© 2013 MLB Advanced Media, L.P. All rights reserved.

3/14/2013 4:44 P.M. ET

Big Papi's heel problems not unexpected

If the thought of Opening Day puts a spring in your step, please allow me to dispense a bit of advice: don't spring up too quickly, you might hurt yourself.

No kidding. Just ask David Ortiz.

It was on July 16th, about eight months ago now, that the Sox DH partially tore the Achilles tendon on his right leg. He appeared in one game in August and the next time we saw him in a Sox uniform was this February in Ft. Meyers, Fla. After an offseason of rest and rehabilitation, the 37-year-old slugger hoped to be off and running when he picked up his activity level. Instead, a session rounding the bases set him back on his heels. At the very least, that's where he was feeling the pain.

"Even with rest and the best treatment available, the recovery from the type of injury that David Ortiz suffered is tough," said Dr. John Giurini, chief of podiatric surgery at Beth Israel Deaconess Medical Center. "At some point, you ramp up the activity, which in the case of most athletes involves running with a lot of stops and starts. It's not unusual to have some discomfort."

The challenge for the doctors, physical therapists and, of course, the athlete/patient, is to find that fine line between the level of activity that will lead to a return to action rather than re-injury. In Papi's case, MRIs showed inflammation to be the source of the pain. As a result, it's thumbs-down to any chance of Ortiz being a part of the Opening Day lineup.

"I am going to say this as a Red Sox fan as well as a physician," said Dr. Giurini. "Hopefully after a bit more rest, some anti-inflammatories, and additional physical therapy he will be able to ramp up the activity level and not have another setback."

Ortiz has several challenges to contend with. He had heel problems during the 2011 season. His Achilles, while no longer torn, now has some added scar tissue, and he's not as young as he used to be. Join the club.

"We lose flexibility with age. And tendons, while elastic, are not as flexible as they used to be. Scar tissue is a natural occurrence when the body heals itself. It's non-elastic and it doesn't rehabilitate in the same way. The older we get, the more stretching we require to maintain that flexibility."

We can't turn back the clock, but we can be smarter about choosing appropriate footwear, and more honest about our own limitations.

"Seven years ago, I went to the Red Sox Fantasy Camp," said Dr. Giurini. "I started preparing a good seven months ahead of time precisely because I wanted to enjoy myself, not injure myself."


"Well, I didn't tear both hamstrings like one of my camp mates did. I might have been a bit sore, but I didn't miss a workout, not even an inning. I had a great time."

You don't happen to DH, do you doc?

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.