A-Rod Returns in Charleston: Medical Observations About His Hip

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A-Rod Returns in Charleston: Medical Observations About His Hip
This X-ray of a left hip (not one of Rodriguez) shows prominent bone on the head and neck of the femur (white arrow).

The New York Yankees' Alex Rodriguez returned to baseball Tuesday night, making his first rehab start since undergoing hip surgery in January. Most of the fans here in Charleston showed up mainly for the novelty of one of baseball's great players coming to town. As an orthopaedic surgeon, I was much more interested in watching how well his hip rotated with each swing of the bat or when chasing ground balls.

A-Rod underwent arthroscopic surgery on his left hip in January. Performed by Dr. Bryan Kelly at the Hospital for Special Surgery in New York, the surgery aimed to correct a hip labral tear and femoroacetabular impingement (FAI) found at the end of last season.

The labrum is a cartilage bumper in the acetabulum (socket). A player with a tear in his labrum might feel pain in the groin and a catching sensation with twisting motions.

FAI is a condition in which extra bone develops on either side of the ball-and-socket hip joint. In A-Rod's case, it appears to have been a bony prominence on the femoral head. The extra bone can catch against the socket with flexion or rotation of the hip. An affected baseball player would likely feel pain in the groin with twisting to swing the bat.

Bryan Hoch of MLB.com reported that A-Rod complained of a lack of explosiveness at the plate. Impingement in his left hip when turning his body during the swing could explain those struggles.

Dr. Kelly held a conference call with reporters prior to performing Rodriguez's surgery. According to Andrew Marchand and Wallace Matthews of ESPN New York, Dr. Kelly anticipated the need to reattach the torn labrum, remove the extra bone and repair any cartilage damage. According to a Yankees news release soon after the surgery, the procedure "went as planned and without complication."

Tuesday night, Yankees fans got their first glance into A-Rod's recovery from that surgery. If the surgery went as expected and the third baseman rehabilitated well, Rodriguez should expect less pain and better hip motion as he returns to the field.

Unlike most of the fans here, I wasn't interested in A-Rod's hits or home runs. I wanted to see how well he moved side-to-side and rotated with his swing. The time line below gives my account of Rodriguez's fielding efforts and plate appearances.

6:54 p.m. (ET): Starting lineups. There is a lukewarm ovation from the sellout crowd here at The Joe. Charleston might be the friendliest city in America, but some fans just don't like him. 

7:07 p.m.: On the first pitch of the game, the batter for the Rome Braves bunts a short chopper toward third base. A-Rod runs forward quickly to track down the ball, lunges to pick it up and fires to first. He doesn't get the runner, but he showed no difficulty with hip flexion or rotation on that play.

7:13 p.m.: A-Rod bounds into a 5-4-3 double play on his first real swing. I wasn't impressed with his body rotation, but it might have been the pitch.

7:35 p.m.: Batter hits a cheap bloop single about 10 feet past the plate up the third base line. A-Rod, probably knowing there was no chance to get the runner, halfheartedly goes after it. It's hard to blame that one on his hip.

7:48 p.m.: In his second and final at bat, Rodriguez badly misses one pitch and later strikes out. Maybe it was the pitch, but his groin might be affecting his batting more than his fielding. 

7:50 p.m.: With A-Rod out of the game, I am headed to the press conference. I'll update the story if he has any important information to share about how his hip felt. It will be interesting to see if he has any hip or groin discomfort later tonight or tomorrow.

From an orthopaedic sports medicine surgeon's perspective, A-Rod looked good. Honestly, he moved better than I expected in the field. I expect his swings will look better and stronger with more at-bats. If he didn't suffer any major setback Tuesday night, I would expect Dr. Kelly to clear him for more innings and games and the Yankees to advance him back to the majors in the coming weeks.

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