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Strasburg likely headed for elbow surgery

Strasburg likely headed for elbow surgery

WASHINGTON -- Stephen Strasburg said Friday he was in shock when he learned that he had a significant tear in his ulnar collateral ligament -- an injury that is expected to force to the Nationals right-hander to undergo Tommy John surgery.

Shocked and disappointed are probably the best words to describe the feelings of the Nationals, their fans and everyone else who has enjoyed the phenom's amazing first act this summer.

"It was kind of a shock to me. I really didn't feel anything," Strasburg said during a news conference. "It's good that it happened in a way [now], instead of when we are going to the postseason or getting ready for the World Series.

"It's a new challenge. I want to be the best in everything. Right now, I want to be the best at rehabbing and get back [on the mound]."

Strasburg, who was originally placed on the disabled list because of a flexor strain in his right forearm, had an arthrogram performed on Thursday afternoon to determine if something is seriously wrong, and doctors found ligament damage in the elbow.

He will seek a second opinion from Dr. Lewis Yocum in Southern California before the Nationals make a final decision on surgery, but the club said that procedure is necessary. Strasburg will leave for California on Saturday, with elbow surgery to follow soon thereafter.

Strasburg is expected to be back at 100 percent in 12-18 months.

"We feel there is a significant tear and there is going to be Tommy John surgery," general manager Mike Rizzo said. "Lewis Yocum is one of the leading experts in this field. We are certainly going to listen to what he says, but I anticipate Stephen will have Tommy John surgery."

One person that Strasburg sought out was teammate Jordan Zimmermann, who had elbow reconstruction last August. Zimmermann made his first big league appearance of the year on Thursday.

Zimmerman told Strasburg to work hard and not have doubts in himself.

"He said early on you are going to be questioning myself," Strasburg said, recalling his conversation with Zimmermann. "It's going to be really, really good some days. The next day, it will be tight. So he said, 'You just have to remind yourself that it is 100-percent healthy, just to push through and just stick with the program, not try to do too much. At the same time, get what you need done."

The Nationals knew about the test results as early as Thursday afternoon, but Strasburg requested that the release of the news be delayed because he didn't want to put a damper on Thursday's news conference introducing Bryce Harper, who was taken by the Nats No. 1 overall in June during the First-Year Player Draft.

"We are going to take this news, persevere, move on and get our rotation intact," Rizzo said. "It's depressing, but I look at the brighter side. I look to Tommy John as a surgery that has great success.

"We have a big, powerful 23-year-old right-handed pitcher with power stuff. The success rate for guys coming back from Tommy John and retaining that stuff is very good. We saw two examples of it on the mound yesterday, with [Cardinals starter] Chris Carpenter and Zimmermann. We saw Tim Hudson come back from Tommy John surgery in Atlanta."

Strasburg hurt his forearm on Saturday in an 8-1 Nationals victory over the Phillies. With the Nats leading, 5-1, and one out in the fifth, Strasburg was facing Phillies outfielder Domonic Brown when -- on a 1-1 pitch -- he grimaced in pain and shook his right arm.

Strasburg then motioned for the Nationals' trainer to come to the mound. Manager Jim Riggleman, pitching coach Steve McCatty and head athletic trainer Lee Kuntz came out to see what was wrong with Strasburg, who wanted to stay in the game but left a few moments later.

Strasburg felt the injury was similar to what he experienced at San Diego State University. No damage was found during that time.

"It felt more like a flexor strain than anything," Strasburg said. "It felt like my forearm cramped up.

"As far as the stress test, I didn't feel any pain. That was the thing that kind of threw it off. I think that comes from being strong and flexible to begin with. Who knows when it happened? The bottom line -- it was it is and you have to move forward."

On Sunday, Strasburg underwent an MRI on the forearm, and the team doctor didn't like what he saw, so Strasburg had to wait until the swelling subsided before undergoing an arthrogram.

Strasburg's agent, Scott Boras, said Thursday that there was nothing wrong with Strasburg's delivery and that the Nationals had done an excellent job in the way they have handled Strasburg. Boras said he was on the same page with Washington when it came to developing Strasburg.

"His delivery is fine," Boras said. "The idea of what a guys does when he delivers the pitch as opposed to what he does before the delivery is the issue. We know this and are aware of it. We have heard the 'Curly W Theory' and all of these things. The point is, those references are made to the shoulder -- shoulder injuries.

"Again, Stras is still growing. His body is going to get bigger and he is going to get more strength as time goes on. I have had so many pitchers who have had [Tommy John surgery] and pitched for many, many years."

Almost immediately, Strasburg became the ace of the Nationals' staff, going 5-3 with a 2.91 ERA in the first 12 starts of his career. He currently leads the Nationals in strikeouts with 92.

This marks the second time Strasburg has needed to be shut down because of an injury. On July 28, Strasburg was scratched from his start against the Braves after experiencing right shoulder stiffness during his warm-ups in the bullpen.

Strasburg, the No 1. overall Draft pick in 2009, was warming up just minutes before that game when pitching coach Steve McCatty and Kuntz noticed that something was wrong with the righty after eight pitches. Strasburg told McCatty that he was stiff but could pitch in the game.

Riggleman and Rizzo were informed of Strasburg's arm issue, and Rizzo pulled the plug on Strasburg's start. Strasburg was placed on the DL the next day.

Bill Ladson is a reporter for MLB.com and writes an MLBlog, All Nats All the time. This story was not subject to the approval of Major League Baseball or its clubs.

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