Phillies first baseman Rhys Hoskins grabs his leg after getting hurt during a spring training game this year.
Rhys Hoskins has been the Philadelphia Phillies’ first baseman since being promoted to the big club from AAA Lehigh Valley in August of 2017. During that time, he has largely labored in the shadow of superstar Bryce Harper.
While Harper has held the headlines, Hoskins has deserved better, delivering 30 doubles and 30 home runs each year, despite a batting average hovering around .240.
When the Cubs visit the defending National League champs next month, though, don’t expect to see either taking the field.
Both are currently recovering from reconstructive surgery. Harper tore the ulnar collateral ligament in his right elbow last season but continued as a designated hitter, had Tommy John surgery after the World Series, and is projected to return after the All-Star break. Hoskins tore his left ACL chasing a pop fly in spring training last month. His season is over.
The research on pitchers recovering from Tommy John surgery is pretty clear. Based upon the outcome of thousands of cases, we now know the average recovery time is 20 months and never less than a full year. Efforts to speed up the process have usually ended up in an abbreviated run that ultimately ends in a second surgery.
As for returning to play a field position or just hit, one would expect a quicker recovery because the stress on the re-built ligament is far less for such players than it is for pitchers. For that same reason — far less typical wear and tear on the elbow among position players — there have been far fewer cases to consider. Still, a study published in the American Journal of Sports Medicine in 2020 should give us an idea.
The investigation looked at 137 big leaguers — other than pitchers — who underwent Tommy John surgery between 2010 and 2018. On average, they started taking batting practice six-and-a-half months after surgery but sometimes as soon as four-and-half months. Then, they did not hit in a game until an average of 10-and-a-half months post-op but on occasion as soon as seven-and-a-half months.
Given that data, Harper’s target date for return-to-play makes sense.
Even though Hoskins is done for the season, published reports regarding his recovery did not make sense. Those stories mentioned 7-9 months. In the last year, I have seen predictions of 6-8 months for other professional athletes with the same injury.
Yet, the latest research, in multiple inquiries, has demonstrated the dangers of any timetable faster than 9-12 months. A study published online in Sports Health just last month is the latest. Following 39 female high school athletes for two years after undergoing ACL reconstruction, the researchers found four re-injured the reconstructed knee while five tore the ACL in their opposite knee. Those same nine returned to competition in an average of 30 weeks, barely seven months. The other 30 waited an average of 39 weeks — or nine months.
The type of graft almost certainly played a role, too. All nine who suffered a subsequent injury had a hamstring tendon graft used in their reconstruction. Among the other 30, nine had a hamstring tendon graft, 16 had a patellar tendon graft, and five were given a cadaver graft.
One of the supposed benefits of the hamstring graft over others is a quicker comeback. Nonetheless, as this study shows, there is just no rushing recovery from reconstruction of the ACL.
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With the track season upon us and with that season also being relatively short, the temptation will be there to hurry back from another type of leg injury. Runners and some coaches will want to discount – or ignore altogether – the pain caused by stress injuries to the bones of the thigh, shin, and foot.
The April issue of the British Journal of Sports Medicine includes a literature review regarding how long it takes to return to sport following this type of overuse trauma.
When the tarsal navicular – a bone in the foot just below the inside ankle – is the site, recovery averages 127 days, just over four months.
Injuries to the femoral neck – where the thigh bone becomes the hip -- require 105 days, three-and-half months.
When the fibula – the smaller of the two shin bones – is involved, a runner should expect to be sidelined 56 days, nearly two months.
The most common site for a stress injury is the tibia – the larger of the two shin bones – and the pain is often referred to as “shin splints.” Fortunately, injuries to the back of the tibia have the quickest average recovery, at 44 days, but that is still six weeks. Damage to the front of the bone is more complicated.
Among the 16 studies reviewed, 90% of the athletes were eventually able to return to their sport but accelerating the return was not part of the formula.
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