The Faulty Logic Behind the Decision to Shut Down Stephen Strasburg

There's no real proof that benching the Nationals' star pitcher will protect him from future injury.

The Washington Nationals are planning to shut down starting pitcher Stephen Strasburg sometime before the end of the regular season. Strasburg, a year removed from Tommy John surgery on his throwing elbow, is arguably the team's best starter—which complicates the impending shutdown since the Nationals are almost certainly headed for the playoffs (and possibly the World Series). Jake Simpson offers his own take favoring the shutdown here.

The problem is, none of the arguments for shutting Strasburg down are particularly compelling: by putting Strasburg on the bench prematurely, the Nationals are handicapping themselves in the postseason and not giving themselves any discernible advantage in subsequent seasons. The most compelling evidence in favor of Strasburg's shutdown comes from Dr. James Andrews, a renowned sports orthopedist, quoted extensively in Simpson's article. His evidence is rather straightforward:

1. In the 1 to 2 years immediately following TJS, the replaced tendon is weaker than it should be and at greater risk of injury.

2. Should re-injury occur, the recovery rate for a second TJS is extraordinarily low. Having a second TJS is not a career-ender, but it's very close.

The shutdown of Strasburg, then, is predicated on the logic that the shutdown keeps strain off his still-healing elbow (point 1) and thus avoids an injury that would lead to a second surgery (point 2). In other words, the shutdown is a direct response to Tommy John Surgery and its unique recovery pattern. Thus, Strasburg's teammate Jordan Zimmermann, who had TJS in 2009, is a good comparison. Steve Avery and Mark Prior--two pitchers whose careers were cut short due to chronic injury--are not. Neither Avery nor Prior ever had TJS; other than being phenomenally talented pitchers, they have nothing in common with Strasburg.

Related Story

Why the Nationals Are Right to Shut Down Stephen Strasburg

Of course, if one limits themselves to the TJS-specific shutdown logic, an obvious question arises: If the year(s) after TJS are so dangerous, then why pitch Strasburg at all? Surely the 145.1 innings that Strasburg has already logged are equally threatening to his convalescing arm?

By putting Strasburg on an innings limit, the Nationals' argument essentially says this: Dr. Andrews' assertion is correct, but only after a certain number of innings.

How many innings are we talking about? This is a pretty easy calculation.

Strasburg, to date, has thrown 145.1 innings in 25 starts. That's an average of 5.8 innings per start. Starting pitchers appear once every 5 games. Given the Nationals' remaining schedule (38 games remain), Strasburg would be on pace for 7 more starts. Let's assume the Nationals make something of a playoff run and play deep into October, affording Strasburg another 3 starts.

This says nothing of the fact that the Nationals have four off days before the end of the season and could skip Strasburg without disrupting the rest of their rotation, or the fact that expanded September rosters allow the Nationals to get more creative and reduce Strasburg's workload.

Let's assume the Nationals don't get creative with their rotation down the stretch, though, and that Strasburg has as many as 10 starts remaining in 2012. At his current pace, that would be another 58 innings.

In other words, the Nationals are making a bet that while innings 1-145 were just fine, innings 146-204 are potentially dangerous.

Is there anything to this logic? Even Andrews admits there's no discernible benchmark where a post-TJS pitcher enters the danger zone.

Tommy John surgery is fairly commonplace nowadays. It's very easy to look at the body of work of other post-TJS starting pitchers in MLB their first years back after surgery. Here's what a sample of starters yields:

* Pitcher is still active this season

As it turns out, there are relatively few pitchers who approach Strasburg's 2012 total. Many players who have surgery mid-season are not ready to come back until the middle of the following season, with the offseason serving as natural bookends. Strasburg himself, for that matter, falls into that category, having thrown 24 innings for the Nationals last season.

The Cardinals' Adam Wainwright has 15 more innings than Strasburg and will not be shut down in the middle of a pennant race. Only Scott Erickson, Jon Lieber, and Shaun Marcum have any significant body of work after throwing more than 150 innings immediately following TJS. Their post-surgery histories are rather interesting: Erickson had catastrophic shoulder injuries soon after his return to MLB. Lieber's significant injury was to his ankle. Marcum is currently battling elbow injuries, but these came several years after his Tommy John. Marcum presumably represents what the Nationals are worried about--lingering elbow issues years from now. It would be rather difficult to prove that Marcum's current woes are the result of an increased innings count after his surgery, though--especially given the histories of the pitchers who didn't throw many innings immediately after surgery.

The players who did not throw over 150 innings are a mixed bag. Chris Capuano pitched only 33 innings after his first TJS, only to need the same surgery later. Adam Eaton threw only 33.1 innings upon his return, but was eventually felled by finger injuries. Chris Carpenter threw only 6 innings after his 2007 TJS, and missed the entire 2012 season with nerve problems after leading the league in innings pitched in 2011.

All this seems to indicate three things:

1. Many pitchers are injury-prone regardless of their post-TJS workload,

2. Many of these injuries do not even involve the weakened elbow--or even anything in the throwing arm, and

3. Any suggestion that the additional innings Strasburg could throw in 2012 would cause injury is tenuous, at best.

It seems foolish to ignore the medical opinion of Dr. Andrews, but seemingly the Nationals already have by pitching Strasburg at all in 2011 and 2012. By shutting him down, all they're doing is compounding their mistake: reducing their chances of winning a championship without doing anything to appreciably prevent injury.