Look, the Fenway faithful are used to a little drama. But as we head into the 2026 season, the Boston Red Sox injury report looks less like a list of names and more like a high-stakes medical thriller. Between Tommy John survivors and patellar tendons that just won't quit, Craig Breslow and Alex Cora are playing a very expensive game of Tetris with the 40-man roster.
The vibes in Boston are... complicated. On one hand, you’ve got the shiny new addition of Ranger Suárez to the rotation, which feels like a legitimate win. On the other, the clubhouse is still reeling from the departure of Alex Bregman to the Cubs and the ghost of the Rafael Devers trade.
But if you want to know if this team can actually compete in the AL East this year, you have to look at the trainer's room. That's where the 2026 season will be won or lost. Honestly, it's a mess. But it's a mess with a timeline.
The Triston Casas Dilemma: 11 Months vs. 12 Months
Everyone wants to know about Triston Casas. It's the big question. Can he actually be the guy again? After a 2025 season that basically vanished due to a ruptured patellar tendon in his left knee, Casas is currently walking a tightrope.
He’s been very vocal about wanting to be there for Opening Day. But let's be real for a second. Doctors typically cite a 12-month recovery for that kind of surgery. Opening Day 2026 marks roughly 11 months since he went under the knife.
"It's going to be a tight squeeze," Casas admitted during Fenway Fest.
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The Red Sox didn't wait around for him to heal, either. They went out and grabbed Willson Contreras from the Cardinals to man first base. That move says a lot. It says the front office isn't betting the house on Casas' knee holding up for 162 games. If he's healthy, he's a monster at the plate. If he's not, he might find himself starting the year in Triple-A Worcester just to get his legs back.
The Pitching Staff: Tommy John and "Freak" Elbows
The rotation is where things get truly precarious. We need to talk about Tanner Houck. If you were hoping for a June return, I’ve got bad news. After undergoing Tommy John surgery and a flexor tendon cleanup on August 18, 2025, Houck is officially a long-shot for 2026.
The current projection? Late 2026 at the absolute earliest, but more likely 2027. He’s in the "attack the rehab" phase, which is code for "see you next year."
Then there's the Lucas Giolito situation. Giolito missed all of 2024, came back in 2025, put up a solid 3.41 ERA over 145 innings, and then... his elbow flared up right before the Wild Card Series. Classic Sox luck.
Giolito actually declined his portion of a mutual option for 2026, opting for a buyout to test free agency. He claims he's "fully healthy" and that the late-season scare was just a freak occurrence with no structural damage. Whether or not he ends up back in a Boston uniform or pitching for a rival is the $19 million question.
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Who is actually healthy?
- Garrett Whitlock: He’s the bright spot. After internal brace surgery, he’s not just "on track"—he’s planning to pitch for Team USA in the 2026 World Baseball Classic. That's a massive vote of confidence in his arm.
- Kutter Crawford: After a July 2025 surgery for a right wrist subsheath tear, Crawford is progressing well. He expects a normal spring training. We'll see if the command is there from day one.
- Liam Hendriks: The comeback story of the decade. After battling Stage 4 cancer and Tommy John, Hendriks is finally looking like a bullpen piece again. He’s been throwing in Worcester and should be a high-leverage arm for Cora.
The Infield Shuffle: Story and Mayer
Trevor Story is still here. He opted into the final two years of his deal, and despite some defensive lapses late last year that fans attributed to "diminished range," the team is sticking by him at shortstop.
The internal belief is that Story was just gassed. It was his first full season of health in years.
This creates a fascinating logjam with Marcelo Mayer. Mayer’s 2025 was cut short by a wrist injury in August, but he's supposedly doing "full baseball activity" now. The word around the campfire is that Mayer will likely slide to third base to start 2026. It keeps him on the left side of the infield and lets the Sox keep Story’s veteran leadership at short—at least until Story's contract expires after 2027.
Boston Red Sox Injury Report: The Current List
To make sense of who is actually available for the start of the season, you have to separate the "probables" from the "definitely nots."
The "Ready for Spring Training" Group:
Marcelo Mayer (Wrist) is back to full activity. Roman Anthony (Oblique) is expected to be 100%. Zack Gelof, who the Sox acquired to help the infield, is also recovered from shoulder surgery. These guys are the core of the "new" Sox.
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The "Wait and See" Group:
Triston Casas is the captain of this ship. He’s hitting in cages in Fort Myers, but a patellar tendon is a fickle beast for a guy that size. He might be a DH candidate early on just to save his legs.
The "Out for a While" Group:
Tanner Houck is the big name here. Hunter Dobbins is also sidelined with a right ACL tear from last July and will likely miss the entire 2026 campaign.
What This Means for Your 2026 Expectations
If you're looking at the Boston Red Sox injury report and thinking it's all doom and gloom, you're missing the nuance. Yes, losing Houck hurts. And yes, the Casas situation is murky. But the depth is better than it’s been in years.
Breslow has been aggressive in filling holes. Bringing in Willson Contreras was a masterstroke of injury insurance. If Casas can't go, Contreras handles first. If Casas is healthy, you've suddenly got a terrifying DH/1B rotation.
The rotation, led by Ranger Suárez and a healthy Garrett Whitlock, actually has a ceiling that isn't "fourth place in the East." But they have zero margin for error. If one more starter goes down with "elbow soreness," the wheels come off.
Actionable Insights for Fans:
- Watch the Spring Training Box Scores: Don't look at the stats; look at the innings and the games played. If Casas isn't playing in back-to-back games by mid-March, don't expect him on the Opening Day roster.
- Keep an eye on the waiver wire: The Red Sox are still active. With the loss of Bregman, they are one more injury away from a massive hole at the hot corner.
- Monitor Garrett Whitlock's WBC usage: If he's throwing 95+ for Team USA in March, he's your sleeper Cy Young candidate. If he skips it, be worried.
The 2026 Red Sox are a team built on medical clearances. If the doctor says "yes," they're a playoff contender. If the doctor says "maybe," it's going to be another long summer on Jersey Street.
Check the official Red Sox transaction wire as Spring Training approaches. Pay close attention to Marcelo Mayer’s throwing program in Fort Myers; his transition to third base is the quietest, most important storyline of the spring.