Pain on Left Palm below Pinkie for Right Handed Power Hitter - D1 Junior

Can’t say for sure based on your description of the location on the hand but it sounds like it could be damage to the hamate bone. That is a common overuse injury that occurs with power hitters - especially if they are in the cage a lot. I suggest that you do a little research and see if this possibility seems to fit the symptoms.

You may need a sports medicine Dr that’s familiar with baseball hand injuries to make the proper diagnosis

Raj

Does his bat have a taper knob and does he choke the bat?

Adbono is correct see a specialist.
Bob

Consider stopping the ice. It delays recovery by suppressing the inflammation response that is required for healing.

https://drmirkin.com/fitness/w...delays-recovery.html
https://advance.muschealth.org...ce-on-acute-injuries

A week before the start of the 2023 Juco season, my son thought he broke his hamate. Saw an orthopedist who happened to be a former college player himself. He said it was a bone bruise and was just going to be a pain tolerance situation. My son played in the next scrimmage and couldn't even hold hold the bat by his 3rd at bat. Went to see another orthopedist after that and he was diagnosed with a broken hamate and needed the surgery.

Good luck to your son. Terrible timing for it, as I know. Cost my son his freshman season. He was able to play that summer though.

Our Ortho is a sports specialist and his advice was to take it slowly, which my son is doing.
His Bat is the "warstic bonesaber hybrid bbcor", which pretty much has "No knob". My son's immediate concern was that it could have been the bat, so @Consultant, curious to know if the bat could have contributed to it

@Francis7 In your son's case, did he need an MRI for diagnosis of a broken Hamate? For my son we did an X-ray on the very day of the incident, nothing was broken (atleast of the X-ray).

Was you son able to field, though hitting was causing a lot of pain before the surgery?

There was a fairly recent thread about hamate injuries and bat handles:

https://community.hsbaseballwe...mate-pain-not-broken

Well we will get a MRI done next week and take it from there

My son had the same symptoms. No broken bones. It was the extreme stress on his ligaments that they believe was causing micro tears that werent getting an opportunity to heal. He had to stop hitting for 6 weeks and wore a wrist splint. He did wrist strengthening PT and was told to tape up his wrist for added support when he hit. Whatever it was it did heal, stopped hurting, and he does just wear tape now.

Wow, I wonder how common this is?  I know a kid who is in his senior season (d2) that just broke his

My kid had a recent similar type of fracture but in a different area. I'm not an orthopod but have a little medical background. So take this all with a grain of salt. There is a high chance here of a nondisplaced hook of hamate fracture. But it can be very difficult to diagnose w plain film alone. CT would see it most of the time but MRI is more definitive. If the MRI is negative, my understanding is that it would be pretty definitive that it is not broken.

If it is diagnosed, then you can try for conservative management with casting 4-6 weeks but there is a possibility of fracture "non-union". This is what we did for my kids injury. We cast him and used a low intensity pulsed ultrasound bone stimulator device and high doses of magnesium glycinate, calcium, vitamin D. He was able to avoid surgery and return to sport in about half the time of surgery.

BUT my understanding of hook of hamate fractures is that return to sport is quicker if an excisional injury is performed (compared to ORIF) but has a higher risk of ulnar nerve complications. You can look up a recent 2024 review JHS article "surgical management of hook of hamate fractures: a systematic review of outcomes. Jack Donohue et al.  So hopefully it is just a bruise or more minor injury. But if it is a fracture, you'll have to decide whether or not to risk conservative therapy; with the possibility of failure (non-union) and need for subsequent surgery; and time lost. Or just bite the bullet and have it excised right off the get go with return to sport maybe as soon as 6-8 weeks. Tough timing for sure regardless. I hope this gets resolved in uncomplicated fashion.  Best wishes.

Oh. I thought of another pearl I've learned along the way. Insurance companies often will decline to cover the cost of MRI or make you jump through "prior authorization" documentation hoops or make you get a CT first. That is probably why your doctor didn't order a CT or MRI off the bat (no pun intended). Remember that you can always just "cash pay" for the MRI and bypass insurance entirely.  The cash price is around $400-450 and it will not apply towards your deductible or maximum out of pocket but it removes a hassle and delay factor if you run into it.

Also, remember that surgeons get paid to do surgery.  The first guy we saw was all about doing surgery; no other options. Turns out there were options. Be as informed as possible.

Also, while he is down, don't let him forget that studies have shown that visualization practice is almost, if not, as effective as real hitting and fielding. If he can make himself visualize hitting and fielding in ideal fashion for 30 minutes a day, when he returns to sport he'll be ahead of the game.

@Dadbelly2023 I really appreciate your feedback and advice. The Ortho, a sports specialist has worked with my son before...so we know him well and he was the one who recommended rest & recovery. However even after 10 days, even as there is progress - there are still signs of Pinky stiffness and pain on left palm when swinging soft toss, we want to make sure to check out the issue.
Will look out for the MRI charges/approval as you suggested. The Ortho is going to order it tomorrow..just to identify what could be the potential issue
Praying it's something minor and that he can play the season

@Momball11 Thats kind of the direction our Ortho recommended. About 2 weeks of rest from hitting and PT to strengthen the area. My son, a CIF mentions that his fielding is back to almost usual level and even hitting of tee is getting better (Ortho recommended 15 swings off Tee after 10 days). But he does have pain on the side of the palm below left Pinkie, when he tried to hit off a soft toss. He feels that up-to the point of contact there are no problems but as he continues the swing and extension there is pain and the power is not there.

We discussed with the Ortho and agreed on having an MRI done to make sure/identify what we are facing here. He is ordering it tomorrow

@Dadof3 posted:

Wow, I wonder how common this is?  I know a kid who is in his senior season (d2) that just broke his

Hamate is very common

@Raj posted:

@Francis7 In your son's case, did he need an MRI for diagnosis of a broken Hamate? For my son we did an X-ray on the very day of the incident, nothing was broken (atleast of the X-ray).

Was you son able to field, though hitting was causing a lot of pain before the surgery?

First orthopedist, he had an x-ray and CT Scan. Second orthopedist, he had an x-ray, MRI and then another CT Scan...which was annoying because it's hard to see on a MRI. So, that was basically a waste of time.

You have to be careful with orthopedists. In addition to this hamate miss, I have another story.

2021, son's junior year in HS. Something was really bothering him in the hips and pelvis, groin area. So, we see an orthopedist who was a DO. They did an MRI and said:

He has a genetic abnormality in his hip bones. This would require surgery right away. They needed to shave down both his hip bones. The DO couldn't do it but recommended someone who could do it. This was supposed to be life altering because without the surgery, it would impact his ability to walk as he got older.  Orthopedist said that he would never catch again and just playing baseball again was probably off the table.

Obviously, we got a second opinion, this time with an orthopedic surgeon, someone who makes their money getting people under the knife.

He looked at the same exact MRI and said:

It's a groin pull. I see it on the MRI as clear as day. Shut it down for a few weeks and take some anti-inflammatories.

That's what we did and he was fine. And, the pain never ever came back. That was about 4 years ago now.

Back to the hamate, it's a really common injury and doesn't take much. I think when it happens, a lot of people try to ignore it, especially if it's in season. But, when it happens, it's never getting better on its own. You have to take it out.

Sorry again to hear about your son. All I say is, if he does the surgery now, he should be fine for summer ball. My son was OK for summer ball.

When my son broke the hook of the hamate bone in his left hand it was not detected by the x-ray. It required an MRI with contrast. Recovery after surgery took 10-12 weeks

Let the trainer know and they should take care of finding out what exactly is wrong and how to proceed.

@TPM My son talked to the trainer, last week..got it iced and would be discussing in detail tomorrow.

@TPM posted:

Let the trainer know and they should take care of finding out what exactly is wrong and how to proceed.

I would disagree. Every college trainer that I've encountered has been an incredibly nice person and someone who sincerely cares and wants to help in any way possible. But, TBH, most are not exactly someone who I would trust to make a diagnosis and come up with a treatment plan. The intent is good. But, I would recommend getting your own vetted medical professional rather than rely on the team trainer.

@Francis7

At this point the player has returned to the team.

Since he is still experiencing discomfort, he is obligated to report to the trainer, who should report to the coach and then determine if a visit to the team doctor is necessary.

I never said anything about the trainer coming up with a diagnosis or treatment plan.