The Red Sox got some good news that Chris Sale’s injury won’t require Tommy John surgery. However, that doesn’t rule out the procedure.
Chris Sale hasn’t pitched in a game since August 13, 2019 after being shut down with an elbow injury. After spending the winter resting and recuperating, he arrived at spring training battling the effects of the flu that turned in pneumonia, but both he and the Red Sox stressed that his arm was fine. It’s startling how much can change in just the span of a few weeks.
After throwing a light batting practice session on Monday, it was reported the next day that Sale experienced elbow soreness and would be getting an MRI on his ailing arm. Red Sox fans and the media feared the worst: that this meant Tommy John surgery for Sale, but the team remained cagey in divulging information to the press. Sale and the Red Sox ended up getting not only a second opinion, but a third as well.
Among those whose opinion was sought was the renowned Dr. James Andrews. As the week wore on, Red Sox fans awaited the grim news. Most fans and reporters assumed this inevitably meant Tommy John surgery, with many taking the approach that since the Red Sox were already punting on the season (their words, not mine), they may as well shut Sale down now and let him get surgery to come back strong in 2021.
Finally today we got an update from the Red Sox: Sale has a flexor tendon strain in his left elbow and won’t need Tommy John surgery… yet. Oftentimes these injuries get better with rest, although usually they eventually require Tommy John surgery to fully repair.
"“A reading of an MRI by Dr. James Andrews, Dr. Neal ElAttrache and Red Sox team doctors revealed that Sale, who experienced soreness on Monday following his live batting practice session on Sunday (his first time throwing to hitters in 200 days), has a flexor tendon strain in his left forearm. Based on the readings from the MRI, his ulnar collateral ligament has not suffered any further damage since last August, when he was shut down for the season with elbow inflammation and received a PRP injection from Andrews,” per Boston.com."
These injuries typically require 4-6 weeks of rest from throwing before assessing again. If there is no improvement, then Tommy John surgery is required. In Sale’s case, 4-6 weeks would put him into mid-April before he would be able to resume throwing. However, interim manager Ron Roenicke stated that Sale would try playing catch again in one week to see how his arm felt.
Sale himself, always the member of the Red Sox to hold himself most accountable, sounded devastated.
Sale also said that if things haven’t gotten any better in two or three weeks, they’ll make a decision on Tommy John surgery. Taking into account the fact that Sale’s arm hasn’t improved since August, nearly seven months ago, it would seem that if he was ever going to get Tommy John surgery, now would be the time to do it. The 2020 season looks to be a rebuilding year for the Red Sox and there is little to be gained by having Sale go and gut it out every start just to win 75 or 80 games.
If last season and its aftermath are any indication, the Red Sox won’t get a full season out of Sale this year and would only prolong his unavailability after surgery on the back-end the longer they put it off. If the Red Sox shut him down this month and make the decision for surgery, that gives Sale a jump-start on his recovery and hopefully has him ready to come back in the early or middle parts of the 2021 season.
Given the five-year and $145 million investment the Red Sox made in Chris Sale, it would seem like the prudent course to maximize their return would be the path laid out in the previous paragraph. It remains to be seen what they end up deciding, but we will hopefully have more clarity on the entire situation by the time the calendar turns to April and the regular season starts.