What we know about Dustin Pedroia’s injury and his future with the Red Sox

Red Sox manager Alex Cora has told Pedroia to take it easy.

Dustin Pedroia looks over his shoulder after lining out to right against the Braves on May 27.

Dustin Pedroia played pain-free for the Red Sox against the Blue Jays in his third game since returning from knee surgery. He woke up the next morning and still felt fine. Then the second baseman arrived at Fenway Park, felt something off during stretching, and was back on the 10-day disabled list after one hit in 11 at-bats on the season.

Pedroia visited Dr. Riley Williams III in New York for an MRI Tuesday. Williams, who performed the cartilage restoration procedure Pedroia underwent in October, diagnosed the complications as inflammation, per manager Alex Cora, and said it was “nothing that has to do with surgery.”

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Last season, Pedroia had two stints on the disabled list before his surgery. The latest addition to his lengthy injury history — a list that begins with a broken ankle caused by a Lance Briggs hit in high school football and includes multiple season-ending operations — is especially worrisome due to its nature and the 34-year-old’s age.

But the 2008 AL MVP isn’t counting himself out just yet.

“I’m going to be back to normal,” he said.

Here’s what you need to know about Pedroia’s injury and Red Sox future:

What is the injury?

Pedroia’s October surgery was the second operation the second baseman had on the same knee within 12 months.

The source of his knee problems was reportedly a game in Toronto in September 2016. There was no mention of Pedroia on the injury report that night, and he continued to play the rest of the season but required an arthroscopic procedure in the offseason to repair a partially torn meniscus and remove damaged cartilage.

That surgery was a success, and Pedroia stepped up to the plate as the leadoff hitter on Opening Day. Then, the left knee issue returned in the form of Manny Machado’s hard slide into second during a game in April 2017.

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In the bottom of the eighth inning, Baltimore’s Mark Trumbo hit a ground ball to shortstop Xander Bogaerts. Bogaerts flipped it to Pedroia for the out at second base, but before Pedroia could twist and turn the double play, Machado slid over the bag and spiked the outside of Pedroia’s knee.

After the game, Machado said that he didn’t intentionally spike Pedroia, who refused to talk about the MLB rule that forbids takeout slides.

“I don’t even know what the rule is,” he said. “I’ve turned the best double play in the major leagues for 11 years. I don’t need a f****** rule, let’s be honest.”

What he would need — after two stints on the disabled list and some hobbling on the basepaths — was a second surgery. This time, the procedure was intended to restore the cartilage in his knee. The way Pedroia described it, the surgery would “basically give you tread on your tire and you can go crazy again.”

After rehabbing the knee in Florida and Pawtucket — where the organization was careful not to rush his recovery — he made his season debut for the Sox on May 26. He played three games before inflammation sent him back to the disabled list and a specialist. The good news for Pedroia is that this time, unlike last season, the injury shouldn’t require another procedure.

“Last year, if I didn’t have surgery, it wasn’t going to get any better,” he said. “It’s going to get better. So, just stinks going through it.”

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The pain he felt this week was from a completely separate area of his knee than where he had felt it during rehab, which left Pedroia feeling, understandably, concerned. However, Cora reported the doctors in New York told the second baseman the pain had “nothing to do with the surgery” or structural damage — just inflammation.

“I believe mentally he’s in a good place,” Cora said. “He’s relieved.”

Pedroia is reportedly scheduled to resume baseball activities on Thursday.

Would the Red Sox move on from the long-time star?

Over the course of his 13 years in Boston, Pedroia has packed his trophy case to the tune of four All-Star nods, the same number of Golden Gloves, the 2007 AL Rookie of the Year award, and the 2008 AL MVP prize. Plus, two World Series rings.

For his performance, Pedroia was rewarded in 2014 with an eight-year deal that will pay him $16 million this season and $40 million more over the next three years. That contract looks a lot better if Pedroia stays on the field and plays like he did in 2016 (.318 BAA, .825 OPS) as opposed to last season, when he posted a .293/.369/.392 slash line in an injury-shortened 105 games.

Pedroia turns 35 in August. As The Boston Herald‘s Jason Mastrodonato noted, there are only six full-time position players 35 or older in the major leagues this year — and five of them are designated hitters. The second baseman is likely to join that group in Boston, unless the team released their longest-tenured player or found a trade partner willing to take on his contract.

Neither situation appears in play at this time.

Boston’s options at second base beyond Pedroia include Brock Holt and Eduardo Nunez in the majors, and Michael Chavis in the farm system — who was recently suspended 80 games for PED use.

“We just go forward,” Pedroia said of his recent setback. “The end is going to be better.”

To ensure that’s the case, the Red Sox are asking him to rein in the relentless hustle that has made him a fan favorite. Cora said although the team loves when Pedroia runs out a routine ground ball to short, he doesn’t have to go all out on a near-guaranteed out.

“The guy that we want is the healthy one that can contribute offensively and defensively,” he said. “Now it’s on us as far as a workload. But he understands that he has to slow it down a little bit.”

Easier said that done — the 5-foot-9, 170-pound force didn’t jog his way to the MLB. Taking his time might be a new approach for Pedroia, but it could prove necessary to preserve cartilage as he chases a third World Series ring.

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