Steven Strasburg is an enormously talented 24 year-old baseball player, who has already established himself as one of the very best pitchers in the Major Leagues. Strasburg missed most of last season after undergoing “Tommy John surgery” to repair his elbow.
The normal protocol in the year after Tommy John surgery is for a pitcher to throw between 160 and 180 innings, and then stop for the remainder of the season. Otherwise, the thinking goes, the repaired arm will endure too much stress, creating a high risk of a breakdown that year or in the next few.
Heading into this season, there was little reason for Strasburg’s team, the Washington Nationals, to consider deviating from this protocol, which so far has worked well for another excellent young Nats pitcher, Jordan Zimmermann. Now, though, the Nats unexpectedly find themselves with the best record in baseball, and with a real shot at playing in, and winning, the World Series.
Without Strasburg, the likelihood of that much success would decrease. Nonetheless, the Nationals are adamant that they will follow the usual protocol and shut down their star pitcher, probably in early September.
Is this a good decision?
I believe that clearly it is, assuming the 160-180 inning limitation has a sound empirical basis. The Nationals are a young, up-and-coming team that, with a healthy Strasburg, could compete for championships for years. Moreover, there is nothing close to a guarantee that the Nats would win it all this year with Strasburg pitching for the duration.
Nor should we assume that the Nats won’t make, or win, the World Series without their star pitcher. The team possesses two starters who are comparable to Strasburg right now (Zimmermann and Gio Gonzalez), and two more (Edwin Jackson and Ross Detweiler) are maybe half a run per game worse, as I rate them. In addition, John Lannan, a capable starter, waits in the wings.
Under these circumstances, it would be foolish to take any appreciable extra risk to Strasburg’s health in the name of trying to maximize this season’s prospects.
But would pitching Strasburg more than 180 pitches entail any appreciable extra risk? Or is 160-180 number just an arbitrary compromise between doctors, who err on the side of the patient and covering themselves, and baseball management that wants to maximize short-term return on investment? Amidst all the discussion of one of the most interesting decisions in the history of baseball, it’s difficult to find any specific analysis of this question.
But this is the essence of the issue. The Nats unexpected quest for the championship shouldn’t prompt them to take risks that ignore evidence regarding pitchers’ health. But it should require them to take a closer look at the evidence.
This piece by Jayson Stark, the best I’ve seen on the subject, suggests that what some describe as decades of empirical evidence about the risk of pitching more than 180 innings after Tommy John surgery comes down to two pitchers who ventured to 200 innings or so. Both of them, Josh Johnson and Kerry Wood, suffered serious injuries thereafter.
Stark also cites a study of teenage pitchers that shows a huge additional risk associated with pitching regularly after being “fatigued.” But Stark doesn’t say that the study shows the point of fatigue to be 180 innings. In any event, the fatigue point for older pitchers probably is not the same as for teenagers.
If these fragments are the only empirical evidence supporting the 160-180 number, I’d be tempted to allow Strasburg to pitch beyond 180 innings this year. However, I would probably resist the temptation.
But there are alternatives to simply letting Strasburg pitch regularly until he reaches the magic number and then shutting him down. Some have suggested shutting him down earlier and then starting him up again for the playoffs. But that would seem to heighten the risk to the pitcher, given the extra work involved in revving up again after being shut down.
A more sensible approach would be to have Strasburg miss one start and then have him pitch, say, once a week for five innings. This would give him ten more starts, which would just about preserve him for a full playoff run, assuming a 180 inning limit.
If the issue is fatigue, as it appears to be, then putting Strasburg on a schedule that increases rest time between starts represents a smart way to minimize risk, quite apart from the goal of prospering in the playoffs. Many years ago, as I understand it, baseball had its “Sunday pitchers,” aging veterans who just pitched once a week. The great Lefty Grove worked such a schedule with very good results in his waning days with the Boston Red Sox.
Using this approach with Strasburg would also give the Nats helpful flexibility. If they find themselves in a one-game, wild-card playoff, they might be able to move Strasburg up a few days – which they certainly would want to do if Gonzalez and Zimmermann aren’t available. Same thing with a deciding game of a playoff series. And if a particular game warrants six innings from Strasburg (e.g., to assist a tired bullpen), another game might be compatible with four innings of work.
So that’s what I’d be inclined to do. But all that matters is what the Nats will do. And their decisionmaker, GM Mike Rizzo, has made it clear that he intends to pitch Strasburg in a normal rotation until he reaches approximately 180 innings.