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ST. LOUIS — Clay Buchholz missed nearly three months with shoulder troubles and the Boston Red Sox have massaged him through the end of the season and most of the postseason. That cautious approach ends tonight in Busch Stadium.

Buchholz will start Game Four of the World Series tonight against St. Louis’ Lance Lynn and it’s virtually certain it will be his last start of the season. He can let go with whatever he has.

Buchholz visited renowned Birmingham orthopedist Dr. James Andrews a couple times during the summer to have the shoulder checked and confirm everything is all right. He seems satisfied he can pitch tonight with no real fear – even though he admits he’s not 100 percent healthy.

“I don’t think there is any risk there. My one thing that I have is to go and compete,” he said. “Go out there for as long as John Farrell wants to leave me out there, and give the team a chance to win to the best of my ability.”

Buchholz was 12-1 with a 1.74 ERA in 16 starts for Boston in the regular season. He was 9-0, 1.71 when he went on the disabled list in early June, and didn’t return until Sept. 10.

When he finally came back, he was nearly as good (3-1, 1.88). So what’s gone wrong in the postseason?

Buchholz has posted a 5.40 ERA and allowed 19 hits in 16∑ innings, including five earned runs in Game Two of the ALCS against Detroit. Opponents are batting .284 against him.

The Sox were thrilled he pitched shutout ball into the sixth inning of Game Six against the Tigers but the Clay Watch has been a daily discussion during the Series as the shoulder stiffness lingers amid chatter that Buchholz is struggling to work when he’s not 100 percent.

“I’m sure there’s going to be people talking to me each time I leave the field,” Buchholz said. “Being at this level, especially on this stage, it’s tough to take yourself out of a game. I’ve never done that before. But with this scenario that’s going on right now, I’m going to tell them the truth.”

Farrell could have either Felix Doubront and Ryan Dempster at his disposal if Buchholz struggles. And he realizes he may need to have a quick hook.

“You go in and pay close attention to every pitch that’s thrown, look at how they’re maintaining their arm strength or overall stuff and you adjust accordingly,” Farrell said.

Farrell said there was no thought given to using Jon Lester on short rest in place of Buchholz and potentially getting Lester three starts in a seven-game series.

“I recognize we’re in the World Series, I recognize the time of year,” Farrell said. “I would rather have Jon Lester at full strength, or with normal rest, than three days of rest.”

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The Red Sox worked out first baseman Mike Napoli at third during batting practice Saturday and might be pondering using him there to get more offense into their lineup. Napoli didn’t start Saturday because David Ortiz played first with no designated hitter available in the National League park.

Farrell told Boston reporters after BP that Napoli at third is an option in the series – even though Napoli has never played a major-league game there and only played third one time in Class A ball in 2002.

Napoli was a catcher his first seven years but switched to first base this year, playing 131 games there because of degenerative hip problems and foot trouble.

Farrell said the transition to the infield has been seamless.

“What we’ve seen, in addition to being a good athlete, he plays low to the ground with good hands,” Farrell said.

“The way he’s worked around the bag, with a lot of throws in the dirt, he’s saved a number of runs with that. We’re ecstatic with the way this year has turned out for him defensively.”

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The Red Sox put Daniel Nava in left field in place of Jonny Gomes, who was 0 for 7 in the first two games.

Jarrad Saltalamacchia got the start at catcher over David Ross, despite being in a 3-for-19 slump and having 17 strikeouts in 29 postseason at-bats.

The Cardinals went without Allen Craig, who went 2 for 7 as the DH in the first two games. He has not played the field since suffering a foot injury Sept. 4.

“As far as being able to throw him out there defensively, it’s a process, and he took some more ground balls,” said manager Mike Matheny. “He feels good and made a stride forward today. That may end up happening, but right now the timing, we just can’t do it yet, as far as a start goes.”

email: mharrington@buffnews.com