[RedSoxAnni]

Buchholz has a stress fracture

It has been obvious for about a week now that something was wrong with Clay Buchholz beyond a muscle strain in his lower back. Day by day, a little more information comes out.

Theo Epstein danced around the subject yesterday and now comes word from Comcast's Sean McAdam that Buchholz has a stress fracture.

There is a possibility for a late-season comeback, but odds are that Buchholz is done until 2012.

These next two months will help the Red Sox determine their No. 3 starter in the playoffs, whether it's John Lackey, Erik Bedard or somebody else.

[MrNewEngland]

Wow, that sounds awful. A fractured spine...?

[acr]

I want to know how the medical staff didn't discover this earlier, and let him start rehabbing with a broken bone in his lower back? That could've ended his career. Shit, someone's gotta be fired over this one.

[RedSoxAnni]

It is possible that they didn't see the fracture on the initial films, but it is also possible that the fracture occurred when he threw off the bullpen mound last week. Stress fracture (spondylolysis) of the spine is relatively common in athletes, and it can be part of a series of progressive injuries starting with stress reaction, which is an overuse injury. The treatment for both is the same - rest. That means complete rest, with no activity. If Buchholz had stress reaction and started throwing again he could have suffered the fracture then. This is not a "broken back" but a crack in the outer portion of the vertebra. These fractures are normally detected using three imaging techniques in combination - standard x-ray, a bone scan, and either CT or MRI and sometimes both.

The treatment is going to be the same - rest. In rare circumstances the fracture can progress deeper into the lamina and then surgery to fuse the vertebra could be indicated. Right now this is the sort of injury that should be managed by the training staff and by physical therapists.

Now, what I really find interesting is that this announcement was made the morning after the trade deadline. Maybe we didn't want to look too anxious?

[acr]

Is this the same medical staff that told Ellsbury he just had a rib strain last year? Embarrassing.

[rominer]

RedSoxAnni, on 01 August 2011 - 11:20 AM, said:

It is possible that they didn't see the fracture on the initial films, but it is also possible that the fracture occurred when he threw off the bullpen mound last week. Stress fracture (spondylolysis) of the spine is relatively common in athletes, and it can be part of a series of progressive injuries starting with stress reaction, which is an overuse injury. The treatment for both is the same - rest. That means complete rest, with no activity. If Buchholz had stress reaction and started throwing again he could have suffered the fracture then.

I don't remember if there was an earlier MRI to compare to. Obviously there's no way to go back in time and prove it, but this seems plausible to me.

One injury progressing into a different injury? I think anyone who's played any sports has been around that block a few times. Not usually anything quite as ominous sounding as "fractured spine," but then, who knows? "Routine MRI" isn't really in the rec league budget.

Seems to me the concern here could be the Red Sox medical staff, but we don't really have the information to judge. The question I have is more: Is this preventable for Buchholz in the future, or was it the inevitable result of someone with his wiry frame throwing 96mph?

Quote

Now, what I really find interesting is that this announcement was made the morning after the trade deadline. Maybe we didn't want to look too anxious?

I'm thinking there's no "maybe" about it.

[RedSoxAnni]

rominer... You bring up a good point about preventing this in the future... Spondylolysis is most common in adolescent athletes, particularly gymnasts and competitive divers who arch their backs. (Full disclosure - I am getting this info from a friend who is a college athletic director). Trainers are well aware of the condition and they suspect it when young athletes complain of lower back pain. They want to catch it at the "stress reaction" stage. I think you may be onto something about his physique. Maybe he needs to build some muscle to prevent overuse injuries.

The "cure" is resting the lower back, and particularly avoiding the activities that caused the injury. Like pitching... He should work with a physical therapist to find appropriate activities. They'll probably prescribe anti-inflammatory drugs, like Motrin or other NSAIDs. He and Mrs. Buchholz should probably consider separate bedrooms for a while... Yet, THAT will aggravate the condition. Sometimes a backbrace is recommended. In rare circumstances people with stress fracture need surgery to fuse the vertebrae. Let's hope that rest does the trick.

[BigSlick]

RedSoxAnni, on 01 August 2011 - 12:02 PM, said:

He and Mrs. Buchholz should probably consider separate bedrooms for a while...

Anni, I love ya, but have you seen his wife?


Anyway, this whole thing is very depressing. We all have incredibly high hopes for October, but this puts a serious dent in them. Hopefully Bedard's shoulder holds up and he's able to be a solid replacement.

[RedSoxAnni]

The Sox released this statement at 6:12 pm today (8/2):

BOSTON, MA - Red Sox Medical Director Dr. Tom Gill issued the following statement today in regards to right-handed pitcher Clay Buchholz:

"Clay has a stress fracture in his lumbar spine. He is responding to treatments and his symptoms are improving. We have sent Clay to see three spine specialists, who all agree that the injury is stable and will heal on its own. Clay will follow a five-step structured rehabilitation program, which will progress as his symptoms allow. When completed, Clay will be cleared to resume throwing. There is currently no time frame on his return, and his return this season has not been ruled out."

[RedSoxAnni]

Update on Buchholz from boston.com


Buchholz met with back specialist Dr. Thomas Watkins in Los Angeles yesterday, and he confirmed the stress reaction the Red Sox suspected after Buchholz threw a side session July 25. Still, he left the meeting feeling reassured, knowing that the injury wouldn't be career-ending. He sat in Watkins's office early yesterday morning and immediately noticed the jerseys hanging up of players Watkins had helped in the past -- from Josh Hamilton to Eli Manning.

"You just walk in there and you see how many [players he’s worked with]," Buchholz said. "He’s got jerseys hanging up of all the players that he’s helped and that gave me a sigh of relief too, knowing that he’s worked with a lot of athletes before.

It's interesting that this story refers to "stress reaction" and Dr. Gill's report says "stress fracture". As I wrote earlier, stress reaction can progress to stress fracture. It does sound like he has a fracture, though.

[acr]

The way Heidi was talking makes it sound like the injury won't be re-aggravated through normal pitching activity and the only obstacle to Clay coming back would be his pain tolerance. That sounds promising to me.

[LooiesWindup]

BigSlick, on 01 August 2011 - 01:02 PM, said:

Anni, I love ya, but have you seen his wife?

http://www.google.co...iw=1219&bih=846

Sigh. Happily married Looies will have to take one for the team and volunteer as Mrs. Buchholz' personal bed warmer for the interim. No matter how long it takes for Clay to get healthy.

[Manny's PS2]

Starts throwing tomorrow. Might be a nice addition out of the 'pen. Hope the back holds up...

[acr]

If Buch can pitch in any capacity during the playoffs, we've gotta be odds-on favorites in the AL

[pedroia15]

acr, on 30 August 2011 - 05:26 PM, said:

If Buch can pitch in any capacity during the playoffs, we've gotta be odds-on favorites in the AL

I think it's safe to say that we need a new training staff immediately.