Typically, when a pitcher learns Tommy John surgery is not needed, they’re relatively upbeat. Chris Sale conveyed entirely different emotions Thursday morning.

The Boston Red Sox pitcher, who recently underwent an MRI for left elbow soreness, was diagnosed with a flexor tendon strain, the team announced. According to the MRI, Sale’s ulnar collateral ligament (UCL) did not suffer any additional damage between Aug. 13 (his last start) and Sunday, when he threw live batting practice for the first time since initially suffering the injury. The 30-year-old left-hander plans to resume throwing in roughly a week, and proceed from there.

However, Sale on Thursday admitted he still is concerned about the injury, and that surgery remains a possibility. He and the Red Sox are hopeful for the best, but clearly are fearful of the worst.

“I can’t tell you how it feels,” Sale said during a press conference at JetBlue Park. “I can’t tell you what the process is until I pick up a baseball for the first time. As of right now, I’m just spinning my wheels.”

Red Sox interim manager Ron Roenicke sang a (slightly) more optimistic tune.

“Everybody thought with the imaging, that this is the way we should go,” he said. “Let’s give it a try and see where we are. Hopefully, he’s right back on track and this is just a setback.”

As someone who takes great pride in his craft and desperately wants to live up to the $145 million extension he signed last March, Sale understandably is frustrated over his latest setback.

“It sucks,” he said.

“Tough spot, for myself, this team and the organization going forward, … There’s optimism to be had, and I’m thankful for that. But I know the situation we’re in right now — it’s just not fun. I know there’s an expectation level that not only our fans, my team, you guys, myself hold me to… I haven’t met that. I haven’t. This is about as tough of a situation as I’ve ever been in. I was able to get through most of my career doing what I love to do and helping my team win, and for sure, over the last year and up to this point, I’ve done nothing but fall flat on my face.”

While UCL injuries are most commonly associated with Tommy John surgeries, a flexor strain is a no less ominous diagnosis. In fact, many pitchers have suffered the injury and eventually undergone surgery.

Here’s some useful context from The Boston Globe’s Alex Speier:

Since joining the Red Sox in 2017, Sale has been one of baseball’s best pitchers when healthy and on his game. The problem, of course, is injuries and inconsistent late-season performance rightfully have begun to rule the narrative.

Though he was healthy and made 32 starts in 2017, Sale faltered down the stretch (4.09 combined ERA in August and September) and gave up nine earned runs over 9 2/3 innings in the American League Division Series.

He was on track to put together a Pedro Martinez-like season in 2018 before landing on the injured list in late July with a left shoulder injury. Sale returned Aug. 12 but was placed back on the IL with the same injury before returning in September to make four uninspiring appearances. Though the Red Sox went on to win the World Series, Sale — with his 4.11 ERA — largely was a passenger despite a dominant ninth inning in the clinching game against the Los Angeles Dodgers.

Sale entered 2019 with major concerns over durability and velocity. Both issues persisted throughout a forgettable campaign that saw him go 6-11 with a 4.40 ERA. He called it a season after experiencing elbow inflammation following his Aug. 13 start.

And now, with his spring training seemingly over before it really started, Sale is nearing the lowest point of his Red Sox career, if he hasn’t already reached it. It’s fair to wonder whether we ever will see Sale reclaim his status as the most dominant pitcher in Major League Baseball.

“We’re at a fork in the road,” he said Thursday morning.

Still, if there’s anyone built for the potential battle ahead, it’s Sale.

“It’s a gut punch. It’s a tough realization. But, I’ve said it time and time again, I’ve got no time to hang my head or sit in a corner and pout. I’ve got work to do and I’ve got an uphill battle to climb.

“But I’ve got my climbing shoes on, so I’ll be ready to roll — whatever way we gotta go.”

Thumbnail photo via Mark J. Rebilas/USA TODAY Sports Images