How risky is Gore entering 2011?

Is Frank Gore a health risk entering this season?

This just in: The San Francisco 49ers' offense is suspect. With inconsistency at the quarterback position, a struggling offensive line and foot injury to wide receiver Michael Crabtree, this team likely will be challenged in the point-scoring department. Add to the mix new coach Jim Harbaugh, who brings his style and a fresh playbook, and the offseason lockout, and it complicates the challenge of preparing to face a new football season.

Thankfully, there is one constant. The running back who was third in the league last year in average total yards per game, the back responsible for more rushing yards in 2010 than everyone else on his team combined, a quiet, stoic, hardworking fellow and two-time Pro Bowler Frank Gore. Whereas the Niners defense has made vast improvements over the last few years and includes recognizable names such as Patrick Willis, Gore remains the only standout on the offensive unit. Sure, Crabtree made a splash when he was drafted in 2009 -- and has potential -- but his NFL debut was delayed by a contract holdout and then a foot injury and has missed all of the preseason thus far with another foot injury. Then there's the addition of Braylon Edwards, who has made some impressive grabs this preseason, but how his season plays out is yet to be determined.

At the end of the day, Gore, 28, is old reliable. Gore is the one Niners player who consistently presents an offensive threat. Gore can run and catch the ball, and he poses a danger to defenses by simply being on the field so much that other teams have to constantly account for his whereabouts. Shortly after joining the 49ers, Harbaugh announced his plan to keep Gore as a key member of the offense, perhaps even trying to get the ball into his hands more frequently in passing situations. In other words, Gore could get even more work.

But then there are the injury concerns. Everyone's heard them; most everyone has expressed an opinion on them. Gore has racked up his share of injuries and has had more surgeries than most of us will likely ever endure. Over the course of his collegiate and professional careers, Gore has undergone bilateral ACL reconstructions and bilateral shoulder surgeries. He has endured groin and ankle injuries. Last year, his season ended prematurely as the result of a relatively rare hip fracture that did not require surgery, but did result in him missing the last five games of the season.

Perhaps the perception is not quite the reality in this case. The number of injuries is significant. The missed time? Maybe not. It's true Gore has played in all 16 games just once in his NFL career (in 2006). However, he played in 15 games the subsequent season, meaning he's missed just one game during that 2006-07 stretch. Three of the other four seasons, he played in 14 games. If you subtract 2010 (in which he played in 11 games, his fewest in a single season), he has played in 91 percent of games within a five-year span. That's an A-minus. Far above average.

But if one factors into the injury equation Gore's exposure rate in games alone (the number of plays for which he is on the field in games, not practice plays), his injury rate per exposure is less than, for instance, Reggie Bush, who even without counting 2010 (when he played in only six games, his fewest in a single season) played in just 81 percent of games within a four-year span. In his first four years in the league, Bush had 488 rush attempts; Gore had 939 in his first four. Bush admittedly also served as a punt returner, a punishing role, but the point nonetheless is that Gore had many more opportunities on the field in which he could sustain an injury compared to a number of his peers.

There are some lingering concerns this summer about a contract extension, but he reportedly agreed to a three-year deal, so Gore remains the 49ers' every-down back who pounds away for the bulk of the team's yardage on the ground, scoring not overwhelmingly but regularly.

And there is no reason to think the fantasy outlook on Gore changes significantly from what it has been over the last few years. He is consistent and productive but comes with an expectation of some risk involved. The mileage is adding up; when a team relies on a single player so extensively week in and week out, it is bound to take a physical toll. Just how that will manifest itself is hard to quantify, but it would hint at making it increasingly difficult for Gore to stay on the field as the season progresses. That said, he works diligently to maintain excellent physical conditioning. He has also been unique in the world of football in that he has returned from injury in a prior year without a subsequent drop-off in performance.

For now, within the 49ers offense Frank Gore remains the one constant.

Stephania is a physical therapist who is a Board Certified Orthopedic Clinical Specialist and a Certified Strength and Conditioning Specialist. She is a clinician, author and teacher with extensive experience in the area of orthopedic manual therapy and sports medicine. Follow her blog here.