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Strasburg’s doctor: there are no studies supporting the Nats decision to shut him down

Sep 13, 2012, 12:33 PM EDT

Mike Rizzo AP

UPDATE II:  Yocum walks it back. Now he says he did talk to the Nats. Oy.

UPDATE: Boras says, nope, the Nats DID talk to Yocum. This is getting interesting.

12:33PM: All throughout the Strasburg Shutdown drama, we repeatedly heard how the doctors were all saying that it’s advisable to shut Strasburg down. That doctors were consulted and that the Nats’ plan was medically sound. Those of us who didn’t like the decision were told that we had to defer to the team and their cadre of medical experts because we, after all, are not doctors.

Only one problem: no one with the Nationals ever asked the guy who performed Strasburg’s surgery what he thought about it and, more significantly, the guy who performed the surgery tells the L.A. Times today that there are no studies supporting the proposition that shutting him down will protect him at all:

The doctor who performed elbow surgery on Stephen Strasburg said he did not tell the Washington Nationals to shut down their ace pitcher.

“I wasn’t asked,” Dr. Lewis Yocum told the Los Angeles Times … Yocum said that, had he been asked, he would not have been able to provide conclusive information about whether Strasburg’s long-term health would be best served by shutting him down.

“There’s no statistic as far as studies,” Yocum said.

Yocum further notes that it’s GM Mike Rizzo who came up with the 160 inning shutdown standard himself. That he imposed it in the case of Jordan Zimmermann, and that he’s doing the same with Strasburg without the aide of any medical directive.

Which, hey, that’s OK in and of itself. Zimmermann has worked out so far, so maybe Rizzo has stumbled upon a bold and effective new standard here. And it is his team and he can do what he wants and what he thinks is best for it.

But given the lack of studies on the matter, those people supporting the shutdown decision have to give up shaming those of us who don’t into silence with some notion that medical necessity or insight governed this decision.  End the erroneous appeals to medical authority — like Scott Boras has done repeatedly — and own up to the fact that it’s Mike Rizzo, not medical science, making this call.

104 Comments (Feed for Comments)
  1. thebadguyswon - Sep 13, 2012 at 12:43 PM

    If the Nats win it all, no one will care about The Shutdown anymore. If not, it will be game on.

    No pressure.

    • Chris Fiorentino - Sep 13, 2012 at 12:52 PM

      It’s a shame because it shouldn’t be that way. The Nationals should be about to enjoy their first post-season trip without having to answer these questions. But because of their loud-mouthed GM, who should NOT have made this thing public, they are going to be asked the questions…and rightfully so. It’s a big story…this is the first time this has ever happened with a player of Strasburg’s talent and a team with the best record in baseball.

      • chadjones27 - Sep 13, 2012 at 5:00 PM

        Rizzo had to make some, if not all, of this public. He wanted Strasburg shut down. The questions would be asked why. And I doubt anyone in the media would have accepted, “because I am the law!” So, Rizzo would have had to explain why.

    • kevinbnyc - Sep 13, 2012 at 1:39 PM

      If they win, I hope they refuse to give Strasburg a World Series ring since he didn’t help them in the playoffs. HA

  2. paperlions - Sep 13, 2012 at 12:50 PM

    The thing is….there isn’t any basis for NOT shutting him down either. Just as no study exists saying he should be shut down, there is no study saying there is no risk to let him throw 200+ innings….because, you know, there has been no study done. When dealing in ignorance, why not err on the side of caution when the potential risk is great?

    • temporarilyexiled - Sep 13, 2012 at 1:05 PM

      What you say makes perfect sense…just as long as the Nationals remain good. If this ends up being their one chance, and they don’t make it, and it’s at least plausible that a team pitching dropoff was the reason, good luck being Mike Rizzo. That said, if John Lannan continues to pitch well, this ends up being too much fuss, and I’m the one playing the fool.

    • cur68 - Sep 13, 2012 at 1:06 PM

      You made my point. Yokum’s not bashing Rizzo, either. He’s just stating the absence of studies. In the absence of evidence they tell us to ask an expert. Since there are no experts in the longevity of a TJS Arm then you are well advised to use caution.

      However, given the dearth of research there’s a wonderful opportunity here. To paraphrase the immortal words of my Introductory Statistics Professor “It is both timely and relevant to ask, how much work can a TJS recipient engage in, in the 2 years following TJS?”

    • thereisaparty - Sep 13, 2012 at 1:22 PM

      There is more than one way to be cautious though. The rigidity of the Nats’ plan and the folly of announcing their intentions were the real mistakes here.

      • voteforno6 - Sep 13, 2012 at 1:28 PM

        So, a team announced its intentions on how to handle a particular situation, and stuck to them. Yeah, honesty of this sort is a real mistake.

      • paperlions - Sep 13, 2012 at 1:35 PM

        Give me a break with that one….if they suddenly announced he was done (rather than announcing an inning limit ahead of time), the uproar would have been deafening and the criticism just as loud.

      • danaking - Sep 13, 2012 at 2:00 PM

        Thereisaparty has a point. Erring ion the side of caution is not a bad idea, and young pitchers who see their innings bumped up too much from year to year do seem to have more arm issues, Tommy John surgery or not.

        But, Rizzo picked an arbitrary number, disseminated about the medical opinions he based that number on, then complicated his situation by running Strasburg out there every fifth day for much of the year, knowing he’d hit his ceiling around Labor Day. Sure, it’s a surprise the nats are this good. Still, once he saw the team was going to be in contention, Rizzo should have started thinking of ways to push back the shutdown date without adding innings. Skip a start here and there. make Strasburg a true “fifth starter:” everyone else pitched on four days rest, but his turn gets missed when a day off would push someone else back. Fewer innings per game. Something. Now he’s going into the playoffs without his best player. That’s a situation a good GM would bend over backward to avoid; Rizzo ensured it would happen.

      • Chris Fiorentino - Sep 13, 2012 at 2:05 PM

        paper…maybe…maybe not. Maybe they ask him to be “injured”. Maybe they work it out before the season quietly. Maybe they keep it under wraps until AFTER the post season. Rizzo didn’t have to answer the questions before the season or during the season. It could have all been internal. They have no duty to tell the media anything. Period.

      • thereisaparty - Sep 13, 2012 at 2:08 PM

        Re: ‘lions

        We have been able to discuss this for months now. If the Nats suddenly shut him down with no advance warning, citing “fatigue” or some similiar reason, there would be far less room to argue with the decision. The analysis would be clouded in more uncertainty and filled with ex post facto narritives.

        Before the year started, the Nats planned on capping Strasburg’s innings (why not pitches?), similar to how they handled Zimmermann the previous season. With the team’s hot start, the questions of Septemeber and October began to arise quite early. Yet the Nationals refused to be flexible. Tom Tango shows that using Strasburg on Saturdays-only (more rest between starts can’t possibly do more harm) wouldve extended his usage throughout the entire season, while only creating two extra “sixth starter” games.

    • braddavery - Sep 13, 2012 at 1:25 PM

      But how do you know the risk is greater then? Maybe shutting him down will somehow create a problem with his arm next season. It can go in circles when there is no basis for any opinion.

      • paperlions - Sep 13, 2012 at 1:39 PM

        You do have to use some logic….would love to hear how staggering the increase in a young pitcher who is recovering from TJ surgery (who pitched 120 more innings this year than last) could possibly increase injury risk. Making up implausible scenarios that are not consistent with what is known isn’t helpful….a lot of things are known about injury risk to pitcher related to age and post TJS, one thing that isn’t is exactly how much wear an arm can take soon in the years following surgery, and how that effect interacts with pitcher age and previous use.

        Again, Strasburg has never thrown 120 innings at any level, he’s already surpassed that by 40 innings this year.

  3. kevinleaptrot - Sep 13, 2012 at 12:50 PM

    That’s interesting, especially when you consider this Thomas Boswell column in the Washington Post on August 14th of this year.

    • kevinleaptrot - Sep 13, 2012 at 12:55 PM

      And this one from July 5th.

      Damn I hate it when I get dragged into beating a dead horse!

    • pantswearer - Sep 13, 2012 at 1:14 PM

      Boswell is a shill for Rizzo and completely dismisses the opposing viewpoint. Not sure how you think this is a “CASE CLOSED” argument you’ve made.

      • kevinleaptrot - Sep 13, 2012 at 3:13 PM

        Strasburg ain’t going to pitch again this year. “CASE CLOSED.”

  4. kkolchak - Sep 13, 2012 at 12:53 PM

    Once again, it isn’t JUST the TJ surgery that is a factor but the fact that Strasburg had yet to pitch more than 110 innings in a single season. I would have more sympathy for the “don’t shut him down” argument if he had still looked as dominating in August and September as he did in April and May. But he didn’t. He was last in the rotation in ERA after the All Star break and and was really struggling with his command at times.

    Funny, but I also remember the Nats getting criticized for supposedly rushing him back to pitch LAST September. Since they are going to get criticized no matter what they do, they might just as well take the cautious approach.

    • 12strikes - Sep 13, 2012 at 1:35 PM

      Your comparing apples (last season) and oranges (this season). The Nat’inals were not in the playoffs last season, so bringing Strasburg back last season made no sense. This year they are in the playoffs and his already pitched 160 innings.

      • paperlions - Sep 13, 2012 at 1:44 PM

        How so? The goal is recovery of the pitcher, if having him pitch last year was consistent with the goal and considered a safe practice, their place in the standings is irrelevant….just as sitting him now should be a decision made with the goal of keeping him healthy for a long time and not made based on the standings.

        Someone is comparing apples to oranges, but it isn’t kkolchak (or Rizzo). The standings are irrelevant to the goal and reasons for the decision and a red herring in this discussion.

      • 12strikes - Sep 13, 2012 at 2:19 PM

        I thought “the goal” was to win a championship?

        If Strasburg was healthy enough to pitch last season, take the winner off, and pitch this season, how is he NOT healthy enough to pitch in the playoffs?

      • paperlions - Sep 13, 2012 at 2:38 PM

        The goal of the team is to win, this year and every year. To best serve that goal, it is best to keep talents like Strasburg on the field for many years. The potential benefit of having him pitch another 9-10 starts (if they went to the WS) is small compared to the risk of having him throw 220 innings (if they didn’t shut him down)….twice as much as he has ever thrown and 180 more than he threw last year.

        Could they have handled it differently? Sure. Will it matter to their chances to win this year? Probably will have a small negative effect….and possibly a positive effect given how badly his pitched the last month.

      • 12strikes - Sep 13, 2012 at 2:51 PM

        Well your goal CAN’T be to win this year if you’re shutting down your best pitcher.
        “Potential Benefit”… Another name for that is World Series Championship.

        Oh in case you are interested since 2000 there have been 4 WS-MVP’s that have been pitchers.

      • The Dangerous Mabry - Sep 13, 2012 at 3:55 PM

        Exactly what criteria are you using to call Strasburg their best pitcher?

      • pdowdy83 - Sep 13, 2012 at 4:49 PM

        12strikes, bringing Strasburg back last year makes PERFECT sense. His rehab was only partially done when the minor league season ended last season and so they brought him back to finish pitching through his rehab. A lot of people are missing a lot of points with this story.

        The Mets are shutting down Harvey at 170 innings. There is talk about the Cubs shutting down Samardjza. The Nationals shutting down Strasburg is on that same plan. He has never pitched more than 120 innings in a season so they gradually build up his arm. I don’t understand why so many people have latched on to the TJ surgery aspect and not the fact that he has no career base for innings at this stage. The only thing the TJ surgery really has to do with it is it kept him from building that base of innings in his rookie season and last year.

      • 12strikes - Sep 14, 2012 at 8:43 AM

        @pdowdy83 – I have zero problems with him pitching at the end of last season. my point is, if he could pitch last season, take the winter off and pitch 5 1/2 months this season, how can they say that pitching another 2 months is bad?

  5. alexb64 - Sep 13, 2012 at 12:53 PM

    I’m shocked there aren’t medical studies dedicated specifically to the development of professional pitchers’ arms. You’d think that would be a perfectly justified use of research money & time. Publicly questioning an organization about something they’re doing to protect a young player whom they’re heavily invested in with guaranteed money is a really great way to ensure many years of lucrative work with professional athletes.

    Look I get the fact that this sucks for Nats fans & it would’ve been best had they scheduled his starts out so that he could pitch a full season + post season without exceeding the innings limit, but as a franchise they have a significant amount of money invested in this guy & (gasp) from their perspective the chance to compete for ONE World Series this year is prioritized behind competing LONG TERM & selling out their ballpark LONG TERM. Of course Davey Johnson hates it, you really think Davey’s concerned about how The Nats are doing 2 years from now? He’s concerned about winning a World Series by any means necessary & at his age probably just retiring for good or temporarily to turn it into one more final big payday.

    I have no issue with finding fault in how they implemented this shutdown, but the people who have nothing invested in this but their widdel feewings & emotions that are questioning that any inning limit what-so-ever was necessary seriously need to get over it.

    • kkolchak - Sep 13, 2012 at 12:57 PM

      “it would’ve been best had they scheduled his starts out so that he could pitch a full season + post season without exceeding the innings limit,”

      Actually, as it turned out they really needed him to be dominant during the season’s first half when their offense was sputtering due to all of the injuries. Had they say, not begun his season until May, they might have won four or five fewer games (especially because Lannan was AWFUL in April at AAA) and would be in a dogfight for the division title right now with a very tough remaining slate of games.

      • someguyinva - Sep 13, 2012 at 1:25 PM

        I don’t think anyone associated with the Nats was counting on there being a post-season back in March, and so including 25-30 post-season innings in the 160 count would’ve looked like a sure-fire plan to get Strasburg to only 130 innings this year. That would’ve meant that next year, when the Nats were supposed to be good, according to the plan, might have included another Strasburg Shutdown drama.

        As for Lannan being awful in April at AAA, I’d bet that some of that was likely due to his not wanting to be there. I’m not saying he’d have been Strasburg had he started the season with the Nats, but I’m guessing he’d have been better there than he showed at AAA.

        Now, you can say “Well, once it became clear that they were good, they could’ve manipulated Strasburg’s routine, skipping starts here and there, etc.” but the counter-claim to that is that this means more wear and tear on a pitcher than does keeping him on a normal every five days routine. Is the counter-claim true? Don’t know for certain, as there may not have been any studies on it, but that’s the argument against the start and stop.

        The decision’s made, however, so we baseball fans are just gonna have to sit back and watch what happens to the Nats this year without Strasburg, because he ain’t coming back till 2013.

    • sknut - Sep 13, 2012 at 1:01 PM

      This is a good point. I wouldn’t be surprised if more teams (if they have not already) put money and resources in trying to avoid injuries and planning for big injuries such as this one.

      What I don’t understand is why at some point didn’t they just place him on the DL for a few weeks in order to stretch the season out so he would be available for the post season. Nobody would have thought oddly if they said he had a dead arm period.

      • kkolchak - Sep 13, 2012 at 1:12 PM

        My take is that they didn’t want to screw up his regimen. This is a guy who got 8-up after getting Icy Hot in his jock earlier this year. 😀

    • thereisaparty - Sep 13, 2012 at 1:27 PM

      “I’m shocked there aren’t medical studies dedicated specifically to the development of professional pitchers’ arms. You’d think that would be a perfectly justified use of research money & time.”

      Elaborate on how you would design such a scientific study. There is just too much noise.

      “Publicly questioning an organization about something they’re doing to protect a young player whom they’re heavily invested in with guaranteed money is a really great way to ensure many years of lucrative work with professional athletes”

      You want to judge a surgeon by his innocuous comments or his ability to perform surgery?

      • churchoftheperpetuallyoutraged - Sep 13, 2012 at 1:54 PM

        Elaborate on how you would design such a scientific study. There is just too much noise.


      • alexb64 - Sep 13, 2012 at 4:10 PM

        “…You’d think that would be a perfectly justified use of research money & time.” I’m going to teach you a neat little trick about internet comments, not everything someone says is meant seriously. Sometimes people will drop hints of this by saying things, just for example, that it would be perfectly justified to use medical research money & time to study the effect of innings on young pitchers’ arms for no other reason than that they make a lot of money & their employers don’t want to pay them to not be valuable.

    • paperlions - Sep 13, 2012 at 1:32 PM

      It isn’t actually possible to do a rigorous medical study of TJ recovery.

      What are you going to do, give 100 guys TJ surgery whether they need it or not, and then assign them to different treatment groups and see how it goes? Yeah, not happening.

      What has happened teams have tried different approaches with different guys, but there is no replication or standardization for strong inference….resulting in a mash of data and some generalities but no absolutes.

      In the end, smart franchises will play it safe with young and uber-talented assets.

      • wlschneider09 - Sep 13, 2012 at 2:02 PM

        It would not be hard at all to go back through all the TJS pitchers and look for a correlation between use and reinjury. You just heave to be careful about drawing conclusions. Other than that I agree with everything you’ve been saying.

      • paperlions - Sep 13, 2012 at 2:13 PM

        I think that is the data available, and I’m sure there are loose correlations with things like # of pitches/games thrown during certain time periods….but there is probably too much noise and stochasticity to draw strong conclusions or to determine thresholds…just to understand generalities.

      • CJ - Sep 13, 2012 at 2:52 PM

        this comment shows you have less understanding of how clinical trials work than you think you do. It’s easily possible. And you should see what is researched these days, something like this would be easily justifiable.

      • paperlions - Sep 13, 2012 at 3:21 PM

        Would love to see that scenario. TJ surgery is fairly specialized/rare compared to other invasive procedures. More importantly, you can’t evaluate recovery for MLB level pitchers by evaluating recovery for people that are not pitchers with both a history of and ability to throw a baseball 90 mph. I’m pretty sure your comment shows more about your lack of understanding of the importance of context than my understanding of rigorous experimental design.

      • alexb64 - Sep 13, 2012 at 9:27 PM

        Okay & AGAIN, I was not seriously saying it was possible. I thought I made that clear, but I guess not.

  6. stikolaboloni - Sep 13, 2012 at 12:58 PM

    GMs have been playing doctor for years, hence the evolution of long relievers, lefty specialists, setup men, etc. There’s no study that ever said if you take a guy out at 100 innings his career will last exponentially longer than a guy who pitches 110 innings. Just like there is no data to suggest Strasburg’s career will last X amount longer if he pitches 160 innings this year vs. 190. Every athlete is different. Nolan Ryan averaged 230 innings over 27 big league seasons. You think he would’ve took a seat in the middle of a pennant race?

    • woodenulykteneau - Sep 13, 2012 at 1:03 PM

      Um, actually, yes there is a study that pertains to the usage of young pitchers, which does say that the more you work a young pitcher, the shorter his career:

      • pantswearer - Sep 13, 2012 at 1:21 PM

        Got anything from the last decade? Pitcher usage, training regimens, medical rehabilitation, and athletes have all evolved over the last 30 years.

      • stikolaboloni - Sep 13, 2012 at 1:23 PM

        Um, clearly you didn’t even read your own little citation. The data is based on pitchers’ rookie year data which it defines as “the major league season in which he pitches 45 or more innings for the first time” which for Strassburg was 2010. But the way more glaring omission is that it doesn’t account for anything said “young pitcher” did before his first big league season and for that reason alone can’t be taken seriously. Some guys at Strassburg’s age pitching their “rookie season” in the bigs have already logged hundreds of innings in the minors. Come back to me with a real study

      • woodenulykteneau - Sep 13, 2012 at 4:00 PM

        Sure, right after you pass your TOEFL.

    • churchoftheperpetuallyoutraged - Sep 13, 2012 at 1:57 PM

      Nolan Ryan averaged 230 innings over 27 big league seasons

      Survivorship bias. There’s a ton of guys who threw a ton of innings at a young age and flamed out due to overuse/injury as well as guys who never had an arm issue at all. For every Ryan/Carlton you want to bring up, there’s a McClain/Valenzuela on the other side.

      • stikolaboloni - Sep 13, 2012 at 2:14 PM

        Exactly. So you indirectly proved my overall point above that “Every athlete is different” and there is no hard data to support that capping his innings at a random number will in fact help or hurt his career

      • churchoftheperpetuallyoutraged - Sep 13, 2012 at 2:46 PM

        no hard data to support that capping his innings at a random number will in fact help or hurt his career

        But what if there’s data to show that Strasburg was wearing down, that he might be getting tired, and then we can show studies that “prove” that pitching tired has a direct increase on injuries. Would that be enough?

      • stikolaboloni - Sep 13, 2012 at 3:08 PM

        Countless variables in play for why he pitched poorly his last two outings. Even if you could clearly define “pitching tired” the argument isn’t that pitching tired correlates to injuries anyway. Barring a CG, every pitcher comes out of every game at some point when they’re deemed “tired.” In Game 1 of the season if a guy throws 8 innings and then comes out because he’s tired, then goes out to start 30 more games that year and pitches 10 years in the majors.. did his career wind down because he pitched when he was tired in Game 1?

  7. mungman69 - Sep 13, 2012 at 12:59 PM

    What will people say when they shut him down and he throws his arm out next year.

  8. bluesnats - Sep 13, 2012 at 1:02 PM

    There wasn’t a need for Mike Rizzo to claim they were following Yocum’s protocol. It’s always a bad idea to lie to the public/press when the truth is easily found out. I’m in the err on the side of caution camp, but this doesn’t help promote the idea.

  9. jfian24 - Sep 13, 2012 at 1:12 PM

    Ah, jeez. I’ve been a supporter of the shutdown, but this certainly changes things. I don’t recall Rizzo specifically citing Yocum, but Stephen Strasburg certainly has. Strasburg referred to Yocum as the doctor that “resurrected” his career and whose advise should be followed. If Yocum was never even asked for advice, then someone appears to have mislead Strasburg into believing the opposite.

    Rizzo definitely has some explaining to do.

    • natslady - Sep 13, 2012 at 1:20 PM

      No, he doesn’t. I listen to Rizzo on the radio every week and when questioned for more details he always says the information is “propietary” and the decision was his alone. Enough already.

      • pantswearer - Sep 13, 2012 at 1:28 PM

        He’s not obligated to explain himself, but he has consistently defended his position with vague medical experts or reports. Now that a medical expert has contradicted him we’re supposed to accept “enough already” and dismiss the issue?

      • 12strikes - Sep 13, 2012 at 1:30 PM

        natslady…. Drinking every drop of the Red, Navy blue, White Kool-aid that Mike Rizzo pours.

        “Propietary”? Has a baseball GM come up with something that Medical Science does not know about. Maybe he has invented the Tricorder? Maybe he hired Theresa Caputo?

      • natslady - Sep 13, 2012 at 1:33 PM

        The medical expert didn’t contradict him. All he said was that there was no conclusive (statistical) evidence one way or the other. Yes, Rizzo said he relied on medical information, but ALL ALONG he said the final test would be the “eye test,” in other words, his scout’s eye and his baseball experience. What is so hard to understand about that?

      • natslady - Sep 13, 2012 at 1:34 PM

        Yup, drinking the 89-54 Kool-Aid. Yep, sure am.

      • jfian24 - Sep 13, 2012 at 1:36 PM

        Seriously? So how did Strasburg come to believe that Yocum had advised this course of action? Is there something in the “propietary” information that says “mislead your player”?

      • 12strikes - Sep 13, 2012 at 1:39 PM

        Glad your enjoying the Kool Aid, since because of Mike Rizzo you sure won’t be drinking the champagne. BTW… Mike Rizzo won in exactly 0 of those games, and they guy his is shutting down (for no goo reason) won 15 of them.

      • 12strikes - Sep 13, 2012 at 1:40 PM

        goo = good.. (Come on HBT, get an edit button)

      • delawarephilliesfan - Sep 13, 2012 at 2:27 PM

        Then listen a little more:

        “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.”

  10. goskinsvt - Sep 13, 2012 at 1:13 PM

    I hate how everyone is acting like if they didn’t shut down Strasburg, they automatically win the WS. Their chances of winning the world series (as someone noted in a previous HBT article) are somewhere in the neighborhood of 12.5% with Stras and 10% without Stras. The entire notion that the Nationals postseason success rests solely on the availability of a single pitcher is asinine.

    • someguyinva - Sep 13, 2012 at 1:28 PM

      Yes. This.

    • delawarephilliesfan - Sep 13, 2012 at 1:47 PM

      Yes, well……5 years from now when the playoff are more routine, you will look back on tiny turning points.

      2008 NLCS – Dodgers have gone up 5-3 in Game 4, and were on the verge of blowing the game with Bases Loaded and 1 out when Chase Utley barely makes a diving cath then flops on to 2nd for an inning ending Double Play. The Phillies get 4 in the 8th to win and go up 3-1

      2010 NLCS – Game 4 Phillies tie the game in the 8th inning and have a runner on 2nd with no body out. They strand him and lose in the 9th to go down 3-1, rather then tie 2-2

      2011 NLDS – Game 5. Need a studly performance from Roy Halladay. They get one – the Cards only score 1 run. The Phillies score zero and go home.

      I could go on and on… point is you need EVERYTHING in your arsenal in the playoffs. You can’t make up for it next week if you lose a game you should have won. Will it hurt the Nats? Maybe, maybe not.

      • goskinsvt - Sep 13, 2012 at 2:31 PM

        Oh I agree and I’m not saying that shutting down Strasburg isn’t going to hurt them, I’m saying the idea that they are a lock to get to the WS with him is ridiculous.

      • delawarephilliesfan - Sep 13, 2012 at 2:35 PM

        Yes, I agree. Those locks have a funny thing of un-latching……still waiting for the 2011 WS parade that was imminent were 98-52 with 12 easy games to go….

    • sabathiawouldbegoodattheeighthtoo - Sep 13, 2012 at 4:04 PM

      Again, this guy pitches in 20% of the games, and about 66.7% of the innings in those games. In the playoffs if it might go up to 25% of the games, but the Nats have some pretty nice alternatives.

  11. shawndc04 - Sep 13, 2012 at 1:22 PM

    >>But given the lack of studies on the matter, those people supporting the shutdown decision have to give up shaming those of us who don’t into silence with some notion that medical necessity or insight governed this decision.<<<

    You have beaten this to death. Rizzo has said that he has studied data about pitchers who have had surgery. Prove to me that he doesn't have information, whether Dr. Yocum knows of it or not. Prove to me that Rizzo hasn't spoken to medical personnel other than Yocum. Tell me why Rizzo would fabricate having facts to support his decision when, as you and others repeat ad nauseam, that the opportunity to win a WS may not occur again in the foreseeable future. As far as I know , you have no investment in the Nationals, nor a management role, and you're frankly not entitled to the information that caused Rizzo to make the decision that he did. As you are not a Nationals fan, I'm not sure why you care; what Rizzo is doing is not illegal, nor unethical. You and the other national "pundits" have never given a rat's rear end about this team so please spare us the fake concern that you have repeatedly expressed. Once again, the decision has been made and Nationals fans are fine with it. Good grief.

    • natslady - Sep 13, 2012 at 1:29 PM

      As Richard Justice said yesterday, if the worst thing Rizzo does in his career is be overprotective of a young pitcher’s arm he can rest easy.

    • pantswearer - Sep 13, 2012 at 1:33 PM

      Rizzo has compelling evidence because Craig can’t prove he doesn’t! Interesting logic.

    • delawarephilliesfan - Sep 13, 2012 at 1:34 PM

      The problem is, Rizzo all along has calimed Yocum as one of his sources. So something doesn’t add up here.

      Perhaps Yocum is now chaging his story, I don’t know. But it does deserve some explaning.

      Frankly, I would not have seen anything wrong had Nats simply said “We are doing this, and that is that”. They chose the medical excuse path. From a baseball persepctive, it changes nothing, but from a PR perspective, this is what happens. Your expert says this, the other expert says that.

      • natslady - Sep 13, 2012 at 1:44 PM

        Agree on that. That’s why I always thought having the doctors weigh in would be counterproductive, and I’m not sure why Yokum is speaking this late in the story… People go for “second opinions” all the time. I wonder why? Probably because doctors don’t agree. And here, when the statistical evidence is admittedly thin, the case studies are few and every athlete is different, all the more reason to trust your judgement in the end, or in this case, to trust your GM’s judgement.

      • churchoftheperpetuallyoutraged - Sep 13, 2012 at 2:00 PM

        The problem is, Rizzo all along has calimed Yocum as one of his sources. So something doesn’t add up here.

        Has Rizzo said this, or has Rizzo quoted a “medical doctor”? The problem I have with Craig’s entire premise is that because Yocum doesn’t know of any study, Craig is dismissing any of Rizzo’s comments vis a vis a medical expert’s opinion. As if there aren’t any other doctors in the field who might have knowledge of this.

        However, if Rizzo has said Yocum specifically has informed the team, I stand corrected.

      • delawarephilliesfan - Sep 13, 2012 at 2:13 PM

        Yes, he specifically sited Yocum on many occasions. Not his only source certainly, but he was ofetn mentioned as a prime source
        “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.”

      • natslady - Sep 13, 2012 at 2:25 PM

        Right. And you can see from Yokum’s quote (below) that he supports Rizzo following the “Zimmermann” program. I’d call that a recommendation. But in the end, Rizzo always said he’d use the eye test.

    • 18thstreet - Sep 13, 2012 at 1:42 PM

      One cannot prove a negative.

    • natstowngreg - Sep 13, 2012 at 2:54 PM

      Hear hear. Someone makes a phony argument, then knocks it down.

      The decision was not just about medicine. It’s also about the ability of someone to perform on a Major League team. The former is the province of Dr. Yocum, Dr. Andrews, and others with vast experience in the care and treatment of orthopedic injuries. The latter is the province of Mike Rizzo and other scouts and personnel types with vast experience in evaluating baseball talent. In the end, the responsibility rested not with the doctor, but the personnel type.

      Yes, the medical evidence is lacking. As Dr. Yocum suggested, the Zimmermann and Strasburg rehabs may well become the precedents. Certainly, they should spark research that will provide insights on rehabbing from TJS. Yes, Mike Rizzo made, and is responsiblefor, the decision. Duh.

  12. delawarephilliesfan - Sep 13, 2012 at 1:24 PM

    Careful Craig, Rizzo has a temper, and as he likes to remind people who didn’t ask, he has been in baseball 30 years

    • voteforno6 - Sep 13, 2012 at 1:33 PM

      I’ll take him over Amaro any day of the week.

      • delawarephilliesfan - Sep 13, 2012 at 1:36 PM

        I agree – I’ll take Rizzo on the Nats anyday of the week too 😉

  13. rockthered1286 - Sep 13, 2012 at 1:44 PM

    Not to take anything away from Stras, who is hands down a better pitcher than anyone in my O’s rotation (and nobody would disagree in Baltimore) but this truly proves that baseball headlines, even in the playoff hunt, are few and far between this year. I don’t think a day passes without a Stras update, even after he’s done for the year. I’m waiting for an article about “Stras eats Strasburger in the dugout” or “Strasburg caught throwing laundry in hamper- TJS issue non-factor.”

    It’s ridiculous. At first I was interested in the whole thing because it seemed assanine to blindly pick an inning cutoff without consulting Yokum, Stras, or Boras. But then I realized- who cares? It’s his team and as long as Stras or Boras aren’t protesting then who cares?

    But again, lack of stat related stories leave us with these human interst pieces trying to run the same story day in/day out with a new spin. Strasburg:HBT::NY Jets:PFT

  14. willclarkgameface - Sep 13, 2012 at 1:52 PM


    • delawarephilliesfan - Sep 13, 2012 at 1:57 PM

      My client will be filing a slander suite against you

      • sabathiawouldbegoodattheeighthtoo - Sep 14, 2012 at 10:59 AM

        Chiropractors aren’t REAL doctors, so no harm done here.

      • delawarephilliesfan - Sep 14, 2012 at 11:26 AM

        Right there with ya, brother.

        I was actually going to pick another one, but that guy had the catchiest URL

  15. sabathiawouldbegoodattheeighthtoo - Sep 13, 2012 at 1:52 PM

    The only way to know a particular person’s breaking point is to push him until he hits it. Then it is too late. While some guys could throw 400 innings a year and be OK, others can’t handle more than 160. I think teams are smart to err on the side of caution here.

  16. tomtravis76 - Sep 13, 2012 at 2:02 PM

    Rizzo has made his bed, and we will see what happens.

    Its a great time to be in the DMV. All of the old Orioles fans who converted to Nats fans are breaking out the old black and orange, while still supporting the Nats. A Beltway World Series would be great. The Ravens are looking like a real Super Bowl contender and RG3 is the talk of the NFL universe.

  17. natslady - Sep 13, 2012 at 2:10 PM

    So, based on the fact that Craig can’t even read a calendar, that his position on the Shutdown is well-known (“idiotic”) and that he has been known to cherry-pick stories for dramatic headlines, I decided to see what Dr. Yokum said in addition to the quote above. As I read it, Yokum SUPPORTS Rizzo’s decision, and he proposes that Zimmermann and Strasburg’s shutdowns might be the model for the future. Oh, Calcaterra left that part out, didn’t he?

    Yocum noted that Rizzo set his own standard with Nationals pitcher Jordan Zimmermann.

    Yocum performed Tommy John surgery on Zimmermann in August 2009; he returned to pitch 31 innings at the end of the 2010 season. Rizzo limited Zimmermann to 161 1/3 innings last season.

    Zimmermann, 26, has not missed a turn this season. His 3.01 earned-run average ranks seventh in the National League.

    Yocum said that process — and not any medical directive — essentially determined how Rizzo would proceed with Strasburg.

    “It’s based on Mike’s experience,” Yocum said. “Mike is extremely confident. His track record speaks for itself. Zimmermann did extremely well.”

    Yocum said the results with Zimmermann and Strasburg might well influence how other teams handle the progress of young pitchers coming back from Tommy John surgery, in which a damaged ligament in the forearm is replaced.

    “If there was a guarantee, everybody would be doing it right now,” Yocum said. “You just don’t know. This may be the beginning of a trend.”

  18. Old Gator - Sep 13, 2012 at 2:13 PM

    Craig, you should be ashamed of yourself for second guessing the lack of medical information.

    See, and you thought we’d given up.

  19. CJ - Sep 13, 2012 at 2:56 PM

    Well, I’ve been saying this all along, and got mocked and ridiculed by nationals fans. Now a doctor with legit credentials is raising the same points, and gets mocked and ridiculed by nats fans.

    The noise in DC is beginning to sound like a Cheezitz commerial: LA LALA CAN’T HEAR YOU!!!!!!!!!!!

    • paperlions - Sep 13, 2012 at 3:47 PM

      Except, of course, that he didn’t say they were wrong…he just said he there wasn’t sufficient evidence to make a decision. Again, if you have to guess, it is best to act with caution.

      • CJ - Sep 13, 2012 at 4:22 PM

        I get that. Saying “bah, who needs him we’ll still win not 1, not 2, not 3…..” isn’t exactly caution.

  20. natslady - Sep 13, 2012 at 3:44 PM

    The headline could read, “Strasburg’s surgeon supports Rizzo, says shutdown could be model for future.”

    And the lede: Despite a lack of conclusive medical studies, Dr. Lewis Yokum respects Mike Rizzo’s decision… etc., etc.

    But that slant wouldn’t support your position, Craig, would it? Seriously, you should consider recusing yourself from Strasburg articles for about a year.

    Yokum just did TJ on another Nats pitcher, Lucas Giolito, who is not a Boras client. Don’t you think (speculation, of course!) that if he didn’t approve of Rizzo’s program he would say, you are damaging my patients’ careers with over-caution, find another surgeon.

    Also, there is NO evidence AT ALL to suggest Strasburg was misled by Rizzo. Rizzo said in February he would follow the Zimmermann program. Jordan Zimmermann and Stephen Strasburg live in the same apartment building, and have discussed their situation. Zimmermann talked to him about what was going to happen and how he (JZ) felt, with the difference that it was not in a pennant race. If Strasburg was “misled” is was by his own wishful thinking, thinking that it might not happen. That is very human, everyone hopes against hope that some dreaded–but certain–future event somehow won’t happen.

  21. florida727 - Sep 13, 2012 at 4:13 PM

    Baseball people are, by nature, statistic freaks (see: Bean, Billy). So here’s some math/stats for you…

    160 innings. 6 innings per outing = 26.6 (call it 27) starts. Pitching once every 5th GAME (not DAY) = 135 games. Last I checked, they play 162. That means they’d NEVER have Strasburg for pennant chase, let alone the post-season. Eventually, Rizzo will wise up. Either that, or don’t start him until, what, July?

  22. sgtr0c - Sep 13, 2012 at 4:24 PM

    It is so hard to get to the world series, so hard…… It is a diservice to the Nat fans, not to to use any and all talents available to them. Especially, during a season the have set themselves up so nicely. It is so hard to get there, anything can happen in future years, their time is now. And they shut down their ace…….

  23. bringingthepain - Sep 13, 2012 at 5:34 PM

    This has nothing to do with baseball,doctors, or the boys arm. This is all his agent Boras doing. Protecting his investment so he can get another deal out of him. Plain and simple.

  24. mrbiz8505 - Sep 13, 2012 at 5:48 PM

    But they weren’t in a playoff race the yr they shut down Zimmerman….

    • sabathiawouldbegoodattheeighthtoo - Sep 14, 2012 at 11:01 AM

      Tendons don’t know when they are in playoff races.

  25. vercmj - Sep 14, 2012 at 1:35 PM

    According to, a Post by Adam Kilgore, who is “The Washington Post’s” Nationals main reporter posted at 6:53 p.m. on September 13, Link: “The Los Angeles Times earlier reported that Yocum said the Nationals never asked him about Strasburg’s innings limit. This evening, Yocum, who is based in Los Angeles, released a statement to the Times regarding his role:

    “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.”

    Dr. Yokum repeatedly was consulted by the Washington Nationals GM, Mike Rizzo, as recently as mid-August, about shutting down Stephen Strasburg. Of course, Dr. Yokum is not going to give an exact number of innings when Strasburg should be shut down. As Dr. Yokum said, that is a team decision, but, in general, Dr. Yokum is supportive of what the Nationals did, and Dr. Yokum, medically supports the Nationals decision. How many times does this have to be said. There is no story here. You are trying to get one, when there is not one. This is typical sensationalism journalism. I am sick of it. It’s one reason people do not give blogs credence nor watch television news and television sports commentators; they are sensationalism promoters, instead of news reporters.

    • natstowngreg - Sep 14, 2012 at 5:14 PM

      Thanks for posting the link to Kilgore’s piece, even if hardly anyone will see it. I’ve been waiting for Craig or one of the other bloggers to post on this, since it answers the questions about the extent to which Dr. Yocum was consulted. As I suspected, it was just a misunderstanding.

      • natstowngreg - Sep 14, 2012 at 5:20 PM

        Apologies. Need to remember to check for updates to the post first.

        *bangs head against wall*

        Still, few will see the update, where Dr. Yocum corrects the original (erroneous) report. That is unfortunate.

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