Yordan Alvarez's ‘small' hand fracture adds another chapter to Astros' ambiguous medical history

New York Times

a day ago

HOUSTON — A month into an injured list stint for 'inflammation,' a small fracture has been discovered in Yordan Alvarez's right hand, sidelining the Houston Astros slugger for the foreseeable future while inviting further scrutiny on a medical staff struggling to get players back onto the field.
Alvarez underwent imaging on Friday evening that revealed a 'small' fracture near the fourth metacarpal, general manager Dana Brown said on Saturday. The fracture is '60 percent healed,' according to Brown, who still hopes Alvarez can return 'in the near future.'
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Alvarez has not appeared in a major-league game since May 2. On Saturday, the three-time All-Star acknowledged the injury occurred in a game prior to that date, but Alvarez attempted to play through it 'because I've played before with pain in my hand.'
'I didn't think it was going to be something big,' Alvarez added through an interpreter. 'But I think the fact that I kept playing caused my hand to stress more and caused the small fracture.'
The team first described Alvarez's injury as a muscle strain on the top of his right hand. According to Brown, initial imaging taken on May 6 showed inflammation and fluid around the area.
After three weeks of rest and ambiguous updates — always with positive undertones — team officials hoped Alvarez could return during this weekend's series against the Tampa Bay Rays. Two minor-league pitchers flew in from Florida on Friday morning to throw live batting practice against Alvarez at Daikin Park.
Alvarez hit one home run into the right field seats and stung a few other line drives, but still felt pain in his right hand. Additional imaging ensued on Friday evening, which revealed the fracture.
'It doesn't surprise me that it was fractured,' Alvarez said. 'I knew there was something there on my first MRI with the muscle strain, but that's what I was dealing with. Time passed and it was supposed to get better, but it wasn't like that. I knew I couldn't go out there and support three or four games out there.'
Both Brown and Alvarez said the Astros only took two images of Alvarez's hand: the one on May 6 and another on Friday evening. It's unclear why additional imaging wasn't ordered once Alvarez's inflammation subsided.
Asked whether Friday's imaging came with Astros' doctors or an external physician, Alvarez replied, 'Both.' Brown acknowledged that Alvarez received a 'second opinion through him and his agent.' Alvarez's agent, Dan Lozano of MVP Sports Group, declined comment on Saturday.
'That's normal in baseball,' Brown said. 'There's a lot of guys that do that and we're not opposed to it. The beauty is our doctors will always communicate with the doctor (who gives) the second opinion and we'll work through it.'
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Nowhere in Brown's team-written biography does it describe any medical education in his past, yet he sat atop a bench on Saturday afternoon attempting to explain how a $2.8 billion entity has now twice failed to discover a fracture in one of its franchise players.
Last season, after insisting for almost three months that outfielder Kyle Tucker suffered a 'shin contusion,' the club acknowledged he suffered a fracture, but only after The Athletic prepared to report the story, citing multiple league sources.
No two injuries are identical, but the parallel between Tucker and Alvarez's predicaments is difficult to ignore. Understanding how damaging the public perception can be is crucial, too. Players needing months to recover from fractures is understandable to a fan base. Needing that for a contusion or inflammation is more difficult to digest.
The Astros continue to refuse all interview requests for head trainer Jeremiah Randall, claiming the sport's collective bargaining agreement prevents it. Still, the Pittsburgh Pirates, Minnesota Twins and Athletics are among teams that make their medical staffs available in either informal or on-the-record settings. The Detroit Tigers issue a formal injury report twice a week.
On Saturday, Houston opted for its head of baseball operations to deliver a radiology lesson.
'I think part of the problem is twofold: You don't see the calcium or callus buildup until five weeks or so, and that's part of the problem,' Brown said. 'When you do these imagings and you have so much fluid and inflammation, it is very, very difficult to diagnose it. Even with multiple opinions, it's very difficult to see.'
Both Brown and Alvarez acknowledged that swinging a bat within the past week may have exacerbated the injury, inviting wonder why Alvarez did so in the first place.
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'I was in agreement with that plan, but I knew something wasn't right,' Alvarez said on Saturday. 'But there wasn't anything more to show after the first MRI. When I first hit off the pitchers yesterday, I knew I wasn't going to be able to play three or four games straight and that's when we decided to do again the MRI.'
Three years ago, former general manager James Click called into question the team's 'return to play procedure' after admitting Jake Meyers rushed back from a shoulder injury. Click promised a review, but got fired before it could be conducted.
Perhaps it would behoove Brown to begin one of his own. He already acknowledged rushing pitcher J.P. France back from a shoulder injury last spring. Luis Garcia still hasn't appeared in a major-league game since undergoing Tommy John surgery in May 2023. Lance McCullers Jr. had several setbacks while recovering from flexor tendon surgery.
Asked if he is concerned about how Houston's medical staff has handled his injury, Alvarez said he is not.
'Because maybe I should have said something before that I wanted another study,' Alvarez said through an interpreter. 'But I didn't do it because that was the first thing that came out. It got to the point where I wanted to do another study and that's what we did.'
As a result of it, Alvarez will not swing a bat for the foreseeable future. Neither Alvarez nor Brown wanted to put a timeline on his return, though doing so would've accomplished little. Gone is any benefit of the doubt — or believability — in anything this team reveals about its injured players.
'Just let it heal completely and he'll be back,' Brown said.