Stephen Strasburg may not pitch again in Washington until 2012, and the news is devastating for baseball fans. (Photo: Associated Press)

The news couldn't be much worse for Washington Nationals fans: Stephen Strasburg will require Tommy John surgery, causing him to possibly miss the entire 2011 season.

For the nuts and bolts of the news, Adam Kilgore at the Washington Post has some good background.

Nationals Fanboy Looser says Nats fans "can take heart in knowing TJ surgery isn't the death sentence many used to think. Tim Hudson. Chris Carpenter. Josh Johnson. Jordan Zimmermann."

Watch the immediate response come in on Twitter, and we'll add more reaction as it comes in from across the country today.

5:48 p.m.: For some advanced baseball talk, Chris O'Leary, who calls himself an expert at pitching mechanics, has a bleak outlook for Strasburg's future. He notices what scouts call an "inverted W," based on the shape of his arms as he prepares the pitch. He considers Strasburg's case to be borderline, but any inverted W is considered bad, bad news.

Going forward, the way this typically works for Inverted W guys is that they come back from the surgery and look great for a few years and then their mechanics again take their toll, but on the shoulder this time. Given Strasburg's velocity, I'm thinking that, if nothing changes in his mechanics and he remains a starter, then the Nats will get one or two years of value out of him before his shoulder blows up.

For Strasburg to have any chance of pitching more than 5 years he's got to change his arm action and get rid of the Inverted W. He also needs to ditch the slider because that is an absolute killer of the elbows. Changing his arm action may knock 5 or so MPH off of his velocity, but that's what it's going to take to reduce the load on his arm.

As a small pick-me-up after reading that, ESPN has a game in which you try to name the top 11 pitchers, sorted by wins, who have had Tommy John surgery. It's not easy.

5:30 p.m.: TBD's Samuel Chamberlain notes that manager Jim Riggleman has been through this before, and puts Kerry Wood's injury in perspective.

5:22 p.m.: There will be a lot of stories in the national media about Strasburg, and The List has documented some of the more grammatically dramatic entries among them. Here's how Michael Rosenberg is earning his keep at Sports Illustrated:

There is something terribly sad about this latest Stephen Strasburg news. It's not just sadness for Strasburg, who apparently needs Tommy John surgery -- he is a wealthy and (mostly) healthy young American male who should be fine, no matter what happens. And it's not just sadness for the Washington Nationals, who lost the one guy who has made them relevant.

No, it's the sadness of an artist who is no longer able to paint, or a musician who suddenly can't play a chord. What is lost is not just a game or a part of a career, but something on the outer edges of human achievement.

Stunning hyperbole aside, Rosenberg goes on to compare Strasburg to other recent flamethrowers in MLB: Kerry Wood, Mark Prior, and Joel Zumaya.

Zumaya, like Strasburg, featured a 100 mph fastball. But Strasburg hurt himself while pitching in a competitive baseball game. Zumaya hurt himself while playing Guitar Hero, and later lost time when a box fell on him.

Wood and Prior pitched under the management of Dusty Baker, who has a reputation for running young pitchers into the ground, while Strasburg was protected with kid gloves from Day 1.

In other words: Beware of comparisons when they're very different situations, as there's no direct comparison for Strasburg. They can be useful, but don't expect to find a blueprint in any one player.

4:53 p.m.: Mark Zuckerman is transcribing this afternoon's press conference at Nationals Insider.

And Ian Koski of Nationals Daily News appeared in-studio on TBD TV to discuss the injury. Sorry for the typo on your name, Ian.

4:28 p.m.: One of the most fascinating story lines we expect to emerge is how Strasburg's injury impacts the team's plans in 2011, as a writer at Fangraphs brought up earlier today. Most importantly, it could change how the Nationals approach Adam Dunn and his contract, which expires at the end of this year.

At the 4 p.m. press conference, GM Mike Rizzo said Strasburg's injury doesn't affect Dunn. "I think the injury to Stephen and the signing of Adam Dunn are two independent things," he said.

But the 30-year-old Dunn will command the kind of dollars befitting a team that's competing tightly for a playoff spot. With some fans already giving up on a Strasburg-less 2011 season, some are wondering whether he's now worth the investment.

Nationals Review has the most thorough look at 2011, explaining how the injury could impact plans for many different Nationals.

4:08 p.m.: Happening right now: Strasburg, manager Jim Riggleman and GM Mike Rizzo are addressing the media. Watch a livestream at CSN Washington or follow as TBD's Samuel Chamberlain tweets from the press conference.

3:57 p.m.: Baseball Prospectus' Will Carroll doesn't think there's anything the Nationals could have done to prevent this fate. "All the protections and conservative buildup to his career did not work, but we're not sure why," he wrote.

At The Nats Blog, WIlliam Yoder wonders if Strasburg's new change-up is to blame. This is one of the more interesting theories out there, and one we'll have to track in the coming days.

Here's a frightening thought for you:

Yes, Tommy John surgery is almost always successful these days, however there is a possibility that Strasburg's body was just not built to last as a major league pitcher. If there was no good methodology to keep him healthy now, then what does that say about the future?

3:37 p.m.: SB Nation DC has a round-up of the best tweets found soon after the news. We'd warn you about the language, but you probably already assumed there would be some four-letter words in there.

Teddy Never Wins points a finger at the organization, pointing to the eight Nationals pitchers who have been hurt this year. "[I]t is apparent that no one in the organization knows how to take care of a young pitcher's arm," Jeremy Stewart wrote.

3:25 p.m.: Dr. James C. Dreese, an orthopedic surgeon and the baseball team physician at the University of Maryland, has performed about 30 Tommy John surgeries on high school and college baseball players over the past seven years.

"We haven't had anyone who wasn't able to go back [to pitching]," he told TBD.

That isn't to diminish the significance of the surgery. High-end fireballers like Strasburg put tremendous strain on the ligament on the inner side of the elbow, and pitching through it becomes impossible, he said. Pitchers find themselves unable to achieve the same velocity and suddenly less able to control their pitches, he said.

"You don't see it in pitchers who are in the lower end of the velocity curve," Dreese said. "It's seen much more frequently in pitchers like Stephen Strasburg."

As for recovery time, Dreese said Strasburg can't simply will himself to coming back sooner than his body will let him. Most of the factors that determine recovery time are out of a player's control, such as other injuries or unexpected setbacks. And virtually every athlete at the major league level is pushing themselves to the max trying to get back on the field, he said.

"The guys that take care of these athletes at the highest levels are very good at what they do," he said. "They're very dedicated to taking care of these injuries. He'll be in very good hands, and I think he'll have the best chance possible to be competing again."

And though his players were able to consistently get back to the mound, Dreese said frequently cited estimates that 90 percent of players return to form might be a little high. He said the number more likely falls between 70 and 90 percent.

2:57 p.m.: TBD's Samuel Chamberlain spoke to Dr. Brent Wiesel, director of the Georgetown University Medical Center Orthopedics Department's Shoulder Service and a shoulder and elbow surgeon. He offered a more detailed take on the timeline ahead for Strasburg's recovery.

2:10 p.m.: We freshened up on our knowledge of Tommy John surgery in the way every seasoned journalist knows is best: We went to Wikipedia.

Perhaps we shouldn't stop there. This 2008 story from MedPage Today details a rise in young pitchers getting the surgery, and several misconceptions surrounding it. Among them: "There is no evidence that Tommy John surgery will make a pitcher's elbow stronger than it would have been under natural development."

For the wannabe med students in the crowd, here's "a patient's guide" to the operation.

1:52 p.m.: TBD TV talked to Marc B. Danziger, M.D., a Board Certified Orthopaedic Surgeon. He forecasts a 12- to 18-month recovery period, and believes the injury wasn't a result of a gradual breakdown common in older pitchers. "His was just an acute injury from the pitch that he threw," he said.

1:25 p.m.: Expect a lot of this over the coming days, weeks and months: Guesswork on what really caused the injury.

The Sporting News talked to Tom House, a "pitching guru" who thinks Strasburg's workload this year was to blame.

"For me, it was probably too many pitches with the intensity of a major league game, and his body just couldn't handle it," House said.

At our 1 p.m. update, you'll see Nats GM Mike Rizzo preemptively dispute this theory, saying doctors believe it was a one-time incident that caused the tear. Strasburg threw 68 innings in Washington and 55.1 innings in the minors in 2010 for a total of 123.1 innings. It was widely expected the Nationals would cap him at about 160 innings in his rookie year.

1:07 p.m.: Fangraphs, one of the smartest baseball sites out there, has a wholly depressing take on the injury, and what it means for the future of the franchise. Dave Cameron says it will have a far-reaching impact on many other personnel decisions:

 

This is a loss for the game. Obviously, it’s a pretty significant blow to the Nationals as well, who now have to re-think their path to contention and potentially push back their time-frame a year or two. If they were thinking of re-signing Adam Dunn before, they almost certainly shouldn’t now. Losing Strasburg for 2011 and getting a questionable version of him for 2012 pushes the Nats back into long-term building mode, as they just lost a player they simply can’t replace. This injury has a significant effect on the decisions Washington has to make this winter.

1:00 p.m.: Nats320 has the complete transcript of the conference call between GM Mike Rizzo, Team President Stan Kasten, journalists, and bloggers.

Rizzo said doctors believe the injury was caused by a one-pitch incident, not a pattern of misuse.

 

Question: Is this frustrating in any way and is there anything you feel you could have done differently to avoid this outcome?

Rizzo: Frustrated, yes. I would describe it as frustrating because injuries to pitchers happen to people you think it couldn’t happen to. This player was developed and cared for the correct way and he was developed in the correct way. Things like this happen, pitchers break down, pitchers get hurt, but we are certainly not second guessing ourselves. We have developed a lot of pitchers this way and we are satisfied with the way he was developed. Scott Boras is satisfied he’s been treated and developed. And Stephen is also. We are good with that. Frustrated, yes, but second guessing ourselves--No.

12:28 p.m.: ABC7 had this video at noon from Rebecca Cooper. The video of Strasburg wincing is suddenly even more chilling.

12:26 p.m.: Dr. Michael Kaplan, ESPN's medical analyst, delivers some good news – relatively speaking – saying on SportsCenter that "the prospects are very good" Strasburg could return in 2011.

"I think we can be relatively confident that he'll come back and be the pitcher he was," he said. "But obviously, it's a tough all on this next year."

12:14 p.m.: ESPN's Bill Simmons adds Washington to a list no one wants to be on:

1. 
   sportsguy33 Can't believe the Strasburg news. Updated list of sports cities that God apparently hates: Cleveland, Buffalo, Seattle, Washington. 27 Aug 2010 from web

12:10 p.m.: ESPN.com has a few poll questions for its readers. Just to warn you, the answers aren't encouraging for Nats fans.

Most notably, 63 percent believe Strasburg won't live up to his potential after surgery, but most people aren't blaming the organization.

11:31 a.m.: More blog posts coming in: William Yurasko says Strasburg is still worth the $15 million the Nats paid for him. He suspected when bloggers like him were invited to the conference call that he was going to hear good news...oops. Can't win 'em all.

Nationals Daily News points out that Jordan Zimmermann returned from the same surgery in just under a year when he made his comeback last night.

11:23 a.m.: When sports news breaks, to get a general sense of how it affects the team and its fans we like to turn to two places: Twitter and comment threads on blogs.

So we're keeping an eye out for the most active comment threads on the blogs. Out of the gate, there's been the most activity at Nationals Insider and Kilgore's entry at The Washington Post.

11:14 a.m.: "Tommy John" is a name no sports fan wants to hear.

As Kilgore explained above:

Tommy John surgery requires a grueling, 12-to-18 month rehab, but the success rate for pitchers returning to full strength and capability is roughly 90 percent. While the surgery will rob Strasburg of most if not all of next season, the chances he will be able to continue his career as a flame-throwing strikeout artist are strong. 

Baseball Prospectus took a long look at the history of the surgery. We found this nugget the most interesting: 

That Tommy John surgery seems all too common is perhaps the best measure of its success. While there is still a failure rate of 10 to 15 percent, most of these happen on younger subjects. It would be more accurate to say that the pitcher fails himself in most cases, rather than the surgery being the problem. Some think the procedure is becoming too common, with younger and younger patients. Others want to have their "prospect" son given the procedure when young so as to avoid it later.