Sale nearly hit Urshela with the next pitch and wound up giving up hits to six of his next seven batters, including DJ LeMahieu second home run of the game.
Sale and manager Alex Cora were ejected during the seven-run inning as the Yankees routed the Red Sox 9-2 in Saturday's doubleheader opener, extending Boston's longest losing streak since 2015 to six games.
"I felt like he kind of changed the landscape of the game. There's got to be something that can be done about this," Sale said. "It's a little tough when at this level you give those guys in those situations extra strikes and extra outs. Yeah, I've got to do a little bit better job of locking it in and getting my job done, not worrying about what's going on back there with him, but nonetheless it's tough."
Sale (5-11) tied his career high by allowing eight earned runs in 3 2/3 innings and fell to 0-4 with a 9.90 ERA against the Yankees this season. He was 29-12 with a 2.56 ERA for the Red Sox when he signed a $160 million, six-year contract in March but has a 4.68 ERA since.
Boston fell 12 1/2 games behind the AL East-leading Yankees and 4 1/2 games back of second-place Tampa Bay. The Red Sox have 53 defeats, one shy of their total en route to a World Series title last year, and dropped to 4-9 against New York this season.
"It seems like it has flip-flopped from last year, where they are at right now, where we are right now," Cora said.
Boston held a players-only meeting between games.
"Everybody's frustrated," reigning AL MVP Mookie Betts said. "Not every year is going to be like last year. We have to just figure out a way."
LeMahieu homered on Sale's fifth pitch and hit a three-run drive for his career-best 17th and a 7-1 advantage.
The Yankees sustained yet another injury when Edwin Encarnacion broke his right wrist when hit by a pitch from Josh Smith in the eighth.
New York took a 2-1 lead on four singles, the last by No. 8 hitter Breyvic Valera . Cora, not pitching coach Dana LeVangie, went to the mound with the intent of getting tossed by Estabrook.
"It was only one purpose. I wasn't talking about mechanics or anything," Cora said. "Just let me know when he's coming, and I'm going to let him know how I feel."
What did Cora say?
"You see all this traffic here? One pitch changed the whole inning," the manager recalled as the PG-rated version.
Cora pointed nearly two dozen times at various Yankees runners and the plate as he returned to the dugout.
"They're human. They miss calls," Cora said. "And sometimes we bark at them and then we look at video. It's like, oh, he was right."
Left-handed-hitting Brett Gardner fell behind 0-2 against the Sale, worked the count even and hit a two-run single up the middle against the 30-year-old left-hander. The Yankees nearly got another run on center fielder Jackie Bradley Jr.'s overthrow because the agitated Sale forgot to back up the plate. Four pitches later, LeMahieu lined a changeup in the first row of the right-field seats.
"I think I like that right-field wall, for sure," LeMahieu said.
Aaron Judge followed with a double, and when bench coach Ron Roenicke went to the mound to change pitchers, Sale shouted at Estabrook from a distance and also was ejected.
Among his grievances, Sale cited a 2-2 fastball to Judge ("it was almost down the middle"), a called third strike against J.D. Martinez that ended the top of the first ("just God awful"), a 3-1 pitch from German to Xander Bogaerts in the fourth ("not even close") and a called third strike in the fifth that caused Betts to squawk ("and Mookie doesn't say anything to anybody)."
"Nothing's going to happen to him, I'm sure," Sale said in a subdued voice, his hands in the pockets of his red shorts. "He'll be out there today at third base and probably behind the plate again. I'm sure I'll get fined. I'm sure A.C. will get fined, all for things that I think we can be justified by."
German (14-2) allowed five hits in seven innings , including homers to Andrew Benintendi in the second and Jackie Bradley Jr. in the fifth. He improved to 8-0 against the AL East this year and became the first Yankees pitcher to last seven innings since CC Sabathia on July 6.
German has thrown 108 innings, 15 shy of his career high, raising the possibility of a limit.
"We'll obviously start to have those conversations," New York manager Aaron Boone said.
New York is 41-18 at Yankee Stadium and clinched its 28th winning home record.
BEEN A LONG TIME
Boston is on its longest skid since losing eight in a row from July 12-23, 2015.
Bob Costas made his YES Network debut, filling in as Michael Kay recovers from vocal cord surgery.
Red Sox: LHP Brian Johnson (1-1) was activated from the IL to start the second game, likely against RHP Chad Green (2-3). Johnson had not pitched since June 22 because of an unspecified non-baseball-related medical matter.
Yankees: CC Sabathia (right knee) had a platelet-rich plasma injection and anticipates playing catch next week ... SS Didi Gregorius has not played since rolling over his left wrist fielding a ball Wednesday.
Daddy's back: Boston LHP David Price (7-5) and Yankees LHP J.A. Happ (8-6) both return from paternity leave to start the series finale.
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Encarnacion fractures wrist on hit by pitch
Edwin Encarnacion fractures his right wrist after getting hit by an 87 mph pitch against the Red Sox.