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Chris Sale begins a throwing program in Fort Myers

Chris Sale is hoping to avoid surgery on his left arm.Barry Chin/Globe Staff

According to a major league source, Red Sox lefthander Chris Sale has commenced a throwing program in Fort Myers, Fla., after being shut down at the beginning of the month with a strained flexor tendon in his left forearm.

This marks the beginning of an effort to see whether Sale will be able to return to the mound this year or whether he will require surgery. He underwent an MRI March 2 that revealed the strain, and reviews of the images by Red Sox team doctors, Dr. James Andrews, and Dr. Neal ElAttrache all yielded the conclusion that Sale should try to recover with rest and rehab.

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Even so, when Sale discussed the diagnosis on March 5, he recognized the uncertainty of his health moving forward.

“[The doctors] seem confident and everyone agreed, hey let’s take some time off, get some anti-inflammatories in there, start another throwing program and see what we get,” Sale said.

“I’m going to do it the best I can and get after it. And however the coin flips, that’s how we pick it up.

"We’ve got work to do and I’ve got an uphill battle to climb, but I’ve got my climbing shoes on. So I’ll be ready to roll whatever way we’ve got to go.”

Could Chris Sale be pointed in the right direction when it comes to his health?John Bazemore/Associated Press

Even before his elbow injury and weeks before MLB delayed the start of the 2020 season in response to the COVID-19 pandemic, Sale was slated to open the year on the injured list. He had contracted pneumonia in February, and the illness delayed his buildup and meant that he’d be unable to pitch in big league games before mid-April.

The elbow injury, which occurred one day after he faced hitters in live batting practice, further pushed back that timetable at least into May.

With spring training canceled and the start of the season postponed indefinitely — and unlikely to start before late May or June — it’s possible that Sale could be ready whenever the season does start.

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But given that he felt healthy in preparing for spring training before experiencing his setback, neither the team nor he can take for granted either that timetable or his ability to pitch at all this year.

The resumption of a throwing program represents the first of many steps in trying to make such a determination.

“Obviously there is uncertainty regarding his pitching status generally that we’re going to want to resolve," Red Sox chief baseball officer Chaim Bloom said last week, before Sale started his throwing program. "We’re still going to want to resolve that. We’re still going to want to progress him.

"We’re still going to work even during this time period without games to try and get some progress and some more definition on his status.”


Alex Speier can be reached at alex.speier@globe.com. Follow him @alexspeier.