Red Sox ace Chris Sale out for rest of regular season following elbow injection; avoids Tommy John surgery

Over the weekend, the Boston Red Sox placed left-handed starter Chris Sale on the injured list due to elbow inflammation. Sale, who missed significant time last season due to a shoulder injury, met with Dr. James Andrews on Monday to discuss what comes next -- be it rest or something more severe, like elbow surgery. 

According to ESPN's Jeff Passan, Sale does not require Tommy John surgery -- or any kind of surgery, for that matter -- which is obviously good news. Red Sox president of baseball operations Dave Dombrowski made the following announcement later Monday evening:

"Sale was evaluated by Dr. James Andrews this morning in Pensacola, Florida. Dr. Andrews confirmed that Sale has inflammation in his left elbow and treated it with a platelet-rich plasma injection. Dr. Andrews recommended a period of shutdown from throwing. Sale will be re-evaluated in six weeks by Dr. Andrews."

The six-week shutout period all but guarantees Sale's 2019 season is over. I suppose it's possible he could return late in the postseason should the Red Sox make a deep run. But the team is currently 6 1/2 games out of a postseason spot, and even then Sale would need to get back up to speed on the mound after being shut down.

Still, this is the best-case scenario for the Red Sox, who could've had their 2020 season altered had Sale required an operation, even an operation other than Tommy John surgery. Sale is not out of the woods yet -- inflammation is a symptom of something and that something could create problems down the road -- but the initial diagnosis is good news, relatively speaking.

Chris Sale SP •

Although Sale has had an inconsistent and poor season relative to his lofty standards, his 110 ERA+ ranked third on the Red Sox among the eight pitchers with more than five starts. Depth and high-end performance have been issues for the Boston rotation all season, and an extended absence from Sale will further exacerbate those problems. 

Already this winter Dombrowsi was going to have to find a replacement for Rick Porcello, an impending free agent authoring a disappointing season. At least, one figured, Dombrowski could rest easy knowing he would have Sale, David Price, Eduardo Rodriguez, and Nathan Eovaldi under contract.

The Red Sox could theoretically turn to prospects Mike Shawaryn, Tanner Houck, Denyi Reyes, or whomever else. But those internal candidates either leave something to be desired or are not expected to be ready for primetime ahead of next season. Rather, the Red Sox would likely have to find external help -- presumably on the free-agent market. That could prove challenging.

Yes, Gerrit Cole is going to be a free agent -- ditto Madison Bumgarner, Hyun-jin Ryu, and Zack Wheeler, among others. But it's unclear if the Red Sox would be willing to spend the funds necessary to land any of the top horses. Remember, the Red Sox may have to contend with replacing J.D. Martinez if he opts out, and will have to have sufficient budget room for whatever Mookie Betts earns through arbitration in his final year of eligibility. 

Of course, this is Dave Dombrowski and the Red Sox we're talking about. They should be able to sign whomever they want within reason. But, as we saw last winter with Boston's bullpen situation, their impulse isn't to always respond to an apparent hole or perceived weakness by cutting a blank check.

Losing Sale for any length of time -- be it a month or a year -- was going to alter the Red Sox's path forward in ways both obvious and not, predictable and otherwise. This isn't manufactured drama, it's the truth. And it's as good of a reminder as any, as the Red Sox's championship anniversary nears, that fortunes can change quickly in baseball -- on an individual as well as an organizational level.

CBS Sports Staff

R.J. Anderson joined CBS Sports in 2016. He previously wrote for Baseball Prospectus, where he contributed to five of the New York Times bestselling annuals. His work has also appeared in Newsweek and... Full Bio

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