Why the Strasburg-Rizzo-Dr. Yocum controversy matters

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UPDATE: The he-said, he-said is over. Yocum has reversed himself. Call off the dogs.

5: 54 PM: As of now we have a he-said, he-said when it comes to Dr. Lewis Yocum and the Washington Nationals. Mike Rizzo and Scott Boras say that they consulted the man who performed Stephen Strasburg’s Tommy John surgery before arriving at the shutdown. Yocum says they didn’t, and that he hasn’t spoken to the Nationals since Strasburg’s surgery two years ago.

Who is telling the truth? I dunno. It’s quite possible that Yocum, who doesn’t have the same vested interest here, is forgetting random conversations or wasn’t clear about what Bill Shaikin of the Los Angeles Times was asking him.  It’s also possible that the man who once compared Oliver Perez to Sandy Koufax is … not being completely accurate.  Only time will tell.

But I think it’s wrong to believe that this is all just a little media spat. I think there is a significance to this, because in large part Mike Rizzo and Scott Boras have used the credibility of Dr. Yocum — and medical studies Yocum says do not exist — to defend their decision to shut down Stephen Strasburg. If Rizzo and Boras are being less than honest here, it says something important about their candor with respect to this issue. And when one’s candor is in question, it calls into question their judgment as well.

The shutdown rationale cited by Mike Rizzo, Scott Boras, their media surrogates and many Nationals fans over the past few months clearly relies on Yocum and said medical studies. Look at this Thomas Boswell column from July 5. And when you do so, note that Boswell is widely considered to have very good sources in the Nats’ front office, and many assume he speaks directly to Rizzo on such matters:

Doctors and baseball’s best brains have studied the recovery of pitchers from Tommy John elbow surgery since 1974. That’s 38 years, folks. The data has been interrogated, tortured and water-boarded. Each decade, the total recovery rate has improved. It’s now 89 percent. Partly, it’s medical. But it’s also experiential. Baseball ultimately asks, “What works?”

And the methods that work best — not 100 percent, but very high — become best medical practice. That’s what the Nats are following.

Except Yocum — who performs Tommy John surgery for a living and is the Angels team doctor — says that there is no such consensus. He is aware of no studies, he told Bill Shaikin, which provide any statistical rationale which support the shutdown decision.

And it’s not just the data. Rizzo has relied, he says, on Yocum’s own advice and counsel.  In August, Boswell wrote another column on the matter. There, he talked about Mike Rizzo running into Stephen Strasburg’s father, who was questioning the shutdown decision.  Boswell gave voice to what Rizzo told Mr. Strasburg he was basing his decision on:

The answer takes a long time. It includes decades of statistics on rehabilitation from Tommy John surgery and how annual “innings load increases” have led to disastrous re-injury in the past.

It includes the view of the surgeon, Lewis Yocum, who’s performed all the operations on Nats pitchers in recent years. It is Yocum’s belief that pitchers who break down from premature returns from elbow surgery — sometimes ruining their shoulders, and their whole careers, rather then their new elbows — don’t usually do so during the first big stress year but rather the following season.

If Rizzo spoke to Yocum, Yocum’s comments today are inexplicable.  If Yocum is not lying, however, Rizzo never talked to him and thus could not truthfully tell Stephen Strasburg’s dad that Yocum thought this was a good idea.

Two days later the middle man was eliminated and Rizzo himself said he consulted with Yocum:

“We’re looking at the long term health of the franchise and for Stephen Strasburg,” said Rizzo. “We’ve got a plan, we’ve got a blueprint of how to do this. This isn’t Mike Rizzo’s plan, he didn’t go to Medical school but Dr. Lew Yocum did and Dr. James Andrews did. We’re taking their recommendations and putting them into place.”

Again, Yocum says he never talked to Rizzo. Is he, in light of Boras’ comments this afternoon, going to go back and think harder about whether he was consulted?  If so, what was incentive to say what he told Shaikin?

I have no idea how this is going to shake out. But no matter how it does, it is significant. Not with direct respect whether the shutdown is a good idea. Indeed, it may, ultimately, be a great idea no matter who talked to who. And if Strasburg never gets hurt again and has a fabulous career, give Mike Rizzo his kudos for his prudence.

But make no mistake: if Yocum is telling the truth, the shutdown was Mike Rizzo’s decision, not that of some overwhelming medical consensus, let alone the input of the operating physician. And, if Yocum is telling the truth, it means that Mike Rizzo has been misleading in defending his decision.

Maybe this isn’t significant to you. If I were a Nationals fan, however, I would consider it pretty significant.

Adam Eaton sustains leg injury after tripping over first base

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Nationals’ outfielder Adam Eaton was carried off the field after stumbling over first base on Friday night. In the ninth inning of the Nationals’ 7-5 loss to the Mets, Eaton appeared to catch his ankle on the bag as he ran out an infield single, suffering a leg injury on the fall. He was unable to put pressure on his left leg after the play and required assistance by two of the Nationals’ athletic trainers as he exited the field.

Eaton is scheduled to undergo an MRI on Saturday, but Nationals’ manager Dusty Baker told reporters that it “doesn’t look too good.” It’s the first significant leg injury the outfielder has sustained since 2014, when he went on the 15-day disabled list with a hamstring strain. He’ll likely be replaced by Michael Taylor in center field for the next couple of games, though that could be a temporary fix as the Nationals seek a better solution during Eaton’s recovery process.

Madison Bumgarner likely sidelined through the All-Star break

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It’s been just over a week since Giants’ left-hander Madison Bumgarner got a serious scare after a nasty dirt bike accident. He escaped with bruised ribs and a Grade 2 strain of his left shoulder AC joint, but there was some speculation that the injuries would cause a significant, if not permanent, setback in the southpaw’s career. Thankfully, things aren’t looking quite so bleak today. Not only will Bumgarner not require surgery, but he could return as soon as the week following the All-Star break, the Giants said Friday.

Of course, that timeline is wholly dependent on how smoothly the recovery process goes, so nothing is set in stone yet. NBC Sports Bay Area’s Alex Pavlovic estimates 2-3 months of rest and rehab, including “two months before he can get back on the mound and then another three to four weeks of throwing and rehab starts before he’s big league-ready.” It’s a long and laborious schedule, but still looks much better than any surgical alternative.

Prior to the accident, Bumgarner was working on a solid start to the 2017 season. He maintained a 3.00 ERA, 1.3 BB/9 and 9.3 SO/9 through 27 innings with the club, though his average 1.75 runs of support per start fed into an 0-3 record.