Boston Red Sox ace Chris Sale is expected to avoid Tommy John surgery after a second opinion on his injured left elbow from Dr. James Andrews confirmed a previous diagnosis of inflammation, sources familiar with the situation told ESPN.

Sale, who was placed on the 10-day injured list Saturday, flew to meet with Andrews on Monday, sources said. The 30-year-old is in the midst of the worst season of his 10-year career after this spring signing a contract extension that begins in 2020 and pays him $145 million over five years.

Following his last start six days ago, Sale felt soreness in his elbow and underwent an MRI. Initial readings showed changes from the MRI he had in the spring but weren't clear enough to definitively judge whether there was damage to his ulnar collateral ligament.

Monday's news delivered a collective sigh of relief to Boston. The course of treatment for Sale is unclear, as is his timetable to return, though both are expected to be determined in the coming days, according to sources.

With a 6-11 record and 4.40 ERA, Sale has struggled despite an American League-best strikeout rate and an elite strikeout-to-walk ratio. He has struggled with home runs, allowing 24 in 147 ⅓ innings, more than 60% higher than what he's averaged in his illustrious career.

Sale is coming off arguably the best season of his career, even though a shoulder injury sent him to the injured list twice in the second half of 2018. He nevertheless pitched to a 2.11 ERA, and while his stuff in the playoffs was substandard, Sale finished the Red Sox's dominant World Series run by striking out the side to clinch the championship.

The diminished velocity on Sale's fastball didn't scare the Red Sox away from handing him a long-term deal the year before he reached free agency. Boston, which is paying Sale $15 million this year as part of his first contract extension, owes him $30 million in 2020, 2021 and 2022, and $27.5 million in 2023 and 2024.

Early-season velocity worries this year eventually waned, and occasional flashes of brilliance reminded of classic Sale. Just 10 days ago, Sale shut out the Los Angeles Angels for eight innings, allowing two hits, walking none and striking out 13. In his last start, against Cleveland, he punched out 12 in 6 ⅔ innings. His elbow began hurting the day after that start, sources said, and after informing the team of the issues Friday, Sale underwent an MRI Saturday.

Even with his struggles, the loss of Sale for any period of time will hurt the Red Sox as they try to claw back into the playoff picture. A 13-7 victory Sunday finished a sweep of Baltimore and extended their winning streak to five games, but the Red Sox still find themselves 6 ½ games behind the Rays for the second wild-card spot and five games back of the Athletics as well.