An MRI reveals that Boston Red Sox pitcher Chris Sale has a flexor strain in his throwing elbow. However, he says that Tommy John surgery might be a possibility after he resumes throwing again later this month. AP file photo

FORT MYERS, Fla. — Boston Red Sox left-hander Chris Sale has a flexor strain in his throwing elbow, but will try to pitch through it.

Tommy John surgery remains a possibility, Sale said during an emotional press conference at JetBlue Park on Thursday.

He’ll rest for at least a week, then start building back up as if spring training were starting all over again. If his elbow responds well, he’ll try to pitch through the season.

If not, surgery is likely.

“That’s what the future holds for me,” he said. “That’s what we determine in two or three weeks.”

Sale had an MRI that was reviewed by team doctors as well as Dr. Neal ElAttrache and Dr. James Andrews. The images revealed only a flexor strain and Sale’s ulnar collateral ligament looks the same as it looked last August, when Sale first felt pain in his elbow.

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“Talked to many doctors, I’m not exactly sure how many, but at least a handful,” Sale said. “Top guys, world renown, and they seem confident and everyone agreed, ‘hey let’s take some time off, get some anti-inflammatories in there, start another throwing program and see what we get.’

That Sale will avoid Tommy John surgery right now provides a slim ray of hope, but Sale was quite honest about his future if the elbow tightness and soreness don’t go away.

“It sucks,” he said. “Obviously don’t want to be sitting here giving you this information. It’s a tough spot for myself, this team and the organization going forward.”

Having made just 25 starts since signing a five-year, $145-million contract extension last spring has made this more difficult for Sale to swallow. Knowing the Red Sox will struggle to compete without him adds to the pressure.

“That’s what makes it tough to sleep,” he said. “I know what I mean to this organization, to this team, the success going forward. And I know the faith they put in me. That’s evident in the press conference I had in spring training last year with the contract.

“I couldn’t possibly feel worse about any situation I’ve ever felt in my entire life because of that. Plain and simple. I don’t think I’ve ever let anybody down this hard, ever. … Someone gives you something because they believe in you, they expect something from you and you don’t live up to that.”

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Sale made one thing clear: when he does start throwing again, he’s not going to hold back and he’s not going to change the way he throws. He’ll either pitch the only way he knows how or endure a year-long recovery process from Tommy John surgery.

“Because at the end of the day I have to do what I have to do,” he said. “And I pitch the way I pitch. Ten days from now, if I pick up a baseball and start throwing it, and I build up the way I’m supposed to build up, I’m going to do what I have to do. I can’t change. I have to pitch the way I pitch.

“If I go out there and I can pitch at a high level with my effort level, the way I’m comfortable and the way I’ve always done it, I’m going to ride it out. And if I can’t do that, we’ll figure something out.”

THE RED SOX signed right-handed pitcher Collin McHugh to a one-year contract, the club announced. To make room for him on the 40-man roster, the Sox designated Hector Velazquez for assignment.

McHugh, 32, has spent the last six years with the Astros, serving a versatile role in which he made 110 starts and 85 relief appearances for Houston. In that span, he posted a 3.63 ERA and showed flashes of brilliance in both roles, finishing eighth in the voting for the American League Cy Young award in 2015 and later posting a 1.99 ERA in 58 relief appearances in 2018.

With two open rotation spots, the Red Sox will likely look at McHugh as a starter. The righty doesn’t appear likely to be ready for the beginning of the season as he was just recently cleared to begin throwing after undergoing a tenex procedure to alleviate an elbow issue.

McHugh made 35 appearances (eight starts) in 2019, posting a 4.70 ERA in 74 2/3 innings.

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BY RECENT standards, the heckling the Houston Astros heard at JetBlue Park was rather tame. Some boos during pregame introductions, a chant of “cheaters!” in the ninth inning.

Maybe that’s because Jose Altuve, Alex Bregman and rest of their All-Stars were missing from the lineup against the Boston Red Sox, who lost 5-0.

Perhaps there was another more pointed reason.

“It could be here, too,” Astros Manager Dusty Baker cautioned Thursday. “And then (the Red Sox) got to be careful of the reception.”

Major League Baseball continues to look into allegations the Red Sox illicitly swiped signals during their run to the 2018 World Series title. Manager Alex Cora and the team already have split – that was in the wake of his role as bench coach of the 2017 champion Astros and a sign-stealing scandal that rocked the sport and resulted in MLB punishment.

“We’re still waiting for our investigation to be over. So it’s still there,” said Ron Roenicke, who took over for Cora.

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“But I think we’re pretty focused on what we’re doing and what we need to do. And then we’ll see what happens with ours. I know (the Astros are) going to have a tough time this year going through what they’re going through. But I hear everything that’s going on,” he said.

Jeered earlier this spring on exhibition stops in Lakeland against the Tigers and Port St. Lucie against the Mets, the Astros weren’t harshly targeted by the Boston crowd.

The jeers and taunts, such as they were, were not nearly as loud and robust as the Astros have become accustomed to at other road games this spring. Indeed, they were rather lackluster and mild.

None of Houston’s starters from the postseason last year made the 2 1/2-hour trip from the Astros’ camp in West Palm Beach.