Okajima has not appeared in a game since Friday, when he allowed
a career-high four runs, including two homers -- in one-third of an inning in an 8-7 loss to the New York Yankees.
Red Sox manager Terry Francona was evasive Wednesday
about the exact nature of Okajima's health, but he said the left-hander was given time off to "refresh" his arm.
"I don't want to go into everything," Francona said before Boston's 6-1 loss to the Blue Jays on Wednesday. "We monitor everything on these guys. We have baselines from the beginning of spring training until now. There's things that we just want to keep going in the right direction. Sometimes the best way to do that is to have a guy not pitch."
Okajima, in his first season in the major leagues, allowed nine runs in his past seven outings, raising his ERA from 1.17 to 2.28. He is 3-2 with four saves in 64 games.
Okajima took three days off after Friday's meltdown, then began a throwing program Tuesday designed to strengthen his arm.
"You probably won't see him for a few more days," Francona said. "It's not an easy thing to do, but it's the right thing to do."
Ramirez, who has not played since Aug. 28, resumed hitting last Sept. 12 but is still sore.
"When he ran, it started grabbing at him a little bit. We're stuck there," Francona said. "His work ethic has been very, very good," Francona said. "I understand, over the course of years, there's been some hiccups. This isn't one of them. We miss his bat. He's a Hall of Fame bat that's not out there. Rookie [Jacoby] Ellsbury has done a great job of lessening the blow, but it is Manny Ramirez. He's trying his best to be out there. He's just not ready."
Youkilis, hit by a pitch from New York's Chien-Ming Wang on Saturday, took some swings Wednesday but remains sore. Crisp could return for Friday's game at Tampa Bay.
Without Okajima to set up closer Jonathan Papelbon, Boston will continue to turn to Eric Gagne, who has allowed 14 runs and 23 hits in
14 innings since the Red Sox acquired him from Texas on July 31. He wasted an eighth-inning lead in Tuesday's 4-3 loss.
"It's pretty simple," Gagne said. "I'm beating myself up right now. Yesterday. I walked guys and you can't do that. This game is pretty simple. I'm making it a lot harder than it is right
Francona isn't worried about Gagne's confidence.
"He's tough enough to handle what's been thrown at him or we wouldn't do it,' Francona said. "I think we need him and I think
he'll do it."
Gagne isn't questioning himself either, and said his Boston teammates have remained supportive.
"You go out there and stay positive and think positive," Gagne said. "I've been lucky that I've never had a stretch like that. It
makes it a lot easier when you have guys coming up, patting you on
the back and saying, 'Keep it up.' Everybody goes through that. The timing is not very good."