TORONTO -- Boston Red Sox pitcher John Lackey, initially diagnosed with a right biceps strain after coming out in the fifth inning of Saturday's 5-0 loss to the Toronto Blue Jays, is flying back to Boston for an MRI Sunday.
While Red Sox manager John Farrell said initial signs were encouraging, "we can't rule anything out" until doctors review the MRI results.
"I think everybody's worried about him," Red Sox catcher David Ross said. "I'll say a prayer for him. He's such a good teammate, first of all, and to come back and throw the ball as well as he was today, I was really excited for him."
How concerned is Lackey that the injury might be serious, and there is a significant tear in his biceps?
"I don't know," he said somberly. "See what happens tomorrow when I get it checked out.
"Hopefully we'll get a picture of it tomorrow and get after it and it's nothing too crazy."
Lackey was making his first start since Sept. 25, 2011, and just over 17 months after he'd undergone Tommy John reconstructive elbow surgery, performed by Dr. Lewis Yocum. He had struck out eight batters after Emilio Bonifacio was called out on strikes leading off in the fifth, and had made just one mistake, a high cutter that J.P. Arencibia hit for a two-run home run in the fourth.
But after throwing a 2-2 pitch to Jays leadoff man Jose Reyes, he clutched his right arm in agony as Reyes skipped over the pitch, the ball skidding to the backstop.
"He tried to throw a cutter away," Ross said. "I knew something had to be wrong, [because] he just jerked it down and in. I turned around after getting another ball from the umpire and I saw him grabbing his arm."
Lackey's first thought at that moment?
"The year and a half of getting to this point," Lackey said, "and having to do it again."
On the previous pitch, a breaking ball fouled off by Reyes, Lackey could be seen shaking his right arm.
"I felt a little something tight on the pitch before, but it grabbed me pretty good on the last pitch," Lackey said.
"It felt like a pretty good cramp," said Lackey, comparing it to similar pain he has had in his hamstrings. "All biceps, wasn't elbow. Pretty frustrating. It was scary when it happened, for sure."
Second baseman Dustin Pedroia immediately came to Lackey's side as Farrell and trainer Rick Jameyson sprinted to the mound. Lackey walked off shortly thereafter, his arm dangling at his side.
"Obviously we took him out immediately," Farrell said, "but once he was in the clubhouse here, he iced it down and the cramping went away.
"The testing he went through in the training room after some time elapsed, the test strengths, the manual testing in here showed good strength, almost full strength. So there are some initial positive signs here, but we can't rule anything out, and that's why the [MRI] exam will take place."
Farrell insisted that there was no elbow involvement in the injury.
"The elbow is fine. This is in the belly of the biceps," Farrell said. "Kind of, I would say, an abnormal area for a guy to feel that grabbing sensation on one pitch."
The symptoms he experienced, Lackey said, did not resemble the discomfort he experienced with his elbow in the past.
"My hand didn't go numb or anything like that," Lackey said, "like I've had with elbow stuff."
Lackey underwent Tommy John surgery after a 2011 season that was turbulent both and off the field, as he posted the worst starting ERA (6.41) ever by a Red Sox pitcher while also going through a difficult divorce that played out in public. He missed the 2012 season, but impressed the Sox by his commitment to rehab and showing up in dramatically trimmer condition.
He experienced no setbacks during spring training, during which he made seven starts, including two minor league games and a minor league intrasquad game last Sunday that served as his final tune-up to Saturday's start.
"I would hope, and I'm sure he will, [Lackey] takes a moment to reflect back on what the last 16 months have been," Farrell had said Friday afternoon. "We all feel John has the ability to impact our team in a positive way as much as anyone in our clubhouse."
Lackey gave up a leadoff single to Reyes, who promptly stole second, but struck out two of the next three batters, including Edwin Encarnacion with a terrific slider. With his velocity touching 94 mph, he retired eight in a row before singles by Reyes and Rajai Davis with two out in the third, but quelled the threat by striking out Melky Cabrera, punching his glove as he came off the mound.
Adam Lind singled and Arencibia homered to give the Jays a 2-0 lead, but Lackey appeared back in command until misfiring badly with the cutter to Reyes.
"He was sharp," Farrell said. "He had good action to his secondary stuff, the velocity was probably the best we've seen to date, he was free and easy, he threw all of his pitches for strikes.
"He gets a cutter in the zone to Arencibia [who hit a home run] ... but other than that he got out of a couple of jams with men on base, and I think into that inning overall he was pitching as well as we could have anticipated or hoped."
Lackey said he felt "really good."
"Made one mistake, pounded the strike zone pretty well, had some strikeouts," he said. "Felt my stuff was pretty good."
That all ended, though, with one pitch. Lackey said he plans to fly back to Boston on Sunday morning.
"We'll see what happens tomorrow," he said. "Hopefully it's not too serious."