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12/14/09 12:01 PM EST

Medical issues holding up Lowell trade

Swap between Sox, Rangers expected to take a few days

A review of medical records, a complete physical and official approval by higher authority is what's standing in the way of a trade that would send Red Sox third baseman Mike Lowell to the Rangers for catcher Max Ramirez.

The two teams discussed the deal in depth at the Winter Meetings last week in Indianapolis, but are still working through a number of issues before it can get completed, according to industry sources. A resolution isn't expected for at least a few more days. Both Ramirez and Lowell have physical issues that need to be reviewed and that seems to be the top priority.

Lowell has been bothered by a strained right hip and a sprained left thumb over the past two years. He had hip surgery at the end of the 2008 season and went on the disabled list on June 30 this past season. He was sidelined for 18 days by his strained hip.

Lowell also re-aggravated the thumb at the end of the 2009 season, missed the final series as a precaution before returning for the American League Division Series against the Angels. But it appeared to be a problem in the playoffs -- he was 2-for-10 in three games -- and the Rangers are expected to want a complete physical before they sign off on the deal.

There is a possibility that Lowell could need surgery on the thumb, according to a source. If that is the case, then it would be up to the Rangers to decide if they want to still do the deal.

Boston is also expected to pick up $9 million of Lowell's $12 million salary for 2010 if the deal is completed. But that hasn't been completely approved by the Red Sox ownership and it still must be approved by Commissioner Bud Selig.

Ramirez had a problem with both of his wrists in the 2009 season, but that is not expected to be an obstacle. He is currently hitting .234 with 12 home runs and 33 RBIs in 53 games in the Venezuelan Winter League.

The Rangers are still looking at other options in their quest for a right-handed hitter, and two names have been added to the list. Ryan Garko was non-tendered by the Giants on Saturday and the Rockies have cut loose Garrett Atkins.

The Rangers have had trade interest in them in the past and will consider them again, along with right-handers hitters who have already been on the list: Vladimir Guerrero, Jermaine, Dye, Troy Glaus and Fernando Tatis. If the Lowell deal doesn't go through, Texas probably has about $6-7 million left in its budget, and the club is still looking at catching, a utility infielder and more pitching.

The Rangers prefer Lowell, because he can play third base as well as first. The Rangers found themselves without a proven third baseman at the end of the season, when Michael Young was sidelined for most of September with a hamstring injury. Atkins has experience playing both positions although he hit just .226 with nine home runs, 48 RBIs and a .342 slugging percentage in 126 games for the Rockies in 2009.

If the Red Sox can't trade Lowell to the Rangers due to medical reasons, it could delay them from dealing him anywhere until he can prove his health in Spring Training. Boston was already willing to pay $9 million for Lowell to play elsewhere, so the club is still likely to look for an upgrade at one of its two corner spots, even if it doesn't make a trade.

The Sox could still make a run at top glove man Adrian Beltre at third, or get a first baseman and have Kevin Youkilis spend more time at the hot corner. As long as Lowell is reasonably healthy by Spring Training, he will likely play somewhere besides Boston in 2010.

T.R. Sullivan is a reporter for MLB.com. Ian Browne is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.