That said, you can be excused if you find yourself trying to figure out how Sale went from resuming his throwing program earlier this week to the news we received Thursday.
Photo courtesy of NESN
Sale's tenacity has never been in question, even if his durability has over the past two seasons. After surpassing the 200-inning mark in 2013 and 2015-2017, Sale struggled to reach the finish line in 2018 and 2019 due to injury.
In mid-August last year, Sale was dealing with inflammation in his left elbow and, following a PRP (platelet-rich plasma) injection from noted orthopedist Dr. James Andrews, he was shut down for the remainder of the season.
Sale reported to spring training this year a little behind schedule due to a bout with pneumonia, according to team sources. But after experiencing some pain in March, Sale had an MRI which revealed a strained flexor. Both Andrews and famed orthopedic surgeon Neal ElAttrache examined the imaging and came to the same conclusion - no surgery was necessary. Instead, they advocated shutting Sale down for awhile before resuming throwing.
Two throwing sessions this week resulted in pain, and now here we are with Sale needing season-ending surgery.
The question begs to be answered - what was Sale doing (or not doing as the case may be) during the off season that he didn't realize something was seriously wrong before he came to camp?
And Sale isn't alone. Giancarlo Stanton and Aaron Judge of the Yankees were both in danger of missing the originally scheduled Opening Day due to their own injuries, dating back to last season.
The Yankees were a walking M*A*S*H unit in 2019; things got so bad that the training staff was let go after the season in favor of performance coach Eric Cressey, who comes into the Bronx with a highly-regarded reputation and the HUGE task of keeping the Bronx Bombers out of the trainer's room and on the field.
So where is the disconnnect?
In speaking with various sports trainers, including a former MLB trainer, part of the problem stems from the off-season regimen MLB players go through.
It's obvious they do off-season work; players aren't shy about posting their respective routines on social media. Noah Syndergaard seemed to spend the entire off season (and part of spring training) shirtless. Even physical dynamos (insert sarcasm emoji) such as Pablo Sandoval and Bartolo Colon in the past have gotten into the act of posting videos of their off-season workouts.
Photo courtesy of TMZ
We all saw the pictures of Stanton bench pressing a model this past January - impressive, maybe, but probably has nothing to do with getting himself ready to hit a baseball. Some players train together, but usually it's independent from what the team trainers recommend. And then these guys come into camp and just aren't ready for the rigors of a 6-month, 162-game season.
There's also the mindset of the individual player. One high-profile National League pitcher is known for ignoring his trainers in favor of what he believes is in his best interest. The results for that pitcher have been mixed.
One former MLB pitcher told me in an online exchange about Sale that "What (the doctors) tell the team and the message that is given to (the fans) are typically different. Not saying the Red Sox are lying here. I'm just saying typically there is more to the story than we get."
Chad Jennings of The Athletic (subscription required) wrote on Thursday that "(Chaim) Bloom said that MRI images are not always cut-and-dried, and without a definitive point of damage — a ligament clearly ripped in half — the need for surgery leaves room for different opinions."
With regard to Sale, my educated guess is that something was amiss with his off-season program. Assuming he did what most pitchers do after the season - take a month off from throwing - even if he had not been shut down in August, the Red Sox season ended early enough in 2019 for him to have known by December that something was still wrong with his arm. For that matter, one could say the same for Judge, Stanton, and any number of players around Major League Baseball who carried lingering injuries with them from last year into spring training.
And as if that's not enough, Sale's surgery is going to have to wait until the COVID-19 crisis settles down, due to the strain being placed on hospitals.
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