Getting Back Into the Game After Testicular Fracture

July 8, 2008— -- When Arizona Diamondbacks catcher Chris Snyder suffered a fractured left testicle from a foul ball during a June 30 game, a nation of male sports fans crossed its legs in sympathy.

Indeed, many were surprised to learn, just days later, that Snyder's injury would not require surgery and that he would be on the disabled list for a scant 15 days.

But while most of the attention has been on Snyder's physical recovery, he could face some mental hurdles when it comes to taking his position behind the plate and putting himself once again in harm's way.

Few people are as familiar with this concept than D.J. St. James of San Rasael, Calif.

St. James was a freshman wrestler competing at a high school tournament six years ago. During one match, he was performing a single leg takedown on his opponent when he sustained a sudden and surprising injury.

"When he fell down, his foot came up between my legs," St. James said. "His foot exploded my testicle."

St. James didn't realize the extent of his injury at first. He finished the match with a victory. But the seriousness of the situation soon hit.

"After I walked off the mat, I fell to the ground when I felt the pain," he recalled. "I can't describe how much it hurt. ... It swelled up bigger than my fist."

St. James experienced a testicular rupture. Surgeons would later be forced to remove two-thirds of his left testicle. And though St. James, now 20, said he still participates in club wrestling at his university, the experience is still fresh in his mind.

So when he saw the replayed footage of Snyder's injury, he could empathize.

"I think I was the only one who could watch it without screaming," St. James said. "I told the people I was with, 'Yes, I've been there.'"

Trauma of a Testicle Fracture

Most professional athletes are no stranger to injuries -- even ones as shocking as the one that befell Snyder, 27. But when it comes to mentally processing the pain of a testicular fracture, individual athletes may differ when it comes to how quickly they're ready to return to the field.

"We see these kinds of traumatic events in sports," said Dr. Michael Lardon, a San Diego-based sports psychiatrist who works with a variety of Olympic, National Football League, Major League Baseball and PGA Tour athletes. "The question is, how does a person deal with it?"

He says bad experiences on the field of play can sometimes result in post-traumatic stress disorder, or PTSD.

But is Snyder at risk of PTSD from his experience? Lardon said that Snyder's status as a Major League catcher suggests he may not be.

"For PTSD to occur you need to experience a stress, a trauma, outside the normal range," he said. "If you are talking to a professional catcher, in his life he has been hit all over. ... A big part of it is his perception."

Jack Llewellyn agreed. Llewellyn is founder and president of the Atlanta-based Center for Winning Performance and is the sports psychology consultant credited with helping Atlanta Braves pitcher John Smoltz turn around a slumping career in 1991.

"I don't think [Synder will] have a difficult time with it," he said. "With catchers it's a little bit of a different situation, because catchers are usually perceived as the more rugged guys on a team. They're used to being hit by foul tips."

Still, a testicular fracture is not something that is easily shaken off. In simple terms, a testicular fracture involves a "crack" in the testicle; the organ retains its shape, but it is damaged. Though different from a testicular rupture, which involves a complete hemorrhage of the testicle, a fracture in this delicate organ can be extraordinarily painful -- and may even require surgery, in many cases.

"It is indeed extraordinarily painful," said Dr. Mark Litwin, professor of urology and public health at the University of California at Los Angeles. Litwin adds that the natural vulnerability of testicles is "one of these anatomical curiosities med students never understand."

"The placement of ovaries makes sense. ... [Testicles] are in the worst place you could put them. They really are in harm's way."

Whether Snyder will be able to reconcile the pain of his injury when he crouches back behind the plate will likely be apparent with his reaction to potentially troublesome pitches, Lardon noted.

"If it is PTSD, we see avoidance," he said. "Avoidance is the natural inclination to avoid putting yourself in the same situation again."

But Llewellyn said he believes that any initial tendencies toward avoidance for Snyder should work themselves out quickly. "When he initially starts back, he may flinch a time or two," he said. "But these are strong guys mentally; once things get going I don't think it will be an issue."

Fortunately, no matter the effect on his professional life, doctors said it is unlikely that the injury will affect his personal life.

"This injury and prompt repair should have no effect on his fertility or his sex life," said Dr. Raju Thomas, professor and chairman of urology at the Tulane University Health Sciences Center in New Orleans. "The other testicle will take over, and his remaining testis will recover some."

Getting Back in the Game

St. James said he is familiar with the fear of returning to a sport after a testicular injury firsthand, adding that stepping onto the wrestling mats for the first time after his injury was a challenge.

"I was a little nervous when I got into sports a year afterward because of what happened," he said.

But, he noted, his fear eventually dissipated in the heat of competition. The biggest challenge now? Enduring the friendly ribbing.

"Really, dealing with the aftermath gets intense," St. James said. "It is something that people talk about and joke about, and I've learned to have a sense of humor about it."

And it's something that Snyder may also have to endure, Llewellyn said. "I think his major task will be dealing with the things the batters have to say to him."