An MRI performed in Cleveland on Thursday confirmed a tear in a muscle in Youkilis' right thumb, finishing the team's most consistently productive hitter for the season. He will have surgery to repair the tear in Cleveland on Friday.
Manager Terry Francona said that Youkilis' thumb will be immobilized for six weeks after the surgery and then re-evaluated. Francona joked for Youkilis to return to the Red Sox's lineup this season, "We'd have to drag it out to around Thanksgiving and I don't know how we're going to do that."
Francona's gallows humor has been honed this season, a year in which one major injury after another has sent a core player to the disabled list for an extended period of time.
Already this year, pitchers Josh Beckett, Clay Buchholz and Daisuke Matsuzaka have spent time on the DL, and position players Dustin Pedroia, Victor Martinez, Jacoby Ellsbury, Mike Lowell, Jason Varitek, Mike Cameron and Jed Lowrie have been on the shelf, too, for varying lengths of time.
Just as Lowell and Ellsbury have made their returns to the lineup, Youkilis has departed.
Youkilis had been feeling pain in the thumb for about two weeks. He played through it, but after lining out in his first at-bat against the Indians on Monday night, Youkilis felt more pain and knew from the blue color and swelling there was something seriously wrong, something he could no longer play through.
He had an MRI on Tuesday, and another one on Thursday, which "left no doubt surgery was necessary," general manager Theo Epstein told ESPNBoston.com on Thursday afternoon.
Youkilis, a fiery competitor, seemed almost eerily calm when meeting with the media Tuesday, most likely resigned to his fate.
"It really stinks," Youkilis said. "[This injury] is very rare. Zero athletes have had it, at least as far as the doctors have said. It was a freak accident. I don't know how it happened or the reason behind it. It just happened."
Youkilis said if surgery was necessary it would be a relatively simple procedure and wouldn't be career-threatening. Epstein echoed that sentiment Thursday.
"If there is a silver lining, it is that it is pretty routine surgery," Epstein said. "He'll be back to 100 percent, and have a normal offseason."
While Youkilis is expected to recover in plenty of time to be 100 percent for spring training next year, the Red Sox are now forced to deal with his absence.
Youkilis, 31, was batting .307 with 19 homers and 62 RBIs in 102 games. He was tied for third in the majors in runs scored (77) and led the majors with a .798 slugging percentage against left-handed pitchers. In the American League he was third in on-base percentage (.411), tied for fifth in walks (58), tied for seventh in extra-base hits (50), eighth in slugging percentage (.564) and ninth in total bases (204).
"He is a big part of our heart and soul," Epstein said. "He was one of our best players and one of the best players in the league. It's a big impact."
Red Sox slugger David Ortiz said: "That's a major hit. It just got worse around here. It's going from worse to worst. He's one of the best players we have, no question about it. It's not what you want to see. But you gotta do what you gotta do, and he has to take care of [the injury]. This isn't the last year of baseball here. He has to come back healthy for next year.
"Youk is a guy who plays the game hard," added Ortiz. "He's like Pedroia. When you see him come out of a game you know there's some kind of problem. He can play with pain."
With Youkilis gone, Epstein said the team try and find a left-handed first baseman to help fill the void, but there doesn't appear to be anything imminent on that front.
In the meantime, the Red Sox have veteran infielder Lowell, Francona said.
"As tough as it is to lose Youk, how many teams can lose a Youk and put in a Mike Lowell?" Francona asked. "That's how I look at it."
Lowell, whose ailing hip has forced him from third baseman to first base, now has a consistent role on this team. For most of the season he has been an afterthought, a player the Red Sox tried to trade. As recently as Monday he was on the DL and in roster limbo. But when Youkilis went on the DL, Lowell was activated, installed at first base and crushed the first pitch he saw for a two-run homer on Tuesday night that sparked Boston to a win.
"Even before today we knew that he was on the DL and would be out for at least 15 days," Lowell said of Youkilis. "I never wanted to be an insurance policy because that meant I'd be getting playing time but it's at the expense of someone else."
"It's a major hole for us," added Lowell. "But I still think we're capable of winning baseball games. We can score runs, we can pitch. We can get on a nice little roll."
Switch-hitters Lowrie and Martinez also are options to play first base.
And so it goes for the injury-plagued Red Sox.
"[Youkilis' injury] creates an opportunity for other players to step up and help offensively," Epstein said. "[The flood of injuries] seems to be happening all in one year. Hopefully that will give us a year or two of good health. All teams deal with injuries, but we're getting them in spades this year."
"We just have to fight it," Ortiz said. "It's not over yet. You can't hang it up. Even without Youk in the lineup you have to try to compete, and whatever happens, happens. You have to try to fight back and if you do, you could be playing in October."