Nats can hope, but can't count on Strasburg returning to form

PLAYER REVIEW: STEPHEN STRASBURG

Age on opening day 2022: 33

How acquired: First-round pick, 2009 draft

MLB service time: 11 years, 118 days

2021 salary: $35 million ($11.4 million deferred)

Contract status: Signed for $35 million annually from 2022-26 ($11.4 million deferred each year), free agent in 2027

2021 stats: 1-2, 4.57 ERA, 5 GS, 0 CG, 21 2/3 IP, 16 H, 12 R, 11 ER, 4 HR, 14 BB, 21 SO, 1 HBP, 1.385 WHIP, 90 ERA+, 5.71 FIP, 0.0 fWAR, 0.0 bWAR

Quotable: "He looks great, he feels great. He's going to begin throwing the beginning of next month. And our expectation is that he's going to be pitching to prepare for the season, at the beginning of the season." - general manager Mike Rizzo on Oct. 2

2021 analysis: Though the Nationals were optimistic about Stephen Strasburg entering spring training, there were legitimate questions about the state of his arm following his aborted 2020 season, in which he made only two starts and then had surgery to repair carpal tunnel neuritis in his right wrist. And though there didn't appear to be any lingering effects of that surgery in February or March, there were a couple other physical hiccups that sent the veteran hurler into the season with questions still abounding.

What followed was an agonizing period of highs and lows and even more questions. Strasburg looked quite good in his season debut, holding the Braves to one hit over six innings. But then he looked completely out of whack in his next start against the Cardinals, getting blasted for eight runs in four innings with diminished velocity and some obvious body language that suggested his shoulder didn't feel right.

Strasburg would head to the injured list for the first time on April 18 with right shoulder inflammation, then return five weeks later and hold the Orioles to one hit over 5 1/3 innings. He was OK in his next start against the Reds (three runs in five innings), but looked off again June 1 in Atlanta and was pulled after only 30 pitches. He went back on the IL the following day with a neck strain.

The rehab process was slower this time around, with medical staff not wanting to let Strasburg pitch again until it was clear he was fine. And for a while, it looked like he was. He was throwing off a mound in late July and appeared to be only a few weeks away from returning - until he noted continued discomfort during one of his throwing sessions. The Nats shut him down and sent him to see a specialist, who finally emerged with the worst-case diagnosis: thoracic outlet syndrome.

Strasburg underwent surgery July 28 and began the long process of beginning another rehab program from another major injury. This one, coupled with the Nationals' July collapse, prompted the club to embark on a massive trade deadline sell-off and start the process of rebuilding the organization.

2022 outlook: The Nationals continue to say they fully expect Strasburg to be ready for spring training and prepare to begin the 2022 season on time. He's scheduled to begin throwing Nov. 2, which gives him 2 1/2 months to ramp up before pitchers and catchers report to West Palm Beach, Fla., ample time.

And all of that may come to fruition. But unlike with Tommy John surgery, rehab from thoracic outlet surgery doesn't come with a time-honored and tested schedule. There aren't nearly as many examples of pitchers returning to full form from this injury, though there are some success stories among the group.

If nothing else, Strasburg is going to have to pass a number of tests between now and opening day. He needs to begin throwing. He needs to start pitching off a bullpen mound. He needs to face live hitters. He needs to make an exhibition start against another club. Then he needs to return five days later and do it again. Countless eyes will be focused on him every step of the way, noting every positive and every concerning development throughout the process.

Could Strasburg make a full return and be the ace of the staff in 2022? Sure. It's not inconceivable. But can the Nationals count on that happening? Not at all. Because of his stature and his contract, they have to hope it happens. But because of his personal history and the spotty history of others returning from this injury, they have to prepare themselves for the possibility he's never himself again.