“Yo MDS, check out the tats bro.”

I (MDS) want to feel sorry for all the Josh Hamilton owners out there in fantasy land, but I can’t. I can’t get fooled again. You know who else can’t get fooled again?  “Donny Pump”. Our resident physician physical therapist called the Cardinals’ bluff on Adam Wainwright and now he’s here to share his medical opinion (thanks Donny!) on Hamilton’s fractured hambone. An interesting read, I must say, after the jump.

Editor’s Note: this was originally posted in the comments of the Corporate Ladder: Top 100 Overall Players (which should get a fresh coat of paint next Monday).

Not sure if you’re going to post on Hamilton’s injury (or if top 100 updates are coming), but I figured I’d give my take on him, which I can summarize in 6 words: Not good, but could be worse.

We know it’s a nondisplaced humerus fracture, and while it’s never good to fracture your humerus, it’s a good thing that it’s nondisplaced (meaning the fractured ends of bone haven’t shifted alignment, the bone is essentially cracked through but nothing has moved). If he had a displaced fracture, he’d need surgical fixation of the bone, which entails screws and plates and such, and he’d probably miss the season. Since it’s nondisplaced, they’ll put him in a sling and immobilize the arm to allow the fracture to heal, which typically takes 4-8 weeks depending on the size of the fracture and whether or not he’s compliant with keeping it immobilized. The arm must be kept immobilized, this is key, if he gets antsy and takes his sling off too much or tries to use his arm before the fracture is healed, he risks slowing the healing process or even displacing the fracture. Believe me, I’ve seen it before with younger guys, the pain starts to lessen and they think it’s ok to yank the arm all over the place, then boom, the bone snaps worse or doesn’t heal. It happens, let’s hope he’s not stupid and listens to the medical staff.

The big unknown thing here is WHERE on the humerus the break is. Rotoworld is reporting is 6-8 weeks, which makes me think it’s somewhere in the midshaft of the bone. If the fracture is up higher toward the shoulder, where tuberosities (bony bumps) come off the humerus, he could be in trouble. These tuberosities are where the infamous rotator cuff muscles attach, and it’s quite common for someone to break the humerus and tear these muscles as a result. Haven’t heard anything like that reported, so I’m cautiously optimistic this isn’t the case with Hamilton. While it sounds like he’ll probably avoid the latter scenario I presented, we’re still talking around 2 months just for the bone to heal. He’s lucky the x-rays originally didn’t show the fracture, which means it’s probably fairly small, but until it’s healed, not only can’t he catch (VERY lucky it’s not his throwing arm) or swing the bat, he really can’t move the arm much period. Patients often can develop stiffness and mild atrophy/strength loss in the shoulder and elbow as a result of the immobilization, so he’ll need to rehab with stretching and strengthening exercises before he begins baseball activities. Then he’ll likely need a rehab stint to ensure everything is in order.

Prediction: Hamilton returns in July around the All-Star break, perhaps a few weeks before if things go well. You knew what you were getting into when you drafted him in the 2nd round, if you own him you should stand pat and wait it out. If you don’t own him, I’d send a few lowball offers out now for him, nothing too cute or extravagant until we hear more specifics about the injury, but he could be a 2nd half lottery ticket if the situation remains as it stands currently and now is the time to act as his owners will be panicked and vulnerable.

Don Brown, PT, DPT