Another take on Buchholz's back

August, 3, 2011
BOSTON--You got to read (and hear) ESPN injury expert and ESPNBoston's Joe McDonald on Clay Buchholz's back injury here.

Here's another perspective from Will Carroll of, another injury guru:

"The worrisome comp for Buchholz's injury isn't another pitcher. It's not David Wright, who missed two months with a very similar stress fracture in his lower back. No, the comp the Red Sox would rather not hear is Jacoby Ellsbury. Last year, the team seemed to lose a bit of confidence in their medical staff when Ellsbury's rib fracture was "missed." To be fair, the miss was because Ellsbury's pain was "referred," a term that means the pain was away from the location of the actual problem. The best known example of referred pain is sciatica, where the actual problem is in the back, but the pain travels down the nerve into the leg.

"Buchholz's injury was, like Wright's, presenting as a simple strain with spasm and tightness. It was responding to treatment. It walked like a duck and quacked like a duck, but this was no duck. In fact, the location of the fracture (L2 vertebrae) is an unusual one, with one study pegging this type of injury as occurring in only 1-3 percent of cases, with more happening in the lower back. Once the condition recurred, further options were investigated and imaging locked in the stress fracture. This condition, which is technically a spondylolysis, usually occurs over a period of time rather than through a traumatic origin. It's quite possible that Buchholz has been pitching with this for quite a while. At this stage, it really doesn't matter.

"It's going to take two weeks of rest, minimum, before activity can start up. As we saw with Wright, it can be longer. That's tougher for a pitcher, who not only loses stamina, but has to use his back on each and every pitch. If Buchholz is able to come back, he'd likely have to go to the pen, which has its own perils. It's unlikely that Buchholz will return this season, but in the long term, this should not be an issue once the stress fracture heals. I'm putting his ERD as 9/30, indicating I believe he is out for the season, but I'm writing it in pencil.''



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