Byron Buxton Knows You Can't Spell 'Sisyphus' Without 'Hip'

[Lucas Seehafer PT]

Image courtesy of Bruce Kluckhohn-Imagn Images

Sometimes, the road to injury recovery feels Sisyphean. Things are feeling good. The rehabilitation is progressing, the pain is improving, and baseball activities are resumed. And then it happens. A misplaced step, a twist of the leg, or a slide into second base, and all of a sudden, the 1,000-pound boulder rolls back down the hill, demanding to be pushed again.

Such has been the experience of All-Star center fielder Byron Buxton, who was placed on the injured list yet again last week due to lingering hip impingement symptoms. Unfortunately, Buxton (an MVP-caliber talent when healthy) is no stranger to the Sisyphean rebounding from injury, but it’s fair to wonder if this time—for this season—his trial is over. Maybe this boulder can’t be pushed back up the hill.

Hip impingement involves excessive bone growth near the head of the femur or along the acetabular rim (socket), and in some cases both. This excess results in reduced range of motion and “pinching” pain at the hip, particularly during activities that involve running, twisting, cutting, and decelerating (i.e., baseball). If the overgrowth is significant enough, it can impinge on the labrum, a ring of tissue located inside the hip that holds the ball of the femur within the socket, improving stability and force transmission through the joint. The labrum has very little blood flow relative to other tissue in the body. As such, it does not heal well on its own. If the damage is large enough, it may cause pain, inflammation, and reduced stability, which may require surgical repair.

Why Byron Buxton Might Need Hip Surgery, and When He Could Play Again

This injury can often be managed successfully, with targeted rehabilitation focused on restoring range of motion and improving muscle strength to divert force away from the joint. When indicated, a steroid injection may be deployed to reduce swelling. However, if these interventions fail (as they have so far, for Buxton), surgery to shave the excessive bone and/or address damage to the labrum may be warranted.

Return to play following surgery to correct hip impingement largely depends on the extent of tissue operated on, though the literature on the return for position players following hip labrum repair is scant. High-level baseball players have previously returned to play within 3-8 months following hip arthroscopy, including impingement and labral repair procedures. Twins general manager Jeremy Zoll indicated that surgery may be on the table, which could place the beginning of Buxton’s 2027 campaign in question depending on when and if that decision is made.

Buxton’s struggle is the latest in a chain of examples of his body failing him. Make no mistake: There are no morals when it comes to injury. One cannot simply will oneself to orthopedic health. Injury is the result of the complex, chaotic interplay between innumerable variables, not any sort of ability. (Whoever coined the phrase “The best ability is availability” had no understanding of injury pathology and risk mitigation. Perhaps it should come as no surprise that a football coach, Bill Parcells, is credited for the saying's popularity.)

He will undoubtedly bounce back, yet again, and perform at a high level next summer. After all, it’s not like Sisyphus ever gave up. At a certain point, though, Buxton and Twins fans must both start to feel cursed—just as Sisyphus was.

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[Cory Engelhardt]

Lucas, you are definitely one of the top 25 influencers in the world in my eyes :)

Always appreciate your articles. Thanks!

[Thumbs Down Guy]

Hoping it takes Buxton a long recovery. Only because I would love to see him at top performance during the second half of the season and pushing hard for division dominance.

[dberthia]

In his present state, he's not good to anybody, so if he needs surgery I hope he gets it done ASAP. The season is lost, so there's no point in trying to get him back on the field this year.

[LastOnePicked]

Make no mistake: There are no morals when it comes to injury. One cannot simply will oneself to orthopedic health."

This is 100% true.

"He will undoubtedly bounce back, yet again, and perform at a high level next summer."

This is 100% wishful thinking. I have hope as well, but there are certainly doubts.

[PuckettPond]

Surgery now as we have CF covered with Keaschall, Jenkins & Erod coming up. When did his personal physician Dr Ruth say when Buxton will be healthy for baseball activities?  

[Hrbeks Divot]

Informative and entertaining stuff as usual @Lucas Seehafer PT. Great work!

[Western SD Fan]

Thank you for your expertise which, for me, confirmed many of our instincts that Buxton likely shouldn't have come off the IL the last time.  Buxton, Zoll, Shelton, and the training staff should have had a long conversation and determined that Buxton wouldn't have been able to help the team after he went down on July 28th.  That's when this injury should have been addressed.  We may have lost a month of recovery time due to everyone believing he could play through it.  We would have found out sooner that we needed Jenkins or other help in St Paul quicker had they chosen this route.

[Wedman13]

1 hour ago, PuckettPond said:

Surgery now as we have CF covered with Keaschall, Jenkins & Erod coming up. When did his personal physician Dr Ruth say when Buxton will be healthy for baseball activities?  

I am blessed to have been christened by Kriedler, heard TIN MAN and Dr Ruth in the same season.  I didn't see that coming at all on opening day....

[bjorks]

For reference, I have a torn labrum in my right hip, which is basically a hip impingement from slipping in the mist with my driver. Right at impact my right leg shot out behind me and I looked like a hockey player on one skate (it happened on first hole so of course I kept playing). I've done both PT and had steroid injection and while the injection worked great for pain, it lasts about 6 months and I'm obviously not trying to play MLB. I'm going on 18 months since I did this and here's what I've learned and I'm not trying to compare it to BB, but we basically have the same issue.

1) From a mobility perspective I orignaly lost about 60% range of motion and have gotten about 30% of that back. 

2) 98% of the time it feels completely fine and then you step/turn the wrong way or you attempt to do something athletic (twisting) and it feels like someone just took a knife to your groin. It's a sharp, isolated, jab where I'd say the pain goes from 0 to 15 in the blink of an eye. 20-30 minutes later it feels sore, but almost fine.

3) Surgery for torn hip labrum has a low success rate according to my surgeon. The shots are basically for comfort, it doesn't promote healing per say, but you can't be on that crap forever. My options are basically live with it for now or have my hip replaced. 

4) Other option is PRP injections and my quote was $23,000 for 1 billion stem cells injected into the socket 2x...I go in next week to to possibly schedule my hip replacement surgery next week at age 49. 

I say all this because it's one of the most annoying injuries I've ever had (played in college at D2 level) and like I said it feels fine 98% of the time and then BANG! I tore the muscle off my pelvis in college and have the pelvic mesh, which felt like a gun shot when it happened and the pain in my hip when I move wrong is worse. I feel for BB, literally. It F'ing SUCKS

[Whitey333]

Same old Buxton drama.  Its been going on for more than a decide.  The few times he has played over the past 12 years have been a mix of greatness and mediocrity.  The drama needs to end.

[mluebker]

I hope he gets the surgery, comes back from it a little less fragile, and settles into one of the corner outfield slots. Maybe that can extend his career for a few more years and keep his bat in the lineup.

[David Maro]

If he really wants to play next year he should be having the surgery this week. To many players want to get treatment and then realize its January and the injury is no better. If he goes that route he will lose the 27 season. The 26 season is over and having him on the field for a handful of games is silly.

[PatPfund]

I don't think Bill Parcells (or whoever said it) misunderstood anything with the 'best ability' quote. Abilities (or to put it another way, talents) are one of those things that can be honed, but most of it is out of a person's control. I played baseball for over 50 years, but all the practice in the world was never going to make me a pro-level (even minors). Being available to play is a critical ability; part self-care, part luck, part constitution. No knock on Buxton (whose contract, FYI, was priced on partial availability), but it is what it is. I hope he does the surgery sooner, but either way, Byron is usually a PT player, and he probably will be next year. 

[The Great Hambino]

14 hours ago, bjorks said:

For reference, I have a torn labrum in my right hip, which is basically a hip impingement from slipping in the mist with my driver. Right at impact my right leg shot out behind me and I looked like a hockey player on one skate (it happened on first hole so of course I kept playing). I've done both PT and had steroid injection and while the injection worked great for pain, it lasts about 6 months and I'm obviously not trying to play MLB. I'm going on 18 months since I did this and here's what I've learned and I'm not trying to compare it to BB, but we basically have the same issue.

1) From a mobility perspective I orignaly lost about 60% range of motion and have gotten about 30% of that back. 

2) 98% of the time it feels completely fine and then you step/turn the wrong way or you attempt to do something athletic (twisting) and it feels like someone just took a knife to your groin. It's a sharp, isolated, jab where I'd say the pain goes from 0 to 15 in the blink of an eye. 20-30 minutes later it feels sore, but almost fine.

3) Surgery for torn hip labrum has a low success rate according to my surgeon. The shots are basically for comfort, it doesn't promote healing per say, but you can't be on that crap forever. My options are basically live with it for now or have my hip replaced. 

4) Other option is PRP injections and my quote was $23,000 for 1 billion stem cells injected into the socket 2x...I go in next week to to possibly schedule my hip replacement surgery next week at age 49. 

I say all this because it's one of the most annoying injuries I've ever had (played in college at D2 level) and like I said it feels fine 98% of the time and then BANG! I tore the muscle off my pelvis in college and have the pelvic mesh, which felt like a gun shot when it happened and the pain in my hip when I move wrong is worse. I feel for BB, literally. It F'ing SUCKS

I'm also in the torn-hip-labrum club.  It's the most frustrating injury I've ever had (played football at the D3 level - I was never a bjorks-level athlete), partially because it's difficult to diagnose without an MRI, partially because the symptoms come and go seemingly out of nowhere exactly as you described in point 2.

I took the surgery route, which included re-shaping the top of my femur (congenital defect left me with too much femoral neck for the hip joint, which led to the labrum tear that caused the impingement).  It took several months to fully heal, but I was able to play two more seasons.  My lateral movement never returned, but it was ish to begin with, so no big loss there.  They told me a hip replacement in the future was virtually guaranteed, but I've been able to dodge it for 20 years so far.

Tying this back to Buxton, I completely understand how his issues can seemingly come and go and flare up in a really painful fashion, and I also get the frustration involved with an injury where it's tough to acutely pinpoint the cause.  When I finally got the tear diagnosed with the MRI, a part of me was relieved to finally be able to point to something to be able to show my coaches I wasn't making things up.  With the obvious caveat that not all impingements are created equally, I hope they give some real consideration to the surgical option.  There's plenty of time for recovery, and the psychological benefits of eliminating these flare-ups are almost as important as the physical benefits.  I would also strongly encourage the Twins to consider any future time spent in CF by Buxton to be a bonus from a roster planning standpoint

[Vanimal46]

14 hours ago, bjorks said:

For reference, I have a torn labrum in my right hip, which is basically a hip impingement from slipping in the mist with my driver. Right at impact my right leg shot out behind me and I looked like a hockey player on one skate (it happened on first hole so of course I kept playing). I've done both PT and had steroid injection and while the injection worked great for pain, it lasts about 6 months and I'm obviously not trying to play MLB. I'm going on 18 months since I did this and here's what I've learned and I'm not trying to compare it to BB, but we basically have the same issue.

1) From a mobility perspective I orignaly lost about 60% range of motion and have gotten about 30% of that back. 

2) 98% of the time it feels completely fine and then you step/turn the wrong way or you attempt to do something athletic (twisting) and it feels like someone just took a knife to your groin. It's a sharp, isolated, jab where I'd say the pain goes from 0 to 15 in the blink of an eye. 20-30 minutes later it feels sore, but almost fine.

3) Surgery for torn hip labrum has a low success rate according to my surgeon. The shots are basically for comfort, it doesn't promote healing per say, but you can't be on that crap forever. My options are basically live with it for now or have my hip replaced. 

4) Other option is PRP injections and my quote was $23,000 for 1 billion stem cells injected into the socket 2x...I go in next week to to possibly schedule my hip replacement surgery next week at age 49. 

I say all this because it's one of the most annoying injuries I've ever had (played in college at D2 level) and like I said it feels fine 98% of the time and then BANG! I tore the muscle off my pelvis in college and have the pelvic mesh, which felt like a gun shot when it happened and the pain in my hip when I move wrong is worse. I feel for BB, literally. It F'ing SUCKS

I'll be joining you on the hip replacement train in a few years I'm sure... I had 2 hip surgeries due to labrum tears. The last surgery was 15 years ago, and I still have the same challenges you face. There are certain movements I will never do with my left leg, because of the instant pain you described in point #2. 

If Buxton's experience is similar to what I went through before the surgeries, he is likely dealing with a dull pain that lasts all day and night on top of the knife piercing pain if you make the wrong move. 

[bjorks]

2 hours ago, The Great Hambino said:

I'm also in the torn-hip-labrum club.  It's the most frustrating injury I've ever had (played football at the D3 level - I was never a bjorks-level athlete), partially because it's difficult to diagnose without an MRI, partially because the symptoms come and go seemingly out of nowhere exactly as you described in point 2.

I took the surgery route, which included re-shaping the top of my femur (congenital defect left me with too much femoral neck for the hip joint, which led to the labrum tear that caused the impingement).  It took several months to fully heal, but I was able to play two more seasons.  My lateral movement never returned, but it was ish to begin with, so no big loss there.  They told me a hip replacement in the future was virtually guaranteed, but I've been able to dodge it for 20 years so far.

Tying this back to Buxton, I completely understand how his issues can seemingly come and go and flare up in a really painful fashion, and I also get the frustration involved with an injury where it's tough to acutely pinpoint the cause.  When I finally got the tear diagnosed with the MRI, a part of me was relieved to finally be able to point to something to be able to show my coaches I wasn't making things up.  With the obvious caveat that not all impingements are created equally, I hope they give some real consideration to the surgical option.  There's plenty of time for recovery, and the psychological benefits of eliminating these flare-ups are almost as important as the physical benefits.  I would also strongly encourage the Twins to consider any future time spent in CF by Buxton to be a bonus from a roster planning standpoint

My oldest son (18) has the congenital defect and on his MRI you could see the extra bone growth and like you they wanted to shave it down. As frustrated as I've been with BB over the years, knowing the hip impingement is most likely a torn labrum as the primary cause, it's actually nice to know because I can relate to it a bit better. There is unfortunately no overnight, quick fix to this other than going under the knife. The stretching, injections, etc. they're all temporary fixes that don't matter one bit if he/us move the wrong way. 

What I'd share with fans is I've had to "remake" my golf swing (it wasn't good anyway), but I can't imagine at all trying to hit at the MLB level with knowing if you do just a little too much you're going to get that quick pain. It's always in the back of my head not to do too much and that's no way to be a professional athlete.