BOS@DET: Avila gets hit with backswing, leaves game

DETROIT -- A day after suffering what Tigers officials called a mild concussion on a David Ortiz backswing, catcher Alex Avila felt good enough to play, and showed no lingering signs that would hold him out. With his history, however, the club is being more cautious.

"He said he felt good, said he could play, no headache or anything," manager Brad Ausmus said. "But he's not playing."

Avila passed the standard concussion protocol, but head athletic trainer Kevin Rand wanted to make sure he got through a full pregame workout Saturday before declaring him available to play. He could return to the lineup for Sunday night's series finale against the Red Sox.

"Basically for us, this is one we would consider day to day," Rand said.

Even after Avila returns, though, the Tigers are going to watch him for symptoms. His history shows why.

When Avila took a foul tip that knocked him out of a game last August in Cleveland, he cleared a doctor's examination, passed concussion tests, flew to the next stop on the road trip and returned to action for a full game before the worst of the symptoms emerged the next day, three days after the actual injury. That forced him onto the concussion DL for just over two weeks.

"He had what's called delayed onset symptoms," Rand said. "Obviously we have to keep an eye on that."

The medical staff has adopted some preventative measures since then. Besides a more protective helmet, Avila now has to wear a CryoHelmet after every impact on his head, whether it's a foul tip or a swing, with or without symptoms. The soft helmet applies cooling therapy directly to the head and the carotid artery in the neck, and is intended to reduce inflammation.

"And we put that on for 30-40 minutes after a game," said Rand.

Avila wore the CryoHelmet after Friday's game, Rand said. They were presented with the device last postseason, and they've used it since.

Friday was at least the third such incident for Avila in as many years. Before last summer's foul tip in Cleveland, Avila missed nearly a week in September 2012 after colliding with Prince Fielder while chasing a foul popup, also in Cleveland. That was originally diagnosed as a sprained jaw before headaches and memory loss emerged the next day.

So far, his only symptoms this time have been the questions he got wrong when Rand quizzed him on the field.

"He missed the count. For me, though, I asked him who we played the day before, and had we beat them, and he didn't know that," Rand said. "You're going to err on the side of caution."