Category Archives: Baseball

All Blogs, Baseball, Wrist/Hand

Kyle Seager Thumb Injury

Leave a comment

On Friday, March 8th, Seattle Mariners third baseman Kyle Seager injured his left hand when attempting to dive and catch a ball. Initial X-rays showed no fracture or dislocation. On March 12th, Seager underwent surgery to repair a ligament in his left thumb. Seager’s injury likely occurred when the thumb was forcefully radially deviated.

 

This is likely an injury to the ulnar collateral ligament of the joint between the metacarpal and the proximal phalanx of the thumb (MCP joint). The second joint of the thumb.  The UCL is the structure that stabilizes the MCP joint on the side of the thumb that faces the rest of the hand. When it ruptures this ligament pulls off the phalanx. The part of the ligament towards the tip of the thumb comes off the bone. If that end of the ligament flips over the top of another structure in the area (the adductor aponeurosis), it won’t heal back and the thumb will be loose with pinch.  It can be difficult to tell by examination (or even MRI) if the ligament is in this non-healing position. People often consider surgery when there is substantial laxity and the possibility of not healing is higher.

 

Timetable to return is described as 10-12 weeks. That means that he might plan to return when the ligament is about 80% strength, which is reasonable.

 

All Blogs, Baseball, strain

Todd Frazier Oblique Strain

2 Comments

After a few weeks into Spring Training, Mets’ third baseman Todd Frazier felt increasing discomfort on the left side of his chest and abdomen while swinging. After an MRI on February 25th, team personnel diagnosed an oblique muscle strain. There is currently no timetable for his return. He was treated with a cortisone shot and he will stop swinging to rest the muscle.

The oblique is a large abdominal muscle extending from the lower rib to the pelvis, the large bone that supports your hip. This muscle plays an important role in twisting motions of the trunk. The oblique can be strained (pulled), meaning partially torn with a hard swing of the baseball bat. Muscle strains usually occur with eccentric contractions, meaning that the muscle is forcibly lengthened when it is trying to contract and shorten (do it’s job). Muscle strains heal themselves. The pain from a strain can make an athlete less effective a their sport.

It’s not typical to have an MRI to diagnose this problem. It’s usually obvious in context (symptoms) and on examination (signs). It’s also not typical to have a steroid injection. Steroids decrease inflammation. Inflammation is an important part of the healing process. Inflammation also causes pain. Steroid injections are usually used to relieve pain in the hopes of returning to play sooner.

All Blogs, Baseball, Knee

Dustin Pedroia Regrets Knee Surgery

Leave a comment

In October of 2017, Dustin Pedroia of the Boston Red Sox had surgery for a cartilage defect in his left knee.  He was expected to return a few months into the 2018 season, but he only played a few games in the middle of the season. In recent reports Pedroia has stated that he wishes he had not chosen to have the procedure.

“No, I wouldn’t have done it,” Pedroia said. “I don’t regret doing it, but looking back and knowing what I know now, I wouldn’t have done it.”

“It’s a complicated surgery,” he added. “The cartilage in my knee is great now, but the graft is the thing. You’re putting somebody else’s bone in your body. To get that to incorporate fully, there are so many things that, going into it, I didn’t know all that stuff. I thought, ‘They were like, you tore this, we can fix it. Great.’”

This got Sports Injury Blog’s attention for several reasons. First, reports of injured athletes almost never discuss decision making. Surgery is nearly always portrayed as necessary, when in many cases it is optional.  

Second, all cartilage restoration procedures are debatable. Surgeons still haven’t fully worked out the risks and benefits. They are probably best considered experimental at this stage. Many of the treatments that professional athletes try are unproved, but that is almost never discussed in media reports. Each of us benefits from knowing the limits of modern medicine and the status of current best evidence.  

Finally, we almost never hear about the decision-making process: how athletes make choices about surgery and other treatment.  And we nearly never hear about misgivings, limited understanding, and perhaps false hope. This is an inherent part of the human illness experience. The silence on these issues among injured athletes feels somewhat dehumanizing; as if they are immune to uncertainty, limited health literacy, bias, false hope, and regret.  

Kudos to Dustin Pedroia for his openness about these often neglected aspects of the illness experience. Everyone stands to benefit from his reflections on his ongoing health journey.

UPDATE: Pedroia returned to action off of the injured list on April 9th. On Wednesday, Pedroia said he “felt a pop” in his surgically repaired knee while swinging, twisting during an at bat. The at bat was Pedroia’s first of the game in a 5-3 loss to the Yankees.

The second baseman was later placed on the 10-day injured list, but reports indicate he received positive news about his knee. Remarkably, he did not have an MRI. It is reported that the Red Sox expect Pedroia back on the field soon. Pedroia has only appeared in six games this season while recovering from the initial knee injury.