Red Sox concerned about injury

BOSTON -- Almost two years to the day after Boston Red Sox center fielder Jacoby Ellsbury collided with third baseman Adrian Beltre and fractured five ribs -- an injury that caused him to miss all but 18 games in the 2010 season -- the team is terribly concerned that their leadoff hitter may be lost again for a substantial amount of time.

David Ortiz did not need to see a TV replay to know how badly Ellsbury was hurt in the fourth-inning play. He had seen the Red Sox center fielder in the training room before he was taken to Mass. General Hospital.

"He couldn't even take his shirt off," Ortiz said.

The anguish in Ortiz's voice was out of place in what should have been a pain-free Red Sox clubhouse, as they had just thumped Tampa Bay, 12-2, in the home opener, a welcome salve to the team's 1-5 start.

"What did they say about Ellsbury?'" Red Sox chairman Tom Werner asked as he walked toward the office of manager Bobby Valentine.

Friday night, a baseball source said that Ellsbury had sustained a dislocation or subluxation of his right shoulder. No timetable was offered as to how long Ellsbury will be out.

"It depends on how he responds," the source said.

A minor dislocation typically requires a minimum of four to six weeks, but if further evaluation reveals additional trauma to the shoulder, such as tears to the rotator cuff, labrum or other muscle or tendons, Ellsbury could be in jeopardy of missing months more.

The difference between a dislocation and subluxation? Dislocation is when the shoulder slips completely out of the joint. Subluxation is when the shoulder slips partially out of the joint.
Treatment involves first popping the shoulder back into the joint, which can be extremely painful. The joint is then immobilized by placing the arm in a sling, and within a few days additional tests are taken to determine whether the shoulder sustained additional damage.

Range of motion and strengthening exercises are then introduced. In cases where the damage is more extensive, surgery could be required.

Officially, the Red Sox would only say that Ellsbury had a shoulder injury -- plain to all who saw the play -- and would undergo further evaluation. But Valentine offered the first clue that Ellsbury would be lost from the lineup when he said he expected another outfielder to be here in time for Saturday's game.

And minutes before Pawtucket's game in Rochester, N.Y., Friday night, the team's Triple-A club scratched outfielder Taiwanese outfielder Che-Hsuan Lin, a telling indication that Ellsbury is headed for the 15-day disabled disabled list and Lin is headed to Boston to replace him.

"It looked bad, man," outfielder Darnell McDonald said. "It looked nasty. We're hoping for the best, man, because he's a big part of what we're trying to do."

Ellsbury was on first after singling home a run off Tampa Bay reliever Burke Badenhop with one out in the fourth inning. He broke for second on a 3-and-1 pitch to the next batter, Dustin Pedroia, but Pedroia fouled it off.

With a full count, Ellsbury took off for second again, which caused Brignac to shift toward the bag, where he was in perfect position to field Pedroia's grounder. Ellsbury was almost on top of him when he stepped on the bag, then leaped in the air to avoid Ellsbury's slide. He was upended, and fell backwards onto Ellsbury's exposed shoulder.

"As soon as I landed on him, I knew something was not right," Brignac said afterward. "I could hear him and it didn't sound -- it sounded like a very painful thing.

"It happened so fast, I kind of landed on him and rolled off. He was yelling and screaming a little bit and I just went over to check on him because obviously I'm not here to hurt anybody, that's not how I play the game. That was just an unfortunate thing."

Brignac said there was little he could have done.

"He broke on the pitch, I had to hold my ground," Brignac said. "He slid a little late, and that also could have been a reason why that happened. He slides earlier, I don't have to be leaving my feet, I can throw and get out of the way. He slid a little later, it could have (gone) both ways. I could have been the one that got injured because of how late a slide it was. I know he's not that type of player, he's busting his tail to get down there and bust up the double play for his team, and I respect that."

Valentine and Rick Jameyson, the team's new athletic trainer, ran out onto the field to attend to Ellsbury, who remained in a prone position, then sat up, clearly in distress. As he walked off the field, he hugged his right arm, close to his body.

"I said a little something as he walked off the field," Pedroia said. "He didn't look very comfortable, and Ells is pretty tough. Hopefully, he's all right."

A prolonged absence would have a profound impact on a team that already is missing one outfielder, Carl Crawford, who was in Boston for pregame ceremonies but is expected to return to Florida to continue rehabilitation on his surgically repaired left wrist.

Crawford also was in town for treatment of what the team is calling a minor elbow sprain.

Last season, Ellsbury ranked third in the American League, behind only MVP Justin Verlander of the Tigers and slugger Jose Bautista of Toronto in Wins Above Replacement (WAR), with an WAR of 7.2. He led the majors in total bases and extra base hits while becoming the first Red Sox player ever to hit 30 or more home runs (32) while stealing 30 or more bases (39).

Ellsbury had gotten off to a slow start this season, with just three hits in his first 23 at-bats, but he'd done the same last season and on Friday had flared a double and scored in the third and lined an RBI single in the fourth.

A number of prominent players have had dislocated shoulders in recent years and missed varying amounts of time. New York Yankees shortstop Derek Jeter dislocated his left shoulder on Opening Day 2003 in a violent collision with Toronto Blue Jays catcher Ken Huckaby at third base, and missed 36 games. Jeter did not require surgery.

Days later that same season, slugger Ken Griffey Jr. dislocated his right shoulder diving for a ball in the outfield and missed 37 games. Griffey returned to the Reds lineup but he was discovered to have a torn labrum and rotator cuff and underwent season-ending surgery that August.

Baltimore Orioles shortstop J.J. Hardy, while still in the minor leagues, dislocated his shoulder and tore his labrum in 2004 and sat out the season.

Milwaukee Brewers third baseman Aramis Ramirez, then with the Chicago Cubs, dislocated his left shoulder diving for a ground ball in 2009 and missed 58 games. He continued to have problems with the shoulder even after he returned to play.

Last June, San Francisco Giants second baseman Freddy Sanchez dislocated his shoulder in June and underwent surgery when it was determined he had also damaged his labrum and the shoulder capsule.

So estimates of Ellsbury missing just six weeks may be the most optimistic scenario.