Call it the never-ending debate
Jayson Stark [ARCHIVE]
August 16, 2012
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The first thing you need to know about Stephen Strasburg's Shutdown Day is that it's going to happen.

No matter how loudly you scream, no matter how eloquently you argue, no matter how many compelling counterpoints you present, the Washington Nationals aren't changing their minds. Period. That's a wrap.

So there is going to come a day, sometime in September, when the Nationals pat their ace on the butt, place his golden right arm in bubble wrap, and say, "Thanks for playing." It's as inevitable as the next Kristen Stewart tabloid blockbuster.

Got that? Excellent. All right, now here's the other thing you need to know about Stephen Strasburg's Shutdown Day:

We're never going to know whether this was the right move or the wrong move.


Doesn't matter if the guy goes on to make his next 486 consecutive starts. Doesn't matter if he breaks down in 2013 or 2018 or 2028. We'll never know. Never. Can't possibly know because we don't live in a what-if world.

It would be awesome if real life were scripted by, say, the creators of "Lost," or the screenwriters from "Sliding Doors." Then we would know what might have been if the Nationals were to decide, "Aw, what the heck. Let's let this guy keep pitching."

But in the absence of parallel universes, we're stuck with this universe. So, as Shutdown Day draws ever closer, the Nationals understand they have no choice but to live with whatever happens. And we give them credit. They're prepared to do that. Or that's what they tell us now, at least.

Those are the facts, friends. And the facts aren't changing. But those facts don't stop people all over baseball from asking, as one NL executive did the other day: "Where's the proof? Where's the proof that if they do this, he won't get hurt?"

And the facts won't stop other people from saying, as another exec did: "I don't think I've ever seen a situation like this. And I don't think I understand it."

There are so many voices just like theirs, uttering those same words. So our mission, with the story you're about to read, is not to spread more hysteria. It's to help each other understand what this team's decision is all about -- but also to examine a couple of key arguments for the other side. So ready? Here we go:

Where's the proof?

Let's start with this important message:

This isn't a decision the Nationals made after clicking on a couple of articles on WebMD. This isn't a decision they made just to see how many Twitter comments they could generate.

Nats general manager Mike Rizzo told ESPN he made this call after consulting with one of America's most esteemed orthopedists (and noted Tommy John surgery pioneer), Dr. Lewis Yocum, and other sports-medicine experts. And guess what?

The sports-medicine community couldn't be more delighted to see a team -- any team -- take a courageous stand like this, with a player this prominent, on a team that might be risking its shot to win a World Series in favor of protecting its ace's health.

Let's hear now from three members of that community -- three men who have spent years trying to peer beyond the surface of pitchers and their often-troubled arms:

-  "In baseball, this is as groundbreaking as 'Moneyball' was in 2001," said Stan Conte, senior director of medical services for the Dodgers and a man who has been tracking baseball injury data for more than a decade. "They're taking something off the blackboard and putting it into practice, and I don't know if they're right or wrong. Only the future will tell us. But at least this is not another case where somebody is following tire tracks in the snow off the side of the cliff just because that's the way a lot of people did it before. In baseball, we've done that repeatedly. And there are a lot of wrecked cars at the bottom of that cliff."

-  We also spoke with Dr. Jeffrey Guy, medical director and team orthopedist at the University of South Carolina, who trained under Dr. James Andrews at the American Sports Medicine Institute and who, like Strasburg, was a pitcher at San Diego State.

One of Guy's missions, dating back to his work with Andrews, has been a proactive effort to promote pitch counts, innings limits and periods of prolonged rest to protect young pitchers as far down the chain as Little League. And he is gratified, he said, to see signs that "that mentality is spreading … and now it's finally getting into all levels of the game, even with a pitcher like Strasburg."

As part of Guy's work, he constantly preaches to young pitchers the need to be shut down -- to "let your body recover, let your ligament recover, let your elbow recover." And it's "amazing," he said, how well even injured pitchers bounce back from those rest periods, "and how strong they feel because they rested."

-  Finally, we spoke with Dr. Glenn Fleisig, who works with Andrews at the American Sports Medicine Institute and is widely described as America's most prominent expert on biomechanics. He cited a remarkable ASMI study of teenage pitchers that showed that pitchers who "regularly kept pitching after they were fatigued were 36 times -- that's 3,600 percent -- more likely to have surgery than not have surgery."

"I've been doing research here with Dr. Andrews for 25 years," Fleisig said. "I've done studies where we find two times, three times, five times. I've never found any other study with a 36-times factor."

All of these men made it clear that, although they're following this story, they would never tell any team what to do. It's not their team, their pitcher, their patient.

But if we were to judge the Nationals' stance on Strasburg strictly from a sports-medicine perspective, there would be almost no question that shutting down a pitcher with his history, before he pitches past the point of arm "fatigue," is an intelligent approach to protecting their player.

However …

Is there "proof" that pulling the plug on Strasburg's season -- at 160 innings, 170 innings or any other number -- will keep him healthy? Here's the bad news: There's none. No matter how they handle him.

For one thing, Conte's research has shown that an incredible 50 percent of all starting pitchers wind up on the disabled list anyway. Yessir, 50 percent. And the rate for pitchers 25 and under is even higher. So chances are, Stephen Strasburg is likely to land back on the disabled list sometime in the next couple of years whether he pitches 160 innings this year or 260. Remember that, OK?

Second, there isn't nearly enough information about pitchers who fit Strasburg's profile to guide the Nationals or anyone else. There have been studies, such as the one we just cited, that look at teenage pitchers. But there has never been a similar study, anywhere in the...
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