Did mechanics cause Strasburg's injury?
Hurler's delivery under scrutiny as he heads to operating table
The pitching mechanics that produced a 14-strikeout Major League debut and a promising start to a professional career are part of what's being examined in the wake of Stephen Strasburg's torn elbow ligament, almost certain surgery to come and a long rehabilitation process to follow.
At issue for some is Strasburg's "inverted W" delivery in which his elbows rise above his shoulders as his front foot hits the ground, before the point of release -- mechanics some say are flawed and have helped send pitchers like Mark Prior and Kerry Wood down a road of arm injuries.
Others say injuries are just part of the game when young men repeatedly hurl the ball up to 100 mph under the intensified glare of the Major Leagues.
To the latter point, the Nationals' steady and very public precautionary approach with Strasburg, dating back to when they signed him to a record $15.1 million deal as the No. 1 overall pick in the 2009 First-Year Player Draft, is generally unquestioned.
As is the nature of the game and that injuries occur.
"Happens," Rays manager Joe Maddon said. "That's one part of the game, regardless of how much care you take and concern and plotting things and planning things, anything's possible when throwing a baseball. It's unfortunate. ... He's going to be fine."
Said Orioles pitching coach Rick Kranitz: "From my standpoint, watching the situation, they did everything that they humanly possibly can do in that situation. They really did. They handled it in my opinion exactly the way you would handle ... you know, the same way we are handling our young guys."
Everyone believes pitching injuries are somewhat preventable. But they can disagree about what can contribute to them -- such as pitching mechanics.
White Sox pitching coach Don Cooper actually stoked the conversation about Strasburg's mechanics about a month before Friday's news that the phenom was being shut down and likely is headed for Tommy John surgery to reconstruct the ulnar collateral ligament in his right elbow.
Cooper told MLB Network Radio in July that the "real concern is what I call an upside-down arm action" -- or the "inverted W," as others call it. When Strasburg went on the disabled list with shoulder stiffness last month, Cooper was prescient, not that he wanted to be.
"I am not wishing this guy bad," Cooper said at the time, "but for him to be having problems right now when they are really, really watching him, what are they going to see when they are trying to get 220 innings from him? He does something with his arm action that is difficult, in my mind, to pitch a whole lot of innings on."
Cooper did not want to address Strasburg's mechanics specifically in the aftermath of the pitcher's injury, but he did discuss mechanics in general, as he relates it to the White Sox pitching program as a whole.
"We have a decent idea of the better working deliveries," Cooper said Saturday. "Our pitching coaches and our trainers and our conditioning guys take good care of them. We are able to make adjustments to deliveries we feel might be threatening to health.
"Everybody says you can't prevent (injuries). Listen, I differ with a lot of people with what they are saying. I'm not going to go into the Strasburg thing, but there are things you can do. I'm not going to say what they are. I believe we have a pretty good handle on them."
Of course, whether or not the inverted W -- more associated with shoulder stress and injury than with the elbow but still a mechanical approach some pitching experts do not like -- really had a causative effect on Strasburg's injury may never be known.
"His delivery is fine," Strasburg's agent Scott Boras said. "The idea of what a guy does when he delivers the pitch as opposed to what he does before the delivery is the issue. We know this and are aware of it. We have heard the 'Curly W Theory' and all of these things. The point is, those references are made to the shoulder -- shoulder injuries.
"Again, Stras is still growing. His body is going to get bigger and he is going to get more strength as time goes on. I have had so many pitchers who have had [Tommy John surgery] and pitched for many, many years."
And not everyone agrees that Strasburg -- or anyone -- can have this type of injury waiting to happen.
Said Kranitz: "You see guys that have nice loose arms and deliveries, and you see another guy that has a violent delivery, and he'll pitch for 15 years. You don't know. All I know is this: If people say that, 'I saw this coming,' I think they're speaking out of turn. Because there's just no way that that's the case. There's just no way."
So, really, the Big W to Strasburg's injury: Why? There might not be an answer to that. Then again, there might be several answers to that.
From the perspective of one team's director of medical services, the jury is still out on the cause-and-effect of certain mechanics vs. others.
"There are a lot of theories on mechanics, nothing proven," said the Dodgers' Stan Conte, the club's head trainer. "Common sense says it would be more likely with power pitchers than finesse. But has anybody spotted a common thread to head it off? No. It's all to be discovered."
But in general, mechanics are something baseball people pay close attention to with developing arms, and part of what they hope will prevent injuries.
"They have to make sure their mechanics are working fine on the mound," said Marlins manager Edwin Rodriguez. "Second, their offseason training is very important -- for any player, but mostly for the pitchers."
For pitching coaches who depend on what they know and what they see in a pitcher's delivery, it's not always black and white.
"I've seen guys with beautiful deliveries get hurt and I've seen guys with ugly deliveries pitch forever," Phillies pitching coach Rich Dubee said.
Obviously, pitching coaches and everyone else involved in a pitcher's development on up through the general manager position are concerned with mechanics. Right alongside performance in that thought process are endurance and health for the long term.
"I know there are things that scouts look for," said Mariners pitching coach Carl Willis. "Certainly, to see a guy get the baseball out of his glove while being over the rubber and get the ball up, get his hand up, with a lot of guys, you see them come out and the hand's down and they have to rotate it up. When you do that, you really put stress on that ligament and the elbow area and it becomes even more important to stay back and balanced over the rubber."
With Strasburg's motion, the concern is that his throwing arm goes from parallel to the ground to whipping through the pitching motion with so much force because it has to come through so quickly that it creates too much stress on the shoulder and elbow.
"Strasburg, you could say you could see it coming, but you never know with arms," Dubee said. "A lot of it has to do with what they do between starts, whether there's balance between the shoulder blades. We do a lot of tests for that. We actually stretch shoulders more because we've found out in the past if you have a tight shoulder it can affect the elbow. But it can be a lot of things."
And one of those things could be that it was just one of those things.
Take it from one of the most durable pitchers of all time: Nolan Ryan.
"Obviously, it's going to send out some concerns to people ... [but] I don't think he has been mishandled," the Hall of Fame pitcher and current Rangers president said. "It's just one of those unfortunate things that happen to pitchers."
John Schlegel is a reporter for MLB.com. Reporters Bill Chastain, Joe Frisaro, Ken Gurnick, Scott Merkin, Doug Miller, T.R. Sullivan, Todd Zolecki and associate reporter Evan Drellich contributed to this story. This story was not subject to the approval of Major League Baseball or its clubs.