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The injury bug has once again bitten Boston Red Sox ace Chris Sale and this time it really doesn’t look good. Sale threw 15 pitches Sunday and complained of soreness in his left elbow on Monday. The lanky left-hander underwent an MRI on Tuesday and those results have been sent to well-known orthopedic surgeon Dr. James Andrews.

Recurring arm trouble for Chris Sale

What’s of most concern to Sale and the Sox is that the injury is to the same arm that shut down Sale at the end of last season. That, combined with fact the MRI results have been sent to Dr. Andrews, can only make the Red Sox and their fans thinking the worst. Andrews is a specialist for repairing injuries related to damaged ligaments, including Tommy John surgery. The Red Sox are expecting to have a diagnosis on Wednesday, March 4.

Sale was scheduled to miss the first two weeks of the season, but that wasn’t due to any type of injury. Sale opened spring training with pneumonia and was already placed on the injured list.

Sale’s big contract extension

Sale is in the first year of a five-year, $145 million extension that was inked last March. The hard-throwing left-hander had, by far, his worst season in the big leagues in 2019 as he finished with a record of 6-11 and carried a 4.40 ERA.

In August, he was placed on the 10-day injured list with left elbow inflammation. Sale met with Dr. Andrews and it was determined he did not need Tommy John surgery, but the injury was significant enough that it kept him out the rest of the season.

Prior to last year, Sale went 29-12 in his first two seasons combined with the Red Sox. In his first year with Boston, Sale recorded 308 strikeouts in 214.1 innings and finished with a 2.90 ERA. He finished second in the American League Cy Young Award voting.

Sale followed up his first season with the Sox with another gem. He went 12-4 with a 2.11 ERA in 158 innings. Sale, however, had a pair of late-season stints on the disabled list, both due to inflammation in his shoulder.

Tough beginning for Red Sox

The Red Sox have already lost one of their top pitchers from last season when they included David Price in a deal to the Los Angeles that was centered around Boston’s Mookie Betts. If Sale is expected to miss significant time, the Red Sox rotation becomes a significant question mark with only Eduardo Rodriguez as the only other proven starter returning to the team.

The Red Sox also saw their manager Alex Cora and the team mutually part ways after Cora was named in Major League Baseball’s investigation into the Houston Astros’ sign-stealing scandal when Cora was a bench coach for the team in 2017.

Cora and the Sox parted ways in January, and Cora was replaced by former Milwaukee Brewers manager Ron Roenicke, who has been Cora’s bench coach in Boston.