49ers Insider Shares Why Ricky Pearsall Avoided Offseason Knee Surgery

For a third straight training camp, Ricky Pearsall is inactive due to an injury. In the previous two years, it had been a hamstring that bothered him.

This time, it's his knee, which is the same one on which he suffered his PCL injury last season. His knee is swollen, causing him to be held out.

The 49ers have concerns about his injury and are weighing all of their options. This development has raised questions about how his PCL was handled in the offseason.

Did they exhaust all of their options? And why wasn't surgery elected? NBC Sports Bay Area's Matt Maiocco revealed to Bay Area radio station KNBR why Pearsall avoided offseason surgery.

Why surgery was avoided

"This doesn't look good... I think it's reasonable, rational, logical, for the 49ers to NOT expect Ricky Pearsall to make any contribution in 2026."@MaioccoNBCS says the Niners could be preparing for Ricky Pearsall to miss the entirety of the 2026 season.

(via @MarkusBoucher &… pic.twitter.com/35Q2IfXcVm
— KNBR (@KNBR) July 30, 2026

"The reason the 49ers didn't push the envelope and have him experience the surgery earlier in the offseason is because the expectation was that it could heal on its own," Maiocco said.

"And if they decided to have the surgery, say in February or March or whenever, you're not giving it the full time to recover on its own, but also you're probably going to miss the season anyway. So, I think that they made a calculated attempt to hope that it would heal on its own, like it often does, and once it didn't or hasn't now, it's time for the 49ers and Ricky Pearsall to decide what they want to do."

PCL surgery can potentially have a recovery time similar to ACL surgery (9-to-12 months). If Pearsall had gotten it in February, then there is a good chance he would have missed the entire season.

It makes sense why the 49ers and Pearsall wanted to avoid it. All he needed was some rest last season before reaggravating it in his return.

The belief is that five months or so would be significant enough to get him back to normal. There's really no telling until he starts to stress his knee after that time.

Surprisingly, I don't blame the 49ers for this. I understand why they wanted to be conservative and see if they could get him up to speed without it.

The one pushback is: can anyone fully trust the 49ers' judgment when it comes to medical? Not really. It's fair to say they misjudged this situation.

Maybe Pearsall getting surgery in the offseason would've been fine for him to return in October. And if the 49ers helped him rehab correctly, he could've done it.

It just feels like every injury situation that occurs on the 49ers, they get it wrong. On one end, they're sensible in their approach, but on the other end, it's hard to believe them.

In any case, I'd fully anticipate Pearsall getting the surgery now and missing the 2026 season.

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