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Stephen Strasburg's MRI is good news for Nationals, but outlook still uncertain

Washington has one of the deepest starting rotations in baseball, but its chances at winning the World Series will be severely compromised if the team's ace is not available or at his best in October.

On Wednesday night, the Nationals beat the Braves in Washington D.C., but the night was far from a success. Making his first start in three weeks because of elbow soreness, Nats ace Stephen Strasburg was forced out of the game in the third inning due to what his manager, Dusty Baker, described as “a pinch in the back of his elbow.” Strasburg underwent an MRI on Thursday, which the team's athletic trainer, Paul Lessard, said came back clean regarding his elbow ligament but did show a flexor mass strain. Lessard said it is "not a season-ending injury," but there was no timetable given for when the 28-year-old righty might be back in action.

When Strasburg was scratched from his Aug. 22 start and placed on the disabled list retroactive to Aug. 18 due to elbow soreness, Baker, Washington general manger Mike Rizzo and Strasburg himself all termed the move "precautionary," with Rizzo telling reporters, “We’ve been monitoring it for a while. We felt like the prudent thing to do—like we always have with our pitchers—was to give him this reset. We’re going to put him on the DL rather than [have him] pitch through some routine inflammation and soreness."

At the time, Strasburg had been cuffed for 19 runs in 11 2/3 innings over his previous three starts, capped by a nightmarish nine-run outing on Aug. 17 at Coors Field during which he failed to make it out of the second inning. Wednesday's start against Atlanta offered no such yellow flags until Strasburg threw a high-and-outside 0-2 changeup to Braves pitcher Mike Foltynewicz, who was trying to bunt. "Was there slippage there, what happened? He's been pinpoint with the fastball," MASN analyst F.P Santangelo said on the broadcast, before adding, "That was a weird looking delivery all the way."

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To that point, Strasburg had struck out three of the eight batters he'd faced. He'd thrown 41 pitches and averaged 95.5 mph with his four-seam fastball, according to Brooks Baseball, while showing off "as devastating a change-up as he had all season," according to the Washington Post's Chelsea Janes. Strasburg had yielded only a second-inning single to Matt Kemp and a third-inning double to Dansby Swanson, whom Foltynewicz was trying to advance to third. On the next pitch, Foltynewicz struck out by fouling off a bunt, but moments later, pitching coach Mike Maddux, trainer Paul Lessard and the Nationals' infielders gathered around Strasburg on the mound. Baker soon followed with what he described as "a long walk" to check out the situation. After leaving the game, Strasburg departed ballpark without meeting with the media.

Given the September roster expansion, there’s no need to place Strasburg on the disabled list, and he will almost certainly get as much rest as possible and be thoroughly evaluated before returning to the mound. Washington, which enters play on Thursday with an 82-57 record and an 8 1/2 game lead in the NL East, is likely to open the postseason on Friday, Oct. 7, which is just 29 days away. 

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This is the latest injury setback in Strasburg's star-crossed career. Through Aug. 1, the former No. 1 overall pick was putting together the best season of his seven-year career, pitching to a 2.63 ERA and a 2.90 FIP with 10.8 strikeouts per nine while making 15 quality starts out of 20. The only hiccup to that point was his 17-day DL stint for an upper back strain in late June and early July. He pitched to a 2.38 ERA with strong peripherals in his first five starts upon returning, but decided to forgo pitching in the All-Star Game in his hometown of San Diego as a precaution. His aforementioned three-start skid ballooned his season ERA from 2.63 to 3.59. In 147 2/3 innings overall, he has a 3.60 mark and a 2.93 FIP with 11.2 strikeouts per nine, the league's third-highest rate; his total of 183 K's ranks sixth.

Any Strasburg elbow injury, of course, carries with it not only reminders of the torn ulnar collateral ligament he suffered in 2010, 12 starts into his major league career, but of the team's precautionary move to shut him down in September 2012 out of concern that his mounting workload—then at 159 1/3 innings—would prove too heavy for a pitcher in his first full season back from Tommy John surgery. That move was second-guessed throughout the industry and ridiculed in some quarters, particularly after the Nationals were ousted in the 2012 Division Series; they've won just one postseason game since. While Strasburg threw a total of 398 innings with a 3.08 ERA in 2013 and '14, he was limited to 127 1/3 innings last year due to neck, back and oblique injuries, though his arm remained sound. Still, the proliferation of pitchers around the game who have needed a second Tommy John surgery within a few years of their first is enough to make Washington fear the worst given even the slightest elbow-related complaint.

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Given Baker’s notoriety when it comes to  handling young pitchers—particularly Mark Prior and Kerry Wood, both of whom suffered career-altering arm injuries during Baker's 2003 to '06 tenure with the Cubs—some have given into the temptation to blame the manager for overworking Strasburg. However, there’s almost nothing in the pitcher’s 2016 workload to suggest Baker is at fault. Strasburg has thrown 110 or more pitches in a start just three times this season; he had 11 such outings in 2013, four in '14 and one in '15. His season high of 114 pitches, set on April 24, is tied for the fourth-highest total of his career; he had starts of 117, 118 and 119 pitches in '13. Nineteen starting pitchers have three outings of 110 pitches this year, while 30 have more such outings, including fellow Tommy John survivor Jose Fernandez (seven) of the Marlins, and fellow Nats Scherzer (eight), Roark (seven) and Gonzalez (four).

The closest thing to fault one can find with Baker’s usage is that Strasburg’s two innings with at least 30 pitches this year came during that three-start stumble; he needed 33 pitches in the fourth on Aug. 6 against the Giants, and 42 in the first inning on Aug. 17 against the Rockies. We don’t have enough information to untangle cause and effect in those cases, however, though we do have a report that the Nationals “analyzed his mechanics, velocity, spin rate and other indicators, and found no signs of major trouble” before restoring him to the active roster.

Washington's concern is heightened by the fact that, back in May, the club signed Strasburg to a seven-year, $175 million extension, one that further weakened what was already slated to be a remarkably weak free agent class this coming winter. If there's good news for the Nats, it's that they have one of the game’s deepest pools of starting pitching talent from which to draw to fill out their rotation for however long Strasburg is out. Staff co-ace Max Scherzer, who has pitched to a 2.88 ERA and 3.18 FIP, is signed through 2021, Gio Gonzalez (4.40 ERA, 3.86 FIP) has $12 million club options for 2017 and '18, Tanner Roark (2.89 ERA, 3.77 FIP) will be arbitration-eligible for the first time this winter and Joe Ross (3.49 ERA, 3.56 FIP) is just a rookie.

Ross hasn't pitched in the majors since July 2 due to shoulder inflammation and soreness that scuttled his first rehab stint; he's on his second such stint now, and after throwing 42 pitches in a start at Triple A Syracuse on Monday and then an additional 20 in the bullpen, he'll throw roughly 80 pitches in a simulated game later this week, with an eye toward returning to a major league mound next week. Rookies Lucas Giolito and Reynaldo Lopez ranked fourth and 48th, respectively, on Baseball America's midseason Top 100 Prospects list, and while they've both posted ERAs above 5.50 while combining for 10 major league starts, fellow rookie A.J. Cole, a former top prospect whose stock had fallen off, has put up a 3.86 ERA with 8.2 strikeouts per nine in 18 2/3 innings over three starts. 

The Nationals' chances at playing deep into October would be far stronger with Strasburg available than without. For the moment, all they can do is hope that he will be.