Salvador Perez has a seatbelt … in his thumb?

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CHICAGO -- Shortly after catcher Salvador Perez hit two home runs in three games after returning from thumb surgery in late July, Royals head athletic trainer Kyle Turner texted Dr. Steven Shin, an orthopedic surgeon in Los Angeles.

“Great job, doc,” the text read.

“I’m like, ‘Hey, it’s not me,’” Shin said recently with a laugh. “It’s all him. He’s making us look good.”

Things didn’t look good when Perez suffered a complete tear of his left thumb’s ulnar collateral ligament back in June, when the Royals were playing the Angels in Anaheim. Surgery was needed, and UCL repairs typically take months to rehab.

“Any time I hear a catcher dealing with a thumb injury,” manager Mike Matheny said in July, “I’m thinking, ‘There’s the season.’ Because I know how painful it is and how long it takes to come back.”

But just five weeks later, Perez was back on a Major League field. In 30 games since his return from the injured list, Perez has seven homers and 26 RBIs, after recording 11 homers and 34 RBIs in 57 games before surgery. In August, the 32-year-old has slashed .295/.330/.467 and played in all 27 games so far, 18 of them at catcher.

The reason Perez was able to return so quickly was because of the type of UCL repair Shin has been pioneering in recent years. Performed on star athletes such as Mike Trout, Chris Paul and others, the procedure includes reinforcing the UCL repair with synthetic tape -- and cuts the time it takes to rehab in half.

“It’s a pretty amazing surgery,” Perez said. “Whenever I have to get something done, after talking to the doctors, I usually search around on it and see what’s going to happen. This was a different type of surgery.”

Referred to as a UCL repair with internal brace augmentation, this procedure includes the surgeon repairing the UCL as they normally would but then reinforcing that repair with the placement of the tape over the ligament. SutureTape, made by Arthrex, is just over a millimeter in width, yet is incredibly strong.

The tape is anchored over the thumb ligament, essentially forming a bridge.

“Once you’re done with the regular sutures that are also secured in the hole in the bone, then you take the two suture tape tails and you bring them back over the ligament, to the metacarpal side,” Shin said. “So you anchor those tails into the bone with another anchor. If you picture it, it’s a ligament with two suture tape tails over it, acting as a seatbelt. It backs up your repair.”

Coincidentally, the Royals were in L.A. when Perez tore his ligament. Kansas City's team physician, Dr. Vincent Key, connected Turner and Perez with Shin and set up an appointment for the next morning. After Shin confirmed that the ligament was torn and talked Perez through his options, surgery was scheduled for the next day.

“The question from Sal is always, ‘What’s next?’” said Turner, who has worked with the Royals for more than a decade and rehabbed many of Perez’s injuries, including his very first one in Rookie ball in 2008. “He’s immediately going to, ‘How much time am I going to miss?' It’s typically a long conversation about his options, what it’s going to take.”

Perez is as passionate about playing as anyone in baseball, and he’s skeptical of anything that’s going to stop him from doing that. But when he heard the timeline for a return, he gave his OK for surgery.

“If getting surgery is going to ruin my season, I would rather put something on my thumb, finish the season and get surgery after,” Perez said. “But when the doctor says, 'Six to eight weeks,' I’m thinking, 'I can come back in three to four,' and that’s when I decided to do the surgery.”

With a UCL repair, too much movement too soon could damage the repair. In a standard repair, the thumb is typically placed in a cast for several weeks to allow the ligament time to sufficiently heal back to the bone. That’s why a return from a thumb UCL repair is so grueling. For example, in 2010, Royals outfielder David DeJesus had surgery to repair a torn tendon in his right thumb in July and missed the rest of the year.

With the internal brace augmentation, though, the period of immobilization is merely a matter of days. The reinforcement offered by the tape is such that an athlete can begin range of motion activity within several days.

“The tape is so strong that it basically acts as security for the ligament tear,” Shin said. “That’s why it gives us -- the surgeon and therapist -- the peace of mind to start motion, at least, because you know that repair is not going to be compromised. It’s being protected by the internal brace.”

With clearance from Shin and the Royals’ trainers, Perez began working with strengthening bands about three days after surgery. A little over two weeks post-operation, Perez was going through catching drills and swinging a bat.

“I told them, ‘I’m not lying to you,’” Perez said. “I just didn’t feel any pain. It was amazing. I couldn’t believe it.”

Shin couldn’t believe it, either.

“The first time I met Salvador Perez, I was like, ‘This guy’s a baller. He wants to play,’” Shin said. “He was actually the first patient who told me that after 10 days, he had no pain. No pain at all. I was pretty incredulous.”

Turner and Royals rehab coordinator Jeff Blum worked with Perez on his progression, although it was hard to slow Perez down. Perez would have likely come back even sooner had Shin given clearance, but the surgeon didn’t want to push Perez too much.

“It was just crazy,” Shin said. “No instability, no pain. He did really well. I could have maybe pushed him up a little bit and had him return to play quicker than anyone else, but he wasn’t the one I wanted to experiment with.

“He’s one of the more impressive athletes I’ve ever treated.”