It's never a good sign for any baseball team -- let alone a defending World Series champion with a mostly returning roster -- to be treating games in mid-August like it's the middle of October.

The Boston Red Sox were forced to show their hand in a three-game set against the Cleveland Indians last week. The team started the series 7½ games out of the second wild-card slot, trailing the Rays and A's. After telling Nathan Eovaldi he was rejoining the starting rotation, Boston pivoted with the urgency of a Game 7, bringing in the righty for six outs across two games, underlying the team's need to win now.

Manager Alex Cora has been stretched so thin for quality outs from his bullpen, his Aug. 16 lineup card -- for the first of three games against the last-place Orioles -- listed ace Chris Sale as a left-handed option out of the pen.

Chris Sale listed on the lineup card as being available out of the bullpen tonight. pic.twitter.com/UeysU3C6uD

— Chris Cotillo (@ChrisCotillo) August 16, 2019

Now the Red Sox's ace, and their impromptu bullpen arm, is finished for 2019. Although Sale is expected to avoid Tommy John surgery, sources tell ESPN's Jeff Passan, he likely will miss the rest of the season with left elbow inflammation. Sale met with Dr. James Andrews on Monday and received a platelet-rich plasma injection, Red Sox general manager Dave Dombrowski said in a statement. Following a recommended shutdown from throwing, Sale will be reevaluated by Andrews in six weeks.

As news of Sale's shutdown broke Monday night, the Red Sox, in the midst of a five-game winning streak, still had just a 5% chance of making the playoffs, according to FiveThirtyEight's model. Put aside all the math, stats and spin, though: Even if Sale were healthy, everything that hadn't gone Boston's way so far this season would have had to go perfectly right for the Red Sox to sniff the postseason.

In other words: The 2019 Red Sox are done, and their World Series title defense is over.

The Sale conundrum

Sale's injury puts a spotlight on the five-year, $145 million extension he signed this past winter, as Boston is left to cross its fingers that Sale will be at full strength next season. As noted by Buster Olney, rival evaluators expressed surprise that Dombrowski and the Red Sox did not wait longer to finish the extension, given the 30-year-old Sale's shoulder injury during the second half of 2018.

The uncertainty surrounding Sale further spotlights the financial commitment to the Red Sox's rotation. There will be even more pressure on David Price, who has started 30 games twice in four seasons in Boston, and Eovaldi, who inked a four-year, $68 million deal after hitting free agency, then spent three months on the injured list after undergoing arthroscopic surgery to remove loose bodies from his elbow.

With the Red Sox unlikely to re-sign Rick Porcello, Boston will find itself in 2020 with significant questions in an area that has been fundamental to the team's success in recent years.

Boston's lack of organizational pitching depth manifested itself this year with Eovaldi's injury, and the performance of top pitching prospects Bryan Mata, who has a 6.25 ERA in more than 40 innings in Double-A Portland, and former first-round pick Tanner Houck, who has mostly pitched out of relief in Triple-A Pawtucket.

The Red Sox could turn to the free-agent market, which is highlighted by 29-year-old Gerrit Cole, who will likely net the biggest pitching contract in free agency, and Madison Bumgarner, who has a 3.72 ERA in 27 starts in his age-29 season. In addition to having Porcello's $21 million come off the books, the Red Sox also will shed Pablo Sandoval's $18.445 million salary this offseason, creating some financial flexibility.

Given the prospect haul Dombrowski sent out for Sale, Boston would need to get creative in order to land a top-of-the-rotation starter via trade.

What went right for the 2019 Red Sox

There have been plenty of bright spots, as you'd expect on a team with MLB's highest Opening Day payroll. Rafael Devers keeps finding ways to top himself. The 22-year-old has become one of the best third basemen in the sport, hitting .332/.380/.596 while making significant strides in the field. He has put up eye-opening performances like his six-hit, four-double outing in 10 innings against the Indians, and is now tied with Alex Bregman of the Astros in FanGraphs WAR among all third basemen in baseball at 5.5.

Xander Bogaerts has not only thrust himself into the conversation about the best shortstop in baseball, he has emerged in the team's clubhouse as a leader, especially in his hands-on mentorship of Devers. The 26-year-old is hitting .309/.384/.562, already has a career-high 27 homers, and ranks first among qualified shortstops in FanGraphs WAR at 5.6. Signing Bogaerts to a six-year, $120 million extension has quickly become one of the best moves the Boston front office has made in recent years.

Other Red Sox have had good seasons. Right fielder Mookie Betts isn't going to win another MVP award this year, but he has put together a strong second half so far, hitting .313/.386/.592 with eight homers and 15 doubles. Andrew Benintendi, J.D. Martinez and Christian Vazquez have all contributed to a juggernaut offense that ranks second in runs scored in MLB, trailing only the Yankees.

What went wrong

Offense can get you only so far. The difference between the 2018 and 2019 Red Sox jumps right off the stats page: the 5.04 starters ERA, a number that gets even more dizzying when thinking about the $88 million commitment to the rotation. Sale had, by far, the worst season of his career (6-11 with a 4.40 ERA) following his blockbuster offseason extension. Porcello has posted a 5.49 ERA, the highest mark of his career. Eduardo Rodriguez, who came into the season as the fifth starter, leads the rotation with a 4.10 ERA.

Eovaldi's prolonged absence forced Dombrowski to turn to internal options Hector Velazquez (5.81 ERA in 26 games, eight starts) and Ryan Weber (4.35 ERA in 11 games, three starts) and, later, in a pre-deadline deal, Andrew Cashner (7.29 ERA in nine games, six starts). Eovaldi's replacements averaged three innings per start.

So many times this season, Eovaldi has been cited as a stopgap answer. As the trade deadline approached, Dombrowski touted the flame-thrower as the team's solution to a slowly crumbling bullpen. Even when the team demoted Cashner to the pen, Cora could not commit to using Eovaldi as just a starter or a reliever, underlying the team's lack of in-house solutions and organizational depth, something the division rival Yankees have shown a seemingly endless supply of in 2019.

Who's to blame

Blaming deadline inaction for the demise of the Red Sox's season assumes one small move could have fixed this team. Owner John Henry told WEEI.com before the deadline that the team was already over budget and couldn't add payroll during the season.

Cracks in the team's roster construction and payroll started to show back in the offseason. Dombrowski made a huge commitment to Eovaldi, who had undergone two Tommy John surgeries and has started more than 30 games just once in his eight-year career. When he chose not to bring back Craig Kimbrel or Joe Kelly, who have been lackluster with the Cubs and Dodgers, respectively, Dombrowski cited internal bullpen solutions like Tyler Thornburg and Steven Wright, neither of whom contributed. After posting a 3.72 ERA and leaving 77 percent of runners on base (fourth in baseball) in 2018, the Red Sox's bullpen this year has a 4.28 ERA and is leaving 72 percent of runners on base (16th in baseball).

The lack of organizational starting pitching depth highlighted the team's struggle to develop young starting pitching prospects, a problem a team with a huge payroll should be able to fix. Boston not only failed to find enough rotation solutions, the starting pitching problems compounded the bullpen issues by wearing down the relievers. Moving Eovaldi to the pen upon his return felt more like using tape to patch holes in a flooding luxury cruise ship. That falls on Dombrowski.

What's next

Dombrowski was brought in to spend money and trade prospects to acquire Sale, Kimbrel, Price and Eovaldi and push for a World Series. Dombrowski was tasked with a similar mission in the later years of his tenure in Detroit, making the playoffs every year from 2011 through 2014, where he fell short of a World Series title before being released from his contract in August 2015. The Tigers' current ground-up rebuild and the $124 million due over the next four years to 36-year-old Miguel Cabrera, who has nine homers and has hit .278 in 400 at-bats this season, remain as the rubble from Dombrowski's tenure.

Betts becomes a free agent after the 2020 season, as does Jackie Bradley Jr., which complicates any plans to add payroll this winter. Boston has $237 million committed to just Sale, Price and Eovaldi for the next three years, with Porcello hitting free agency this offseason and a farm system without much premium pitching talent. The 66-year-old Dombrowski has one year left on his contract, but ownership might have to decide even sooner if the man who built maybe the greatest team in franchise history is the right person to lead the Red Sox into their increasingly murky future.