That would make a lot of sense, that he was struggling with some kind of upper-body discomfort, and would be a reason for optimism, but it does not seem to be the case. The pain only started last week. It really sounds like he got the flu or COVID - go figure! - had a bad cough, and suffered the injury from that. There have been previous MLB players injured from sneezing.
The ankle is definitely something he pitched through for a bit, but not all season. He had just started to do better when that became an issue.
Run support was also an issue of course (early on especially).