Report: Chris Sale avoids Tommy John surgery, for now, after getting third opinion on elbow

Jack Baer
Chris Sale will not be going under the knife in spring training. (AP Photo/John Bazemore)

After getting a reported third opinion from a doctor on his elbow, Boston Red Sox ace Chris Sale is not currently expected to undergo Tommy John surgery on his elbow, according to The Athletic’s Ken Rosenthal.

The positive development comes after Sale’s elbow MRI was reviewed by Red Sox team doctors, then Dr. James Andrews, then Dr. Neal ElAttrache on Wednesday, according to the Boston Globe’s Pete Abraham.

“We want to make sure that we get everybody's opinion on this,” Red Sox manager Ron Roenicke said, per the Globe. “We need to get this right. It's a very important player that we want to do things the right way.”

Chris Sale has dealt with elbow issues since last August

Sale reportedly began experiencing left elbow soreness on Sunday, followed by the Monday MRI. He had previously missed the end of last season due to elbow inflammation, but received a PRP injection in his elbow and was cleared by Andrews to throw in December.

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Sunday’s ill-fated live batting practice was reportedly the first time Sale had faced batters since last season, and he again felt pain in his elbow.

Sale was set to start the regular season on the injured list due to a case of pneumonia that delayed his start at spring training, and he seems almost certain to miss even more time as he treats and rests his elbow.

Are the Red Sox making a mistake with Sale?

Opting against Tommy John at this point is clearly a massive risk for Sale and the Red Sox, as there is no guarantee he won’t experience even worse elbow issues once he starts throwing again.

There is a very good chance Sale is merely delaying Tommy John, meaning he would go from potentially being available in 2021 had he undergone the surgery soon to missing the entire 2021 season. Add in the fact that the Red Sox aren’t even expected to be contenders this year and, yeah, that sounds like a foolish move, but it’s important to remember that Tommy John surgery is not an automatic success.

To many, Tommy John surgery is three words that mean a pitcher will miss a season and possibly more, but for the player, it means a year of painful and frustrating rehab. That’s not even to mention that while the success rate of the surgery is certainly high, there’s always a chance it or an after-effect could make things even worse.

What’s more, there are stories of pitchers avoiding Tommy John after partially tearing their UCLs. Masahiro Tanaka partially tore his UCL in his first season in MLB and still hasn’t undergone the surgery. Instead, he’s topped 150 innings for the Yankees in every year since.

Adam Wainwright tore his UCL as a high school junior and held off Tommy John until 2011, while Ervin Santana avoided TJ entirely after spraining his UCL in 2009.

There are, of course, counter-examples — Shohei Ohtani for one — but the medical science of holding together and reconstructing elbow ligaments isn’t so simple that every pitcher with a damaged UCL should have Tommy John, nor does it mean Tommy John is a guarantee the pitcher will be back and the same after a year and change.

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