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

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.

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