Akron RubberDucks outfielder Greg Allen made an early departure from game two of a doubleheader against the Altoona Curve on Sunday, May 7th. Allen had to leave the game following an injury to his right wrist. Following a second opinion, it was later revealed on Monday, that Allen had suffered a fractured hamate bone.
What is it? The hamate bone is one of eight carpal (wrist) bones in each wrist. The hamate is located at the base of the fifth metacarpal, which is the long bone in the hand that articulates with the pinkie finger. The hamate serves as the attachment site of a variety of structures, including muscles and ligaments. In the event of an injury, such as a fracture, to the hamate; pain, swelling, reduction in mobility and strength can occur. A fracture refers to a break or a crack in the bone, which decreases the structural integrity of the bone and it’s ability to function properly. As it pertains to baseball players, the way the bat sits in a hitter’s hands while swinging lends itself to repeated stress on the hamate that can potentially lead to an injury such as a fracture. Injuries to the hamate can occur when a player is hit on the wrist by a pitch or simply via repetitive stress of the bat hitting the hamate bone as a result of swinging a bat over the course of time.
How is it fixed? Treatment for fractures of the hamate bone may vary slightly from case to case. A lot of the time, however, surgery yields the best outcomes and return-to-play rates. Surgery usually involves one of two options: surgical removal of the broken portion of the hamate bone, or open reduction with internal fixation (ORIF), which involves the use of hardware such as plates, screws etc. to stabilize the hamate and allow for bone healing. Following surgery, a period of immobilization is utilized so as to minimize the use of the surgically repaired wrist and allow for healing to occur. After the cast has been removed, physical or occupational therapy is initiated to restore range of motion and strength of the hand/wrist involved. Efforts throughout the rehab process are also made to control if not eliminate pain altogether. Once the individual achieves full, pain free range of motion and strength of the wrist/hand, return to sport activities are introduced. The wrist and hand are especially important for gripping the bat while hitting, so adequate grip strength is essential at this stage of the rehab process. If a player is unable to grip the bat appropriately, it is possible loss in bat speed and power can occur. Once the player receives clearance from the medical team, the individual can begin a return to live game action progression.
My take. The Indians indicated Greg Allen underwent successfully surgery on May 9th, to address the broken hamate bone in his right wrist. The current timetable for his return to the Rubberducks, as provided by the Indians, is 4-6 weeks. However, recent research studies, analyzing baseball players who received surgical intervention for hamate fractures, have shown return to play can be anywhere from 4-10 weeks. The ball club did not specify which surgical procedure Allen had performed, but this should not have a huge impact on the time it takes him to return to live game action.
For additional information of hamate fractures in baseball players, check out the research study referenced in this edition of Doctor’s Take.
We will continue to monitor the status of Greg Allen as he progresses through the rehab process and will provide the most up to date injury analysis and breakdown as new information becomes available.
Brandon Bowers, PT, DPT, is a graduate of the University of Toledo, Doctor of Physical Therapy Program and currently practices in Columbus, Ohio. He is an avid Cleveland sports fan and has experience rehabbing athletes of all levels and from a variety of sports. Follow Brandon on Twitter for more Cleveland Indians injury insight and analysis: @blbowers12
The information provided is the professional opinion of Brandon Bowers, PT, DPT and is based on his clinical experience and the most current clinical evidence available. This information should not be interpreted as or substituted for medical advice for a specific condition or diagnosis.