An Occupational Therapist Explores Potential Treatment Prognosis for Javy Báez’s Thumb

An MRI revealed that Javier Báez has suffered a hairline fracture of his left thumb. While the Cubs are still holding off on giving an official update on a timeline for his potential return pending an appointment with a hand and upper extremity specialist, it’s not unreasonable to suspect that El Mago’s regular season is over.

Because I’m not a physician and don’t know the exact severity of the injury, everything that I offer ahead is informed speculation of what I’d think is likely for Báez, rather than a hard and fast prediction. In other words, don’t take this stuff to the bank.

Treatment

The best news for Javy, the Cubs, and fans is that the injury will almost certainly be treated without surgical intervention. Rest and immobilization are probably going to be the order of the day, making it far less likely that there will be any lingering effects compared to having to go under the knife.

I’d be willing to bet that, in addition to a total cessation of baseball activities, Báez’s thumb will be fitted for a custom splint designed to immobilize the carpometacarpal joint (essentially the base of the thumb). The hand therapists working with Javy will design this splint around the specific features of his hand, which tends to produce better results than splints bought off the rack at the pharmacy.

Such a design is typically traced on a paper towel before being transferred to a highly moldable thermoplastic, which is then shaped on the patient’s hand. The second image is what the finished product might look like, though it will almost certainly be more polished and professional than the one featured here.

If you haven’t figured it out by now, the contents of those images are my own work. I apologize to the seasoned hand therapists out there, but feel free to send me an image of your superior product and I’ll replace it.

Following immobilization, with or without a splint, there’d have to be at least some recovery time built in to allow him to regain strength and function in the thumb and ensure adequate grip strength. It may come as a surprise given the role opposable thumbs have had in human evolution, grip strength is actually most impacted by the ring and pinky fingers. Still, for something like swinging a bat against major league pitching, the thumb needs to be at full strength for best results.

Prognosis

While it might not be what you or Javy want to hear, the Cubs have every reason in the world to be conservative with this process. A hairline fracture requiring only rest and immobilization is very unlikely to produce any detrimental effects in the long term. If they were to rush him back and aggravate the injury, however, there’s a possibility that the injury would require surgical intervention.

My best guess — and it truly a guess in every sense — is that 4-6 weeks is a reasonable timeline, with the short end of that being on the optimistic side. If the Cubs were to advance to the National League Championship Series, I’d be surprised if we didn’t see Javy playing in it.

As for whether I think the Cubs can get to the NLCS in his absence, I’ll spare you my thoughts on that one.