Chris Sale

Red Sox ace Chris Sale has begun a throwing program at the team’s spring complex, Alex Speier of the Boston Globe reports. It’s the first throwing action for the left-hander since he was diagnosed with a flexor strain earlier this month.

Sale’s health has been an ongoing point of discussion for upwards of 18 months in Boston. The southpaw spent two stints on the injured list due to shoulder inflammation late in the 2018 season, but the Sox were convinced of his health last spring when signing him to a five-year, $145MM contract extension. Concerns escalated when Sale experienced a dip in velocity early in the ’19 season and pitched to an alarming 6.30 ERA through the end of April.

However, Sale’s velocity trended back up, and over his next 15 starts, he looked like his vintage self: 93 2/3 innings of 3.27 ERA ball with a sensational 150-to-22 K/BB ratio. Three of his next four (and final four) starts of the season were clunkers, though, and Sale went on the shelf for the remainder of the season on Aug. 17.

Sale was cleared of ligament damage last August and underwent a platelet-rich plasma injection as well as a six-week period of rest and rehab. The lefty went through an offseason throwing program but was slowed by pneumonia early in camp before undergoing an MRI that revealed the flexor strain he’s currently battling. He’s been cleared of ligament damage, but Speier notes that surgery to repair the flexor issue remains a possibility if the throwing program doesn’t go well.

The Red Sox are paying Sale $30MM in 2020 — the first season of his front-loaded extension. The delayed start to the 2020 season could give him an opportunity to return to health prior to Opening Day (the date of which remains unclear) — an outcome that didn’t appear possible just weeks ago. That would be a substantial boost for the Red Sox, as their rotation behind the lefty is mired with question marks. Eduardo Rodriguez is presently projected to get the Opening Day nod. He’ll be followed by Nathan Eovaldi, Martin Perez and a yet-to-be-determined fourth and fifth starter. If Sale is healthy, the Sox would only need to fill one spot; Collin McHugh (who is also on the mend), Ryan Weber, Matt Hall, Kyle Hart and Mike Shawaryn are among the in-house options.

Red Sox lefty Chris Sale has avoided the worst case scenario — for now. That’s the good news. But the situation “sucks,” he acknowledged in a discussion with reporters including Ian Browne of MLB.com (links to Twitter).

Sale has not incurred new damage to the ulnar collateral ligament in his pitching elbow. But he’s still not in the clear. His most recent attempt to ramp up ran into yet more elbow trouble, casting doubt as to whether he can proceed without surgical intervention.

At this point, the veteran southpaw says, he simply doesn’t know what to anticipate. On the one hand, there’s still hope that he’ll be able to return relatively early in the 2020 season. Once the inflammation subsides in a few weeks’ time, he’ll attempt to start throwing again. If everything goes well, Sale might conceivably miss only a month or so of action.

And what if the elbow keeps barking? That would seem to put an end to the rest-and-rehab approach that he and the team have employed since last summer. Sale acknowledged that Tommy John surgery is a possibility. It isn’t entirely clear whether other surgical approaches may also be considered.

It’s a tough spot for the Red Sox, who have $145MM invested in the star southpaw for the next five seasons. Sale offered a tough self-assessment. “I was able to get through most of my career doing what I love to do and helping my team win,” he said. “For sure, over the last year and up to this point, I’ve done nothing but fall flat on my face.”

Those harsh words are surely a reflection of a trying situation. But it’s hard to fault Sale himself for the fix he’s in. He has long been durable, productive, and (by all indications) hard-working. Unfortunately, elbow woes are common for hurlers.

March 5: Sale has been diagnosed with a flexor strain, Roenicke tells reporters (Twitter link via Mastrodonato). He’ll be shut down from throwing until next week and even then will be limited to simply playing catch. The next steps will depend on how he responds to that activity. Roenicke notes that Sale’s “UCL looks the same as the last image.”

March 4, 4:35pm: At this point, there’s no expectation that Sale will require Tommy John surgery, Ken Rosenthal of The Athletic tweets.

9:05am: We learned yesterday that star Red Sox lefty Chris Sale had undergone an MRI after he experienced elbow soreness, with Dr. James Andrews set to review the results. That has now occurred, but a diagnosis and course of treatment remain unknown.

Boston manager Ron Roenicke tells reporters, including Jason Mastrodonato of the Boston Herald (Twitter link) and Peter Abraham of the Boston Globe (Twitter link), that the club has sought another opinion. Another premier specialist, Dr. Neal ElAttrache, will review the imaging and weigh in with his opinion.

Presumably, the hope is to land upon a consensus after receiving the viewpoints of Andrews, ElAttrache, and the Sox’ own team medical staff. All involved are taking their time, says Roenicke, because there’s a “need to get this right.”

Sale will ultimately decide upon what course of treatment he deems best. But there’s a shared interest in arriving upon the best long-term approach to his as-yet-unclear elbow ailment. The Red Sox owe Sale $145MM over the next five seasons.

Roenicke says that fans and media shouldn’t read into the ongoing uncertainty. Sale isn’t necessarily staring down Tommy John surgery, it seems. Indeed, it’s not really even clear whether that is a possibility on the table at the moment.

What is known to this point: Sale was shut down and received platelet-rich plasma treatment in August after visiting Andrews. The southpaw said he had been cleared of ligament damage. He was cleared to throw over the winter; indications were that he’d be a full participant in Spring Training. Sale was delayed at the outset of camp, with the explanation given that he was dealing with a case of pneumonia, but began throwing recently without evident issue. But his elbow began barking after facing live hitters recently, prompting this new round of medical analysis.

Star Red Sox lefty Chris Sale is slated to undergo an MRI on his elbow, skipper Ron Roenicke tells reporters including Jason Mastrodonato of the Boston Herald (via Twitter). At this point, the outlook isn’t known.

Sale reported soreness in the joint after throwing. He had dealt with some arm woes late last year, but seemed to be at full arm health as camp opened. Sale was delayed by illness, but the expectation was that he’d be able to ramp up as normal — just on a slight delay.

The results of the MRI will be sent to famed surgeon Dr. James Andrews for analysis. That’s alarming, at first glance, given that Andrews is known for performing so many Tommy John surgeries. That said, it’s also an obvious and sensible decision, given that the orthopedist treated Sale last season and is therefore intimately familiar with his medical situation.

There’s no reason to rush to judgment. But the situation is obviously concerning for a Boston organization that is entering an interesting and uncertain season. Just days ago, Sale told MLB.com that his arm felt good. Now, there’s sufficient cause for imaging.

Sale’s importance to the Red Sox largely goes without saying. The long-time ace is not only a key component of the rotation, but will occupy a big chunk of the team’s spending for the next several years. The extension he signed this time last year guarantees $145MM in salary from 2020 through 2024.

Red Sox manager Ron Roenicke says that star lefty Chris Sale won’t be ready for the start of the season, as Alex Speier of the Boston Globe reports (Twitter links). This news doesn’t come as a surprise but is still a bit of a disappointment. It’s worth reminding that the recent slate of rule changes in MLB included pushing the minimum IL stay for pitchers back to 15 days.

Sale, whose return from elbow woes was interrupted by pneumonia, is said to be approximately two weeks behind the schedule of the remainder of the team’s starters. That provides a solid gauge as to the earliest possible point at which he’d be slotted back into the MLB rotation. Fortunately, the delay largely reflects the poorly timed illness, not any development of concern with regard to Sale’s throwing arm.

While the Sox would surely prefer to hand Sale the ball on Opening Day, the team can live with a few missed starts. That said, the organization needs to rack up every possible win if it hopes to surprise sans Mookie Betts. Even with the rival Yankees dealing with a host of worrisome health problems early in camp, the New York roster is loaded. The Rays look strong and there are several good Wild Card competitors from other divisions.

Despite the desire to turn Sale loose as soon as possible, it’s quite understandable that the Red Sox would elect a conservative course. The club is invested in him for the long run and has obviously not put all of its eggs in the 2020 basket.