The 49ers have spent another week without Nick Bosa on the practice field, and the reason is the same one that has followed him since camp: knee tendinitis and soreness tied to his reconstructed ACL.
That absence had started to feel worrisome before Monday. But Kyle Shanahan and John Lynch have since said the team is now keeping Bosa out as a precaution, which at least changes the tone of the situation. It does not, however, erase the concern.
The safest way for San Francisco to handle this is to assume the knee will be part of the story all season. That kind of approach keeps the 49ers from getting blindsided if the soreness flares up again, and it gives them a better chance to manage Bosa in a way that keeps him available.
That’s the nature of tendinitis. It doesn’t announce itself on a schedule.
It can show up after Week 1 if Bosa plays, or it can wait until Week 6. In that sense, his knee feels like a random number generator this season - the biggest variable on the board.
There is still a path where the issue turns out to be a short-term bump and nothing more. Maybe the trouble in training camp really was just that, and it never comes back. But there’s a reason to be skeptical of that outcome.
Bosa is dealing with the second ACL tear in that knee, and he chose to rebuild it with a sliver of his patellar tendon again, which is the common graft choice for professional athletes. Even so, that decision can leave the knee a bit weaker, and that’s likely where the tendinitis is coming from.
The hard part for the 49ers is that there isn’t a real fix here beyond rest. Rest is what settles the swelling and stiffness down. Because of that, it would not be surprising if Bosa misses multiple games this season.
At this point, that should be the expectation.
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