Shoulder Soreness Sends Sale, Quantrill to Shelf

Mar 27, 2023

As far as ballplayers go, Chris Sale and Cal Quantrill don't have a whole lot in common. Sale is an established star, with the resume and salary to prove it; Quantrill only recently completed his first full season as a starting pitcher. At his peak, Sale was the preeminent strikeout artist in baseball and arguably the best of all time; Quantrill has the lowest K-rate among qualified pitchers this season. Both have gone under the knife for Tommy John surgery, but while Quantrill has been the picture of health ever since, Sale has yet to return to his former glory.

This past Friday, these two dissimilar pitchers found themselves in the same boat when they landed on the injured list with shoulder inflammation, just days before their respective clubs were due to face off in a three-game set. Shoulder inflammation is a vague descriptor, and the prognosis for it can vary widely. Sometimes a pitcher will only miss a couple of starts to let the pain subside, but in a worst-case scenario, shoulder problems can lead to season-ending surgery. There is no reason to believe, as of yet, that either Sale or Quantrill will need to go the surgical route, but it also seems unlikely that either will return as soon as the minimum 15 days are up. Sale will undergo further testing and might not have a proper diagnosis until this weekend. Quantrill, meanwhile, has stopped throwing altogether.

Up to this point, Sale was enjoying a comeback season. His 59 innings pitched were his most since 2019, and while his numbers weren't exactly ace-like (4.58 ERA, 3.71 FIP), his mere presence on the mound every five days was a boon for the Red Sox and a personal victory for the man himself. Through 11 starts, Sale racked up 1.2 WAR, thanks in large part to his magnificent 10.83 K/9, which ranks fourth among qualified AL pitchers. That's still a far cry from the godly 13.21 K/9 he posted over his first three years in Boston, but for a 34-year-old pitcher coming off so many injury-riddled seasons, all those strikeouts are an incredible accomplishment.

On top of that, Sale was looking more and more comfortable as the weeks went by. His first three outings were a struggle, as he gave up 18 hits, seven walks, and 16 runs in 12 innings of work against the Orioles, Tigers, and Rays. Then he settled in against the Twins on April 18, recording 11 strikeouts and earning his first quality start in more than a year. Over his last eight games, he posted a 2.87 ERA, 2.73 FIP, and a 6.50 strikeout-to-walk ratio. His 1.5 WAR in that time ranked fifth among AL pitchers.

Not so coincidentally, Sale saw his four-seam fastball velocity increase in that outing against the Twins, and he continued to throw the ball harder over his next several starts:

In his first three appearances, Sale averaged 94 mph on his four-seam, 93.5 mph on his sinker, 78.7 mph on his slider, and 86.3 mph on his changeup (per Pitch Info). Over his next six outings, those numbers all rose; his four-seam was up to 95.1 mph, his sinker to 94 mph, his slider to 79.6 mph, and his changeup to 87.3 mph. It's no wonder he was performing so well. Unfortunately, while that extra velo contributed to his success, there's a good chance it also led to his downfall. Not only was Sale throwing harder, but he was also throwing a higher percentage of fastballs, which meant he was exerting himself significantly more.

A couple of weeks ago, Ben Clemens wrote about Sale in his "Five Things" column, admiring how he was still bringing the heat in the eighth inning of a masterpiece against the Cardinals. It was undeniably impressive to see him throw 97 for his final offering of a 110-pitch outing, but in hindsight, I find myself screaming through the screen at Sale to take it easy. He threw 111 pitches in his following start and tossed his second-hardest fastball of the game (97.4 mph) during the very last at-bat. The problems began to appear his next time out, when he lasted only 73 pitches and saw his velocity dip on all his offerings. He threw just 59 pitches the start after that, and his velocity was even lower still. The Red Sox placed him on the injured list the following day.

Sale is in a challenging position, trying to return from so much time away while adjusting to the natural aging process. The last time he was fully healthy, he was still in the prime of his career. Now he's 34 years old, practically geriatric for a professional athlete. A younger Sale might have been able to ramp up his velocity so quickly, but his older self doesn't seem to have that luxury.

To make things even more difficult, Sale is also pitching his first full year in the post-sticky stuff era. I don't mean to accuse him of any illicit activity, but it's worth pointing out how steeply his spin rates dropped in 2021. It's just one more thing to adjust to as he attempts his comeback:

Sale will be missed atop the Red Sox rotation, which was already lacking front-line talent to begin with. That said, Boston has the depth to get by in his absence. Alex Cora's bullpen is loaded with capable starting pitchers, including Kutter Crawford, Nick Pivetta, and Corey Kluber. Cora gave Crawford the start on Saturday and suggested he would be temporarily taking Sale's place in the rotation, but Kluber and Pivetta are backup options if Crawford falters. The Red Sox will need to add pitching if they want to compete for an AL Wild Card berth, but they have the arms to get by in the meantime:

Unlike Sale, Quantrill has been stumbling through the 2023 season. Across 54 starts from 2021 to ’22, he posted a 3.28 ERA and 4.09 FIP. His 6.65 K/9 was fifth-lowest among qualified starters in that time, but he kept his walk rate and home run rate better than league average, and a stellar defense helped him convert most of those ensuing balls in play into outs. This season, his strikeout rate has been lower than ever, his walk rate is higher than ever, and his defense hasn't done him any favors. The result? A 5.61 ERA and 4.94 FIP, both among the bottom ten in the sport:

Before his injury, Quantrill was also giving up significantly more hard contact. His hard-hit rate has fallen from the 69th to the 49th percentile this season, and his average exit velocity has risen by more than a mile per hour. His xISO rose from .159 last year to .203 this year; his 5.85 xERA is even higher than his actual earned run average.

The root of Quantrill's problems lies in the swing decisions batters are making against him. Opposing hitters have been swinging at more of his pitches in the strike zone and chasing fewer pitches outside it. His chase rate has fallen from the 77th percentile to the 28th. The result has been fewer called strikes and more balls, leading to fewer strikeouts and more walks. This also explains why hitters were making better-quality contact against him: It's a lot easier to crush a pitch that's inside the strike zone.

Unfortunately for Cleveland, identifying the problem is a lot easier than fixing it. Quantrill was struggling with all three of his most-used pitches this year: his sinker, cutter, and changeup. His cutter was no longer an effective out pitch against right-handed batters, his changeup wasn't an effective weapon against left-handed opponents, and his sinker was getting crushed by righties and lefties alike. Overall, righties were pummelling his pitches at an exit velocity three miles per hour faster than last season, and lefties were striking out less and walking nearly twice as often. Yet despite his troubles, Quantrill wasn't working with any less velocity, spin, or movement than before. The Guardians will hope this time on the injured list does the 28-year-old some good; perhaps with a little rest and a healthy shoulder, Quantrill will be able to rediscover his success from the past two years.

Meanwhile, Cleveland's rotation might actually be stronger now than it was before. Taking Quantrill's spot is Triston McKenzie, who threw five scoreless innings (with ten strikeouts!) on Sunday in his return from the injured list. The rest of the Guardians’ rotation is made up of Shane Bieber, Tanner Bibee, Aaron Civale, and Logan Allen, all of whom have been performing well this year; it speaks very highly of that group that Bieber has the worst ERA and FIP among them. Indeed, the Guardians are so happy with their pitching depth that they DFA’d longtime back-end starter Zach Plesac to make room for McKenzie on the roster. Barring any further injuries, their staff will be just fine in Quantrill's absence. Now, if only they could score some runs… but that's a problem for another day.