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Surgeon: Nats 'playing it safe' with Strasburg shutdown

Friday - 9/7/2012, 4:32am  ET

AP: 4ad03fe4-7ea9-4838-949d-e9761fc8e126
Washington Nationals starting pitcher Stephen Strasburg delivers a pitch against the Arizona Diamondbacks during the first inning of a baseball game on Friday, Aug. 10, 2012, in Phoenix. (AP Photo/Ralph Freso)
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Paula Wolfson, wtop.com

WASHINGTON - Today is the day Nationals fans have been dreading. It's Stephen Strasburg's last home start of the season.

Management is standing by its decision to shut down the pitching ace after 160 innings - a limit he'll reach next Wednesday on the road against the New York Mets.

Strasburg says he feels fine two years after his elbow surgery. Many fans are upset that team management is standing firm on his shutdown, with the playoffs right around the corner.

But Dr. Scott G. Edwards, the chief of hand and elbow surgery at Medstar Georgetown University Hospital, understands.

"I think management was just playing it safe, and I give them a lot of credit for making that tough decision and standing by it."

Edwards has performed the type of surgery that repaired Strasburg's elbow. The operation is called "Tommy John surgery," named after the legendary Dodgers southpaw who was the first to undergo the procedure back in 1974.

The surgery involves a very important ligament that stabilizes the elbow. That ligament can tear or rupture from the repeated stress of hard throws.

"It is not possible to simply take the frayed ends - like the end of a rope - and kind of whip stitch them all together and expect them to heal. So you have to replace that tissue, in this case, a ligament, with something else," Edwards says.

That "something else" is a tendon that gets little use in another part of the body. And the problem is, that tendon has to learn its new role, and the arm must be reconditioned. It's a process that can take a very long time.

The higher the caliber of the athlete, the less chance he has of getting back to his full potential, Edwards says.

But Strasburg is doing well -- much better, in fact, than predicted at the start of the season when the 160- inning limit was set.

Some fans have complained that an easy way around the 160-inning limit would have been to pull Strasburg for a while and hold him in reserve for a possible championship run.

But Edwards says that is absolutely the worst thing the Nats could do.

Strasburg's conditioning would be out of whack and he would face the real possibility of another injury, perhaps to his shoulder if the team pulled him, Edwards says.

"It is not like parking your car in a garage and expecting it to run well two months later. It is a dynamic process."

As long as Strasburg and team management are smart about it, the two-year-old repair to Strasburg's elbow should last a very long time, despite the wear and tear of every single fast ball, he says.

Helping the pitching ace stay in top form is a team of doctors, physical therapists and trainers.

Sports physical therapist Scott Epsley, who works with many of Edward's patients at Medstar Georgetown, says it's fair to say Strasburg won't be just sitting on the couch after the shutdown.

"You can't just stop with this kind of athlete because things do de-condition. So they need to continue some things over the off-season," Epsley says.

He expects Strasburg to do some throwing pretty much on a daily basis, as well as strengthening exercises that have become part of his routine.

"He is just not going to be doing nothing right now. There's no time off," Epsley says.

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