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Red Sox continue to deal with conundrum regarding a struggling, frustrated Chris Sale

There was certainly no lack of things for pitching coach Dave Bush (rear) to work on with Chris Sale during Saturday's off-day workout at Fenway Park.Barry Chin/Globe Staff

Against the backdrop of Red Sox optimism that formed after a Game 2 win in the American League Division Series, a cloud hovered: What has happened to Chris Sale?

Sale inherited a 2-0 lead in the bottom of the first inning against the Rays and promptly laid a historic egg. The lefthander allowed five runs before being pulled in favor of Tanner Houck for the second. He thus became the 22nd pitcher ever to last just one postseason inning and allow at least five runs.

Amazingly, the Sox withstood that faltering start in a 14-6 win — thus improving the record of teams in such outings to 2-20. But the Sox face unanswered questions about what’s wrong with Sale and what role he might fulfill moving forward this postseason.

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Sale came to the optional off-day workout at Fenway Park on Saturday in hopes of forging answers. He worked in the bullpen — a rare undertaking for a pitcher the day after his start — to see if he could start to iron out flaws in his delivery.

“Chris is frustrated. He feels like he’s letting us down and letting himself down and not pitching the way he wants to. He’s determined to get figure it out,” said pitching coach Dave Bush. “He wants to be better. He holds himself to a very high standard. This is hard for him to handle.”

After nearly 17 months of rehabbing from Tommy John surgery, Sale returned to the Red Sox rotation in mid-August.

Pitchers returning from the procedure and lengthy process to make it back endure nearly unavoidable peaks and valleys. Their arm strength is great in some starts and terrible in others. Their command goes from pinpoint to scattershot. Arsenals change across outings in a way that can be alarming, but that falls well within the standard course of recovery.

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Sale, who declined to speak while returning to the clubhouse from his bullpen session on Saturday, withstood inconsistency in both his mechanics and stuff through August and most of September, performing well enough to help propel the Sox towards the playoffs. He didn’t allow more than two earned runs in any of his first seven starts back, and the Sox went 6-1 when he pitched at least five innings.

He was building on that performance in the last week of the regular season in Baltimore, having logged five scoreless frames against the Orioles. At that point, in 40 innings, he had a 2.25 ERA with 46 strikeouts and nine walks.

Back on the mound in the sixth, he left a changeup over the plate that was smashed for a three-run homer in a deflating 4-2 loss. He returned to start Game 162 for the Sox and looked lost — his changeup serving as a hit-me pitch, his fastball command coming and going. With the season on the line, manager Alex Cora felt compelled to pull him after 2⅓ innings.

Then came Game 2 of the ALDS, which was even worse. Sale didn’t try to throw his changeup, and the Rays were swinging from their heels against a mid-90s fastball, Jordan Luplow crushing one that was several inches above the strike zone for a grand slam. After allowing 10 earned runs in those first 40 innings, he’s yielded 10 in his last 3⅔ at the most critical time of the year.

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“Part of it is certainly just the ups and downs that come with Tommy John recovery,” said Bush. “We’re asking a lot from him, not only to come back, but we’re asking him to pitch in the playoffs now. They’re some higher stress environments. Some days, he responds and feels really good. He did for the most part. He’s had a couple times now when he hasn’t.

“I think a big part of it is just the unfortunate physical ups and downs that happen during Tommy John recovery, where sometimes you just don’t feel very good. And on this stage, it’s a lot more noticeable than it would be at other times.”

So how do the Sox proceed with a pitcher who as recently as two weeks ago represented a source of consistency but who now has seen a performance plummet?

“Keep working. We’ve got to work,” said Cora, who said the Sox would explore not only Sale’s mechanics, but also whether he was tipping pitches (a concern raised by Luplow’s homer on a pitch well above the zone). “We’re going to look at everything. Hopefully we can figure it out before he takes the mound again, and he’ll be the guy we always envisioned.”

Can the Sox afford that leap of faith?

Cora said the team hasn’t yet decided on a Game 4 starter. While Nick Pivetta is a strong candidate, assuming he’s not needed out of the bullpen in Sunday’s Game 3, so are Sale and Eduardo Rodriguez.

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Cora said Sale wouldn’t be considered as a bullpen option “for health reasons.” Would the team be comfortable with him starting Game 4 or Game 5 against the Rays without seeing him on the mound?

The Sox do have alternatives, of course, with Tanner Houck representing an obvious one after five dominant innings of relief behind Sale on Friday. He’d be on four days of rest in a potential Game 5, should the series get that far.

“He’s been outstanding,” said Bush. “He’s peaking at a time right now when we really need him. He’s pitching really well for us.”

Can the Sox bet on Sale to do the same? It is a question they hope they have an opportunity to answer.

Second baseman Christian Arroyo takes batting practice during an optional workout at Fenway Park Saturday.Barry Chin/Globe Staff

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