Twins Injury Roundup: Updates on Byron Buxton, David Festa, and Cole Sands

[Lucas Seehafer PT]

Image courtesy of Wendell Cruz-Imagn Images

Unfortunately for the Minnesota Twins, the hits just keep coming. General manager Jeremy Zoll met with reporters recently to provide myriad injury updates, but between that media session and the writing of this article, the team suffered another blow, as Byron Buxton was removed from Tuesday night's game and placed on the IL with continued hip discomfort. Below is information regarding the injuries of Buxton, David Festa, and Cole Sands.

Byron Buxton
Buxton was placed on the injured list Wednesday afternoon after receiving an injection in his troublesome right hip. The Twins continue to label the injury as hip impingement, a diagnosis I wrote in detail about for my newsletter. Long story short: impingement generally takes weeks of targeted rehab to calm down. The injection Buxton received from Dr. Larson was likely a cortisone derivative, such as methylprednisolone (say that five times fast... or even once), which aims to reduce inflammation and pain, but notably, it does not "cure" any of the causative factors. It can take up to two weeks for the medication to reach full efficacy, and activity is also significantly reduced in the days following the injection to give it the best chance to work. In short, don't be surprised if Buxton's IL stay extends beyond the minimum 10 days—perhaps significantly so.

The fact of the matter is that impingement (whether true or pseudo-) is not generally a condition from which one can fully recover in season. Most athletes can recover well without the need for surgical intervention—which, depending on the surgeon and protocol, can shelve athletes for 4-6 months—but doing so takes time. Moving forward, the Twins and Buxton will probably continue to take a day-by-day approach.

David Festa
This update, while perhaps unsurprising, stings. According to Zoll, David Festa underwent surgery on Wednesday with Twins doctor Chris Camp to address shoulder impingement and continued neurogenic thoracic outlet syndrome symptoms. While specific details of the surgery weren't reported (other than to say that the shoulder issue would be done arthroscopically and that Festa was having his pectoralis minor muscle "released"; read: detached from the bone), it's likely that his shoulder surgery involved shaving excess bone from the scapula (shoulder blade) to free up room for the rotator cuff. The pectoralis release is to reduce compression of the brachial plexus, a bundle of nerves that sends and receives signals. Hopefully, that double-procedure will restore full function of the arm.

The Twins did not provide an expected recovery timeline, because there really isn't one, and that, frankly, sucks. The recovery and rehabilitation process will be slow and deliberate, and both the Twins and Festa will do everything in their respective powers to get him back to the majors. In many respects, though, this type of surgery is a last-ditch effort. He can't be counted on even for 2027; he'll be a wild card in camp next spring. Think Matt Canterino.

(In the interest of full disclosure: Dr. Camp is an orthopedic surgeon at the Mayo Clinic, and I work as a part-time physical therapist at the Mayo Clinic. I do not treat Twins' athletes and would not write about Twins' injuries if I did.)

Cole Sands
Cole Sands pitched one major-league inning between IL stints, and his season is now officially done. Sands has dealt with elbow soreness all season stemming from a forearm flexor strain. He was scheduled to meet with Dr. Camp on Wednesday to discuss the results of a CT scan and determine an appropriate next step, per Zoll. After having that meeting, the parties agreed on a path forward: surgery to remove loose bodies from his elbow. Sands told reporters Thursday morning that he hopes to have a normal offseason, after having the surgery and rehabbing over the ensuing two months.

The flexors are a group of muscles on the front of the forearm, which flex the fingers and wrist. These muscles share a common tendon that attaches to the inner elbow, near the ulnar collateral ligament. As such, the muscles–specifically the flexor carpi ulnaris and the flexor digitorum superficialis–protect the UCL from the significant force required to throw a baseball at a high velocity. Sands and the team each noted that his UCL is intact, based on a series of images taken throughout the spring and summer. His flexors showed some inflammation and a strain, but that's settled down encouragingly; the surgery will focus on removing bone chips and give him time to further rest the arm to ensure full recovery for the muscle and protect the ligament heading into next spring.

View full article

[TopGunn#22]

Great information Lucas, really appreciate the analysis.  It's pretty sobering stuff, especially regarding Buxton in the midst of a playoff chase.  They haven't had Festa at all this year, and have had a very limited go with Sands, but Buxton is their MVP and it will hurt to be without him, possibly for the remainder of the season.

With this news, I know the Twins have said they are in "BUYER" mode.  But does this in any way alter their thinking, knowing they could be without Buxton for at least several weeks, and possibly the rest of the season?  How realistic are the Twins chances without Buxton?   

[Post-Concussive Blues]

Love these injury breakdowns. And thank you for calling it hip impingement and not “a” hip impingement. I’m sure it could be argued either way grammatically, but to me the impingement is an ongoing/habitual process and therefore not specifically countable. I don’t know why this always bothers me.

[umterp23]

Buxton is an all-star for sure but not sure you can labeling him the MVP of the team this year. Has played in 9 games since the start of July with really no meaningful moments that I can remember in this month, (now I’m old so memory may not be the best). Team is 38-40 this year when in lineup and 17-15 without. He may not be ready till mid-late August which isn’t ideal for chase to get above .500 and have meaningful games the rest of the year. Just feels like another mismanagement of guys going on IL timely to address issue, he hasn’t been right since mid to late June.

[LambchoP]

Sucks to lose Buck at this stage of the season. Hopefully he's not out too long. Hopefully Festa and even more importantly Abel will be healthy for next season. Speaking of Canterino, what's up with him? Did his arm finally fall off? I thought he was supposed to be throwing again by now. Haven't seen anything about him being released?

[jkcarew]

In short, don't be surprised if Buxton's IL stay extends beyond the minimum 10 days—perhaps significantly so.
 

Surprised if he’s out longer? I’m thinking most of us would be shocked if he’s not.

[Hunter4848]

Im shocked Buxton is milking another trip on the bench...

In the thick of a playoff race and our alleged team leader is nowhere to be found.

[tony&rodney]

Thank you for the writeup. I have been a fan of Festa and his road back to MLB could be difficult. Hoping for the best.