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Notes: Good news for Williamson08/17/2004 8:12 PM ET
By Ian Browne / MLB.com
BOSTON -- The third opinion Red Sox right-handed setup man Scott Williamson received on Tuesday from renowned surgeon James Andrews just might prove to be the charm.
Andrews recommended -- at least for now -- for Williamson not to undergo Tommy John reconstructive surgery on his right elbow.
After getting a second opinion from Reds medical director Timothy Kremcheck last weekend, Williamson had a scheduled appointment to undergo the operation on Wednesday in Cincinnati.
That procedure would have knocked him out for the remainder of this season, and likely all of 2005.
Instead, Williamson will go on a rehab and strengthening program. Red Sox team doctor Bill Morgan did not rule out the possibility of Williamson pitching again this season.
It has been difficult for doctors to get a handle on Wiliamson's condition because of the Tommy John surgery he had in 2001, which makes subsequent MRIs on the elbow difficult to read.
"Dr. Andrews looked at him, his studies, etc., and agreed that he still has some stability left," said Morgan. "He came through a battery of tests and it looks like the stability is pretty good. The MRI looks somewhat abnormal, but following a reconstruction, there is an abornmality there anyway. [Dr. Andrews] recommended a 10-to-14 day rehab course and we're going to see how he does. If he does well throwing after that, we'll continue progressing him. If he has problems, then we'll consider the reconstructive surgery."
The next 10-to-14 days will be critical for Williamson.
"He was very relieved at this point and time, but cautiously so," said Morgan. "He knows that the reality is that this is a test period to see how he does. We're going to have a conference call tomorrow and talk about when he's going to begin [rehab exercises] and where he's going to begin it, but he will start in the next couple of days."
Morgan said that Williamson's situation has required a maximum amount of diligence, which explained the three opinions.
"The difficulty is, with a fresh rupture, it's very clear. With a reconstruction, you always have an abnormal situation," said Morgan. "So interpreting the tests, the MRI, the arthogram, is very difficult. So we have to rely more on the clinical examination, like how stable is the elbow, and it appears very stable. And he doesn't have a lot of pain.
"Clearly, if he does well and his velocity is good, and he's doing well, there's nothing to do. If, in fact, he continues to have problems, then there's other things to do. He may want to look at it arthroscopically and see if we see the ligament from within, and then progress from there," said Morgan.
The biggest tell-tale sign will come when Williamson starts throwing again.
"If he goes through this short rehab, which means physical therapy, and starts to get his strength back and then progresses into a short toss to long toss and then is able to get his velocity up, then yes, if he's throwing high 80s and low 90s, then he can't have a ligament problem," said Morgan.
Nixon expected back: The Red Sox could get a jolt sometime in September. According to Morgan, it is realistic to think right fielder Trot Nixon -- limited to just 29 games this season -- could return in time to make his presence felt down the stretch.
Nixon has been hampered by left quad woes since the beginning of May. But after shutting it down on July 25, Nixon has stayed away from baseball activities and has focused solely on strengthening the quad.
So far, that plan has worked well.
"Yes, as long as we continue on the path we're on right now, I don't think early September or mid-September is unrealistic at all," Morgan said.
Morgan said that the Red Sox hope Nixon can start embarking in baseball activities when the club returns for a homestand on Aug. 26 against the Tigers.
Second basemen getting close: Mark Bellhorn, who took batting practice from both sides of the plate before Tuesday's game, is making fast progress from his fractured left thumb. According to Red Sox general manager Theo Epstein, Bellhorn could begin a minor league rehab assignment by the end of the week.
Pokey Reese's strained right ribcage is improving as well. He is likely to be activated a week or so after Bellhorn.
"Pokey is also showing signs of turning the corner at this point," said Morgan. "He has very little tenderness."
Timlin and Embree: Veteran setup men Mike Timlin and Alan Embree have both struggled in recent weeks, and manager Terry Francona is doing everything he can to keep them fresh and effective.
"Timlin has thrown, at this point this year, 10 innings less than last year. Same appearances, 10 innings less," Francona said. "Embree has thrown four more appearances, but he also didn't have a stint on the DL [like he did in 2003]. We've tried to manage it."
Francona said that he would continue to pick his spots with both pitchers, particularly Embree, who could get a couple of designated days off per week.
"I think Mike Timlin is going to be fine," Francona said. "I did stay away from him for a couple of days and because of that, they're might have been a little rust. But I think it will help him down the stretch where we go to him and be confident in going to him."
This story was not subject to the approval of Major League Baseball or its clubs.
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