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Tuesday, June 29, 2010
Pedroia leads list of injured Red Sox

By Stephania Bell

Three top Boston Red Sox players were bitten by the injury bug during their weekend series against the San Francisco Giants. Let's see what the future holds for the trio of Sox stars.

Dustin Pedroia
Dustin Pedroia will miss six weeks after breaking a bone in his foot with a foul ball on Friday.
Dustin Pedroia: Shortly after Pedroia fouled a ball off his left foot Friday, it became apparent that he would require a trip to the disabled list. The unanswered question at that time was how long he would be out. Pedroia was diagnosed with a fractured left tarsal navicular bone, a bone situated on the inner aspect of the midfoot near the high point of the arch.



Here's the good news. The fracture was nondisplaced, so the bony ends remain in alignment, which means the fracture is a better proposition for independent healing. The second and very important bit of good news is that the fracture was discovered right away. In cases when a fracture goes undetected, activity too soon after the injury could result in either a displaced fracture (as the bone can move) or at the very least could result in nonunion where the bony ends fail to fuse. Not only do those scenarios translate to a lengthier healing process, but surgery also is often required to help facilitate the healing.

Part of what contributed to early diagnosis was that Pedroia's injury was traumatic. He fouled a ball off his foot, it hurt, he limped and the team immediately knew there was a problem that needed to be investigated. Initial X-rays taken at the stadium were reported as negative, but further tests, including an MRI and CT scan, showed the break, according to ESPNBoston.com's Gordon Edes. Often, the navicular bone falls victim to a stress fracture that evolves over time and may be difficult to detect. It often requires more sophisticated imaging to see a crack in the navicular, which was also true in Pedroia's case. The key for a successful outcome is good bone healing, and Pedroia's early placement in a boot and on crutches was critical.

The Red Sox have indicated that Pedroia will not require surgery to pin the bone and have projected his absence at six weeks. As the bone healing progresses, he will have to work to regain his range of motion and strength back around the foot and lower leg so that he can return to all his offensive and defensive duties. Fortunately for the Red Sox, Pedroia is no stranger to hard work, and if anyone can will himself back sooner rather than later, it's he. That said, bone heals at different rates in different folks, and how long that takes for Pedroia ultimately will determine how long he is out.



Victor Martinez: Add Martinez to the list of Red Sox players with a broken bone but thankfully also to the list of guys who won't need surgery to fix it. Martinez, who fractured the tip of his left (catching) thumb, is dealing with the standard pain and swelling that accompanies such injuries. His status however is not yet clear. The Boston Globe, citing sources, is reporting that Martinez will go on the disabled list on Tuesday. But according to Edes, based on communication with Martinez's agent, Alan Nero, the decision has not yet been made.

Although there are means of padding and supporting the thumb to perhaps allow Martinez to use a gloved hand, there is the issue of just how effectively he could perform. As a catcher, he has to repeatedly catch -- and control -- balls coming into the glove at high speed, and that's not an easy task with a compromised thumb. He might be able to function somewhat better at first base, although the thumb still could present challenges. Serving as a designated hitter would entirely remove the concerns related to the glove, but then there is the issue of batting.

If Martinez's thumb remains significantly swollen, which according to Edes was the reason he ultimately could not remain in Sunday's game against San Francisco after suffering the injury, it will be difficult for him to bend the thumb. If he can't bend it adequately, he will not have a good grip on the bat and will lose power. A powerless player at DH sounds like an oxymoron. The Red Sox are likely evaluating their options along with Martinez's hourly progress. Fantasy owners should prepare for the possibility of being without Martinez for the near future.

Clay Buchholz: Of the three players who caught the injury bug in San Francisco, Buchholz looks to have escaped with the least serious consequences. Buchholz was forced to exit his Saturday start after pitching just one inning, but not because of a throwing injury.



Just after reaching first base on a single in the top of the second inning, Buchholz hyperextended his left knee while running from to second. According to Edes, Buchholz pulled up limping and was quickly escorted back to the dugout. Buchholz attributed it to his "indecisiveness" going into second base. "I was either going to slide or bail off. I landed weird and felt a little pop behind my knee."

Early reports suggest that the injury was not especially serious and the Red Sox are not planning to place him on the DL, according to Edes. The most common structure injured in a mild hyperextension is the hamstring, the large muscle on the back of the thigh, as it crosses the knee to attach just below the joint. The Boston Herald reported that Buchholz had "minor bruising and walked with a discernible limp," both of which would be characteristic of a hamstring strain.

More serious hyperextension injuries, usually the result of contact, could take out more structures on the back side of the knee, including the meniscus, joint capsule (fibrous tissue surrounding the joint), other small reinforcing ligaments or even major ligaments such as the anterior or posterior cruciates (ACL and PCL). In fact, even a dramatic, noncontact hyperextension injury could lead to an ACL tear, so if Buchholz got away with just a minor hamstring injury, it is good news indeed.

The injury is to his left, or lead, leg, which means the left hamstring is responsible for helping to stabilize Buchholz's body during follow-through. That translates to significant contraction force at the lower hamstring to help control position of the knee. Last year, Los Angeles Dodgers pitcher Chad Billingsley suffered a hamstring injury to his lead leg (also while running) and missed only one scheduled start. Although no two injuries are identical, it does inspire hope for Buchholz that he will not be forced to miss much time, if any. Much will depend on how his hamstring responds during the next few days and whether it will feel strong enough to support him pain-free once he returns to throwing.