The restoration of Grady Sizemore

GRADY SIZEMORE CLIMBED onto the training room table, not expecting much. It had been two years since the 31-year-old last played pro ball, five since he was fully healthy and one of the game's brightest rising stars. Now he was a free agent, and though he'd come far enough in recovery from his latest knee surgery to pique teams' interest, his progress had plateaued over the past few weeks.

"I spent a lot of time feeling 80 to 90 percent, then you'd get a speed bump," says Sizemore, who still couldn't run without discomfort. He kept hoping he'd wake up one morning and everything would snap into place, but with spring training four weeks away, it wasn't looking good. "I was just afraid, I was stressed, frustrated," he says.

On this January day, Dan Dyrek, the Red Sox's director of sports medicine service, was about to examine Sizemore at EXOS, the high-end training facility in Phoenix where he had spent the past 12 months rehabbing. Dyrek was there only by tragic happenstance: He had come to Arizona for his father's funeral, and Boston GM Ben Cherington asked if he'd go see the former Indians center fielder while he was nearby.

Sizemore thought it'd be a waste of time. He had spent the past few weeks working out, hitting and fielding in front of scouts, and the Red Sox, while among the teams present, hadn't seemed too interested.

As Dyrek began to ask questions and poke and prod his body, it felt to Sizemore like just another in a long string of exams. Since 2009, Sizemore had basically lived in doctors' offices. He'd flown all around the country -- Vail, Colo., Miami, Los Angeles -- seeking out top specialists and surgeons, someone who could explain why his body continued to fail him, why he hadn't fully recovered. It remained a mystery. "You just didn't get a lot of answers," Sizemore says. "That was the hard part." He felt lost in the medical wilderness, with a third straight MLB season set to begin without him.

SIZEMORE EXPLODED ON the scene in 2004 with electrifying speed and power, a five-tool star -- six if you count his drawing power. The year after his debut, MLB.com reported that female TV viewership of the Tribe had jumped 200 percent. In 2007, he was heralded on the cover of Sports Illustrated as "without a doubt one of the greatest players of our generation," a claim he backed up the next season by slamming 33 home runs and stealing 38 bases. And over his first four full seasons, he missed just nine games.

But then an epic run of injuries and procedures -- elbow trouble, abdominal surgeries to correct sports hernias, right knee contusions, microfracture surgery on his left knee, arthroscopic on the right -- forced him to miss more than half the games between 2009 and 2011. During 2012 spring training, while still rehabbing his knee, he hurt his back and required season-ending surgery. The next September brought cartilage damage in his right knee and another microfracture surgery. It seemed that every time Sizemore tried to get back, he triggered some new problem -- and a bad one. "It was never a tweak or a sprain," he says. "It was always 'Yeah, that's a broken bone' or 'That's damaged cartilage.'"

Through this rise and fall, Sizemore and his agent, Joe Urbon, both Seattle- area natives, became close friends. For Urbon, whose baseball career was cut short by a torn ACL, watching injuries derail Sizemore was particularly painful. "What we were being told to do and what he was doing to get past injuries, it just wasn't working," Urbon says.

Microfracture surgeries like the one Sizemore underwent in the fall of 2012 are notoriously difficult to recover from. The surgeon uses an awl to drill small holes in the bone near the damaged cartilage, thereby releasing marrow in hopes that it will help build new cartilage in the affected area. Roughly 40 percent of athletes who have the surgery return to previous form, but more common are cases like those of Greg Oden, whose NBA career was derailed almost before it began, and Chris Webber, who never played with the same burst. Sizemore would miss the entire 2013 season after having the operation.

For two months post-op, Sizemore couldn't even move his leg and would spend eight hours a day on a machine that bent and straightened it for him. It was weeks before he could walk again.

As the 2013 season began without Sizemore, he and Urbon plotted a course for recovery, starting with a commitment to a year of rehab and physical therapy at EXOS. "We agreed we had one more shot," Urbon says. "I don't think Grady could afford at the time -- mentally, physically, emotionally -- to have something go wrong again." At EXOS, Sizemore worked daily with athletic trainer Ashley Rice, doing squats and lunges, stretches and bending -- all in mind-numbing repetition -- in the hope of making his hips and trunk stable enough to take pressure off his knees. "There is no enjoyment in rehab," Sizemore says.

Sizemore knew the odds were against his ever returning to the majors, but he pressed on, suppressing doubts, anger and frustration in the process. He had been known throughout baseball as a steady clubhouse guy, but staying even-keeled now wasn't easy. "I was probably a tough person to be around for a long time," he says. "Whether I'm upset or angry, I bottle it all up."

EXOS staffers describe Sizemore as all business, totally fixated on baseball. Sizemore's neuromuscular therapist, Eric Ford, is used to athletes cussing and howling in pain while he kneads their muscles and tissue. But in 30-minute sessions, four times weekly, Sizemore never complained. When the pain became too much, he just laughed.

About six months in, Sizemore began strength training on a strict timeline. Each week had two goals, such as jumping in a pool or, later, being able to turn and cut. Progress came in fits and starts, but whenever Sizemore got close to running, knee pain wasn't far away. "You get six weeks into that running progression, and you have a setback and you have to start all over," he says. "I was trying so hard just to jog."

By this past winter, he was able to run, though with lingering pain. Urbon invited teams to EXOS to have a look, and more than 15 sent scouts. "It was a curiosity," Cherington says. "Of course, he was an elite player at one time, but boy, it's been a long time." For all Sizemore's troubles, he was able to do enough in workouts to impress. He wasn't as agile as scouts remembered him, but he still had that quick, compact Sizemore swing. By mid-January, Cincinnati had made a major league offer, and Sizemore was ready to sign. On the other side of the country, Cherington was about to call Dyrek.

DYREK JOINED THE Red Sox in 2012 as part of a massive overhaul of the team's medical staff after two years of internal feuding and players questioning their quality of care. Formerly of Mass General, Dyrek is known in Boston as the guy who held Larry Bird's back together in the latter years of the NBA Hall of Famer's career. That, plus 30 years of physical therapy experience, made him a solid pick to regain player trust in the Red Sox organization. He was brought on full time in 2013, and before long he was winning praise for helping David Ortiz recover from an Achilles injury and helping Dustin Pedroia play through a torn ligament in his thumb.

Dyrek says the focus of his work with players is in the treatment of recurring injuries. The key to preventing them, he says, is not just to treat the pain but to dig deeper through muscle, soft tissue and scar tissue to an injury's underlying cause. "There's an epidemic of poor diagnoses in sports medicine," he says. "People treat the tip of the iceberg. They treat the acute injury."

Sizemore was a perfect case of repetitive injury for Dyrek. Their first meeting, scheduled for 30 minutes, evolved into a two-hour consultation. As he worked through Sizemore's muscles, joints and tissue, Dyrek found remnants of untreated injuries. For years, Sizemore's doctors had treated only his pain -- the tip of the iceberg. Now Dyrek was focused on understanding what was underneath. "You could see how these problems built up over time to his current presentation," he says. "You have to look through the layers. We did the archaeological dig and said, 'We're going after these old problems, the ones that built to an escalating scenario.'"

Dyrek spoke to the questions Sizemore had been carrying with him through five years of frustrating failed recoveries. He drew links between injuries and explained how compensating for one problem had cascaded into a series of others. Sizemore had seen the best specialists, but they all had focused on their own areas of expertise. Dyrek was the first to look at Sizemore's body as a whole.

"He explained why things happened," Sizemore says. "No one had told me my quad was pulling my kneecap in the wrong direction and causing stress on that cartilage. I had just heard, 'Hey, you have cartilage damage.'" For each problem identified, Dyrek had a physical therapy technique to relieve stress and pain. "He had an answer for every injury," Sizemore says.

From the moment he first got off Dyrek's examining table, Sizemore felt things were different. "I was like, 'Where has this been?'" he says. But it was too soon to jump for joy: Sizemore wasn't sure the Red Sox even wanted him. So he called Urbon and told him to find out whether their interest was real. He wanted to play wherever Dyrek was. "It was one of those things that you weren't looking for, but once you found it, you had to have it," he says.

Dyrek was equally enthused. "Here's a case that was begging to be treated," he says. "Here's a guy who hasn't played in two years, and the exam is indicating there are problems that haven't been treated. We might have a lot of opportunity."

In short order, Cherington and Urbon hashed out a deal: a major league contract for $750,000, with incentives up to $6 million. The news became official on Jan. 22, five days after Dyrek and Sizemore met.

IT'S SIX HOURS before the first pitch against the Yankees on April 22, and Sizemore is sitting in the home dugout at Fenway Park, chatting about his recovery. He pulls out his phone, nervously checking the time. He has always been fastidious about his pregame regimen, but now it's more important than ever. Sizemore is still rehabbing -- an hour to an hour and a half each day -- and doesn't want to be late for Dyrek.

He never told the doctor of his role in the decision to come to Boston, though he did plan to arrive at spring training the same day as Dyrek. Upon coming to Florida, Sizemore still felt discomfort, but in the few weeks since their meeting, he had shown marked improvement. He felt far closer to 100 percent.

As March came to a close, Sizemore shocked baseball once by making the Red Sox's roster, twice by hitting a home run in the opener. But his goal had never been homering on Opening Day -- it's to make it to game 162 healthy. "I wasn't going to put a lot of stock into it," he says. "I had come back and had early success before, then broken down again a month later."

Through the first part of the season, Sizemore continued to improve physically but struggled at the plate, batting .242 through May 6. Cherington remains hopeful -- Sizemore's swing looks good -- but won't say whether he expects Sizemore to keep a roster spot through the season. "We're just focused on today," the GM says. "We believe in him, [but] we see a guy still getting acclimated to playing at this level again."

The doctor is more optimistic. "He's not going to be at his maximum probably until the middle of the season," Dyrek says. "We haven't seen the full Grady yet."

For Sizemore, much of the stress and frustration of the past five years has already dissipated. "I almost probably put too much stock in getting back," he says. "Now that I'm back, I have a better outlook on everything else."

He peeks at the time again and heads down the dugout tunnel for another day of rehab work. He might never again be in the 30/30 club. He might not even hit above .250. But at least, finally, he has his answers.

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