By Adam Kilgore
Washington Post Staff Writer
Wednesday, July 28, 2010; D01
First, the initial steps of their nightmare scenario unfolded. On Tuesday night, Stephen Strasburg played long toss in right field, his typical warmup. He moved into the bullpen and threw maybe five pitches, grimacing after at least one. Then the Washington Nationals scratched Strasburg from his start against the Atlanta Braves after the pitcher had "trouble getting loose in the bullpen," General Manager Mike Rizzo said.
Next came the relief.
The Nationals consider Strasburg day-to-day after a body of medical tests revealed right shoulder inflammation and soreness but no structural damage, Rizzo said. An X-ray came back negative, and an MRI exam taken before the game ended showed no changes from the MRI the Nationals performed on Strasburg immediately after they signed him last summer -- no damage to his labrum or rotator cuff.
"That's good news," Rizzo said. "You always like the positive news that the caution that you showed was worthwhile. This is something, given a couple a days rest, he should be better."
The Nationals are not planning for Strasburg to visit any more doctors or undergo any more tests. He will take a regimen of anti-inflammatory medicine, and the Nationals will gauge Strasburg's condition Wednesday before determining their next course of action. They have not ruled out Strasburg making his next start as scheduled, give or take a day.
"We're not going to eliminate anything," Rizzo said. "We're going to be cautious with him."
"Chances are, it's nothing severe," said a major league medical source who has not worked with Strasburg but is familiar with his circumstances. "A guy that valuable, they might say, 'Wait a minute, hold it.' A regular guy, you give him some anti-inflammatory, have him throw a side in two days and get him out there. This guy, you might wait a month or so. He's a different animal. But I wouldn't be overly concerned."
The larger concern is what might be causing Strasburg, noted for impeccable mechanics, to suffer the inflammation. The biggest worry is the strain of throwing in the upper 90s, no matter how sound a pitcher's form.
"Obviously, there's a reason for this," said the source. "Is he fatigued? There's a lot possible reasons. They are going to have to figure out why he is tight. There's no question it's a red flag. You can only throw 98 or 100 for so long."
There is also the public-relations aspect of handling an injury to Strasburg. If Strasburg pitches soon and aggravates his shoulder, "there's going to be a lot of people asking a lot of questions," the source said. "I don't see the gain in pushing him out there. With a young pitcher, it's important to shut him down. They were smart [Tuesday]. I take my hat off to them."
Strasburg had no symptoms and offered no warnings this week, Rizzo said, and had not felt any similar sensation as a professional. Strasburg did endure similar stiffness and inflammation at San Diego State. He threw a clean bullpen session over the weekend and felt fine after playing catch Monday.
Strasburg went through his typical pregame routine. Early Tuesday afternoon, Strasburg appeared calm, at ease. He sat at his locker watching video on his laptop, then moved to a clubhouse couch comfortably. He laughed when a clubhouse attendant told a joke.
He long-tossed in right field of Nationals Park, his normal program. Things changed when he entered the bullpen. He threw four or five pitches, and pitching coach Steve McCatty could sense something off. He asked Strasburg how he felt. "I feel stiff," Strasburg said. "My shoulder's stiff."
"I didn't see anything," Iván Rodríguez said afterward. "[But] he wasn't looking the way that I always see him when I catch him in the bullpen."
McCatty got the attention of bullpen coach Jim Lett, who dialed a phone connected to the dugout to speak with Manager Jim Riggleman. He and McCatty spoke briefly and decided Strasburg could warm up more and try to loosen his shoulder, but knew that would not be the prudent decision. "I didn't hear in Steve McCatty's voice that this has got a chance to be something real serious," Riggleman said. "Hopefully it's not."
Trainer Lee Kuntz called Rizzo in his office, and "I pulled the plug on it," Rizzo said.
Strasburg retreated into the clubhouse, where Nationals medical director Wiemi Douoguih administered a labral test and capsule test -- he placed his hands on Strasburg's shoulder to test the strength of the labrum and rotator cuff. He was fine. Strasburg showered and left Nationals Park to undergo the X-ray and MRI exam. Rizzo intimated the problem may have sprung from a full season of pitching every fifth day for the first time. In college, Strasburg started only on weekends, and he is still growing familiar with the routine of a professional pitcher.
Strasburg has been scratched as a professional before. In the Arizona Fall League last year, he was scratched with a stiff neck. Before the final start of his season, Strasburg heard a "pop" in his knee. Both ailments amounted to nothing more than temporary inconveniences. That was his neck and his knee, though. This was his arm, perhaps the most valuable appendage in baseball.
"I definitely was worried," center fielder Nyjer Morgan said. "But it hasn't really hit me yet. When we lose one of our guys, it kind of sucks, especially a talent like that. He's definitely a big part of this piece we're trying to get built here."
When emergency replacement Miguel Batista was announced as the starting pitcher, the large crowd at Nationals Park, expecting to see the 22-year-old phenom, booed. The only thing missing was the sound effect after a Whammy appears on the game show "Press Your Luck."
Batista gave them a show, shutting out the Braves for five innings before handing it over the bullpen to finish off a 3-0 victory. Before the second inning, though, some fans could be seen exiting Nationals Park, walking up Half Street to the Metro. A chant arose: "We Want Strasburg! We Want Strasburg!"
"A lot of people come to see Stephen Strasburg pitch," Rizzo said. "Disappointed that they're not going to see him. Unfortunately, I can't worry about that. I need to worry about the long-term longevity of the pitcher and what's good for the franchise."
Before the end of the night, Strasburg returned to Nationals Park from the hospital where he had received his tests. He walked into the entrance of the clubhouse for a moment, then turned around and walked briskly away with Douoguih down a corridor to avoid a reporter. Strasburg had not pitched, but the Nationals had avoided a nightmare.
Staff writer Dave Sheinin contributed to this report.