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Depleted Sox try to put best foot forward

Depleted Sox try to put best foot forward

On a weekend by the bay in San Francisco that produced a broken thumb for Victor Martinez, and a partially torn hamstring for Clay Buchholz the most serious and untimely injury was to Dustin Pedroia. On Friday night the Sox second baseman fouled a ball off the top of his foot. One pitch later he limped out of the batter's box and onto the DL with a fractured navicular bone. The Sox haven't been bitten by the injury bug; they're being devoured by it.

Before you ask when this is team going to catch a break here's the latest from Terry Francona's MASH unit. They did, but not the good kind. Catcher Jason Varitek broke a bone in his right foot when he fouled off a ball in the eighth inning against the Rays. At this moment there's no word on exactly which of the 26 bones in his foot that it was, so let's talk about the injury we know more about - Pedroia's.

"I was watching the game and saw it happen", says Dr. John Giurini, Chief of the Division of Podiatry at Beth Israel Deaconess Medical Center. "The reports I have seen have indicated that it's a non-displaced fracture. The bone is cracked but not separated which from a treatment standpoint is good news."

The kind of blunt force that Pedroia's foot absorbed might be compared to the force of a heavy weight being dropped on the foot or if you swung a sledgehammer and hit your foot by mistake (okay, if I swung a sledgehammer). Painful certainly, but better than the "nutcracker" fracture that Dr. Giurini often sees.

"It's a common injury in car accidents. When a driver or front seat passenger has their feet pressed against the floorboards anticipating impact and the force of the crash flexes the feet back violently it can shatter the bone. That will often require surgical repair."

You might have seen the pictures of Pedroia wearing a walking boot and using crutches. Dr Giurini indicated that he'd likely wear the boot for 4-6 weeks before beginning accelerated rehab, although the infielder will probably be on an exercise bike well before that. And it's a good bet that he's using some kind of electronic bone stimulating unit to promote healing.

"He has access to good doctors, trainers and treatment. He can work on his recovery full-time"

The navicular bone was described in some accounts as a non-weight bearing bone. I asked if that might make a difference in Pedroia's recovery.

"Well, technically it is non-weight bearing in that it doesn't come into contact with the ground. It forms part of the longitudinal and transverse arches of the feet that distribute the weight of our bodies. But it plays a significant mechanical role in the midtarsal joint during adaptive movements as we run and walk on uneven terrain. It's not an insignificant bone."

And considering that Pedroia was batting .374 in June (.462 in the week prior to the injury) it's not an insignificant loss for the Sox to absorb. It's hard to imagine that he won't cool off a bit when he comes back, but what about slowing down?

"I don't really see the injury affecting him at the plate in terms of his stance or swing. The midtarsal joint does lock up the foot, making it a rigid lever and helps in propulsion or push-off, so it does come into play accelerating out of the batter's box or fielding, but there are no indications that the tendons in that area are involved. If that's the case there shouldn't be a lingering effect."

There has got to be a time or two this season when Terry Francona wondered whether he was managing a clubhouse or a walk-in clinic. At least the Sox aren't required to shell out hazard pay. They might have trouble making payroll.

Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.

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