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SCOTTSDALE, Ariz. — Mookie Betts is the obvious bellwether of the Red Sox offseason, the team’s fortunes seemingly tethered to how it proceeds with a superstar now a year from free agency. Yet as much as the decision on Betts — keep him, trade him, try to extend him — will shape the club’s 2020 ambitions, he’s not the only Red Sox star whose outlook will have a huge impact on the team’s fate.

It was three years ago at the GM Meetings here that the Red Sox and White Sox started a conversation that ended a few weeks later with the blockbuster trade for Chris Sale.

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In 2017-18, Sale looked every bit the part of an ace among aces, going 29-12 with a 2.56 ERA while striking out a ridiculous 13.2 batters per nine innings and helping the Red Sox to back-to-back AL East titles and delivering the final out of the 2018 World Series.

Chris Sale is looking forward to putting 2019 behind him.
Chris Sale is looking forward to putting 2019 behind him.John Tlumacki/Globe Staff

But in 2019, Sale endured the worst year of his big league career, struggling with his mechanics while going 6-11 with a 4.40 ERA in 25 starts until elbow tendinitis necessitated a season-ending plasma-rich platelet injection in August.

And now he is preparing for a 2020 campaign that represents the start of the five-year, $145 million extension the Red Sox gave him last spring, a huge bet with huge implications, potentially including what the team decides to do with Betts.

If Sale returns to the form that made him a top-six finisher in AL Cy Young voting every season from 2012-18, the Red Sox probably would be in strong shape in 2020, regardless of whatever other roster decisions they make. If he cannot return to that level, then they could find it difficult to improve on a disappointing 2019 season.

Until he starts pitching in games again, it will be impossible to say what the Red Sox will get from their star lefty. But all signs to date have been promising.

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“He’s going into the [Red Sox facility in Fort Myers, Fla.] pretty much daily and doing really good,” said B.B. Abbott, Sale’s agent. “The arm feels really good. He’s reported back to us and told us that he expects this to be a completely normal offseason.

“I think some of the feedback we got from the orthopedic surgeons that looked at him thought that everything looked great.

“I think that what we saw of Chris Sale in 2019 was not who he has been and certainly not who he’s going to be going forward. We have a hopeful optimism that he’s going to be healthy, and if he’s healthy, he’s going to perform at that level. Period.”

Abbott said it was impossible to know the root of Sale’s injury — whether it was adjustments to his delivery that resulted from his shoulder injury in late 2018, an offseason shortened by a full postseason month on the way to a championship, or a rushed search for mechanical consistency after a slow spring training buildup.

“I think that certainly some of the lingering stuff from the year before, what he went through, the length of the season, the shoulder, things of that nature might have changed something in him mechanically,” said Abbott.

“I don’t think they’ve put their finger on anything specifically, but I do think this full rest, this full time to let the PRP do what it did, and the orthopedic surgeons we spoke to and that the team spoke to, seeing the images, I think was very, very promising.”

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Abbott said Sale has not had a follow-up visit with Dr. James Andrews since the renowned orthopedist administered the PRP injection. But Abbott said Sale has been examined by others both inside and outside the Red Sox organization while remaining in touch with Andrews.

“I think they’ve been doing most of it in-house and then corresponding with Andrews, and then we had some other people get eyes on it as well,” said Abbott.

Red Sox GM Brian O’Halloran added that the Sox expect Sale to visit Andrews in the relatively near future, with the possibility that the lefthander could start throwing approximately one week after the visit, assuming he is cleared to do so.

Brian O'Halloran said the Sox expect Chris Sale to visit Dr. James Andrews in the near future.
Brian O'Halloran said the Sox expect Chris Sale to visit Dr. James Andrews in the near future.Nic Antaya/Globe Staff

O’Halloran also clarified that the reason why the follow-up visit with Andrews was delayed beyond the initially suggested duration of six weeks was because the Red Sox fell out of the playoff race, removing the urgency for a follow-up visit since a return in the playoffs was no longer a consideration.

Of course, the fact that health is the foremost topic surrounding Sale — with his substandard performance on the mound being the second-most prominent — underscores how far off the rails his 2019 season veered. Had Sale been a free agent entering this winter, it’s hard to imagine that he’d have been able to garner the same sort of long-term deal that the Sox conferred upon him before he threw a single regular-season pitch.

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Abbott is aware of that reality, while also noting that Sale is determined to prove himself worthy of the deal.

“We’ve talked about it internally as an agency, some of the challenges we could have had this offseason. But it’s not something he thinks about, because quite frankly, he doesn’t care what he’s making. He wants to be the same guy when he steps on the rubber no matter what he’s being paid,” said Abbott.

“I’m sure you can appreciate how frustrating [2019] was for him,” he said. “He’s that guy who will run through a brick wall for his teammates and the city that he plays in.

“I think having signed the contract that he did, there was a certain additional weight on his shoulders that was added. He took that very, very seriously and continues to take it seriously.

“As he approaches the season, I think you’re going to see the same guy you’ve seen in the past. He’s extremely hungry. That hunger has not subsided at all. I think he’s going to come back with a feeling of something to prove.”

A great deal of the Red Sox’ 2020 outlook hinges on whether Sale does just that.


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