Hit and Run: Cano's stomach woes; Strasburg on disabled list once again

In today's Hit and Run, Jay Jaffe checks in on Robinson Cano's stomach and how it may be to blame for his season-long slump and touches on Stephen Strasburg heading to the disabled list yet again.

1. Cano’s woes difficult to stomach

Robinson Cano has struggled to live up to the 10-year, $240 million deal he signed with the Mariners in December 2013, and that's been particularly true this season. But at long last, an explanation that goes beyond the inevitability of aging and his move to a much-less-hitter-friendly ballpark may be at hand. Via USA Today’s Jorge L. Ortiz, the 32-year-old second baseman has been battling stomach problems since last August:

[Cano] started experiencing stomach discomfort in August. With the Mariners in the playoff chase, he didn't get it checked until their season was over, in October. Cano said he was told he had a common parasite, which was treated with antibiotics, but he was left with acid reflux to this day.

"It still affects me," Cano said. "Sometimes you drink water and it makes you feel like vomiting. I can't eat the same way I did. It's hard to deal with, especially being the first time this has happened to me. Sometimes I eat only once a day before playing, because I feel full. And you just don't have the same energy."

...An avid seafood eater, Cano has eliminated red meat from his menu because it takes long to digest, and the acid reflux delays the digestive process. Despite diet changes and medication, the condition persists.

Cano hit .324/.391/.465 through August of last season but slumped to .265/.333/.398 in September, and he’s been even worse (.248/.289/.363 with five homers) this year. His 87 OPS+ is miles below last year’s 143 or his career 125, while his 17.6% strikeout rate is his career worst, and his 3.5 strikeout-to-walk ratio his worst since his 2005 rookie season. He’s heated up slightly since I checked in four weeks ago, but his performance (.264/.309/.448) would still pass for a cold spell during most of his career.

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​Cano’s woes are at least somewhat reminiscent of those of another Mariner: centerfielder Franklin Gutierrez. After a breakout 6.6-WAR season in 2009, Gutierrez won a Gold Glove in '10, but his offense tailed off considerably from year to year. He was diagnosed with irritable bowel syndrome in early 2011, but his performance continued to decline amid other injuries and a diagnosis of ankylosing spondilitis, a type of arthritis that affects the spine and that may have further contributed to his stomach woes. In early 2014, he decided to sit out the entire season. After rebounding to hit .317/.402/.500 for Triple A Tacoma this year, the now–32-year-old flychaser rejoined the Mariners in late June and has gone 4-for-15 in a reserve role.

Fortunately for Cano, his career hasn’t been derailed to the extent that Gutierrez’s was. But it sounds as though he and the Mariners still have a ways to go before the problem is fully in the rearview mirror.

2. Strasburg out, again

The frustration continues for Stephen Strasburg. Just as the 26-year-old righty was finally pitching up to his potential, he left Saturday's start in the fourth inning and landed on the disabled list for the second time this season, this time due to an oblique strain.

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Facing the Giants at Nationals Park, Strasburg allowed only a second-inning walk and a third-inning single before exiting with two outs in the fourth due to tightness in his left side. Tanner Roark came out of the bullpen to throw 4 1/3 innings of two-run ball in relief while his teammates beat up on Madison Bumgarner and Yusmeiro Petit for a 9–3 win. An MRI taken on Sunday revealed that Strasburg had suffered a strained oblique, and he was placed on the DL, where he could remain for a month.

Strasburg already spent just over three weeks on the disabled list in late May and June due to a strained left trapezius muscle. At the time, he was amid the worst stretch of his career, having pitched to a 6.55 ERA, with four of his final five starts lasting four innings or fewer, two because of departures due to injury. Since coming off the DL, he had been much better, throwing five scoreless innings against the Braves in his June 23 return, then seven innings of two-run ball against the Phillies on June 28 with a season-high nine strikeouts and 113 pitches. Over his three post-injury starts, he had lowered his ERA to 5.16.

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With 12 wins in their last 15 games—including a three-game sweep of the Giants—the Nationals have built a season-high 4 1/2-game lead in the NL East, thanks in large part to their rotation rounding into form. The unit has pitched to a 1.87 ERA over that span, with the starters allowing two or fewer runs in 13 of 15 starts and at one point reeling off a 48-inning scoreless streak, the second-longest in MLB history; that stretch included Max Scherzer's no-hitter. Eight of the 21 runs allowed by the starters in that span came in Roark's spot start in the nightcap of their June 28 doubleheader.

It remains to be seen whether the 28-year-old Roark or 22-year-old rookie Joe Ross is tabbed to fill Strasburg's rotation spot. Roark, who put in a strong rookie season last year with a 2.85 ERA and 3.47 FIP in 31 starts totaling 198 2/3 innings, has made six starts and 15 relief appearances for the Nationals this year, but his numbers have dipped to a 4.33 ERA and 4.66 FIP in 60 1/3 innings this year with just 4.3 strikeouts per nine and 1.3 homers per nine. Ross, a former first-round pick by the Padres who was acquired in the Steven Souza Jr./Trea Turner/Wil Myers trade, has put up a 2.66 ERA with an eye-opening 23/2 strikeout-to-walk ratio in 20 1/3 innings over three starts for the Nationals. He last pitched on July 1, so it remains to be seen whether he gets pushed back from his next start at Triple A Syracuse. It's possible the team could wait until after the All-Star break to sync him up with the rest of the big club's rotation.

As for Strasburg, while there's reason to be relieved that as with the last injury, this one isn't arm-related, the underlying reality is that both injuries are borne of deeper mechanical woes that the team has not addressed and that may continue to resurface in one form or another so long as that’s the case.