BOSTON -- Red Sox third baseman Will Middlebrooks exited Thursday night's game against the Indians with lower back spasms.
When the Red Sox went out for defense to start the fifth inning, Pedro Ciriaco replaced Middlebrooks, who struck out looking in his two at-bats, the latter of which was in the fourth inning, just before he came out of the game.
"His back started to tighten up throughout the course of tonight's game," said Red Sox manager John Farrell. "This is unrelated to the rib injury that he was dealing with in the collision with the wall 10 days ago or so. In his last at-bat last night in Chicago, I think he slipped a little bit coming out of the box, but didn't mention any complaint prior to the game tonight. As things unfolded, the stiffness was there, so he's day to day right now."
Middlebrooks is a player the Red Sox can ill afford to be without for a significant length of time. Third base is not a position of strength for Boston in the upper Minors.
Sidelined Victorino ramps up physical activity
BOSTON -- Shane Victorino was again unavailable to play for the Red Sox on Thursday, and the team is no closer to deciding whether to place the outfielder on the disabled list.
"He continues to improve with each day," Red Sox manager John Farrell said. "He's going to go out and do some light running and then we'll ramp up the physical work or the physical activity. The information we get back after how he responds to that certainly is helpful as far as our decision making going forward."
Victorino left Tuesday's game against the White Sox with tightness in his left hamstring. The 32-year-old outfielder missed time in April when he experienced tightness in his lower back and again last week when the injury reoccurred.
With Victorino again out of the mix, Mike Carp started in left field and Daniel Nava moved to right and occupied Victorino's No. 2 spot in the batting order.
For now, Farrell isn't going to speculate on when Victorino will return.
"He's still day to day, unavailable tonight," Farrell said. "We're no closer to making a roster move."
Ross likely to be activated from DL on Friday
BOSTON -- David Ross re-entered the Red Sox clubhouse Thursday hours after hitting an RBI double and catching five innings for Franklin Morales during Double-A Portland's 8-4 win.
Ross, who has been on the concussion disabled list since May 12, made a one-game rehab assignment for the Sea Dogs.
The catcher doubled in his first at-bat and then struck out twice.
Ross will likely be activated from the disabled list on Friday.
"He'll get examined tonight and probably tomorrow when he comes in and at that point we have the ability to make a roster decision tomorrow," Red Sox manager John Farrell said.
Morales gave up one unearned run over five innings in his latest rehab start. The left-hander has been on the disabled list since Spring Training, when he was sidelined with a back injury. He then strained a pectoral muscle during an April 17 rehab start.
Morales threw 78 pitches on Thursday, notching three strikeouts and two walks.
Morales could be activated as a reliever for the Red Sox, but because he pitched Thursday, that decision is at least a few days away.
"He's not available for the next four or five days at a minimum," Farrell said. "That will be taken into account over the next couple days in our discussions and what potential moves we might make with him."
Ortiz exceeds expectations in return
BOSTON -- For David Ortiz, staying healthy goes beyond the physical. The 37-year-old Red Sox designated hitter is also keeping an open and forthright line of communication with his manager to help keep him on the field.
It's that honesty that manager John Farrell credits with Ortiz staying ahead of any potential problems.
"If he's feeling like he's starting to feel fatigued or he's feeling any additional soreness or he can't loosen up either in between at-bats or day to day, he's been very honest and forthright with that," Farrell said. "Because of that we've been able to stay ahead of that when he needs a day."
Ever since missing the first 15 games of the season with an Achilles injury, Ortiz is hitting .351 with eight home runs and 34 RBIs.
He's taken four days off since his return, but overall Farrell said Ortiz's health has exceeded expectations. The veteran even stole third base for the first time in his career Wednesday against the White Sox.
"He's in a good place physically," he said. "The overall durability has been a little bit better than I anticipated initially."
Boston Marathon survivor tosses first pitch
BOSTON -- A Boston Marathon survivor, who tore 90 percent of his left Achilles tendon, threw out a ceremonial pitch before the Red Sox game against the Indians on Thursday night.
Peter DiMartino, 36, was greeted with a standing ovation as he came out on crutches to the pitching mound and fired a pitch to Boston outfielder Jonny Gomes.
Gomes, who was not in the starting lineup, came out with a bat and posed in his batting stance before catching the pitch.
In addition to his Achilles injury, DiMartino sustained burns covering most of his right leg and shrapnel throughout his body.
DiMartino was accompanied to the mound by Chris Troyanos, who helped coordinate the medical response at the bomb site.
Michael Periatt is an associate reporter for MLB.com. Ian Browne is a reporter for MLB.com. Read his blog, Brownie Points, and follow him on Twitter @IanMBrowne. This story was not subject to the approval of Major League Baseball or its clubs.