Friday, August 27, 2010, 10:38 a.m., Updated at 12:10 p.m., Updated at 5:31 p.m.
By Mark Zuckerman
An enhanced MRI of Stephen Strasburg's right arm has revealed a "significant" tear of the ulnar collateral ligament in his elbow which will probably require Tommy John surgery, Washington Nationals general manager Mike Rizzo said during a conference call this morning.
Recovery time from the ligament replacement surgery is typically 12-to-18 months, meaning Strasburg wouldn't be ready to return until late-2011 at the earliest, a crushing blow to an organization that has pinned much of its long-term hopes on the 22-year-old's right arm.
"We're going to take this news and we're going to persevere," Rizzo said. "We're going to move and we're going to get our rotation intact. And when Stephen Strasburg returns, along with Jordan Zimmermann and the rest of our good young rotation, we'll be prepared to take on the 2011 season and beyond."
Before a final decision on surgery is made, Strasburg will fly to Los Angeles tomorrow to get a second opinion from orthopedist Lewis Yocum, who performed Zimmermann's Tommy John surgery one year and nine days ago. The club, however, is proceeding as though the surgery (in which a tendon from another part of the pitcher's body is removed to replace the torn UCL in the elbow) will happen, perhaps within the next few days.
"We're not going to drag this out," Rizzo said. "If the second opinion is surgery, we'll certainly have surgery, as soon as maybe the next day."
Strasburg injured himself Saturday night in Philadelphia, wincing in pain after throwing a fifth-inning changeup to Phillies right fielder Domonic Brown. He attempted to convince Jim Riggleman to leave him in the game, but the manager immediately pulled him for precautionary reasons.
"It felt like my forearm cramped up," said Strasburg, who once experienced a similar feeling pitching in college and wound up continuing the game. "That was about it."
Strasburg underwent an MRI Sunday in Washington, the results of which revealed a strained flexor tendon in his forearm. Team doctors, though, wanted a clearer look at the forearm and elbow and scheduled the arthrogram (an enhanced MRI in which a dye is injected into the arm) for yesterday.
The pitcher remained confident all along he would be back on the mound in no time.
"That's the thing: After we got the MRI results, I came to the field thinking they were going to let me play catch," he said. "I didn't really think there was anything wrong. It just happened. I can't really explain it."
When he finally learned the results of the enhanced MRI Thursday evening and was told he needed Tommy John surgery, Strasburg's initial reaction was one of anger and confusion. Over the course of the night, he came to accept the reality of the situation.
"I've got great support all around me. They reminded me of everything I should be thankful for," he said. "They put everything in perspective for me. The bottom line is, this is a game. I'm very blessed to play this game for a living. This is a setback, but in the grand scheme of things, it's just a blip on the radar screen."
Though they'll never know for sure, the Nationals believe the injury occurred solely on Strasburg's final pitch Saturday and was not the result of wear and tear.
"I asked the question myself to doctors," Rizzo said. "They think it was an acute injury from a particular pitch. You can't rule out that there was something there, but our doctors looking at the type of tear that Stephen has, it probably was from a one-pitch incident that tore the ligament."
Strasburg, though, thinks it may have developed over time and simply didn't show up until the enhanced MRI was administered.
Though Strasburg faces a long and difficult rehab over the next year, the recent track record for pitchers returning from Tommy John surgery is strong. The procedure has a success rate of anywhere from 85 percent to 90 percent, and dozens of big-name pitchers have come back from the surgery to recapture (or even surpass) their previous form, including Chris Carpenter, Josh Johnson, John Smoltz, Tim Hudson, A.J. Burnett and Billy Wagner.
Strasburg and the Nationals are taking some comfort in that.
"Absolutely," the pitcher said. "You look at all the guys in the big leagues who are Cy Young contenders, Hall of Famers who have had this surgery. It's become such a specialty these days. I'm going to the best, and I know deep down inside I'm going to work just as hard as any of these guys who had to go through it before."
"It certainly could have been worse," Rizzo said. "It could have been the shoulder, the labrum, something like that, which we don't have as much of a successful track record at."
In 12 starts this season, Strasburg went 5-3 with a 2.91 ERA, 92 strikeouts and 17 walks in 68 major-league innings. He also threw 55 13 innings in 11 minor-league starts.
All of that was part of the Nationals' calculated plan to bring Strasburg along slowly in his first professional season. The club was both scrutinized and applauded for the extreme caution it took with the rookie right-hander, leading to plenty of opportunity for second-guessing now.
Rizzo, though, insists he wouldn't change anything about the way the club developed Strasburg.
"Things like this happen," he said. "Pitchers break down. Pitchers get hurt. We're certainly not second-guessing ourselves. We've developed a lot of pitchers this way. We're satisfied with the way he was developed, and I know agent Scott Boras is satisfied the way he's been treated and developed, and Stephen is also. We're good with that. Frustrated? Yes. But second-guessing ourselves? No."
Strasburg had previously not afforded himself the opportunity to reflect on his past year. Now that his rookie season is over, albeit six weeks earlier than he expected, he can look back at all that happened to him -- both good and bad.
"Definitely a whirlwind," he said. "It kind of sucks to have it end like this, but I got a lot of great experience when I was up here. The weird thing about it is, that last game, that was when everything started to click. That was when I had that feeling. I mean, that was a packed house with some rowdy fans, and I didn't feel like they were there. I was just so locked in and everything was working. And sure enough, something happens."
Mark Zuckerman covered the Nationals for The Washington Times from 2005-09. In addition to regular work this season for CSNwashington.com, he also covers the team at www.natsinsider.com. Email Mark at firstname.lastname@example.org.