Thoughts on Buster Posey

Hello All,

Two nights ago, as the Giants came back with a great 4 run bottom of the 9th to extend a game against the Marlins, I lay in my bed watching the game on my Ipad, and hoping it would end soon so I could go to sleep. An hour later, the worst happened.

Scott Cousins and Buster Posey collided with the play at home, and in an instant the entire season for the SF giants changed. As a Giants fan, it was gut wrenching to watch our best offensive player, our leader behind the plate, and a genuine and tough player clinging to the dirt as he experienced excruciating pain. As a baseball fan, it was sad to see the season of the reigning rookie of the year cut short. As a physical therapist though, it was difficult knowing the long road ahead of him and the challenges he faces as he goes through rehab.

Posey and the rest of the baseball world found out the next day he would be dealing with a broken fibula and torn ligaments in his left ankle.  The fibula is the smaller of the two lower leg bones, and there are several ligaments that surround it to give the ankle joint stability. Any physical therapist will tell you they’d much rather see an athlete with just the break; the torn ligaments complicate things so much more, and prolong the injured athletes comeback. To give you a quick overview of the ankle, check out the picture below.

When looking at this picture, you can see that no matter what the direction the fibula breaks in, the chances of escaping the incident without any damage to the ligaments is very small because there are ligaments in all directions of the bone. The Anterior Talofibular ligament (ATFL) is the most commonly torn ligament in the ankle and makes up an estimated 14-33% of all sports related injuries. Judging by the mechanism of Posey’s injury, it is my guess that he tore more than just his ATFL. The specifics of which ligaments are injured doesn’t really matter at this point; whether its 1 or 4, he still has the same road ahead of him.

Although a fracture seems scary, it is actually much easier to come back from a broken bone, than ligament injuries. A broken bone takes about 6 weeks to heal. Bone has a really good blood supply, and because of that it can heal pretty quick. Unfortunately, ligaments don’t have as good a blood supply and therefore can take a lot longer to heal. Surgery is indicated, especially for athletes that need to get back faster, to jump start that ligament healing.

What can Posey and Giants fans expect? Well, depending on the specifics of his specific structural damage and surgery, Posey will be unable to bear full weight for 4-6 weeks. That’s best case scenario, but weight bearing precautions can last up to 8-12 weeks. He could continue to work on upper body and core strength through this time, and even keep his swing up if he has a sweet contraption like this.

 

From there the most important thing for Posey will be to get his full range of motion back in his ankle. After being in a cast or boot following the surgery, the ankle joint will be very stiff. For a catcher the range of motion is especially important because he needs to be able to squat for prolonged periods of time, and that range may take a while for him to get back. Without a doubt, the Giants physical therapist and trainers will be be aggressive with that. After that, the strength and balance should come pretty easily. At best, Posey would be able to play first base in rehab assignments at 12-14 weeks, which is rapidly approaching the end of the season.

If Posey simply had a broken bone, I would have said he’d be back by August. The ligaments and surgery though make me think he’s not coming back, at least not at the catcher position, until next year. Even then, 30% of people with torn ankle ligaments have persistent problems with their ankle that can last a year to forever. Now, after working with the padres rehab last year, I know there are 2 different types of rehab players. There are guys that GET though rehab, and there are guys that WORK though rehab. Posey seems like the kind that will WORK through rehab. I have no doubt that although he has a long road ahead of him, he will do everything in his power to get back to the squat; catching one of the greatest pitching staffs in baseball.

A Bend in the road is not the end of the road, unless you fail to make the turn. The giants have a little overcoming of adversity to do. They’ll get it done.

Have a great holiday weekend everyone !!!

 

 

 

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