Stephen Strasburg Diagnosed With Flexor Mass Strain; No Ligament Damage Found

SATURDAY: Strasburg says he can’t promise he’ll return for the postseason, Chelsea Janes of the Washington Post tweets. Via MLB.com’s Jamal Collier (also on Twitter), Strasburg received a PRP shot yesterday.

THURSDAY 5:03pm: Strasburg will visit noted orthopedic surgeon Neal ElAttrache for a second opinion, Barry Svrluga of the Washington Post reports (Twitter links). That’s team protocol for an injury of this kind, which was deemed to have been acute (caused by one pitch) rather than from accumulated wear and tear.

3:15pm: Nationals right-hander Stephen Strasburg, who had an MRI today after exiting last night’s start in the third inning, has been diagnosed with a flexor mass strain, head athletic trainer Paul Lessard told reporters, including MASNsports.com’s Dan Kolko (Twitter link). On the positive side, he does not have any damage to the ulnar collateral ligament in his elbow.

While that assessment rules out Tommy John surgery, the injury is still notable, and there’s no immediate timeline for his return to action. However, the Washington Post’s Chelsea Janes notes (Twitter links) that Lessard doesn’t feel the injury will end Strasburg’s season — though he also couldn’t definitely state that the key righty would be back.

The flexor mass strain is a fairly common pitching injury, but its outlook depends quite a bit on the situation. Andrew Miller, for instance, only missed about a month earlier this year — though he likely had a shorter road back as a reliever. But more severe forms of the injury can require surgery, as was the case previously for Homer Bailey. Flexor issues more or less ended Cliff Lee’s career. And flexor mass problems can be a precursor to Tommy John surgery, as occurred this year with Carson Smith. Other pitchers who have recently had some kind of injury to the flexor tendon or muscle include Aaron Nola, Wade Davis, and George Kontos.

Clearly, the Nats will be relieved that another TJ procedure isn’t immediately on the horizon. That would have been a major blow given that the club struck earlier this year to keep Strasburg off of the market with a seven-year, $175MM extension. If Strasburg had required a second UCL replacement, odds are he’d have missed all of 2017 and possibly a bit of 2018 as well — assuming he was able to progress well.

That’s not to minimize the immediate loss. Washington obviously viewed Strasburg as a part of its postseason rotation. Though a pair of rough, recent outings inflated his ERA, the 28-year-old has been stellar for most of the season. There are plenty of candidates to take over — the D.C. depth chart shows a variety of intriguing arms — but none will hold the same promise as Strasburg. While it is still too soon to write off a return, it would be a tall order for Strasburg to heal entirely and ramp all the way back up to carry a major workload this fall.