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My son, a Junior CIF @D1, experienced Pain on the Left Hand Pinkie & the side of the Palm below the Pinkie while he was hitting Balls of a Machine about 10 days ago. Took X-ray & also checked with his Ortho and by the grace of God, nothing was broken.

Ortho recommended rest and slowly start with Tee after a week. My son is now back at his college. He mentions that his fielding is pretty much back to 80-90%. His hitting recovery is slow but on the right path. He can comfortably take 15-20 swings off the Tee, but the Palm below the Pinkie starts hurting while he starts swinging soft-toss and also feels there is not enough power in the swings yet
He's applying ice / Pain-spray to the area everyday and makes sure not to over-work the area. Season starts Mid-feb and scrimmages start next week. He definitely is worried that the rate of recovery for hitting and may have to miss atleast the first scrimmage.

He's also ordered - "Left Hand CagePro Batting Sleeve For Right Handed Batters", to provide more support to the area

Looking for guidance/advice if any of you have seen issues like this and the general recovery timeline to expect

Appreciate all your inputs

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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.

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.

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.

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.

Last edited by Dadbelly2023

@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

@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.

@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.

Last edited by Francis7

@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.

Well the MRI shows stress fracture in the hook of the hamate for my son.
The Ortho suggested either to try play through it as Surgery would mean atleast half of the season would be missed. He reccomends playing thru if one can, as there is nothing more to go bad as the bone already has a fracture

Evaluating options.

1. Cortisone may be an option, worth exploring

My son has also ordered - Left Hand CagePro Batting Sleeve For Right Handed Batters to see if it will help

Going to try using an Axe bat to put less pressure there

Has anyone's kids played here with the Injury for a season and if any alternatives have worked?

Hi Raj, I'm sorry this is the case. As it is not fully displaced, I buy the argument to try to play through it. I was thinking of you earlier and have a suggestion. That sleeve you mentioned just has extra padding over the hamate.  Maybe have him try a ring shaped "callus" pad.  Have the orthopod show him exactly where the spot is. Before he hits, when the skin is clean and dry, he can use a solution called Mastisol to increase the adhesion of the pad to the skin. Let it air dry and then place the pad. He might even try using 2 pads stacked onto each other.  It will create a "doughnut" over the hamate and decrease the impact to the fracture.  I hope that is helpful.

Edit:  he can also buy moleskin like what we use for backpacking blisters and cut it into a custom pattern.  That stuff sticks like crazy.

Last edited by Dadbelly2023
@Raj posted:

Well the MRI shows stress fracture in the hook of the hamate for my son.
The Ortho suggested either to try play through it as Surgery would mean atleast half of the season would be missed. He reccomends playing thru if one can, as there is nothing more to go bad as the bone already has a fracture

Evaluating options.

1. Cortisone may be an option, worth exploring

My son has also ordered - Left Hand CagePro Batting Sleeve For Right Handed Batters to see if it will help

Going to try using an Axe bat to put less pressure there

Has anyone's kids played here with the Injury for a season and if any alternatives have worked?

My son attempted to play thru it but could not and eventually had surgery

@Raj posted:

Well the MRI shows stress fracture in the hook of the hamate for my son.
The Ortho suggested either to try play through it as Surgery would mean atleast half of the season would be missed. He reccomends playing thru if one can, as there is nothing more to go bad as the bone already has a fracture

Evaluating options.

1. Cortisone may be an option, worth exploring

My son has also ordered - Left Hand CagePro Batting Sleeve For Right Handed Batters to see if it will help

Going to try using an Axe bat to put less pressure there

Has anyone's kids played here with the Injury for a season and if any alternatives have worked?

So sorry to hear the news. Best of luck with what you decide. But, it's extremely painful and I would suggest considering if it's worth playing through. He's not going to be himself trying to play with it.

@Raj

I am sorry to hear the news, but  glad that your son was able to get a diagnosis that makes sense.

I agree with Dadbelly2023 about injections. I had an injection in my hand last year and I believe that it damaged a nerve. Coach son told me that they never give injections in bb players hands because of what happened to me as an example.

I think the preferred go to is PRP/ maybe oral steroids, anti inflammatory meds.

I also agree that he should try to avoid surgery unless all else fails.

Best of luck to your son. Keep us posted!

TPM

Last edited by TPM

Don't take my advice because I am a nobody from nowhere that knows nothing and shouldn't be trusted.

But, do your own research and vet it out good. And, don't be surprised if you keep seeing that a hamate fracture usually doesn't heal on its own and often requires surgery. This is because the bone's poor blood supply and the difficulty of immobilizing the fracture site make it difficult for the bone to heal.

And, although a few isolated cases of healing with a splint and immobilization with a cast have been reported, surgery is usually necessary.

Again, best of luck to you and your son. And, I am very sorry to hear the news. I do feel for you because I know what this is like since my son fractured his hamate a week before his season started in 2023.

We both wanted to believe it wasn't that diagnosis. (We'll, maybe me more than him, because he suspected it right away.) And, nobody wanted to miss a season. But, the more people we talked to who had it, and the more doctors we saw, accepting the reality was inevitable.

You know once you have been there. Where Mike Trout broke his a few months after my son, I remember seeing the video that day and sending it to my son. My son said to me: As soon as I saw it, I knew immediately that he broke his hamate.

Ask as many as you can and see if anyone was able to play through it and delay the surgery. I would doubt that anyone was successful doing it.

But, again, I'm some rando idiot on the internet. Don't take my word for it. Do your own research and don't discount when you find and hear.

I am very sorry that this happened. It sucks. But, it happens a lot. It's actually a bit of a plague these days. Sorry it came your way.

@francis7.  I hate to hear negative self talk like what you've expressed. Maybe you phrased that because some people haven't been very nice to you here over the years, but your opinion actually does matter because you've gone through this with your son. I think the key is the phrase "stress fracture."  If the fracture truly is not complete, there might be a small chance of being able to play if you can isolate the impact to the area. But otherwise, I kind of agree with you.  (As another internet rando.)

@Dadbelly2023 Appreciate your inputs. He's going to try the Padding out today.
@Francis7 Really value your thoughts as well. Exploring options to see if there is a temporary way out before surgery

@TPM Heard both sides on injections. His Hand doctor told him not to do it, but our Ortho said, he's go for it. He is talking to the team doctor. Will need to go from there. He's done PRP before (for his knees) / worth exploring it as well. All depends on the pain level. In his team there is one who is still playing with Hamate injury from last season using Oral steroids only, while the other had surgery.
It really seems to be very individual based

My ortho's recommendation has been "Pain Management". His thought is - U know the Pain level..check if u can manage it with all ways possible, because its predictable...

@Dadbelly2023 - thanks. And, yes, based on past experiences here, I feel like a disclaimer to ignore me is sometimes warranted.

@Raj - good luck. I know it sucks to miss a season. But, it sucks more to play one and have it be a miserable experience because you can't play like you normally would perform because of an injury. Plus, there's the whole risk of losing eligibility if he plays half a season and then has to shut it down. Bad spot, all around. Again, sorry for you guys.

Quick update. His team doctor also reinforced on No cortisone, but cleared him. Reinforced the options -- play with adjustments and bearable pain or surgery

@Dadbelly2023 Really appreciate your advice on padding. My son had a Donut padding taped by his trainer (After reading ur advice). He also used the sleeve. He used his friend's Axe Bat and was able to swing @75%. He faced live Pitching as well
Had to make some minor adjustments, but he is feeling better. The staff told him that his swing looked almost the same with these accessories.

Ordered Axe Avenge Pro Hybrid

Taking it one day at a time.

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