Strasburg Likely to Have Tommy John Surgery

All of those pitch counts, timetables and plans to not injure Stephen Strasburg's golden arm?  They didn't work.

The Nationals said Friday that their star rookie pitcher has a "significant tear" in his elbow ligament and probably will have Tommy John surgery.

General manager Mike Rizzo said that an enhanced MRI taken a day earlier revealed the extent of the injury to the right elbow. The significant tear is in his ulnar collateral ligament.  Click here to learn more about this type of injury.

The 22-year-old right-hander will travel to the West Coast for a second opinion (preferably not from Rob Dibble). But Rizzo says he anticipates Strasburg will require surgery, ruling him out for 12 to 18 months.

"As you can imagine, he was initially upset," Rizzo said. "But he has really turned himself from being upset to being focused on his rehabilitation. He's determined to get the surgery done and begin the process of rehabilitation."

If he does have the surgery, it will most likely be done by the same surgeon that performed Jordan Zimmermann's similar operation. Zimmerman took Strasburg's place in the rotation Thursday night, his first major league start after elbow ligament replacement surgery in August 2009. He allowed five runs on seven hits in four innings in a game the Nats won 11-10 in 13 innings. They used eight pitchers.

The news of Strasburg's injury brings an abrupt halt to his promising first season. He struck out 14 batters in his major league debut in June and is 5-3 with a 2.91 ERA and 92 strikeouts in 68 innings. He had been kept on strict pitch counts and was to be shut down once he reached about 105 innings.

A month ago, Strasburg was placed on the disabled list because of inflammation in the back of his right shoulder. He was making his third start since returning from the DL when he had to leave Saturday's game against Philadelphia after throwing a change-up to Domonic Brown.

"The player was developed and cared for in the correct way, and things like this happen," Rizzo said. "Pitchers break down, pitchers get hurt and we certainly are not second-guessing ourselves."

Doctors believe Strasburg hurt himself on a particular pitch, as opposed to a gradual buildup, Rizzo said. When Strasburg grimaced in Saturday's game, he told the team he had felt something similar at San Diego State and had continued to pitch through it. Doctors have decided that what happened in college was unrelated to the ligament tear.

All week, Strasburg has said he is strong enough to pitch.

"Stephen felt pretty good and still feels OK," Nationals President Stan Kasten said. "And that's why this has been so confounding."

Strasburg was informed of the diagnosis Thursday night, but the Nationals chose not to announce the news because it would have upstaged the introductory news conference for 2010 No. 1 draft pick Bryce Harper.

So is this the end of Strasburg's career? No. Tommy John surgery has become so common that pitchers don't actually dread it any more.  In fact, some people say pitchers who have it come back stronger.

The Nats' opponent Thursday night, the St. Louis Cardinals, started Chris Carpenter, a pitcher who came back from Tommy John surgery. Carpenter, 14-4 this season, is a perennial Cy Young candidate again since he came back in 2008.

"You go back to Tommy John and how it’s evolved over the course of time, it’s definitely at the point where it’s not a negative anymore,” Rays manager Joe Maddon told the Associated Press earlier this year. "You do believe that if it happens to a young guy, you know you’re going to have him back and possibly even better. It’s the world we live in, man.”

Strasburg even better after the surgery?  That's up for debate.  But at least we know there's now life (and a healthy career) after Tommy.

Stay with and NBC4 for more information.

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