It’s not just Hanley Ramirez’s shoulders and knees that could be keeping him out of the Boston Red Sox lineup going forward. His numbers also may play a role, Manager John Farrell said Tuesday.

Ramirez was held out of the starting lineup for the third straight game Wednesday because of a sore knee after he was hit by a pitch Sunday. Farrell was uncertain if Ramirez would be available to pinch hit. He’s considered day-to-day.

How much of a loss is it to have Ramirez on the bench? That’s the question the Red Sox need to answer.

Entering the game, Ramirez ranked 10th out of the 13 full-time American League designated hitters with a -0.3 WAR, according to FanGraphs. Over his previous two years with the Sox, he had been worth -1.8 WAR (2015) and 2.6 WAR (2016).

It’s certainly not what the Sox expected when they decided to pay him $22 million per season.

Ramirez is hitting .241 with a .747 OPS. Over his last 23 games he’s hit .185 with a .656 OPS.

Farrell was asked if he would consider starting other players at DH due to Ramirez’s poor performance.

“I wouldn’t rule it out,” Farrell said. “Where he was so good against left-handed pitching last year, that’s been still a work in progress, for a lack of a better way to describe it.”

Ramirez hammered lefties to the tune of a .346 average and 1.097 OPS in 2016. Battling constant injuries this season, the 33-year-old is hitting .143 with a .562 OPS against lefties.

“We’re always looking to put the best combination on the field,” Farrell said. “But the one thing you can’t do is completely turn away from what Hanley did last year. While I know that is last year, we’re still working to get some increased performance from him. I think he’s still a key member in our lineup. The presence he provides, the impact he’s capable of, and yet we’re still working to get there.”

Nine of Ramirez’s 10 home runs have been against right-hand pitchers.

“There has been extensive video review,” Farrell said. “There’s been extensive conversations with him. There’s been short stretches where he’s, I think, shown the approach at the plate and the all-field ability to drive the baseball. That has been hit and miss a little bit. We’re just trying to get a consistency that he’s been known for.”

Farrell said recently that a stint on the disabled list wouldn’t do much for Ramirez. The Sox instead are living with his frequent injury troubles and inconsistent production.

Chris Young and Sam Travis were both in the lineup Tuesday night, with Young at DH and Travis at first base, spelling Mitch Moreland. Young hit a three-run homer in the 9-2 victory against the Minnesota Twins.

Moreland has been playing with a broken toe and, after hitting his third homer in as many games Monday, was credited by Farrell for playing through the injury.

“I think the way he’s gone about it given the physical condition he’s in, is a strong message to the remainder of this team,” Farrell said.

Farrell said Tuesday he wasn’t directing that message at anyone.

“No, no, and I respect the question,” he said. “But that was to highlight a guy who has been dealing with a broken toe and continues to perform at a high level, and to compliment Mitch for the way he’s gone about it.”