Clay Buchholz has the Red Sox in a bind

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Clay Buchholz is throwing in the low-90s consistently. His curveball looked plenty good today. He’s been inconsistent with his changeup, but that hardly explains the 9.09 ERA.

Buchholz gave up five more runs in 3 2/3 innings Sunday in a no-decision in what ended up being a 17-inning loss to the Orioles. He’s allowed at least five runs in all six of his outings this season. The three homers he surrendered today brought his season total to 10 in 32 2/3 innings. That’s one more than he allowed in 173 2/3 innings while winning 17 games for the Red Sox in 2010.

Obviously, Buchholz’s command has been an issue. Four more walks today brought his season total to 19. Still, even more than that, it seems like a lack of confidence is his biggest problem.

Questions about his mental toughness dogged Buchholz as he initially struggled to establish himself in Boston. He made such oddly timed pickoff throws to first and sometimes just seemed to shrink on the mound during his first three years before his breakthrough campaign two seasons ago. He hasn’t gotten himself back into some of those odd habits, but there’s certainly been some indecisiveness on the mound during his six starts this year.

For all of his struggles, Buchholz hasn’t really hurt the Red Sox yet. The team is 3-3 with him on the mound (compared to 8-13 the rest of the time) and two of the losses came in extra innings. Still, the club can’t run him out there with a 9.00 ERA for too much longer. If he’s not better next time out, the Red Sox may have to option him to Triple-A and give Andrew Miller or someone else a crack at his rotation spot. They might actually need to do it now after exhausting their bullpen Sunday.

Report: José Ramírez diagnosed with knee contusion

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Indians third baseman José Ramírez had to be carted off the field in the top of the third inning of Sunday afternoon’s Cactus League game agaisnt the White Sox. Ramírez fouled a pitch off of his leg during an at-bat against pitcher Sean Nolin.

MLB.com’s Mandy Bell reports that Ramírez was diagnosed with a left knee contusion after he was taken for X-rays. The X-rays were negative, per ESPN’s Jeff Passan.

Ramírez, 26, finished third in AL MVP Award voting last season, batting .270/.387/.552 with 39 home runs, 105 RBI, 110 runs scored, and 34 stolen bases across 698 plate appearances. He was worth 7.9 Wins Above Replacement, according to Baseball Reference. If Ramírez lands on the injured list, that would obviously be a huge loss for the Indians, despite being the overwhelming favorites in the AL Central entering the season.

The Indians will already start the season without second baseman Jason Kipnis and shortstop Francisco Lindor, though both are expected to return before the end of April. The infield is in rough shape at the moment.