Erik Kratz started in Ruiz's place and center fielder John Mayberry Jr. moved up to the fifth spot in the batting order.
Ruiz leads the Phillies in batting average (.340), home runs (14) and RBIs (58).
"We'll see if he's ready tomorrow," Manuel said before Wednesday's game against the Nationals. "What he's got is something that on certain days it's worse than others. Matter of fact, I've got it myself. I've had it since last September. It's kinda hard to get rid of, but at the same time, the treatment that you do, some days it's a lot better than others. That's kinda how it goes."