BOSTON -- Red Sox manager John Farrell said Thursday that pitcher Clay Buchholz has bursitis, an inflammation of the bursa sac, in his right shoulder, according to the results of an MRI.
Farrell said Wednesday's MRI showed no structural damage to the shoulder and that, after being shut down for a couple of days, Buchholz will resume a structured throwing program over the weekend.
Buchholz has been Boston's best pitcher this season, going 9-0 with a 1.71 ERA in 12 starts.
He has pitched just twice since May 22 for a total of 11 2/3 innings. He has been diagnosed at various times in the past five weeks with irritation of the AC joint and a strained trapezius muscle, both of which come into play for a pitcher in his windup and delivery.
Bursitis can be caused by overuse of injury to the bursa, a sac filled with a lubricating fluid whose function is to reduce the possibility of the tendons and ligaments in the top of the shoulder rubbing against the top of the scapula. Bursitis is traditionally treated with ice, rest and anti-inflammatory medication.
Farrell sounded confident that the shoulder was not otherwise affected, although there have been cases where bursitis was a precursor to bigger issues. That was the experience of Arizona's Brandon Webb, who was diagnosed with bursitis in April 2009 and had shoulder surgery in August of that year.
The manager said he was not ready to declare that Buchholz would be out until after the All-Star break.
"He's in a couple of days of shut-down period," Farrell said. "We're hopeful that he'll initiate a throwing program, likely on the weekend. Structurally everything is good and I think that's the most encouraging thing at this point. As I mentioned yesterday, he had two good work days with more intense throwing. So there's small amounts of improvement but yet we've got to take a little bit of a step back here before we pick it back up again."
Farrell was asked how the trapezius strain has impacted Buchholz.
He's felt it more as he decelerates or as he follows through," Farrell said. "It wasn't at the point of acceleration or when his arm is traveling through the arm slot prior to release. It's always been after the release and that's why, as the intensity increased, the more you're having to put the brakes on. And that's where he was feeling the discomfort or not feeling like it was ready to ramp up to full game speed. That's the sensation he's described to me."
Bone rubbing on the ligaments or tendons is called shoulder impingement, which restricts the motion of the shoulder.
"I wish I could give you practical terms," Farrell said. "Honestly, when you get into the intricacies of the shoulder, and I'm not trying to be a smartass here, I just don't have the description of the anatomy to know what takes places at what point or what the exact body part is. But there's inflammation in there that's causing the restriction. I think the most encouraging thing is the MRI didn't reveal anything further. It was compared to previous MRIs that Clay has undergone and there's been consistencies throughout that which are clean. So this is an inflammation issue that we've got to let calm down."