Jacoby Ellsbury sidelined due to navicular bone injury in right foot

September 07, 2013 - 8:21 am

NEW YORK -- The Red Sox find themselves in a sudden position of uncertainty at the top of their lineup and in center field. Jacoby Ellsbury, who slammed a foul ball off his right foot on Aug. 28, has experienced ongoing discomfort that forced him out of the lineup on Friday. When he did not improve with the downtime, the Red Sox made the decision to send him to Boston to be examined by Dr. Peter Asnis and foot specialist Dr. George Theodore. An MRI taken on Saturday morning, according to manager John Farrell, revealed swelling and inflammation in the foot at the navicular bone (the same one that Dustin Pedroia fractured in 2010 -- essentially rendering him unable to play over the season's final three months -- and that Cody Ross fractured in 2012, resulting in a month off the field), symptoms that now have Ellsbury in a walking boot. Farrell said that the Red Sox are continuing to gather information about the injury, which will require further examinations (and images) of the foot, including a second opinion from Dr. Thomas Clanton of the Steadman Clinic in Denver. (It remains to be determined whether Ellsbury will fly to Denver to meet Clanton or if the foot/ankle specialist will merely have a phone consultation after reviewing the already available images of the foot.) The exact diagnosis of Ellsbury's foot has yet to be determined, and the precise duration of Ellsbury's absence remains unclear. That said, it will clearly be some time before he is in the Sox lineup, as he won't rejoin the club until next week's series in Tampa Bay, after his consultation with Clanton. "We'€™re still in the process of gathering more information. But the MRI showed enough to put him in the boot and immobilize it for now. We'€™re still going through some additional tests and when that information is more conclusive, I think we'€™ll have a better read on the diagnosis going forward," said Farrell. "I don't think we're looking at something that's just day-to-day here. "But before we get into any kind of time frame, I think it'€™s probably best to just, for all involved here, is to wait until we get more conclusive evidence and information that might also include a second opinion which he has the right to and which we support." Despite the uncertain prognosis, Farrell said that Ellsbury -- who is hitting .299/.355/.424 with an AL-leading 52 steals in 131 games this year, including a .313/.353/.469 line with a homer, two doubles and three steals in seven games since the foul ball -- feels that he can play through the injury, and that he fought the decision to send him to Boston. "I will say this '€“ Jake'€™s frustrated and he wants to be on the field. He feels like he can play right now. But at the direction of the medical people, it'€™s like, we'€™ve got to be careful of this," said Farrell. "I can tell you this '€“ Jacoby wants to be on the field. He'€™s kind of pissed he'€™s not here right now to be honest with you.'€ The fact that Ellsbury has played and played well does offer some promise, and represents an obvious contrast to Pedroia's situation. Indeed, GM Ben Cherington said that Ellsbury's injury was distinct from that of Pedroia as well as Ross. "My understanding is that this has nothing to do with, there's no long-term concern here. It's really about how do we best manage it over the course of the next several weeks hopefully, and hopefully he can play a lot in those several weeks," said Cherington. "Until we have all the information, I can'€™t really say much more than that." Given the worsening of symptoms even while he wasn't playing, it was time for him to seek further medical counsel. "He's been playing quite a bit since then and playing well. The soreness increased, so we felt like the right thing to do was to get it looked at again. We did that," said Sox GM Ben Cherington. "We don'€™t have all the information yet, so until we have all the information, I don't think it'€™s the right time to say anything more. I know he wants to play, and we obviously want him to play. That'€™s still our hope, that he'll be playing before too long." While the Sox were reluctant to characterize the condition, Dr. Chris Geary, an orthopedist who is the chief of sports medicine at Tufts, suggested that the presence of swelling and inflammation on the navicular suggested at least a bone bruise while also pointing to the possibility -- though not the certainty -- of a fracture. "Obviously, best-case scenario, [bone bruise] is all it is," said Geary. "You see that with a non-displaced fracture, too. If you got an MRI, there would be edema around, inflammation around whatever small fracture was there. You would get that in addition to a fracture, but you could also have that in the absence of a fracture." The prognosis for a bone bruise, according to Geary, "would be a couple weeks in a boot, be careful with it, try not to foul any more balls off of it. But if you had a small non-displaced fracture, you would have the inflammation around it, plus the fracture, and that's more of what Cody Ross had last year." If there is a fracture, Geary noted, it would presumably be of the non-displaced variety given that it didn't show up on an X-ray. Still, even a non-displaced fracture has the potential to leave Ellsbury out until the postseason, while a more dramatic (but seemingly less likely, given that Ellsbury has played well since the injury) variation of the injury would be that he wouldn't be able to come back at all this year. "Best-case scenario is probably a couple weeks. Worst-case scenario, we next see him playing for the Mariners next year," joked Geary. "I think [the fact he played] puts you in the same spectrum of either a small non-displaced fracture or a bad bone bruise. I think that rules out the Pedroia scenario but it doesn't rule out the Cody Ross scenario." While the Sox are hoping that a worst-case scenario is avoided, it is clear that they will feel the absence of their dynamic top-of-the-order hitter. "This is a guy we'll be missing for the time he's out," said Farrell. With Ellsbury sidelined, the Sox will take what had been a fairly stable outfield alignment of Ellsbury in center and Shane Victorino in right and will take a more adaptable approach. Jackie Bradley Jr. was called up and will play center on Saturday in the expansive Yankee Stadium outfield; Farrell said that he wasn't committed to that on a full-time basis, however, and that Victorino may also see action in center at times. Meanwhile, Victorino will slot at the top of the order in Ellsbury's absence, while the rest of the lineup (especially the second spot, where either switch-hitter Daniel Nava or right-handed Jonny Gomes would represent candidates to slot) could see alterations. As for Ellsbury's future -- which includes his pending free agency at the end of this year -- Cherington said that the foot injury should not impact that. This is a matter that is confined to short-term considerations, and the ability of the leadoff hitter to be a dynamic presence down the stretch. "I don't think there's any long-term risk here for him," said Cherington. "I don't think that's something he's worried about. We're concerned about the now. Trying to treat this the right way now hopefully in a way that allows him to play this year for the Red Sox, help us do what we're doing down the stretch."