The decision for Chris Sale to undergo Tommy John surgery was made Tuesday when he tried throwing with a little extra zip in Fort Myers, Fla., and felt enough pain in his left elbow he had to stop.
It would be convenient to suggest the Red Sox are taking advantage of what will be a shortened season by scheduling the surgery now so Sale will miss fewer games.
But this has seemed inevitable long before the coronavirus reached the United States.
You can go back to 2018 when Sale missed five starts with a shoulder injury before being limited to short outings throughout the postseason. Then came the elbow pain last season that led to eight missed starts and a sharp drop in velocity.
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Sale recently told manager Ron Roenicke that it’s been a long time since he felt like himself.
Since his days at Florida Gulf Coast University, Sale’s spindly body, awkward mechanics and maximum-effort delivery have marked him as an injury risk.
The Red Sox accepted that risk when they traded for Sale and reaped the reward when he helped them win the 2018 World Series.
Now they will pay the price.
Sale is expected to miss 14-15 months; meaning he won’t pitch again for the Red Sox until June of 2021. The timing couldn’t be worse considering the Sox signed Sale to a five-year, $145 million extension a year ago.
That contract, which starts this season, is already regrettable.
The odds are very much with Sale returning from surgery and pitching effectively again. As chief baseball officer Chaim Bloom said Thursday, you can be sure Sale will attack the rehab process with the same dedication that made him one of the best pitchers of his generation.
The surgery will be fairly soon, Bloom said. Oddly, he also cited "confidentiality factors” in not naming which surgeon will do the operation. That’s a first. Presumably it will be Dr. James Andrews, who treated Sale for his injuries the past three years.
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What we also don’t know is whether Sale will regain his 99-m.p.h. fastball and that unhittable back-foot slider he used to punch out Manny Machado and end the Series only 16 months ago.
The natural question many fans have is why didn’t the surgery take place last season?
The answer is simple: Andrews didn’t recommend it. Andrews examined Sale at his Florida clinic Aug. 19, administered an injection of platelet-rich plasma and shut him down from throwing for six weeks.
It was suggested at the time Sale could possibly start throwing late in the season if the Sox advanced to the postseason. But they quickly fell out of contention and that was scrapped.
Sale cleared every hurdle in spring training until he faced hitters for the first time on March 1 in Fort Myers. The pain returned a day later and it was diagnosed as a flexor tendon strain, a different injury than he had in August.
Andrews and another highly regarded surgeon, Neal ElAttrache, recommended Sale try resting for two weeks. But the pain was still there when he started throwing this week.
On March 4, the last time he met with reporters, Sale seemed resigned to his fate.
"I know the situation we’re in right now and it’s not fun … this is about as tough a situation as I’ve ever been in,” he said.
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What could possibly go wrong next for the Sox? It’s been a year of relentless bad news.
The Sox finished in third place last season, a whopping 19 games behind the Yankees. President of baseball operations Dave Dombrowski was fired in September, his high-roller style clashing with the approach ownership wanted to take in building the team.
Manager Alex Cora was forced out in January for his prominent role in helping the 2017 Astros illegally steal signs. Then Major League Baseball announced an investigation into whether the 2018 Sox were guilty of the same offense.
That investigation continues to hang over the team, the process stalled because of the game being shut down.
Spring training, ostensibly a hopeful time, was soured when Mookie Betts and David Price were traded to the Dodgers Feb. 10 in a salary dump for three prospects.
The best of those prospects, outfielder Alex Verdugo, arrived with a stress fracture in his back and wasn’t able to play in spring training.
You can also toss in the Sox having no interest in bringing back Brock Holt, a solid utility player who dedicated his spare time to the kids at The Jimmy Fund Clinic. He instead signed with the Brewers for $3.25 million.
Now Sale is out for the remainder of this season and once baseball starts again, the Sox could be a fourth-place team.
Without Sale, their rotation is Eduardo Rodriguez and Nate Eovaldi followed by Martin Perez, Ryan Weber and perhaps Brian Johnson. The Yankees, Rays and Blue Jays are all much better.
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If there is any bright spot in all this darkness, it’s that Sale will miss fewer games this season with the game shut down because of the pandemic. But that’s hardly something to celebrate.
The season hasn’t even started yet and it feels like it can’t end fast enough.
Peter Abraham can be reached at peter.abraham@globe.com. Follow him on Twitter @PeteAbe.