Cam Maybin’s Wrist: Who’s To Blame

On Friday, Cameron Maybin underwent successful surgery on his right wrist to repair a torn TFCC ligament in his wrist. If rehabilitation goes as planned, he should be able and ready at full strength to start the 2014 season. That’s the good news.

The bad news comes in waves. First, it’s now been 2 full years since Maybin suffered his initial injury on the wrist. He has now essentially lost 2 years of team control over what amounts to a grade 3 sprain. Next, Maybin wasn’t supposed to be having surgery to repair a wrist ligament. He was supposed to be having surgery to repair a nerve impingement in his wrist. It is my understanding from reports that only during the surgery did a doctor finally come to the diagnosis of a torn TFCC ligament.

This is where I run into problems, because up until that point I was on board with the Cameron Maybin wrist injury timeline. If Cam had been suffering a wrist impingement, the fact that it took so long to correctly diagnose, treat with rest and corticosteroid injections, and then finally schedule surgery when that failed would make sense to me. A wrist impingement is a difficult diagnosis that often goes untreated or mistreated for significant lengths of time, then the standard treatment is 3 months rest, and if that fails, then surgery is scheduled.

But if there was no impingement, and all Maybin was ever dealing with was what he was initially diagnosed with, then someone is to blame and someone should be held accountable. First, a timeline of events:

  • August 26, 2011: Maybin injures his wrist during a game while making a leaping catch against the wall. It is not believed to be serious, and an MRI is said to be unnecessary.
  • August 30, 2011: Maybin undergoes an MRI after missing 3 straight games, and not seeing significant improvement.
  • September 5, 2011: Maybin returns to the starting lineup, playing CF. He goes on to have his worst month of the season, hitting .207/.274/.356 with an 80 wRC+ the rest of the season.
  • July 18, 2012: Maybin misses a game with a sore right wrist. He remains available for the next 9 days to pinch-run and as a late inning defensively replacement, but has only 1 plate appearance in that span.
  • July 27, 2012: Maybin returns to the lineup, and does not miss significant time again during the season. However, the season is a disappointment offensively, as he posts a .243/.306/.349 line with an 87 wRC+.
  • April 15, 2013: Maybin aggravates his ongoing wrist injury while making a difficult catch. He is diagnosed two days later with an impingement in the wrist and is put on the disabled list.  The standard treatment for a wrist impingement is at least 3 months of rest and at least one or two corticosteroid injections, which should relieve a majority of the pain.
  • June 6, 2013: Maybin returns from the DL after less than two months. Maybin only is able to stay “healthy” for a few days, however, suffering a knee injury on June 9th.
  • September 2, 2013: A “scan” on his wrist shows ligament damage and a calcium deposit in the wrist. Surgery is scheduled for that Friday.
  • September 6, 2013: Maybin undergoes successful surgery to repair the TFCC ligament in his wrist. There is no report on the treatment of an impingement or a calcium deposit. The timetable for recovery on the surgery is longer than had previously been suggested, which may prevent Maybin from participating in any organized baseball activities in the winter.

Now, with the surgery out of the way and a return to full health hopefully in Cam’s future, what we’re left to wonder is why this saga has gone on so long. Why wasn’t the extent of his injury discovered in the MRI in 2011? Why was he allowed to play with a nagging wrist injury through the entirety of 2012 when it was obviously affecting his performance? Was there ever really an impingement in the wrist? If so, why wasn’t it treated with the standard treatment? How much worse was the injury in September of this year than it was 2 years ago, if at all?

I don’t have any answers to these questions. The problem is that I’m not sure the Padres do either, and I don’t know if they have learned anything. Right now, Yonder Alonso is dealing with his own hand/wrist injury, and he admits that he hasn’t been the same since he was hit by a pitch in early June. He returned from that injury on July 12th, only to hit the DL again on August 31st. Yonder wants to return before the season ends. If I were him, I’d be a little more cautious, and maybe see an independent hand specialist for a second opinion.

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4 thoughts on “Cam Maybin’s Wrist: Who’s To Blame

  1. Good stuff.

    “Why wasn’t the extent of his injury discovered in the MRI in 2011?”

    I don’t know if this applies to Maybin’s case, but when I had knee surgery a few years ago, the extent of my injury wasn’t discovered until the doctor actually got in there and was able to see things that the MRI couldn’t show him. He ended up performing a different procedure that lengthened my recovery time drastically but led to a more favorable long-term outcome. I had no idea this was even a possibility going in, but later was told by my physical therapist during rehab that it happens fairly often.

    Then again, there is the question of how useful MRIs are at all. I’m no expert, but Dr. James Andrews certainly is and has this to say:

    “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.”


  2. There are lots of time that the extent of any injury isn’t known until surgery. MRIs show soft tissue damage that is visible to the beams. CAT scans show details through multiple xrays. Both are limited by the structures that are blocking any tissue damage.. ie bones..

    When they did the MRI of my left knee.. it showed significant meniscus damage. However, when the went in they found that the cartilage was almost completely worn away and had rolled up on itself. Totally different surgery than what they expected. This is quite normal.. the first diagnosis is wrong often. However, surgery is always the last resort. To many things can go wrong. So they always try other treatments until they are forced to do the surgery.
    After 13 surgeries so far.. I consider myself an expert.. LOL

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