Mets injury analysis: Understanding Wilmer Flores’s wrist surgery

Heading into the offseason, Wilmer Flores underwent wrist surgery for an injury that occurred on September 10 after a head-on collision at the plate against the Braves. This article will cover the nature of the injury and the rehabilitation process in store for the Mets’ infielder.

What is the injury?

The wrist comprises eight bones (known as carpals), one of them being the hamate. The hamate is located directly under the ring finger and pinky. The unique aspect of the hamate relative to the other carpals is something called the hook. The hook helps create the Guyon canal (where the ulnar artery and nerve runs to provide blood supply, sensation, and movement to the two aforementioned fingers) and the more popular carpal tunnel (where the median nerve runs to provide sensation/movement to the other three fingers). With that said, injury to the hook of the hamate results in reduced grip strength and wrist pain, both causing an inability to swing a bat.

A fracture to this hook is not typically seen on X-rays, which is why the Mets may have missed the diagnosis early on; a very specific X-ray view (one that is not regularly ordered) would be required. In addition, a CT Scan or MRI would be a better diagnostic tool than an X-ray, but given that these tests are more expensive than an X-ray, a doctor would only order one if X-rays did not reveal anything.

While this injury is not common, it is known to occur in golfers, tennis players, and baseball players as each sport requires a tremendous amount of grip strength. In 2015, Giancarlo Stanton underwent the same procedure.

When will Flores return?

After the surgery to remove the hook, the wrist is immobilized in a cast for three weeks before starting physical therapy. Once the cast is removed, regaining range of motion is crucial as stiffness is very difficult to break up the longer it remains. Range of motion is regained through stretches, massage to loosen up the muscles, and hands-on manual therapy techniques to facilitate more mobility in the stiff joints. When the range of motion is nearly restored, exercises will be given to regain grip and forearm strength.

Overall, recovery should take about six weeks in total before beginning to resume baseball related activities. This should allow Flores to be ready for winter ball should he choose to participate in a league and definitely ready by spring training barring any significant setbacks.