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Medical Corner: Madison Bumgarner, Jeff Samardzija, Dinelson Lamet, and Greg Bird

Dr. Mike Tanner has treated patients with orthopedic injuries for over 10 years as a board-certified specialist and physical therapist. He is currently pursuing a Ph.D., educating physical therapy students and conducting research.

My projected return dates are based on medical protocols, established rehabilitation guidelines, and evidence-based data. Most of the time, I will not agree with the timelines given by teams, beat writers, or others on social media.

Madison Bumgarner – 5th Metacarpal Fracture

We know the injury was a fracture to the 5th metacarpal and required surgery with pins. The use of pins tells us quite a bit about the injury and Bumgarner’s timetable. We often refer to this type of injury as a “boxer’s fracture,” because it is commonly caused by punching a hard surface.  Surgeons use pins when a fracture is displaced and unstable, meaning a cast alone would not heal the fracture. Pins are often left in 4-6 weeks. Four weeks if the fracture is mildly displaced; six weeks if multiple pins were required to reduce the fracture (reduce means line the bones back up correctly).

Before the pins are removed, rehab is limited to a large extent to ensure proper healing, but Bumgarner may do some light toss and as much as possible to retain flexibility in his hand and other fingers. After the pin removal, he’ll need 2-3 weeks to regain his finger flexibility, ramp up his throwing program, and finally pitch a few innings in a minor league game. It’s not going to be six weeks; it doesn’t work that way. Even after Bumgarner returns, it may take him a few weeks to return to form.

Estimated Return: June 12 to June 22

Jeff Samardzija and Dinelson Lamet

For the record, anything near the shoulder in a pitcher can turn into something serious in a hurry, but for now, a minor pec strain isn’t a big problem.  Samardzija will resume throwing on Opening Day and could quickly progress if he doesn’t suffer any setbacks. The real risk is that this turns into a situation that bothers him throughout the season. Lamet is in almost the same boat, but he may return a week later than Samardzija. Lamet suffered the injury three days later than Samardzija and has yet to begin his throwing program.

Estimated Return: May 20 to June 1, barring any setbacks during the throwing program progression.

Greg Bird

I feel like I’ve seen this movie before. Oh wait, I have! Last year Bird underwent virtually the same surgery on July 17 to remove a bone spur on the same foot (in the same location, near what is called the tarsal tunnel). The good news is that he returned six weeks later on August 26. A second surgery can take a little longer to heal, but he likely will return to the team projected 6-8 weeks. His progression this year will probably follow what he did last year. He had live BP three weeks before his return, and he had a 10-14 day tune-up in the minors.

The bad news is that Bird may not last with this type of nagging injury. Surgeons removed a “coin-sized calcium deposit,” also known as a loose bone spur.  These spurs are much like a callus that forms on the palms of our hands. Any time there is too much friction, the body responds by protecting itself with build-up to combat excess friction. Bird’s mid-foot is not happy, and even after he recovers, at some point they will need to identify the real problem. The answer to that problem may be a surgery that keeps him out much, much longer.

Estimated Return:  May 9 to May 21

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