A Problem for Pitchers: How to Handle the Pain

By Chico Harlan
Washington Post Staff Writer
Monday, September 7, 2009

Counting time in the Grapefruit League, the International League and the major leagues, Jordan Zimmermann pitched 111 innings this year. Craig Stammen pitched 149 2/3 . Both only stopped when elbow pain became too much to bear.

The ends for both rookies came with similar epitaphs. They spent weeks -- or months, in Stammen's case -- keeping quiet about elbow soreness, and when they finally spoke up, they needed season-ending surgeries.

The growth of the Washington Nationals, with a backbone formed by young pitching, will largely depend on the development of players such as Stammen and Zimmermann. But Washington's blueprint for rebuilding also places extra emphasis on its ability to balance sometimes opposed desires: The Nationals like to see an attitude that allows pitchers to work through pain; they don't necessarily like the consequences of pitchers who do it.

So when should aching pitchers gut it out? When should they disclose soreness?

"That's a tough question," interim manager Jim Riggleman said. "It's very pertinent."

Riggleman and General Manager Mike Rizzo, asked about the issue, offered similar thoughts -- though abstract guidelines inevitably leave the decision making to the pitcher himself. Riggleman and Rizzo said pitchers must learn the difference between discomfort and pain; the sooner they learn this, the better off they'll be.

"That's the fine line," Rizzo said. "You have to confer with teammates and trainers and veteran pitchers to find out the difference between discomfort and pain, because other than the first day of spring training, there's going to be some kind of discomfort on your body as a pitcher just because it's such a taxing job."

"And when you get to a point where something is more than normal soreness, you've got to speak up," Riggleman said. "Because that might be the indication of something that could blow up on you."

Stammen, who underwent successful arthroscopic surgery on Sunday to remove bone chips in his elbow, is relatively lucky. His injury will require just a six-week recovery and he should be ready for spring training. He pitched the entire season with soreness, only mentioning the pain within the past week.

Zimmermann's injury is far more serious. Washington's top-rated pitching prospect entering the season, Zimmermann first felt elbow pain "maybe a couple starts before the all-star break," he said. He had one start after the all-star break, too, against the Cubs.

"It really started getting bad like towards the end of the Chicago game," he said.

MRI exams would not indicate the full damage until after a subsequent rehab start with Class A Potomac, and Zimmermann required reconstructive elbow surgery -- and will need a 12- to 18-month recovery. Rizzo and Zimmermann were careful to add that there's no way to know when the elbow tear occurred; it's possible that Zimmermann's delay in mentioning the pain in no way changed the severity of the injury itself.

Now more than two weeks removed from the surgery, Zimmermann on Sunday walked through the Washington clubhouse, right arm secured in a black brace that prevented him from extending his arm. Using his left hand, he ate lunch in the players' dining room.

Speaking about his injury, Zimmermann said: "I just thought it was something that pitchers go through, a little pain here and there. I thought it would go away."

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