What if Chris Sale was healthy for his entire Red Sox career?

Editors Note: Strat-O-Matic, the market leader in sports simulation, has partnered with NBC Sports Boston to build simulation experiences for "What If Wednesdays.”

When healthy, Chris Sale has been a perennial Cy Young award candidate throughout his illustrious MLB career.

Unfortunately for the Boston Red Sox, their ace hasn't been able to step on the mound since August 2019 due to an elbow injury. He continues to miss time in 2021 after undergoing Tommy John surgery last year.

We already know the kind of impact a healthy Sale can have on the Red Sox pitching staff. He was key in the 2018 championship run, and the image of him making Manny Machado look foolish on the final out of the World Series will live on in Boston sports lore. But what if Sale had been able to stay healthy the entirety of his Red Sox tenure?

Our partners at Strat-O-Matic used their advanced simulation software to play out the last three Red Sox seasons with a healthy Sale, producing full regular- and postseason results for Boston in addition to complete player stats.

Here are some big takeaways from Strat-O-Matic's 2018, 2019, and 2020 season simulations.

Last week's "What If Wednesday:" A healthy Hayward in Boston

Sale's lone fully healthy season in Boston came in 2017, when he pitched 214 innings while posting a 17-8 record, 2.90 ERA, 0.97 WHIP, and a whopping 308 strikeouts. Those impressive numbers earned the left-hander a second-place finish in American League Cy Young award voting.

His 2018 was just as dominant, though a shoulder injury forced him to miss time toward the end of the season. His 2019 campaign was marred by a nagging elbow injury that eventually required Tommy John surgery and kept him sidelined for all of 2020.

Let's say Sale was healthy for those three seasons. In Strat-O-Matic's simulation, the southpaw makes 22 additional starts with eight more wins and five fewer losses (25-10) than his actual record (17-15). His ERA improves from 3.25 to a sparkling 2.43. The inning, strikeout, and walk totals each improve dramatically.

There's no doubt that Sale's injuries have robbed us of some masterful pitching performances these last few years.

Sale's ailments prevented him from producing like an ace in 2019, and that was a major factor in the Red Sox missing the postseason.

In reality, Boston finished the '19 campaign with an 84-78 record that kept them 12 games out of the second AL Wild Card spot. In Strat-O-Matic's simulation, a healthy Sale boosts the Red Sox win total to 95 and propels them to the Wild Card Game.

Sale's numbers in this hypothetical healthy 2019 season? A 21-4 record, 2.59 ERA, and 346 strikeouts in 222 2/3 innings pitched. That would have given 2019 AL Cy Young Justin Verlander some serious competition for the award.

Interestingly enough, the Red Sox actually lost two more games with a healthy Sale in the rotation in 2018. In the simulated August and September with Sale, they won six of their 10 games during that span. The '18 club actually won eight of 10 in real life. Regardless, the final result was the same as Boston went on to be crowned World Series champs.

Sale's importance is summed up by the Red Sox' simulated 2019 record with him healthy. Boston earned 11 more wins to go from third to second in the American League East standings and clinch a Wild Card spot.

In 2020, not even a healthy Sale could turn the Red Sox' abysmal season around. They avoided a last-place finish in the division with Sale anchoring the rotation, but their four additional wins weren't enough to sneak into the playoffs.

Sale made three starts and five total appearances for the Red Sox in the 2018 postseason. While he was effective despite the shoulder issue, he was even better in the Strat-O-Matic simulation. Sale earned a win in his ALDS start against the New York Yankees as well as his ALCS start against the Houston Astros, then he pitched a no-decision in the World Series vs. the Los Angeles Dodgers.

Altogether, simulation Sale posted a 2-0 record with a 2.24 ERA, 27 strikeouts, and nine walks in his three outings. Unsurprisingly, the team's playoff results were unchanged as the Red Sox cruised to a World Series title with their healthy ace atop the rotation.

The real fun comes in 2019. The real Red Sox failed to make the postseason, but Strat-O-Matic's 2019 club took on the Oakland A's in the Wild Card Game with Sale on the mound.

Unfortunately, Sale still wasn't enough to spark another playoff run for Boston. The simulation had Sale allowing four runs on six hits in five innings in a losing effort vs. Oakland.

Sale was one of the most durable players in the league prior to 2019. He also was one of the game's best. The lanky left-hander finished sixth or better in AL Cy Young voting and was an All-Star every year from 2012-18.

As shown in the 2019 simulation, the 32-year-old's presence is enough to propel the Red Sox to a postseason berth. That's why Boston will hope to get its ace back sooner rather than later as he continues to recover from Tommy John surgery.

There still is no clear timetable on Sale's long-awaited return to the rotation.