FORT MYERS, Fla. -- While the Boston Red Sox and Daisuke Matsuzaka are downplaying his back condition, with Matsuzaka on Thursday calling it just fatigue and saying he could throw if this was the regular season, any health issues involving the Japanese pitcher shouldn't be taken lightly.
And that's not only because Matsuzaka had what the team called a tired shoulder and a groin injury he concealed from the club in 2009, when he made only a dozen starts and won four games.
There's the matter of Matsuzaka's workload, and the example of Hideo Nomo, the most successful Japanese pitcher to perform in the majors.
While Matsuzaka is entering his fourth season with the Red Sox, if you add his eight seasons as the ace of the Seibu Lions in Japan, he has the experience of an 11-year veteran, and all by the age of 29.
Nomo had three seasons with the Los Angeles Dodgers by that age, but then broke down, was traded to the New York Mets and a year later was released. He recovered from his arm problems, but never became the dominant pitcher he was when Nomomania was at its height.
The burden placed on Matsuzaka's right shoulder has been significantly heavier than those placed on his big league contemporaries at the same age.
Since 1995, only two big league pitchers, CC Sabathia and Mark Buehrle, have thrown as many innings by the same age as Matsuzaka, who has thrown a combined total of 1,834 innings. Sabathia, 28, has thrown 1,889 1/3 innings, Buehrle, 29, has pitched 1,847 2/3, totals that Matsuzaka would have easily eclipsed had he stayed healthy last season, when he pitched just 59 1/3 innings.
But while Sabathia and Buehrle have more total innings, that doesn't compare to the workload Matsuzaka carried in Japan. There, he threw 60 complete games, and in his last season, 2006, threw 130 or more pitches in a game eight times, which is one more than all big league pitchers combined to throw last season.
Sabathia, by contrast, has 28 career complete games, Buehrle 23.
And that doesn't count the 200-pitch bullpen sessions Matsuzaka routinely threw in Japan, or the 250-pitch, 17-inning complete game he pitched in high school, or the 189 pitches he threw in his first start in 2003.
Matsuzaka, of course, has insisted that throwing as much as he does has been a key component of his success, and his regimen has been an occasional source of friction with the Red Sox, who obviously had different ideas. Matsuzaka has had only one start with Boston in which he threw as many as 130 pitches, back in 2007, and his average number of pitches per start has ranged from 108.75 in '07 to 91.91 last season.
Questions regarding Matsuzaka's durability were acknowledged at the time the Sox made their $103 million investment in him, including a $51.1 million posting fee to win the rights to negotiate with him.
To his credit, Matsuzaka this winter responded to the Sox's concerns about his overall conditioning by electing to spend nearly six weeks -- a week in December, another five in January -- working out at the Athletes Performance Institute in Arizona, and he reported to camp in the best shape he's been in since he signed with Boston. While in Arizona, he told Japanese reporters that he focused much of his work on his lower body, trunk and shoulders.
"I think this is my best offseason in terms of preparation," Matsuzaka said Thursday, and when asked about his back, added, "I wouldn't go so far as to call it an injury, a little bit of fatigue.
"I think the team would agree, right now I don't think it's that big a deal. I could throw now if I had to. I'll talk to the doctor tomorrow, and based on that conversation, we'll make a plan."
The groin injury he kept from the Sox, he said, accounted for most of his struggles last season.
"Being able to move my lower body effectively is really the lifeline to the way I pitch," Matsuzaka said through interpreter Masa Hoshino. "I was able to get away with it in the WBC [World Baseball Classic], but once I started throwing in the big leagues, it's a different stage, a different level of competition, and I just wasn't able to get away with it."
Matsuzaka sounded committed to better communication with the club, admitting that last year he might have kept his current condition quiet and pitched through it. ("I have a high pain tolerance," he said.)
Counting his victories in Japan, Matsuzaka has 145 career wins; only three pitchers since 1980 -- Doc Gooden (157), Roger Clemens (152) and Greg Maddux (150) -- have had more wins by age 29 (though Sabathia at 136 should pass Matsuzaka this season).
"[Last year] was really a learning experience for me," he said. "It was a difficult season but I'm not going to let that go to waste. By going through that experience, I'll be able to come out the other side a lot stronger and hopefully transfer some of that into the coming season."
Matsuzaka's goal this season, he said, is to get through the year free of injury. He kept it almost as simple when asked if he felt he had anything to prove after last year.
"I want to be able to be the kind of player the team can really rely on," he said. "That's really it."
Gordon Edes is ESPNBoston.com's Red Sox reporter. He covered the Red Sox for 12 years and has reported on baseball for 25 years. Ask a question for his next mailbag here.