Red Sox medical director Dr. Thomas Gill was not surprised when the CT scan -- which was requested by Ellsbury -- revealed the fractures. Gill said that the treatment of Ellsbury would have been the same, regardless of whether there was a hairline fracture.
"Whether something is a rib contusion or a cold hairline fracture or a mainly displaced or non-displaced fracture of the ribs, all those injuries are treated the same way," said Gill. "So what we do, typically as a medical staff, is always just take the precaution of treating everyone as if they have a non-displaced 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 difficulty, hit without difficulty, 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."
When the injury initially happened, Ellsbury was confident he would make a speedy return. More than a week later, he was still unable to take a full swing without being limited by the injury. Now he knows why.
"Well, it makes more sense," Ellsbury said. "A bruise is one thing, but four broken ribs is another. I wasn't sure. I knew it hurt. I was trying to go out there and play, and I was probably pretty close to playing. But yeah, it was just one of those things. When my swing is right, I'll go out there and play."
Ellsbury said he asked for Thursday's follow-up tests just so he could have a better handle on why his recovery was coming so slowly.
"For me, it just wasn't getting better," said Ellsbury. "I kind of asked for it -- the MRI and the CT -- and I'm glad I went about and did it, just to get some kind of closure of what was going on."
Ellsbury said he will wait at least a couple of more days before starting to swing again.
"The biggest thing is kind of when I can execute a normal swing. Then I'll be ready to go, ready to play," Ellsbury said. "I really don't know when that's going to be. I'm not going to swing for a few days. It doesn't really make sense. I'll just kind of let it heal up and let the ribs kind of get where they need to and go from there. Every day, I'm going to wake up and see how it feels and take it day by day. ... Until I can execute my swing, that's when I'm going to get back into the lineup and be ready to play."
Gill said it was hard to say exactly when Ellsbury would be back in the lineup.
"It's a great question. It really is strictly symptom-based," Gill 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."
Mike Cameron, Boston's starting center fielder, is also on the disabled list with a lower abdominal strain. He will be out two to three weeks. In the meantime, Jeremy Hermida, Bill Hall and callups Josh Reddick and Darnell McDonald will continue to get time in left and center. Hall started Thursday's game in left and McDonald -- who homered in his first two games -- played center.