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Stephen Strasburg receives second MRI today

The Nationals will receive their clearest indication yet about the status of Stephen Strasburg's treasured right arm today after the 22-year-old rookie undergoes an arthrogram exam. The Nationals will not receive the results until Friday, results the team says will determine the course of action they take with Strasburg for the rest of the season.

The arthrogram, a more intricate version of an MRI exam in which dye is shot into the area in question, is a standard procedure.

The Nationals have labeled Strasburg's affliction a flexor tendon strain in is his right forearm. Recovery from that injury includes simple rest and rehab, according to one major league team doctor, and does not require surgery.

The arthogram will reveal if anything else is amiss with Strasburg's forearm/elbow area. Earlier this season, Nationals starter John Lannan suffered from a flexor tendon strain but did not receive the second MRI. He missed one start before rejoining the rotation and eventually falling into poor mechanical habits.

Last year, the Nationals were uncertain what was wrong with Jordan Zimmermann's elbow until they administered an arthrogram. The test revealed Zimmermann required Tommy John surgery to replace the ulnar collateral ligament, which attaches to the flexor tendon. (After more than a year away from the majors, Zimmermann will start tonight against the Cardinals.)

Strasburg, while also throwing on a five-day rotation for the first time, has never thrown this many innings -- 123 1/3 between the minors and majors -- in a such a short period of time. The enhanced, unfamiliar workload makes any young starter fatigue and often, the doctor said, a callow pitcher will respond by altering his mechanics and over-throwing so he doesn't lose velocity.

"He'll do everything he can to throw 97 miles per hour," the doctor said, speaking in general terms. "It sets up a red flag. You look for a sign in his delivery. Why is this happening? It's something you've got to ask."

Since Strasburg has shown two signs of weakening as the year grinds along -- he also went on the disabled list at the end of July with inflammation in his shoulder -- the cautious approach may be the only the option the Nationals have. "I don't think they have a choice" but to shut him down for the year, the doctor said.

By Adam Kilgore  |  August 26, 2010; 11:28 AM ET
Categories:  Stephen Strasburg  
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Next: Today's lineup

Comments

"'I don't think they have a choice' but to shut him down for the year, the doctor said."

That quote is meaningful only if it was from Dr. Rizzo, Dr. Kasten or Dr. Lerner.

Posted by: joemktg1 | August 26, 2010 11:54 AM | Report abuse

Wait a minute - did Kilgore just call Strasburg "callow" ("lacking adult sophistication; immature")? And if so, will he be joining Dibble in the time-out corner?

Posted by: HHover | August 26, 2010 12:14 PM | Report abuse

@Hhover:
The word "callow" was part of an indirect quotation from an unnamed "doctor":

"...and often, the doctor said, a callow pitcher will respond by altering his mechanics..."

So, "callow" was, at worst, Kilgore's choice of words to summarize "the doctor"'s thoughts.

Posted by: bertbkatz | August 26, 2010 12:24 PM | Report abuse

Just do it. Don't force it. It's not like we're in playoff contention.

Posted by: PattyinSJ | August 26, 2010 12:30 PM | Report abuse

I'd sure be interested in knowing who this "doctor" is who is quoted as an authority in the article. Is there a reason he was given anonymity? Is he a real doctor or did he stay in a Holiday Inn Express last night?

Posted by: Section222 | August 26, 2010 12:30 PM | Report abuse

The hierarchy of this team is terrified that if they send him out to the mound for another start that irreputable damage will occur, and with all the talking heads(espn,mlb network,masn,comcast,and Boz) predicting doom if he pitch's again this season,well what are they to do? My guess is that we won't see "The Kid" until spring training 2011.

Posted by: dargregmag | August 26, 2010 12:38 PM | Report abuse

"the ulnar collateral ligament, which attaches to the flexor tendon." I'm not a doctor, but I don't think that's technically correct. Ligaments generally attach bone to bone, and if Wikipedia is correct, the UCL attaches the humerus (upper arm bone) to the ulna (elbow/forearm bone) - http://en.wikipedia.org/wiki/Ulnar_collateral_ligament_%28elbow%29

Tendons generally connect muscle to bone, and the flexor tendon is what attaches the forearm muscle to both the ulna and humerus - http://en.wikipedia.org/wiki/Flexor_carpi_ulnaris_muscle

so, the UCL and the origin of the flexor tendon are in the same AREA, but they're not specifically connected to each other.

Posted by: TheBorg | August 26, 2010 12:53 PM | Report abuse

I would be shocked if Stras pitches again this year. We can put the available rotation spots to good use to get a look at Zimmermann and Maya, to see if Marquis is truly back to his old form and to assess whether Olsen should be offered arbitration or not. Lots of questions to be answered that will impact offseason decisions.

Posted by: slopitchtom | August 26, 2010 12:53 PM | Report abuse

@bertbkatz - you are right, of course, so perhaps it's the anony-doc who should join Dibble.

@dargregmag - I think you hit it on the head. There are 2 separate questions: what's the right thing to do, and what's the easy thing to do.

If the 2d MRI shows no problems and he's otherwise fine, then I think sending him out for a few more starts, to get the conditioning and experience, is probably the right thing to do. But the easy thing to do--certainly in terms of the potential for criticism--is to just shut him down.

Even if the Nats brain trust decides #1 is the right choice, it's hard to see them not going with #2.

Posted by: HHover | August 26, 2010 12:56 PM | Report abuse

Indeed. Maybe he played a doctor on tv?

---

I'd sure be interested in knowing who this "doctor" is who is quoted as an authority in the article. Is there a reason he was given anonymity? Is he a real doctor or did he stay in a Holiday Inn Express last night?

Posted by: Section222 | August 26, 2010 12:30 PM

Posted by: natsfan1a1 | August 26, 2010 12:57 PM | Report abuse

Here's a third question: what is "irreputable damage"? Is that the injury no one is allowed to talk about?

**********
@dargregmag - I think you hit it on the head. There are 2 separate questions: what's the right thing to do, and what's the easy thing to do.

Posted by: Sec3mysofa | August 26, 2010 1:16 PM | Report abuse

I'll field this one. What is injury to an anatomical part of ill repute?

Posted by: natsfan1a1 | August 26, 2010 1:22 PM | Report abuse

Or in a blog post.
_____

Indeed. Maybe he played a doctor on tv?

Posted by: natsfan1a1 | August 26, 2010 12:57 PM |

Posted by: Section222 | August 26, 2010 1:25 PM | Report abuse

Did they do an MRI test prior to signing him? Seems odd how fast he tubed. I would be stunned if he ever has a dominant year. Maybe the biggest bust ever. Washington has been cursed for a long time.

Posted by: southportwave | August 26, 2010 1:26 PM | Report abuse

Well played, 222. ;-)

Posted by: natsfan1a1 | August 26, 2010 1:27 PM | Report abuse

Hi, folks. Can someone please catch me up? What happened with Dribble? I heard something about Nyjer's suspension/appeal on the radio last night but not about the other item.

Shame about the Cubs' series. Am home recovering from yet another knee surgery... Doc said yesterday it's ok to go to a baseball game as "therapy" but the way the Nattles have been playing, not at all sure attendance would be therapeutic. Anyway, where are the day games when you need them?????

Any word on Nyjer's appeal? Don't feel Riggs gave him support, if that quote is correct.

Posted by: Nats_Lady | August 26, 2010 1:29 PM | Report abuse

Hey Gang-Ho hum...by my (casual) count, the O's are 13-9 under Buck. And I'm on record as being a fan of Riggs.
Go Nats

Posted by: zendo | August 26, 2010 1:30 PM | Report abuse

Feel better, Nats_Lady. (I'm guessing that if you follow the links in the prior post, you'll find something on the Dibble "controversies.")

Zendo, I'm not a stats guru but (1) small sample size, (2) remember how last year many were proclaiming Riggles a genius? Seems like many are saying otherwise now. (Personally, I'm still not convinced that a managerial change makes a major difference in w-l record.)

Posted by: natsfan1a1 | August 26, 2010 1:35 PM | Report abuse

@Nats_Lady -- The way the Nats are playing, if you go to a game as knee therapy you won't have to worry about jumping up and down to cheer too much.

Posted by: Section222 | August 26, 2010 1:41 PM | Report abuse

Nat's_Lady; First and foremost hope you have a safe and speedy recoverey, Nyjer threw a ball into the stand's and hit a fan during the Philly series and mlb is punishing him. Rob Dibble dared to question SS toughness, and NO! don't risk your knee at the ballpark stay home and recover, while your knee might be getting better it's your mental well being that i'd be concerned about, watching this team could prove detremental to your overall mental health.(LOL!)

Posted by: dargregmag | August 26, 2010 1:41 PM | Report abuse

Well Zendo, since you brought it up. It's time for a change. Though it might not be Riggleman's fault, the team needs to find a young smart manager who brings a little life into the clubhouse.

It's been mentioned before that this is a very important off season, no reason to continue status quo in the managerial dept.

Posted by: sjt1455 | August 26, 2010 1:42 PM | Report abuse

Also, if you're following at home and kick the dog/cat, you could reinjure. (Just kidding. I know you wouldn't do that. :-))

---

@Nats_Lady -- The way the Nats are playing, if you go to a game as knee therapy you won't have to worry about jumping up and down to cheer too much.

Posted by: Section222 | August 26, 2010 1:41 PM

Posted by: natsfan1a1 | August 26, 2010 1:45 PM | Report abuse

sjt1455: we HAD "a young smart manager" and he got run outta town...

re: Dribble-- couldn't find a quote, but I too have wondered whether Stras might not be as tough a bird as, say, Livo. On the other hand, he's probably been told and told and told and told to mention the slightest twinge and NOT to "play through" pain or stiffness.

Posted by: Nats_Lady | August 26, 2010 1:50 PM | Report abuse

Shut him down, and bring back Dibble. Free speech n all that.

Posted by: alex35332 | August 26, 2010 1:51 PM | Report abuse

I've narrowed down the list of possible doctors:
http://tinyurl.com/2zb3rl
http://tinyurl.com/2fyx7wd

Posted by: Sec3mysofa | August 26, 2010 1:52 PM | Report abuse

@Nats_Lady: I guess we should never draft another young stud pitcher because the current one keeps getting hurt

Posted by: sjt1455 | August 26, 2010 1:53 PM | Report abuse

Can someone please elaborate as to why Strasburg was rushed to the Majors back in June?

Posted by: ImWithStupid | August 26, 2010 1:57 PM | Report abuse

Princess Grey and Lady Silver (my kitties) don't seem to be baseball fans. They do like to play the piano, though, usually just at the same time when I'm trying to play it.

I'm nervous to go to the game by metro, as last time (before surgery but still with brace on my knee) I almost tripped over a tourist's luggage. But, unlike RFK (grrrrrrrrrrr), the only handicap parking at Nationals Park is $40. For that money I could take Metro Access to the game and cab home (which might be the best choice). They are very nice about getting you a wheelchair at the park, so that's not an issue.


Posted by: Nats_Lady | August 26, 2010 2:02 PM | Report abuse

Things could still change obviously, but Rizzo did reiterate on the John Riggins show yesterday that Riggleman will be the manager next year.

Posted by: marathoner | August 26, 2010 2:04 PM | Report abuse

"Can someone please elaborate as to why Strasburg was rushed to the Majors back in June?"

I think it was something along the line of "he has nothing left to learn down here." His performance certainly doesn't indicate he's an AAA pitcher, something you can't say about half the Nat's pitching staff. Is there really a case to be made that he's not one of the best five starters in the organization?

My guess - he'd be having the same issues if he'd been pitching these innings in Syracuse on five days rest, so no harm was done by the decision. I would expect the facilities and personnel available to deal with them are a bit better at the ML level.

Posted by: zimbar | August 26, 2010 2:27 PM | Report abuse

Wanted:

1 hitting catcher
1 slugging first baseman
1 hitting second baseman
1 slugging right fielder
1 slugging center fielder

Posted by: 6thandD | August 26, 2010 2:41 PM | Report abuse

I'm pretty much sick of saying this but as long as Jim Riggleman is manager they will not win nor will they contend for a wild card or division crown,all of us who post on this blog know that the players know that Riggleman is not going to get in their sh#t even if they stink the joint up and even if he decides to that would be out of character for him soooooooo that would be ineffective,Rizzo is pretty much putting himself in the crosshairs by backing Riggs, now what happens if they lose 100 games?

Posted by: dargregmag | August 26, 2010 3:04 PM | Report abuse

Wanted:

1 hitting catcher
Answer: Ramos, hopefully. Catchers that can hit, whether they hit for power or average, are a rare commodity in baseball. Ramos has a chance to be one.

1 slugging first baseman
- You mean Dunn, right? Who else are they going to get? Pena, a Boras client, is available, but he posted numbers worse than Dunn this season. If were playing here, I imagine you'd want to replace him, too.

1 hitting second baseman
Answer: Espinoza, hopefully. He can't possibly be worse than Kennedy.

1 slugging right fielder
Like who? There aren't any top quality outfielders on the market for 2011. One possibility is that they sign Pena and move Dunn to the outfield (see response to slugging 1B).

1 slugging center fielder

- See above. Slow down. We need some players that can get on base and run in the leadoff spot. Furthermore, sluggers in the OF don't tend to be very good fielders. Give Morgan another year. They aren't close enough to contention to start upgrading through free agency.

My hope is that Espinoza and Ramos can provide offense comparable to what Desmond produced this year. If so, barring injuries to RZ or Willingham, I expect we'll see significant improvement on offense.

Posted by: jboogie1 | August 26, 2010 3:09 PM | Report abuse

now what happens if they lose 100 games?

Posted by: dargregmag | August 26, 2010 3:04 PM | Report abuse

We are playing for draft picks now anyway. Too bad the hOe's beat us to the punch 2 months ago in that game.

Just enjoy the rest of the season- and the opportunity to see what Jordan Zimmerman, Yunesky Maya, Wil Ramos, and Danny Espinoza might be able to do.

Also, enjoy going to baseball games for $10/seat. That's one of the biggest things I am missing, having moved away... (sigh).

Posted by: jboogie1 | August 26, 2010 3:17 PM | Report abuse

jboogie1 = StanK?

Posted by: Section505203 | August 26, 2010 3:43 PM | Report abuse

Carlos Pena instead of Dunn? Well, of course Pena would be attractive to the Nats, since he can be signed for lower money than Dunn.

We have heard from some posters that we should not give a long-term contract to Dunn, because Dunn will be 33 or 34 at the end of a 3 or 4 year contract. What could easily happen is that the Nats will sign a guy who is older already, in 2011, as a cheaper alternative to Dunn. In other words, we will not have to wait a few years for age to start showing. Maybe we can get that upper age range at the start of a new contract for some guy, if Dunn is dumped. Kind of funny, if that happens.

Anyway, Pena is hitting .212. Supposedly, at 32, Pena is only two years older than Dunn. However, given Pena's great drop-off in performance, do we know he is only 32? Just wondering.

Posted by: EdDC | August 26, 2010 3:48 PM | Report abuse

Shut.Down.Strasburg.NOW. There is no reason (outside of increasing his IP / injury risk) to keep throwing him this year. The system probably has enough 'talent' available between the DL (JZimm, Detwiler) & minors (Chico, Martis, Maya) to keep the big club plodding forward for the rest of the year.

I'd initially hoped for a 73-75 win season, but will begrudgingly settle for 67-69 wins (need a 14-21 record just to get to 67 wins) if four farm teams get to the playoffs (SYR, HAR, POT, VT).

Posted by: BinM | August 26, 2010 4:57 PM | Report abuse

I like binM's observations. Bring up the solid AAA pitchers like Chico, Martis, etc. and give them a shot at ending the year with some reasonable momentum heading into 2011. 2010 is over given the current management.

Posted by: clinton56 | August 26, 2010 5:39 PM | Report abuse

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