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Byron Buxton is right on track in his recovery from shoulder surgery


Lucas Seehafer PT

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blog-0305244001579387203.jpgHello all. My name, as you could see from the byline, is Lucas Seehafer and I am a Doctor of Physical Therapy and strength and conditioning specialist working in the greater Minneapolis-St. Paul area. I've been a fan of the Twins since the early 2000's and figured the Twins Daily community may enjoy some insight into the field of sports rehabilitation and performance. If this is the type of content you enjoy, I can be found on Twitter at @sportkinematics and many other sites, including A Wolf Among Wolves, The Step Back, and (soon) Forbes, where I cover athlete health and performance.

 

In what can only be seen as encouraging news, Minnesota Twins centerfielder has been cleared to begin swinging again, according to The Minneapolis Star Tribunes' Phil Miller.

 

Miller reports, "[buxton] will be limited to hitting off a tee or doing other basic drills while his shoulder gains strength, but the Twins expect Buxton to progress to hitting off a pitching machine by early next month. He could be ready to hit live pitching when the Twins hold their first full-squad workout on Feb. 17."

 

Buxton has not been able to swing since undergoing surgery in early September to repair a torn labrum in his left shoulder, which he originally injured after crashing into the centerfield wall.

 

The labrum is a ring of cartilage found in the shoulder - also known as the glenohumeral joint - that serves to deepen the socket; the labrum improves the stability of the shoulder by increasing the surface contact area between the bones of the shoulder - the humerus and the scapula - as well as by creating a vacuum that keeps the head of the humerus in contact with the socket of the scapula.

 

The labrum is often torn in one of two areas: the superior - or top - aspect or the anteroinferior - or bottom front - aspect.

 

The first kind of tear is known as a SLAP lesion; SLAP is an acronym for superior labrum anterior to posterior. This type of labrum tear is commonly seen in the dominant shoulder of overhead athletes as the primary mechanism of injury is repeated, forceful throwing.

 

The second kind of labral tear is known as a Bankart lesion and these are most frequently seen after an anteroinferior dislocation of the shoulder, the most common type of shoulder dislocation. It is likely that Buxton suffered a Bankart tear as his injury was originally - and erroneously - reported to be a partial separation; a separation of the shoulder involves the acromioclavicular joint, whereas a dislocation involves the glenohumeral joint.

 

Overhead athletes are usually cleared to return to higher-level, sport-specific activities by about four months post-Bankart repair, regardless of which shoulder, their dominant or non-dominant, was operated on; Buxton is almost exactly four months post-op.

 

The reason for this is pretty simple: the repaired labrum needs to be protected as much as possible while it is healing and the strength of the rotator cuff - the group of four muscles near the shoulder that assist the labrum in stabilizing the shoulder, amongst other things - needs to be sufficiently built up.

 

Throwing a baseball places a great amount of stress on the labrum of the dominant arm and, depending on the players handedness while batting, so does swinging (see the main image of this article).

 

All of this is to say that Buxton is right on track in his recovery process, which is good news for the Twins and Twins fans alike. Buxton will be brought along further in his recover program as his rotator cuff strengthens further and the Twins along with Buxton are able to determine how increasing the intensity of his workouts impacts his shoulder. As Miller states, barring any setbacks, Buxton should be able to progress to swinging at full-speed by mid-February and partake in game action during Spring Training or, at the very least, the beginning of the regular season.

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Great news! Is there a threat of reoccuring?

Once an anatomical structure is injury, it will always have an increased risk for re-injury. That said, each injury is unique; the risk increase can be wildly variable. Being that the injury was in Buxton's non-throwing shoulder I'd say the risk is less than if it was in his throwing shoulder.

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