Mark J. Rebilas, USA Today

Doctor's Take: Brandon Guyer

The Indians have placed outfielder Brandon Guyer on the DL after he was diagnosed with a left wrist sprain on Sunday. IBI’s resident medical expert Brandon Bowers takes a look at the severity of injury and also gives his thoughts on Guyer’s expected recovery time in the latest edition of Doctor’s Take.

On Sunday, May 14th it was announced that Brandon Guyer was placed on the 10 day disabled list as a result of a sprained left wrist.  According to Terry Francona, Guyer had been dealing with his ailing left wrist over the course of the past week and upon examination by team physicians it was determined a stint on the DL would be necessary.   

What is it? The anatomical definition of the wrist joint is the articulation or contact between the radius and the proximal (close) row of carpal (wrist) bones.  This joint is called the radiocarpal joint.  With the palm facing upward, the radius is the forearm bone which is on the thumb side of the forearm.  The other forearm bone, the ulna, is located on the pinkie side of the forearm with the palm facing upward.  There are eight carpal bones, aligned in two horizontal rows where the ulna and radius end.  The row most proximal to the radius and ulna is comprised of the scaphoid, lunate, triquetrum and pisiform bones and the distal (far) row from the end of the forearm is comprised of the trapezium, trapezoid, capitate and hamate bones.  The carpal bones are held together and stabilized by a variety of ligaments; when ligaments become overstretched, they are unable to function in the capacity which they normally would.  A sprain refers to the over stretching of a ligament or ligaments past their anatomical threshold.  Sprains are graded based on severity with grade one sprains being the least severe and grade three sprains being the most severe.  Grade one sprains involve slight over stretching of the ligament(s) involved, grade two injuries involve partial tearing of the ligaments and grade three sprains consist of complete tearing of the ligaments.  Symptoms of a sprained wrist include, but are not limited to, pain, swelling and decreased mobility/strength.

How is it fixed?  Management of a wrist sprain is initiated with a period of utilization of the acronym RICE, which stands for rest, ice, compression and elevation.  Rest from physical activity is important in order minimize further aggravation of the wrist, ice is utilized in order to reduce swelling and reduce pain, and compression and elevation also assist in the reduction of swelling.  Depending on the severity of the sprain a period of  immobilization may also be used as to reduce pain.  Following the first 24-48 hours, when swelling and pain control are the main concerns, range of motion and strength activities are initiated.  Range of motion of the wrist and hand are imperative in order to allow the individual to achieve full functionality of the hand and wrist by the end of the rehab process.  In more severe cases, surgery can occasionally be indicated, however, in less severe cases rest and rehab usually suffice.  

My take.  The Indians did not indicate the severity of Brandon Guyer’s left wrist sprain, however, this does not appear to be an injury that is going to affect him long term.  Based on the information the team has provided, this appears to be a grade one sprain that should respond well to conservative intervention through physical therapy.  Provided Guyer does not experience any setbacks and the team is not withholding any other details about the injury, I anticipate a 2 to 3 week recovery window.

We will continue to monitor the status of Brandon Guyer 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.


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