NESN

Clay Buchholz Among Red Sox Who Understand Communication Is Key to Prevention of Injuries

Red Sox manager Terry Francona meets with the media at 4 p.m. prior to every night game at Fenway Park (a little later if it is a nationally televised game). For about 30 minutes before that meeting, reporters are given access to the clubhouse.

In addition to any player interviews that need to get done, a daily chore for media members is to glance around at the lockers of some of the injured players. That's where you might get clues as to the progress of those disabled individuals. Perhaps his shirt is soaked with sweat — the sign of a workout — or he has his glove on and is heading to the field — an indication that a game of catch is coming.

Every so often, one of those injured players will walk into Francona's office and close the door.

Before that door shuts, it's not uncommon to see head trainer Mike Reinold and perhaps higher-ups like Theo Epstein and his merry band of messengers inside.

A discussion will ensue. How are you feeling? Are you ready for batting practice? How does Tuesday work to begin a rehab assignment?

Once 4 p.m. rolls around, that's when Francona is asked about what the reporters saw, and he often gives a similar refrain.

"He will progress as his symptoms allow," he has said, most recently when discussing the progress of injured right-hander Clay Buchholz.

Baseball players are afforded the opportunity to be around a medical staff on a daily basis. If they need to have an ankle iced and wrapped, they can — in a heartbeat. If they need to talk about the pain in that ankle, they can do so at the very same time.

In the real world, it takes an appointment with a general practitioner or a referral to a specialist and it could take days to get in. While it might require more legwork to get that face-to-face time, it's imperative to make those appointments and to be entirely frank regarding any physical issues, just as it is for the Red Sox.

"As a primary care physician, I rely on the patients to be up front and honest about their symptoms so we can establish an appropriate plan of treatment," explained Dr. Julia Lindenberg, a primary care physician at Beth Israel Deaconess Medical Center. "It is also important for me to ask patients the right questions to help me identify clearly what their symptoms are and how these symptoms are impacting their daily function."

Back to the big leagues. There has been some focus on the Red Sox medical staff in the past year. The severity of Jacoby Ellsbury's broken ribs was determined after the outfielder tried to return from the original injury. Buchholz pitched through some back pain before he needed to be sidelined due to a stress fracture, although the pitching was not what caused the injury that eventually sidelined him.

In any event, the key to getting those players back to where they needed to be (seems as if it worked just fine with Ellsbury, eventually) is communication. With Buchholz, the club is going through an almost daily discourse to determine if he can pitch again this year.

Buchholz is on a five-step road to recovery. He can only get to each step after he completes the prior one. And he can only complete the prior one with approval from the medical staff.

As medical director Dr. Tom Gill said at the time, "It's kind of our job not to let him get back before it is safe for him."

Buchholz stressed the significance of that back-and-forth.

"If I can be back early, I'm going to do everything I can to come back and help this team, but I want to be healthy doing it," Buchholz said after learning of his stress fracture. "I don't want to go out there and pitch one game and go back on the DL for something I could’ve prevented."

Prevention, in a lot of ways, comes through communication.