Any hopes the Red Sox have of contending in 2021 rest on a skinny pair of shoulders. Left-hander Chris Sale had Tommy John surgery on March 30 -- his 31st birthday -- and expects to pitch again next year.
But how quickly can the Red Sox anticipate his return? And what kind of performance should they expect when he gets there? If history is any guide, a more realistic scenario has Sale returning to form in 2022 -- if at all.
According to an invaluable database maintained by Jon Roegele, 67 pitchers between the ages of 30 and 32 underwent Tommy John between 1974 (Tommy John himself) and 2018 (Johnny Cueto). Of those 67, 56 returned to the big leagues in an average of 18 and a half months. Ten never made it back at all, and one outlier -- former World Series MVP Jose Rijo -- completed an improbable comeback SIX YEARS after 1995 surgery.
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Rijo stands as a case unto himself, however, since he overcame one shoulder surgery and four elbow procedures before returning in 2001. He rehabbed so long, he actually received a Hall of Fame vote during his absence.
Most of the pitchers in this age range who saw their careers end after Tommy John without throwing another pitch were relievers. The only starter of note was former Marlins right-hander Josh Johnson. The 6-foot-7 flamethrower made consecutive All-Star teams in 2009 and 2010 while going 26-11 with a 2.80 ERA, but his failure to return from Tommy John in 2014 deserves an asterisk, since it came seven years after his first procedure.
While the average return takes a year and a half, 25 of the 56 pitchers on this list retook a big league mound within 15 months. If Sale meets this more aggressive timetable, he could be pitching in Boston by anywhere from May to July, and starting to deliver a return on the five-year, $145 million extension that kicked in this season.
The problem is, there's a difference between returning to the big leagues and regaining Cy Young form, and one is a lot easier than the other, as The Boston Globe's Alex Speier noted in a similar exercise.
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A good place to start is Tommy John himself. The 31-year-old had baseball's best winning percentage in 1973 before blowing out his elbow trying the novel surgery that now bears his name in September of 1974. He returned 19 months later in April of 1976 and made 31 starts with the Dodgers, going 10-10 with a 3.09 ERA. He pitched for another 14 years and won another 162 games, retiring at age 46 in 1989 after a 26-year career.
More typical on the positive end of the spectrum is someone like Cardinals ace Chris Carpenter, who needed only a year and a week to return from Tommy John at age 33 in 2008, appearing in his first game on July 30. He made three starts before it shutting it down until a lone relief appearance in September.
With another offseason under his belt, however, he embarked on what represents a best-case scenario for Sale: winning 17 games with a league-leading 2.24 ERA in 2009 en route to a second-place finish in the Cy Young race, and then winning 16 games and making an All-Star team in 2010.
Other pitchers weren't so lucky. Former Cy Young Award winner Pat Hentgen had already struggled for three years when he went under the knife at age 32 in 2001. He returned 13 months later, but was a shell of himself over the next three years, going 9-21 with a 5.27 ERA before retiring.
Similarly, former 17-game winner Gavin Floyd struggled through his final three seasons, while one-time All-Star Eric Milton was limited to just five starts before calling it a career. Closer to home, Daisuke Matsuzaka delivered an ERA over 8.00 in his return from surgery in 2012 and was out of baseball by 2014.
One success story with local connections is John Lackey. Maligned for the first two years of his Red Sox career as an $82.5 million bust, Lackey underwent Tommy John after the 2011 season and missed the entire 2012 campaign. He returned in 2013 to win 10 games with 3.54 ERA before playing a pivotal role in that Boston Strong postseason. He won another title with the Cubs in 2016 and won 60 games with a 3.57 ERA over his final five years post-surgery.
Another best-case scenario is Tim Hudson. The A's right-hander had already recorded three top-six Cy Young finishes when he had Tommy John in 2008 at age 32. He returned 13 months later, in September 2009, and went 2-1 with a 3.61 ERA in seven starts. A year later, he was a 17-game winner and All-Star. He made another All-Star team in 2014 with the Giants, winning his first World Series at age 38.
Which way Sale goes is anyone's guess, but if the Red Sox are being realistic, they won't bank on his return to form until 2022.