Boston's right-hander pitched despite feeling under the weather, fighting an illness that has bothered him since last week. It showed. He didn't have his best stuff and set a career high with eight walks.
Matsuzaka did, however, make the pitches he needed to make to avert disaster against a loaded lineup. Even with all the free passes, he allowed just one earned run on two hits in five dramatic innings, helping the Red Sox to a 6-3 win over the Tigers in front of 39,478 at Comerica Park that extended their winning streak to four games.
"Physically, I was way off today," Matsuzaka said through an interpreter. "Even though I couldn't throw a lot of strikes, my fastball wasn't that bad, and I think [catcher Jason] Varitek did a nice job mixing it up."
Matsuzaka (5-0) walked runners into scoring position in the first and third innings, but found a way to tame the Tigers' sluggers and escape the jams.
He walked two in the fourth, when Curtis Granderson lined a single to center to score a run -- though by that time the Red Sox had a 4-0 lead thanks to two-run home runs by Mike Lowell and Kevin Youkilis.
David Ortiz, back in the lineup after missing Sunday's game with tightness in his surgically repaired right knee, hit his sixth home run of the season to cap the scoring.
Still, no matter how many homers they hit, the Red Sox know they can't walk 10 batters, like they did Monday, and expect to win many games.
"That's not the recipe, the formula to win," Red Sox manager Terry Francona said. "[Matsuzaka] didn't get beat; he just kept plugging away, and that's what he had to do. He pitched with a lot of heart. Thankfully, he didn't give up a lot of hits with all those walks, but he got through it.
"He competes. He didn't have his best stuff. He didn't feel 100 percent, his strength was down, but he competed. Tonight it was good enough. Like I said, it's hard to walk that many people and come out with the win."
Varitek could tell in pregame warm-ups that Matsuzaka didn't look like himself and watched his pitcher carefully.
"He looked pretty bad -- we were pretty worried in the bullpen," Varitek said. "We tried to talk through it as much as possible, and say, 'Listen, we don't want you to go out there and hurt yourself. You have to let us know if you can't go.'"
Matsuzaka went to three-ball counts on five of the first seven batters he faced, which led to early Detroit scoring chances.
With two outs in the first inning, Matsuzaka walked Carlos Guillen and Magglio Ordonez to put runners on first and second with two outs. He recovered, though, by quickly enticing a lazy fly out by Miguel Cabrera.
Matsuzaka did similar work in the third inning. He walked Granderson to open the frame, and after a fielder's choice, he walked Guillen to put two on with one out this time. Then, Matsuzaka went to work. He struck out Ordonez on high heat and then got Cabrera to lift another soft fly ball to center to escape.
"He walked eight guys," Cabrera said, "but when he needed to make a pitch, he made a pitch."
Pitching with a 4-0 lead in the fourth, Matsuzaka allowed Granderson's RBI single -- Detroit's first hit of the night -- and faced yet another two-on situation in the fifth after a walk to Gary Sheffield and a single to Cabrera. This time, Tigers callup Matt Joyce drilled a liner to right -- but right at J.D. Drew, who caught it a step in front of the warning track for the third out.
And with that, Matsuzaka's night ended.
"I don't want to get into too much detail, but I think I didn't achieve too much out there today -- so what happened out there I'm going to leave out there on the field and start afresh," Matsuzaka said through an interpreter.
Recent Red Sox Triple-A callup Craig Hansen gave up two runs in 1 2/3 innings to make it 5-3, until Ortiz's deep shot to right in the ninth. Meanwhile, Hideki Okajima pitched a perfect eighth, and Johnathan Papelbon earned his 10th save of the year to allow Boston and its surprising number of fans in attendance a chance to exhale.
"There's not too many outings where you can walk that many and find a way to get through it, but we did," Francona said.
Scott McNeish is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.