Let's take a look at Tommy John recovery, on the day WSH hands the ball to Detwiler

[Warner2BruceTD]

The Nats are handing the ball to Ross Detwiler with their life on the line, based on a random inning limit number for Strasburg chosen out of a hat supported by zero medical evidence.

Last night, I wrote down a bunch of guys who had Tommy John surgery, and then planned to research their recovery to see if I could find some trends to back up the Nats decision. My research ended after I examined the first name on my list. Tommy John.

Tommy John's first five seasons after "Tommy John" surgery. Keep in mind that this was nearly 40 years ago, and the first surgery of it's kind. I would like to think we've made advancements since then:

1976 - 207 ip, 10-10, 3.06 era
1977 - 220 ip, 20-7, 2.78 era
1978 - 213 ip, 17-10, 3.30 era
1979 - 276 ip, 21-9, 2.96 era
1980 - 265 ip, 22-9, 3.23 era

John would go on to pitch 9 more seasons after 1980, two of which where he threw over 200 innings.

Post surgery, John threw nearly 2600 innings and won 164 games in 14 seasons. Basically, an entire career. Granted, Strasburg throws much harder than John, who was a finesse pitcher struck out 3.4 batters per nine innings during his post surgery run, but there is also no medical evidence that velocity has anything to do with re-aggravating these types of injuries. Strasburg would be just as likely to re injure himself during inning 90 as he was during inning 150 as he would have been inning 200 or even next year at some point. That Tommy John post surgery workload would make people cringe today. But why? Because Mark Prior couldn't stay healthy a decade ago?

Sometimes, people get hurt. Sometimes, people are injury prone. Each body is different. If Strasburg is going to break down again, you can't stop it. If the Nats were 20 games out, shut him down, because although it may not matter, it also can't hurt. But that obviously wasn't the case.

So now Ross Detwiler takes the hill to save the Nats season.

 

[ThomasTomasz]

You never know. Guys like Prior and Ben Sheets kept getting injured no matter what. Then, you've got pitchers who can go out there and no matter what, throw around 200 innings a year and never have a problem.

My problem with this is I understand the Nationals wanting to limit Strasburg coming back. He has yet to even pitch a full season. However, don't start the year thinking you aren't going to make the playoffs and throw Strasburg out there to start the season. Limit him early, and then bring him back leading into June so you have a fresh arm during the summer, and if you were going to have a shot at the playoffs, then let him keep pitching. That is what the Nats should have done.

 

[Slateman]

Tommy John spent a year and a half away, recovering. He had also pitched 200+ innings in a season before. He was 31 when he was injured and was not a power pitcher. And he was a lefty.

Also, I'm curious how Strasburg would somehow enable the Nationals to score more than 4 runs in the past two games.

 

[Warner2BruceTD]

Tommy John spent a year and a half away, recovering. He had also pitched 200+ innings in a season before. He was 31 when he was injured and was not a power pitcher. And he was a lefty.

Also, I'm curious how Strasburg would somehow enable the Nationals to score more than 4 runs in the past two games.

So if staying away 18 months would have enabled Strasburg to throw 1200 innings the next five years, why didn't the Nats do that? At least they would have been following some sort of evidence.

And i'm not sure how John being older makes him less susceptible to injury. Strasburg is younger and stronger. Also not sure how being a lefty against being a righty makes a difference.

Look, this was not meant to be an apples/apples comparison. The point is 35 years ago people were coming back with no kid gloves and not only staying healthy with heavy workloads, but producing at a high level. The Nats picked a number out of a hat based on....what exactly?

 

[NAHSTE]

Yay let's compare innings totals from two totally different eras and pitchers!

 

[Warner2BruceTD]

Yay let's compare innings totals from two totally different eras and pitchers!

Yes, I dug a little deeper and discovered they were tossing underhand in 1979. My bad.

 

[Warner2BruceTD]

Also, Adam Wainwright, 204 innings and counting this season.

 

[Leftwich]

Posts like this need to be on the frontpage

Sent from my DROID4 using Tapatalk 2

 

[Slateman]

So if staying away 18 months would have enabled Strasburg to throw 1200 innings the next five years, why didn't the Nats do that? At least they would have been following some sort of evidence.

And i'm not sure how John being older makes him less susceptible to injury. Strasburg is younger and stronger. Also not sure how being a lefty against being a righty makes a difference.

Look, this was not meant to be an apples/apples comparison. The point is 35 years ago people were coming back with no kid gloves and not only staying healthy with heavy workloads, but producing at a high level. The Nats picked a number out of a hat based on....what exactly?

Now, please dig through the history of young, power arms who threw a ton of innings with little to no build up. It's litered with names like Mark Prior, Kerry Wood, Josh Johnson, Steve Avery, etc

Combine that with recovery from TJS be prescribed by doctors as having a reduced work load during the comeback season and the decision to shut him down was a no brainer.

 

[Warner2BruceTD]

Now, please dig through the history of young, power arms who threw a ton of innings with little to no build up. It's litered with names like Mark Prior, Kerry Wood, Josh Johnson, Steve Avery, etc

Combine that with recovery from TJS be prescribed by doctors as having a reduced work load during the comeback season and the decision to shut him down was a no brainer.

I can also dig through history and find hundreds of names of young power pitchers who threw more innings than any of those guys, nary an issue.

We tend to only remember the people who got hurt.

Again, where is the medical basis for the innings cap post Tommy John surgery? Where is it? If you are telling me they capped Strasburg based on his age/prior workload, that's fine, but that's not what the Nats were saying.

 

[Slateman]

Nationals medical staff and Dr. Yocum. It was combination of work load and TJS.

And if you had watched Strasburg's last couple starts, it was time. Dude was struggling. High pitch counts, bad command, arm slots changing. He was done.

Strasburg wouldn't be starting today anyway. Not on three days rest. And I fail to see how he could have helped the previous two games. Cardinals flat out owned the Nationals pitching and the Nats couldn't hit a beachball.

 

[Warner2BruceTD]

I guess i'm very skeptical of the idea of being able to keep pitchers healthy. I believe pitchers who are going to get hurt are going to get hurt eventually no matter what.

I'm not suggesting pitchers should go back to throwing 300 innings (although i'm 100% certain there are some pitchers who could handle this today, like they did not all that long ago), but i'm fairly certain that if teams returned to the practice of training young pitchers to handle large workloads, instead of the current practice of babying them up the ladder, we'd see stronger arms and more durable pitchers. There is plenty of data that has come out that supports the idea that pitchers are getting hurt more often now and that the sport is seeing more DL trips as opposed to pre-1991 or so when the low inning caps and changed mindset on young pitchers picked up steam.

The Rangers have ditched the idea of slowly working guys up, and have gone back to trying to build horses. They have not seen their minor league pitchers dropping like flies like some have suggested would happen. The young pitchers on the major league staff have stayed healthy. The only guys they've had trouble with are the guys they've yanked back & forth from the bullpen to starting.

We've been babying pitchers for 20 years, and the results have gone backwards. Baseball is intentionally building fragile arms. When do we stop?

 

[Warner2BruceTD]

For every Prior, there is one of these guys http://www.baseball-reference.com/players/b/buehrma01.shtml

For every Avery, I can give you one of these http://www.baseball-reference.com/players/s/sabatc.01.shtml

Heavy workloads from age 20 or 21 onward. 200, 220, 240 innings every year, no DL trips in two decades combined.

You can't predict this stuff.

 

[Kuzzy Powers]

That first post looked like the beginning of a REALLY good article that would never be posted on the front page. :golfclap:

I agree wholeheartedly that the whole being safe thing with Strabourg is really based on little to no evidence and is strictly a fear based thing, and is like one of those unwritten rules of sports that coaches/managers are afraid to break. Its hard to blame the Nationals when you're dealing with such a young player with such an explosive arm, but in the end its going to be a vital aspect in costing their team from going deep in the playoffs, as they really could've used his arm this series. It'll be interesting to see if the Nationals continue to limit him again next year. Its even stranger to me because if anything all evidence points towards the elbow coming back stronger than before. A lot of coaches/managers are way too scared to think outside the box in all sports.

 

[Slateman]

There is little evidence. Dr Andrews said as much. He also agreed with the decision for an innings limit.

Dr. Yocum said that he agrees with the decision.

Dr. Yocum & Dr. Andrews opinions > W2B

 

[Mogriffjr]

I kinda agree with WTB. I mean the kid is throwing side sessions every 2nd day after his start likely, as well as warming up throwing pitches in the pen to make sure he's warm and ready. I really didn't see the harm in an extra 20-30 innings but hey I guess that's why i'm sitting here typing this.

The real fault was starting him so damn early in the season. They could have put him on a program that would have led to him pitching his 160 IP more towards the end of the season as opposed to early September, much like how the Braves did Medlen.

 

[Senser81]

There is little evidence. Dr Andrews said as much. He also agreed with the decision for an innings limit.

Dr. Yocum said that he agrees with the decision.

Dr. Yocum & Dr. Andrews opinions > W2B

But its kind of stupid to listen to the doctor's opinions on something like this. If a football player gets injured, any independent doctor can say "you shouldn't play football ever again...you might get injured". But thats not really a reasonable response. Pitching is an unnatural motion for the shoulder/arm, and there is always potential for injury. So a doctor can always say "If you keep pitching, you might hurt yourself again". Great, thanks fo the update!

I don't understand how anyone can defend the Nationals' handling of Strasburg. Its almost childish in a way, and not very creative or pragmatic. How about this...just rest him for the entire 2013 season next year, because he might get hurt.

 

[NAHSTE]

Detwiler pitched very well, to his credit.

 

[Woy]

Detwiler pitched very well, to his credit.

Holland'd

 

[Slateman]

But its kind of stupid to listen to the doctor's opinions on something like this. If a football player gets injured, any independent doctor can say "you shouldn't play football ever again...you might get injured". But thats not really a reasonable response. Pitching is an unnatural motion for the shoulder/arm, and there is always potential for injury. So a doctor can always say "If you keep pitching, you might hurt yourself again". Great, thanks fo the update!

I don't understand how anyone can defend the Nationals' handling of Strasburg. Its almost childish in a way, and not very creative or pragmatic. How about this...just rest him for the entire 2013 season next year, because he might get hurt.

So, just so I'm clear, you think it's stupid to listen to the two foremost experts at this type of surgery, including the one that actually did the surgery?