Berardino: Ervin Santana Can't Make a Fist or Grip a Baseball Post-Surgery

[Otto von Ballpark]

Don't worry. We have Phil Hughes ready to step in.

He can start, and then be his own mop-up guy too!

[Vanimal46]

Don't worry. We have Phil Hughes ready to step in.

Oh boy!!

 

Thanks for the laugh

[Vanimal46]

He can start, and then be his own mop-up guy too!

He's so versatile!

[Heezy1323]

Sorry for the delayed response, guys/gals. I hadn't read this thread until just today.

A couple thoughts I have with respect to this development, with a couple of disclaimers...

 

Disclaimer 1: I'm not a hand surgeon (I specialize in orthopedic sports medicine, so I operate mostly on shoulders/knees/hips/elbows) so I don't have much personal experience with this type of surgery/recovery

Disclaimer 2: I'm still not certain I understand PRECISELY what was done for Santana

 

If anyone still cares to hear my opinions after the two above points... well, here goes.

 

If I remember correctly, he was immobilized in a cast or splint of some type after surgery (I think I recall seeing that somewhere). This is typically done to protect repaired tissue by immobilizing the surrounding joints. The plus side is that the tissue staying quiet/still allows the healing to progress without the intermittent micro trauma that can occur with movement. The down side is that keeping any joint immobilized for a prolonged period of time can lead to stiffness. Some joints are more prone to becoming stiff than others, and in my experience, elbows and the joints of the fingers are among those joints. So the duration of the immobilization is determined by trying to find that 'sweet spot' between protecting the tissue long enough that healing can occur relatively unimpeded, but not so long that significant stiffness begins to set in. To complicate things further, not everyone becomes stiff at the same rate, so in most cases, this is an educated guess. 

 

As such, being immobilized for several weeks after surgery on your MCP joint (as in Santana's case) is essentially guaranteed to impart some level of stiffness. Hopefully it is overcome relatively quickly with appropriate therapy and stretching after removal of the cast/splint. The issues to overcome include the scar tissue forming at the joint where surgery was performed and also stiffness of the tendon gliding in the tunnel on the palm side of the finger that helps pull the finger down.

 

With respect to timeline, it's really hard for me to say given my relative inexperience in this area. To me, the level of concern regarding his stiffness is pretty low. It is fairly likely (to me) that he recovers his range of motion pretty quickly. To me the larger concern is going to be how his finger responds when he begins throwing. Is he going to have resolution of the symptoms he was experiencing that necessitated the surgery? Is he going to have 'flare-ups' that prolong the recovery? Are his pitches going to have the same control and 'bite'? Is he going to have to change the way he grips or throws any pitches due to this? 

 

Without examining him or having more information, it's hard to make any firm statements. My personal opinion would be that going from not being able to hold a baseball to pitching in a major league game in 6 weeks seems... aggressive. I sure hope I'm wrong or being conservative. I'd love to see him on the bump sooner than later.

 

 

 

 

 

[Vanimal46]

Sorry for the delayed response, guys/gals. I hadn't read this thread until just today.

A couple thoughts I have with respect to this development, with a couple of disclaimers...

 

Disclaimer 1: I'm not a hand surgeon (I specialize in orthopedic sports medicine, so I operate mostly on shoulders/knees/hips/elbows) so I don't have much personal experience with this type of surgery/recovery

Disclaimer 2: I'm still not certain I understand PRECISELY what was done for Santana

 

If anyone still cares to hear my opinions after the two above points... well, here goes.

 

If I remember correctly, he was immobilized in a cast or splint of some type after surgery (I think I recall seeing that somewhere). This is typically done to protect repaired tissue by immobilizing the surrounding joints. The plus side is that the tissue staying quiet/still allows the healing to progress without the intermittent micro trauma that can occur with movement. The down side is that keeping any joint immobilized for a prolonged period of time can lead to stiffness. Some joints are more prone to becoming stiff than others, and in my experience, elbows and the joints of the fingers are among those joints. So the duration of the immobilization is determined by trying to find that 'sweet spot' between protecting the tissue long enough that healing can occur relatively unimpeded, but not so long that significant stiffness begins to set in. To complicate things further, not everyone becomes stiff at the same rate, so in most cases, this is an educated guess.

 

As such, being immobilized for several weeks after surgery on your MCP joint (as in Santana's case) is essentially guaranteed to impart some level of stiffness. Hopefully it is overcome relatively quickly with appropriate therapy and stretching after removal of the cast/splint. The issues to overcome include the scar tissue forming at the joint where surgery was performed and also stiffness of the tendon gliding in the tunnel on the palm side of the finger that helps pull the finger down.

 

With respect to timeline, it's really hard for me to say given my relative inexperience in this area. To me, the level of concern regarding his stiffness is pretty low. It is fairly likely (to me) that he recovers his range of motion pretty quickly. To me the larger concern is going to be how his finger responds when he begins throwing. Is he going to have resolution of the symptoms he was experiencing that necessitated the surgery? Is he going to have 'flare-ups' that prolong the recovery? Are his pitches going to have the same control and 'bite'? Is he going to have to change the way he grips or throws any pitches due to this?

 

Without examining him or having more information, it's hard to make any firm statements. My personal opinion would be that going from not being able to hold a baseball to pitching in a major league game in 6 weeks seems... aggressive. I sure hope I'm wrong or being conservative. I'd love to see him on the bump sooner than later.

 

Thanks for stopping by Heezy! Even though hand surgeries aren't your expertise, your input is much appreciated!

[ashbury]

Sorry for the delayed response, guys/gals. I hadn't read this thread until just today.

A couple thoughts I have with respect to this development, with a couple of disclaimers...

Now, what's your opinion on Vitamin B-12 supplements and/or injections?

[Heezy1323]

 

Now, what's your opinion on Vitamin B-12 supplements and/or injections?

Also not an area of my expertise, but my understanding is that most non-vegetarians are able to obtain plenty of B12 in their diet without supplementation. Also, oral B12 is very minimally absorbed, so injection is a preferred method of administration for those who need it.

 Polanco's situation is sure disappointing. You'd like to think that professional athletes would be ultra-careful about what they are putting in their bodies, but it's hard for me to speculate on the dynamics of the relationship between Polanco and his trainer/trainers in the DR. Hopefully he can use this as motivation and a learning experience, and be better for it on his return. I also hope it will be cause for others in the Twins system to use greater caution with supplements in the future as well (though one would like to think that Santana's prior situation would have been instructive in that sense).