Keeping Score

The Stephen Strasburg Dilemma: Baseball Pain Inside The Beltway

The Washington Nationals will end the season of Stephen Strasburg, their best pitcher who underwent Tommy John surgery almost two years ago, early, even if he's feeling healthy. Will caution come at a cost?

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Evan Vucci / AP

Washington Nationals starting pitcher Stephen Strasburg sits in the dugout during the eighth inning of a baseball game against the Colorado Rockies, Friday, July 6, 2012, in Washington.

I’m not a Washington Nationals fan. And unless you live in D.C., or loved the old Montreal Expos so much that you remained loyal to the franchise when it relocated to the nation’s capital for the 2005 season, you probably aren’t either.

But man, can’t you feel their pain?

The Nats are facing an unprecedented dilemma. Their best pitcher, the phenom Stephen Strasburg, 24, tore up an elbow ligament at the end of his first season, in 2010. The injury required him to undergo Tommy John surgery, the all-too common arm reconstruction procedure named after the former New York Yankees pitcher (John was the first player to receive it). During the highly effective procedure – according to a 2008 study, 83% of athletes who had Tommy John surgery were able to return to the same or better level of play – an injured elbow ligament is replaced with a tendon from another part of the patient’s body. Typically, players require 12-18 months to return to big-league action.

Strasburg returned last season on September 6th, about a year after going under the knife. He made five starts to close out the season, and was terrific: Strasburg finished 2011 with a microscopic 1.50 ERA. Still, the Nationals are proceeding with caution. Team general manager Mike Rizzo has remained adamant that at some point this season, the team will shut Strasburg down in order to reduce the risk of further injuries, and protect the team’s investment (after being taken with the top pick in the 2009 draft, Strasburg signed a four-year, $15.1 million contract).

(MORE: Stephen Strasburg’s Tommy John Surgery: Not The End of the World)

Washington will lose its best pitcher, even if the team is in the thick of a pennant race. As of July 22, Washington was 55-39, the best record in the National League, has been one of the surprises of the season thanks to the emergence of even newer talent such as Bryce Harper, and holds a 3.5-game lead over the Atlanta Braves in the National League East. And if the Nationals make the playoffs, Strasburg won’t be back.

Keep in mind that the Nationals haven’t sniffed the postseason since they started playing in Washington. The franchise has made just one post-season appearance, as the Montreal Expos after the strike-shortened 1981 season. The 1994 Expos seemed destined for a pennant – until another strike cancelled that season. The nation’s capital hasn’t seen a national pastime playoff game since 1933, when the old Washington Senators made the World Series.

These fans have suffered, and the team may cost itself a postseason appearance or World Series title via self-inflicted wound. Ouch.

Like most Nationals fans, Strasburg isn’t thrilled with this strategy. “I said it recently, they’ll have to rip the ball out of my hand,” Strasburg said this week. “and I mean it.” Rizzo, however, isn’t budging. “We’ll do it my way,” Rizzo told ESPN. “I have the full support of ownership on this issue. It’s my decision and I’ve made it. There will be no going back on the decision.”

Rizzo hasn’t given Strasburg a definitive cap on the number of pitches or innings he will throw. Last year, in his first full season back from Tommy John surgery, the Nats shut down starter Jordan Zimmermann after he threw 161 1/3 innings. (Not incidentally, Zimmermann is currently enjoying the best season of his four-year career).  Many fans and analysts have figured that Rizzo will give Strasburg a similar limit.

“There is no magic number,” Rizzo told ESPN. “It will be the eye test. (Manager) Davey (Johnson) won’t decide and ownership won’t decide. It will be the general manager, and that’s me.”

Not every baseball exec would mimic Rizzo’s mindset. “I tend to think that if you can grab the brass ring, you’ve got to go for it,” says one major league general manager. But the docs are cheering the team’s caution. “What they’re doing is prudent,” says Dr. Brad Parsons, assistant professor of orthopedics and residency director at the Mount Sinai School of Medicine in New York. “Because you’ve got to worry about fatigue. If your shoulder muscle is fatigued, you put stress on the elbow.”

In research with high school-age pitchers, Dr. Stephen Fealy, a former college hurler and orthopedic surgeon at the Hospital For Special Surgery in New York, found that as boys threw more pitches, fatigue messed with their mechanics. “The body does less work, and the arm does more,” says Fealy. That imbalance puts more load on the arm, and could lead to serious injury. “The Nationals are taking a common sense approach.”

But even Fealy says that as long as Strasburg shows no signs of fatigue, letting him pitch through the season is far from a reckless risk. No medical research, says Fealy, definitively concludes that pitchers who cut their workload after Tommy John surgery are less likely to get injured down the road. “There’s a whole lot we don’t know,” Fealy says. When it comes to determining the proper pitch limits, “we’re making up a lot of this on the fly,” says Fealy.

So even though Rizzo is exercising restraint, he’s taking a huge gamble in sitting Strasburg. At least one Nationals fan, Patrick Reddington, has been mentally preparing for the day Strasburg shuts down this season. Reddington, a blogger for a Nationals fan site, Federal Baseball, grew up in New Jersey – as an Expos fans. He has followed the franchise since 1980. He is resigned to Rizzo’s decision, and trying to stay positive, trying to support it.

So if, say, the Nats miss the playoffs without Strasburg down the stretch, and he winds up hurting his arm again five or six years down the road anyway, Reddington won’t be bitter?

“I can’t promise that,” he says.

(MORE: Baseball’s Hall of Fame Still Matters)

1 comments
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Chloem
Chloem

Nats fans who are paying attention aren't too worried. We don't have one ace. We have three. We have the best pitching staff in baseball and the best starting rotation in baseball. The 5th man on our rotation has a 3.01 ERA. We'll miss Stras but this team has proven all year that they can excel without key players.

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