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'I think he's going to bounce back': Sox' Robert should return to normal, doctors say

“Great googamooga, can't you hear me talking to you? Just a ball of confusion. That's what the world is today.”

The Temptations released those classic lyrics from the song “Ball of Confusion” in 1970.

The White Sox have been living those words this week.

On Wednesday, manager Tony La Russa admitted he didn't know the rule regarding runners starting at second base in extra innings following a 1-0 loss to the Reds.

Two days earlier, Sox general manager Rick Hahn said standout center fielder Luis Robert is going to miss 12-16 weeks with a right hip flexor injury whether he has surgery or not.

We'll keep the focus on the latter topic here, and enlist some help in trying to explain what Robert is likely going to be dealing with on the comeback trail.

I've seen quite a few hip flexor injuries since jumping on the baseball beat in 1994, but Robert's in a different category. He has a Grade 3 strain, which represents a complete tear.

That sounds like an ominous ailment, but Dr. Andrew J. Riff and Dr. Michael Chiu are two local specialists that know hip flexor injuries inside and out.

Dr. Ruff is a board-certified, fellowship trained orthopedic surgeon who specializes in hip arthroscopy, hip preservation and sports medicine.

Dr. Chiu is a board-certified orthopedic surgeon with a sub-specialty focus in athletic hip, knee, shoulder and elbow injuries.

Both doctors are affiliated with the Illinois Bone & Joint Institute.

As Hahn said, Robert is going to be out 3-4 months after suffering the injury during Sunday's game against the Indians at Guaranteed Rate Field.

Given the rarity of a Grade 3 hip flexor strain, there's been some concern about Roberts ever getting back to his high level of play.

“I really think he will,” Dr. Riff said of the 23-year-old Robert. “Fortunately, he's young. Frequently, we'll see these types of injuries with athletes at the end of their careers. You look at Kobe Bryant and the Achilles' injury or Tony Parker's bad quad injury. For those guys, you start to think this is mileage kind of taking its toll, these muscle tendon units are wearing out a little bit.

“But for Luis Robert, I think this is kind of a fluke and I think he's going to bounce back.”

Robert is scheduled to have more testing before it's determined whether he needs surgery or not.

“It really depends on how bad the tear is,” Dr. Chiu said. “If it's retracted, how well he does with the (surgical) repair and rehab? If that is the case and it's performed well, and he does well with physical therapy, I would anticipate a return to activities with minimum deficit.”

Like the Sox, neither Dr. Chiu or Riff are 100% certain what the near future holds for Robert until more testing is completed.

“I haven't seen his scans, so I don't know specifically where the injury is,” said Dr. Riff, who worked with the White Sox in 2016 as part of his fellowship training. “I would tell you, almost certainly based on the way it's described, it's a mid-muscle injury. The muscle is torn, not the tendon. In most cases, the hip flexor tendon, or iliopsoas tendon, it only tears in patients who are very debilitated.

“We see it often in elderly people or people who have other medical comorbidities. So that leads me to think this is probably more likely a mid-muscle injury, where there is a full return of function, there's no real deficit. Unfortunately, it's a waiting game.”

Dr. Chiu said Robert's injury is more common in high-level soccer and typically happens when two players go for 50-50 balls with their legs. Hockey players are also susceptible to Grade 3 hip flexor strains.

Dr. Riff projects a three-step recovery process for Robert.

The first is 2-4 weeks on crutches where the injury can quiet down and begin healing. The second is daily therapy with massages and light stretching and then, hopefully in July, increased strengthening work to get Robert back on the field.

“This is a non-common injury,” Dr. Riff said. “That's why the timeline is a bit fuzzy. But I think the early prognosis is excellent for a full recovery.”

Dr. Chiu is a board-certified orthopedic surgeon with a sub-specialty focus in athletic hip, knee, shoulder and elbow injuries.
Dr. Ruff is a board-certified, fellowship trained orthopedic surgeon who specializes in hip arthroscopy, hip preservation and sports medicine.
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