There has been plenty of discussion this off-season about how much the Red Sox can actually depend on Clay Buchholz in the rotation. After all, he has had just one full season in the majors, and missed more than half of 2011 thanks to back problems.
There are a few things to keep in mind when thinking about Buchholz and how many innings the Red Sox can expect out of him. First, if the stress fracture in his back had been diagnosed correctly sooner rather than later, he might have even been back in time for September -- and possibly to help Boston stave off their eventual demise. He was already waiting in the wings to make an appearance should the Red Sox had secured a playoff spot during that final series at Baltimore, and that was with the stress fracture diagnosis coming right after the July 31 trade deadline.
Buchholz first started to miss time due to his back in late September of 2010, though: a six-day stretch where he was listed as day-to-day due to "low back stiffness" caused him to miss the last of that season. He then dealt with "stiffness" again on May 29 and June 3, and was listed as day-to-day from June 4 through June 10 with "back soreness." He was placed on the disabled list (and eventually shifted to the 60-day DL) with a stress fracture in his lower back on June 17, but the cause wasn't uncovered until August.
What had been thought to be a "muscle strain" turned out to be much more. A stress fracture can be serious, but it isn't necessarily indicative of future issues, either. We asked Corey Dawkins, an athletic trainer who writes the Collateral Damage injury column for Baseball Prospectus, about the potential for a recurring problem:
True stress fractures of the back rarely recur because of an increased focus on mechanics and muscular balance. From a health point of view, I think he will be fine. From a productivity point of view, that's yet to be determined. Pitchers are such creatures of habit that any change in the way they have been throwing since grade school may make it difficult to get that "feel" for a pitch again and limit his effectiveness. But yes, the chance of another stress fracture is minimal, and he should be fine.
We'll see how he does in terms of production this year, but, in terms of health, things could be looking up for the right-hander.
The back injury limited Buchholz to just 82 innings, but if the cause had been pinpointed earlier, he likely would have thrown more than that. The Mets' David Wright had a stress fracture in his back last year as well, but his was discovered in May; Wright was back at the end of June, and didn't miss any additional time the rest of the year.
It's easy to worry about his innings even when you take into account he should have thrown more last year, though, just because Buchholz's track record in the majors isn't especially long. He has never thrown 200 innings before, but he also just turned 26 last season, and until 2010 had split time between the majors and minors. The 200 inning mark hasn't been miles off for him, though, even if it seems like it has:
| Age | Year | MiLB | MLB | Total |
| 22 | 2007 | 125.1 | 22.2 | 148.0 |
| 23 | 2008 | 58.2 | 76.0 | 134.2 |
| 24 | 2009 | 99.0 | 92.0 | 191.0 |
| 25 | 2010 | 3.2 | 173.2 | 177.1 |
| 26 | 2011 | 0.0 | 82.2 | 82.2 |
Buchholz nearly threw 200 innings at age 24, between Triple-A and the majors. He followed that up with nearly 180 innings in his first full year in the bigs. This, besides the 2011 season in which the stress fracture limited him, looks like a fairly normal innings progression for a young, twenty-something starter.
This isn't to say you can pencil Buchholz in for 200 innings in 2012 without a care. It's just meant to remind you that Buchholz's trajectory hasn't been all that weird, and that the Red Sox have tried to be careful with one of their young assets by giving him enough time in the minors and not rushing him back from the finger and hamstring injuries he suffered in years past.
It's easy to assume the worst, especially when the last bit of baseball we saw came in September, but there's a good chance we'll be pleasantly surprised by Buchholz's output in 2012.