffrey’s legs. CMC did indeed take part in on-field work this week, and he did not experience any setbacks with either his Achilles or his calf ailments.

There is still a chance that McCaffrey will return to game action for the 49ers’ Week 7 tilt with the Chiefs on October 20, provided that his recovery continues to go smoothly. It still seems that the Week 8 contest against the Cowboys or Week 10 matchup with the Bucs are more likely return dates — San Francisco has a Week 9 bye — but the fact that Week 7 is even in play is obviously good news.

October 4: Last we heard, NFL media was circulating good news coming off of Christian McCaffrey‘s medical trip to Germany, where he sought treatment for the Achilles tendinitis that has held him out of the season thus far. Reports claimed that McCaffrey would start running on hard ground this past week and that he was expected back by November. The next day, though, head coach Kyle Shanahan acknowledged that some updates were maybe not as optimistic, per Eric Branch of the San Francisco Chronicle.

Specifically, Shanahan confirmed reports that McCaffrey’s is dealing with bilateral Achilles tendinitis, meaning that the injury is affecting both of the running back’s lower limbs. In the quote, Shanahan hypothesizes that the injury manifested in one leg and that, due to compensating to stay off of that leg, it developed in the other leg as a result.

After being placed on injured reserve just before their Week 2 contest, McCaffrey still will be required to sit out one more game before he’s even eligible to return from IR, but no one seems to anticipate that early of a return. The reason for the extended recovery period is that the 49ers’ plan has been to give McCaffrey time simply to rest before returning for rehabilitation.

“We’ll try the ramp-up,” general manager John Lynch told the media, “and God willing, the thing has quieted down, and we can build him back up in a really smart and thoughtful way.”

While everyone seems to be saying all the right things at times, the air of uncertainty casts a shroud of doubt on the situation. Once McCaffrey reports back to practice, we’ll finally have some eyes on the situation and some expectations to come along with it. Until then, though, McCaffrey’s situation remains as cloudy as ever.

SEPTEMBER 29: Per Ian Rapoport of the NFL Network (video link), McCaffrey’s treatment in Germany went well, and he is back in the US. The three-time Pro Bowler could begin running on hard ground this week, and the club presently expects him back no later than early November.

SEPTEMBER 27: Among many other prominent players on the team, Christian McCaffrey remains sidelined for the 49ers. He is on injured reserve while recovering from the Achilles tendonitis which has affected him since the summer.

[RELATED: 49ers Eyeing Midseason Dre Greenlaw Return]

McCaffrey went to Germany earlier this week to consult with a specialist as he and the team aim to find the best route regarding his recovery. It remains to be seen when he will be able to approach a practice schedule (and therefore become a candidate to be designated for return). A ramp-up period could begin soon, however.

“We needed to quiet it down,” 49ers GM John Lynch said when discussing McCaffrey’s Achilles during a KNBR appearance. “The plan was to give it the time to do that and then at some point in a thoughtful way to ramp him back up… What he does and where he goes, he’s got people who work on his body and have for a long time… Now he’s back here and we’ll have to hit certain markers and try the ramp up.”

Having been moved to IR ahead of Week 2, the reigning Offensive Player of the Year will not be eligible to make his 2024 debut until Week 6. Considerable progress will need to be made for that timeline to be feasible, and the team will no doubt proceed with caution in McCaffrey’s case. He is far from the only professional athlete to travel to Germany while rehabbing an Achilles injury, and the fact he went there suggests he may have received an orthobiologic treatment.

Such treatment consists of stem-cell and platelet-rich plasma injections and is specifically focused on accelerating the healing process for injuries such as Achilles tendonitis. Dr. Kenton Fibel (the Anaheim Ducks’ medical director) recently spoke about the specifics of orthobiologic treatments – which are not FDA approved but are permitted by North American professional sports leagues – and how receiving one would impact McCaffrey’s recovery timeline.

“Usually whenever you’re having some sort of a biologic procedure for a tendon, particularly an Achilles tendon, typically that’s going to require you to have enough time to rest and protect the tendon after the procedure,” Fibel said (via Eric Branch of the San Francisco Chronicle). “And then start to progress things forward while the tissue has a chance to biologically start to heal and restructure… With some of these more important weight-bearing tendons, it’s pretty safe to say that they’re not returning within the first four weeks of the procedure.”

If McCaffrey did indeed receive an injection while in Germany, it will be interesting to see how he and the team proceed with a gradual ramp-up period. If not, further rest could be in store before a return to action becomes realistic. While he recovers, San Francisco will continue to rely on Jordan Mason and Isaac Guerendo in the backfield.