James Paxton Diagnosed With Lat Strain

Red Sox lefty James Paxton began a rehab assignment today but left after facing just two batters. This was initially reported to be lat tightness by Chris Cotillo of MassLive, with manager Alex Cora later telling Pete Abraham of The Boston Globe that Paxton has a lat strain.

Cotillo adds that Paxton is seeing a doctor tomorrow to determine the severity of the issue, but there’s no question this is a significant setback for the hurler. Today was his first attempt to pitch in an organized game since undergoing Tommy John surgery in April of last year. He was still going to need some time to ramp up for a starter’s workload and will now have to push that further down the road. Even a mild lat strain usually requires a recovery period of 2-3 weeks, which means the southpaw will likely be sidelined until some time in September even in a best case scenario.

It’s another disappointing development for Paxton, one of many in recent years, following on the heels of an excellent four-year stretch of effectiveness. From 2016 to 2019, he threw at least 121 innings in each season, keeping his ERA under 4.00 in each campaign as well. He had a 22.9% strikeout rate in 2016 but got it up near 30% for the latter three years of that stretch.

Unfortunately, injuries limited him to just five starts in 2020 and then just a single outing in 2021 before landing on the injured list. Despite two essentially lost seasons, the Red Sox took a chance on him this past winter, hoping he could recover his previous form once he returned to health. The contract reflected his uncertain status, with Paxton receiving a $6MM salary here in 2022 while rehabbing. At the end of the year, Boston will have to decide whether or not to trigger two $13MM club options for 2023 and 2024, effectively a two-year, $26MM deal. Should they decline, Paxton will then get to decide on a $4MM player option for next season.

If Paxton had come through this rehab looking like the solid mid-rotation arm he had been previously, there would have been good reason for the Red Sox to consider triggering their option, especially with Nathan Eovaldi, Rich Hill and Michael Wacha slated to reach free agency this fall. There’s also the uncertainty surrounding Chris Sale, who has thrown less than 50 total innings over the past three seasons due to his own injury concerns. However, the longer Paxton remains out of action, the more the needle will move towards the club declining their end of the deal. As for Paxton’s side of things, that will also surely depend upon the severity of his injury and whether he thinks he can top $4MM in the open market this offseason.

In the short-term, the Red Sox surely would have loved for Paxton to come back and help them with the stretch drive here in 2022, but that’s looking increasingly unlikely with today’s setback. Boston is currently four games behind Toronto and Tampa Bay for the final Wild Card spot in the American League, with three other clubs in between them.

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