Ellsbury treatment unchanged

April, 22, 2010
4/22/10
8:09
PM ET
BOSTON -- Dr. Thomas Gill, the Red Sox medical director, said Thursday night that the course of treatment for injured outfielder Jacoby Ellsbury would have been no different even if the hairline fractures in four ribs had been detected sooner.

A CT scan, which Ellsbury told reporters he requested, revealed the hairline fractures Thursday. Originally, Ellsbury had been X-rayed and diagnosed with bruised ribs after his April 11 collision with third baseman Adrian Beltre in Kansas City. A second set of X-rays taken last Friday in Boston supported that diagnosis.

“Typically, when reviewing the film and examining Jacoby, it pretty much is our standard or anyone’s standard that you do a careful physical examination, you get your X-rays, and then assuming the X-rays don’t show any obvious fractures or lung injuries or any soft tissue injuries, that’s pretty much the much standard of care for looking at potential rib or chest injuries,'' Gill said in a conference call with reporters.

“Whether something is a rib contusion or a hairline fracture or a mainly displaced or non-displaced fracture of the ribs, all those injuries are treated the same way. So what we do is ... just take the precaution of treating everyone as if they have a nondisplaced rib fracture, which basically means you keep people out of competition or you keep them out of playing until they have no tenderness, until they can breathe without difficulties, exert without difficuilty, hit without difficuilty, swing. Once somebody is completely asymptomatic, that’s when it’s safe to return to play.

"There really is not a question of whether there’s a hairline fracture. We treat all injuries as if they probably are. That’s why we typically don’t get CT scans or MRI scans right away, after a potential rib trauma. We get the X-ray, and assuming it doesn’t show a displaced fracture, we end up treating these things the same way. We’ll still continue to treat Jacoby exactly as we did before.”

Gill did not offer a guess on when Ellsbury, who is eligible to come off the disabled list next Tuesday, will return.

“It really is strictly symptom-based,'' he said. "These injuries, they’re very variable as far as how long symptoms last. As long as he can swing, hit, run, catch, do anything that he needs to without feeling it in any way, he’ll be cleared to play.

"Sometimes that can be a week. Sometimes that can be a couple of weeks. It really depends on how fast he progresses. From a medical standpoint, he will be safe to play as soon as his symptoms resolve.”

Gordon Edes

Red Sox reporter, ESPNBoston.com

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