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Why the Strasburg-Rizzo-Dr. Yocum controversy matters

Sep 13, 2012, 5:54 PM EDT

Nationals Rizzo Baseball

UPDATE: The he-said, he-said is over. Yocum has reversed himself. Call off the dogs.

5: 54 PM: As of now we have a he-said, he-said when it comes to Dr. Lewis Yocum and the Washington Nationals. Mike Rizzo and Scott Boras say that they consulted the man who performed Stephen Strasburg‘s Tommy John surgery before arriving at the shutdown. Yocum says they didn’t, and that he hasn’t spoken to the Nationals since Strasburg’s surgery two years ago.

Who is telling the truth? I dunno. It’s quite possible that Yocum, who doesn’t have the same vested interest here, is forgetting random conversations or wasn’t clear about what Bill Shaikin of the Los Angeles Times was asking him.  It’s also possible that the man who once compared Oliver Perez to Sandy Koufax is … not being completely accurate.  Only time will tell.

But I think it’s wrong to believe that this is all just a little media spat. I think there is a significance to this, because in large part Mike Rizzo and Scott Boras have used the credibility of Dr. Yocum — and medical studies Yocum says do not exist — to defend their decision to shut down Stephen Strasburg. If Rizzo and Boras are being less than honest here, it says something important about their candor with respect to this issue. And when one’s candor is in question, it calls into question their judgment as well.

The shutdown rationale cited by Mike Rizzo, Scott Boras, their media surrogates and many Nationals fans over the past few months clearly relies on Yocum and said medical studies. Look at this Thomas Boswell column from July 5. And when you do so, note that Boswell is widely considered to have very good sources in the Nats’ front office, and many assume he speaks directly to Rizzo on such matters:

Doctors and baseball’s best brains have studied the recovery of pitchers from Tommy John elbow surgery since 1974. That’s 38 years, folks. The data has been interrogated, tortured and water-boarded. Each decade, the total recovery rate has improved. It’s now 89 percent. Partly, it’s medical. But it’s also experiential. Baseball ultimately asks, “What works?”

And the methods that work best — not 100 percent, but very high — become best medical practice. That’s what the Nats are following.

Except Yocum — who performs Tommy John surgery for a living and is the Angels team doctor — says that there is no such consensus. He is aware of no studies, he told Bill Shaikin, which provide any statistical rationale which support the shutdown decision.

And it’s not just the data. Rizzo has relied, he says, on Yocum’s own advice and counsel.  In August, Boswell wrote another column on the matter. There, he talked about Mike Rizzo running into Stephen Strasburg’s father, who was questioning the shutdown decision.  Boswell gave voice to what Rizzo told Mr. Strasburg he was basing his decision on:

The answer takes a long time. It includes decades of statistics on rehabilitation from Tommy John surgery and how annual “innings load increases” have led to disastrous re-injury in the past.

It includes the view of the surgeon, Lewis Yocum, who’s performed all the operations on Nats pitchers in recent years. It is Yocum’s belief that pitchers who break down from premature returns from elbow surgery — sometimes ruining their shoulders, and their whole careers, rather then their new elbows — don’t usually do so during the first big stress year but rather the following season.

If Rizzo spoke to Yocum, Yocum’s comments today are inexplicable.  If Yocum is not lying, however, Rizzo never talked to him and thus could not truthfully tell Stephen Strasburg’s dad that Yocum thought this was a good idea.

Two days later the middle man was eliminated and Rizzo himself said he consulted with Yocum:

“We’re looking at the long term health of the franchise and for Stephen Strasburg,” said Rizzo. “We’ve got a plan, we’ve got a blueprint of how to do this. This isn’t Mike Rizzo’s plan, he didn’t go to Medical school but Dr. Lew Yocum did and Dr. James Andrews did. We’re taking their recommendations and putting them into place.”

Again, Yocum says he never talked to Rizzo. Is he, in light of Boras’ comments this afternoon, going to go back and think harder about whether he was consulted?  If so, what was incentive to say what he told Shaikin?

I have no idea how this is going to shake out. But no matter how it does, it is significant. Not with direct respect whether the shutdown is a good idea. Indeed, it may, ultimately, be a great idea no matter who talked to who. And if Strasburg never gets hurt again and has a fabulous career, give Mike Rizzo his kudos for his prudence.

But make no mistake: if Yocum is telling the truth, the shutdown was Mike Rizzo’s decision, not that of some overwhelming medical consensus, let alone the input of the operating physician. And, if Yocum is telling the truth, it means that Mike Rizzo has been misleading in defending his decision.

Maybe this isn’t significant to you. If I were a Nationals fan, however, I would consider it pretty significant.

  1. goskinsvt - Sep 13, 2012 at 6:00 PM

    jfc enough Strasburg shutdown stories, it’s done.

    • goskinsvt - Sep 13, 2012 at 6:00 PM

      and I’m a Nats fan.

    • thebadguyswon - Sep 13, 2012 at 6:07 PM

      With respect, it is nowhere near done.

      • drunkenhooliganism - Sep 13, 2012 at 6:25 PM

        Until Strasburg retires this story will have legs.

  2. natslady - Sep 13, 2012 at 6:04 PM

    I’m a Nats fan. I don’t consider it important. The decision is made. Can we PLEASE play the games now?

    • paul621 - Sep 13, 2012 at 6:23 PM

      They put the games on hold for this?

  3. goskinsvt - Sep 13, 2012 at 6:13 PM

    What seems inexplicable is a doctor who performs major surgery on a patient and then not having anything to say about the recovery of such a patient.

    • indyralph - Sep 13, 2012 at 6:16 PM

      It’s very explicable. It’s called HIPAA.

      • goskinsvt - Sep 13, 2012 at 6:19 PM

        I meant not having anything to say to the patient, not the public.

  4. btwicey - Sep 13, 2012 at 6:15 PM

    Omg just leave it alone!!

  5. randygnyc - Sep 13, 2012 at 6:19 PM

    I think there probably some miscommunication here. Perhaps the nats have done a study on all the pitchers who have had tommy John. This study may have been done independently of the medical community. Still, these studies COULD be comprehensive and conclusive. The other possibility is that rizzo may have had many conversations with yocum, not specific to Strasberg and not since his surgery. Multiple nats have had this procedure and the protocol may be generic regarding subsequent usage.

  6. sgtr0c - Sep 13, 2012 at 6:22 PM

    Bulls-eye!

  7. natstowngreg - Sep 13, 2012 at 6:26 PM

    This actual Nats fans thinks the most likely explanation is, the recollections by Rizzo and Dr. Yocum are fuzzy. That sort of thing happens all the time in interactions between people. If, however, evidence emerges that one of them lied, that person’s credibility will be damaged.

    Even if it turns out that Rizzo misled us Nats fans about The Shutdown(tm), my acceptance of the decision itself will not change. As I said elsewhere, this was both a medical and personnel decision. Not just about the condition of the kid’s elbow, but about his future performance as an MLB pitcher. Yes, medicine (limited as it was) should have been considered. But it was a baseball decision, and the responsible baseball person (Rizzo) made it.

    As for Boras’ recollections, don’t care.

  8. goskinsvt - Sep 13, 2012 at 6:27 PM

    On Thursday, Yocum clarified his comments by saying he and the Nationals — as well as Strasburg and his agent, Scott Boras — had agreed last year that the team would limit Strasburg’s innings this season. Over the course of this year, Yocum said, he has spoken with Rizzo and the Nationals’ medical staff but has left to the team the decisions about how and when to shut down Strasburg.

    Yocum and Rizzo spoke on Aug. 13, as Strasburg approached his innings limit. The Nationals ended Strasburg’s season after his Sept. 7 start.

    Yocum said he stands behind the Nationals’ decision to shut down Strasburg.

    Rizzo declined to comment.

    Yocum also issued the following statement:

    “I would like to correct the misimpression generated from today’s L.A. Times article, that I have not been a participant in discussions with the Washington Nationals regarding the recovery strategy for pitcher Stephen Strasburg. In fact, I have been contacted repeatedly and have had numerous discussions with the Nationals GM Mike Rizzo and the team’s medical personnel, as recently as mid-August. While the final decision was up to the team, as is standard practice, I was supportive of their decision and am comfortable that my medical advice was responsibly considered.”

    Done. No more stories.

  9. natslady - Sep 13, 2012 at 6:34 PM

    goskinvt–thank you very much. PLEASE, no more stories. Take the games off hold and play them!

  10. gallaghedj311 - Sep 13, 2012 at 6:34 PM

    I met a nationals fan in the Florida keys in June who decided to run his mouth bc my friend was wearing a phillies t shirt. It happened to be Chase’s first game back when he a homer at his first at bat. I thought he was the only Nats fan in the country, but apparently I was wrong. There are at least 3 to 4…..

  11. Old Gator - Sep 13, 2012 at 6:35 PM

    By the time this perfect shitstorm blows itself out,moves back over cold water and dissipates somewhere between Labrador and Iceland, the Gnats will have compiled a substantial dossier of information on the performance of shut-down pitchers following Tommy John Surgery. Then, of course, this entire discussion will become moot.

    Meanwhile, it makes sense to me (but remember, I see in four dimensions simultaneously, in purely fractal terms, and play Ouija Scrabble when it rains, so things make sense to me in a way that would seem merely chaotic to the rest of you) that until somebody compiles records and extrapolates stats about the success or irrelevance of shutting down post-UCL transplant pitchers, we’ll never have any stats to work with.

    And Marty, if you’re going to protest that there’s no control group involved here, well yeah, I agree. So we’ll just publish Rizzo’s findings in The Journal of Irreproducible Results, and I won’t have to cough up a hundred bucks and change for a subscription to Nature.

  12. dakotah55 - Sep 13, 2012 at 6:57 PM

    Don’t worry Craig. You’ve still got Bobby Valentine.

  13. kkolchak - Sep 13, 2012 at 7:04 PM

    I’m a Nats fan, and no, I don’t care about this story for one simple reason: letting Strasburg continue to pitch would have been the EASY decision. Rizzo instead made the tough call, the one he will get roasted for if the Nats fail to win the World Series this year. Clearly, HE believes that he is acting in Strasburg and the team’s best interest and HE is the one getting paid to make the call. The rest of this BS is all just sound and fury, signifying nothing.

  14. vikesfansteve - Sep 13, 2012 at 7:24 PM

    Craig, are you saying Yocum is lying but here is no way Philips was lying?

    • Craig Calcaterra - Sep 13, 2012 at 7:26 PM

      Yocum has recanted his prior statement. Phillips is standing by his.

      • vikesfansteve - Sep 14, 2012 at 8:21 AM

        Same thing with Lance Armstrong and Barry Bonds.

  15. oskyfl - Sep 13, 2012 at 7:43 PM

    I agree the decision has been made but the controversy is still there. Is Rizzo interested in making money or winning the World Series? It’s about the money because if he wanted to win the series he could have had limited the innings of the kid especially when they had such a huge lead. I feel sorry for the kid because playoff baseball is not guaranteed so he may never get another chance.

  16. pbsenerchia - Sep 13, 2012 at 7:51 PM

    Yocum didn’t reverse himself, he clarified, and his statements taken together are not inconsistent. Seems a lot more like Shaikin misinterpreted his initial comments.

  17. wethog66 - Sep 13, 2012 at 8:28 PM

    This media driven story matters because it drives hits to this and other baseball related sites.

  18. schmedley69 - Sep 13, 2012 at 8:57 PM

    I just consulted Dr. Nick Riviera and he agreed that the Nats are a bunch of pansies for shutting down Strasburg.

  19. mojosmagic - Sep 13, 2012 at 9:31 PM

    This is a joke. A pitcher needs to throw to build up arm strength. You baby a guy he will always be a baby. The relationship between Rizzo and Boros is very fishy. An agent should have no say in baseball matters. Who knows maybe Rizzo is getting paid off by Borris to be his lackey.

    • kkolchak - Sep 13, 2012 at 10:05 PM

      Wow–how many professional baseball jobs have you had, know-it-all? None would be my guess.

  20. simon94022 - Sep 13, 2012 at 10:59 PM

    It is amazing that the national media care so much about this, when it doesn’t seem to bother Nats fans at all. Strasburg isn’t even Washington’s best pitcher. He has struggled a bit lately with declining velocity and is coming back fro Tommy John surgery. It made perfect sense for the team to shut him down.

    Craig, when you find yourself making the same arguments as Rob Dibble it’s time to quit.

  21. psunick - Sep 14, 2012 at 8:19 AM

    Yawn

  22. shawndc04 - Sep 14, 2012 at 10:18 AM

    Go back to being shamed, Craig.

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