Pedroia's injury shows limits of rehab
Therapy can hasten healing but it can't replicate game moves
Back in June, Dustin Pedroia was given the bad news that he had a broken bone in his foot. He was also given an immobilizing boot, a pair of crutches and instructions to take it easy until the bone had a chance to heal.
Five days later, Pedroia used those crutches to hobble out to the infield at Fenway Park and take grounders while on his knees. The definition of "taking it easy" is apparently relative -- and it was obvious that Pedroia finds it relatively difficult to do. Now the fact is that he wasn't putting weight on his foot, so he really wasn't risking further damage. He told reporters he did it because he was "really bored" and hoped to be back sooner than the six weeks the doctors were calling for.
Turns out it was seven weeks before he got the green light to get back in action. Two games with Triple-A Pawtucket were followed by two in Boston. That increase in activity was followed by enough discomfort to cause Pedroia to head to the bench and eventually back onto the DL, leading some to wonder whether he came back too soon.
"I wouldn't think so," said Mark Dynan, a board certified clinical specialist in orthopedic physical therapy at Beth Israel Deaconess Medical Center. "Given the nature of his injury, and the fact that his foot was immobilized for so long, it's to be expected. The body's natural response to activity that you haven't done in a while is soreness."
Well, sure, that's true for the average Joe who sits around for six months and then can't get out of bed the morning after playing touch football with his 30-something nephews and their pals (not that I would know). But Pedroia had been working full time on rehabbing, so why wasn't he good to go?
"Every physical therapist will tell you that there's a difference between being good to go and going full speed," Dynan said. "Yes, a professional athlete has the benefit of getting treatment and therapy several times a day, and certainly much more time with his therapist to facilitate healing and increase mobility and strength than most people do. However, there are some job specific activities that you can't replicate in a rehab setting."
"For example, take the steal Pedroia had on Wednesday night when the throw went into center field. He had been doing some sprinting as part of his rehab, no doubt, but that quick acceleration, the slide, the re-acceleration and change of direction when he went to third -- you can't duplicate that speed and intensity anywhere but a game. That was a real test. Sometimes you just don't know if you're ready to go back to your sport full speed until you do it."
When talking to reporters the next day, Pedroia first confessed his decision to attempt a steal "probably wasn't the smartest idea" and later amended it to "stupid." He also said he knew that he wasn't going to be able to come back and play 43 straight games.
"When a professional athlete is in the game, he has to go all-out," Dynan said. "That might lead to a few more days off down the stretch to let his body get used to the high level of activity, particularly considering the intensity and effort that the 2007 American League MVP is used to putting on the field. Most of the folks I see can afford to ramp up their activities until they reach a pre-injury level. Of course, if you are a guy who plays a regular game of pickup basketball or a woman who plays in a tennis league, that competitive instinct can kick in and lead you to push things too far too soon. You never want to go back so soon that you risk re-injury."
And from what we know of Pedroia's nature you can assume it won't be long before he's on his knees again ... begging to be put back in the lineup.
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.