Ellsbury says pain in ribs is back

ST. PETERSBURG, Fla. -- Red Sox outfielder Jacoby Ellsbury said he is experiencing pain along the band of the four ribs that sustained hairline fractures when he collided with third baseman Adrian Beltre on April 11. The pain, he said, is not unlike what he felt in the first days after the injury.

Red Sox manager Terry Francona had indicated to reporters that his understanding was that the pain was in a different area, more on Ellsbury's left side, and that the team intended to review the results of X-rays and a CT scan that were taken here on Tuesday when they return home Thursday.

But Ellsbury, who complained of discomfort after a session in the batting cage Tuesday with hitting coach Dave Magadan, explained that the pain follows along the ribs from the front of his chest, where Beltre's knee made direct impact, to his back.

"The pain, I was kind of in the clear with it,'' said Ellsbury, who came off the disabled list last Saturday and played three games before being given Tuesday off by Francona, even before the recurrence of the pain.

"I talked to Tito, and I'll talk to the staff when we get back, let them know my symptoms, and hopefully put together a game plan from there," he said.

"[The pain] is along the same ribs that cracked," he said. "All the ribs are moving, so it can affect the back ribs as well, where it hits the front of the spine. So you not only feel the impact at the direct place where you were hit, but the back side, too, along the band. I felt that originally, but I hadn't felt it again until now.

"You look at the point where we got the break, but sometimes people forget to look at other places,'' he added.

Ellsbury remains irked that the injury was originally described as bruised ribs. "I think they downplay it because they misdiagnosed it,'' he said. "They said you treat it all the same way. Remember that comment? How do you treat a bruise the same as a break?''

Red Sox medical director Thomas Gill had responded to that question directly when further tests showed the hairline fractures.

"It pretty much is our standard or anyone's standard that you do a careful physical examination, you get your X-rays, and then assuming the X-rays don't show any obvious fractures or lung injuries or any soft tissue injuries, that's pretty much the standard of care for looking at potential rib or chest injuries,'' Gill had said.

"Whether something is a rib contusion or a hairline fracture or a mainly displaced or non-displaced fracture of the ribs, all those injuries are treated the same way. So what we do is ... just take the precaution of treating everyone as if they have a nondisplaced rib fracture, which basically means you keep people out of competition or you keep them out of playing until they have no tenderness, until they can breathe without difficulties, exert without difficulty, hit without difficulty, swing. Once somebody is completely asymptomatic, that's when it's safe to return to play.''

Gill indicated at the time that any judgment on Ellsbury's fitness to return would be symptom-based. "These injuries, they're very variable as far as how long symptoms last,'' Gill had said. "As long as he can swing, hit, run, catch, do anything that he needs to without feeling it in any way, he'll be cleared to play.

"Sometimes that can be a week. Sometimes that can be a couple of weeks. It really depends on how fast he progresses. From a medical standpoint, he will be safe to play as soon as his symptoms resolve," he had said.

The symptoms, Ellsbury maintains, have returned -- he felt them again Wednesday when he attempted to hit off a tee -- which would suggest that he will remain out of the lineup indefinitely. A return to the disabled list cannot be ruled out until after he confers with the medical staff.

"I'll see all the medical attention I can get,'' he said. "We'll be in the right place in a couple of days, as far as [knowing] what's going on.''

Gordon Edes is ESPNBoston.com's Red Sox reporter. He has covered the Red Sox for 12 years and has reported on baseball for 25 years. Ask a question for his next mailbag here.