Nats waiting to finalize rehab plan for Strasburg

ARLINGTON, Texas – The Nationals have not yet finalized a full rehab plan for Stephen Strasburg but don’t feel an urgent need to devise one while the right-hander is in the early stages of rest from the stress reaction in his ribs that sent him back to the injured list 10 days ago.

General manager Mike Rizzo said he, the Nats’ medical staff, orthopedist Neal ElAttrache and Strasburg himself will jointly decide on a plan of action once they’ve gathered all information, “but we don’t have that yet.” Strasburg flew to Southern California last week to be examined by ElAttrache after an MRI taken in Washington revealed the stress reaction to his second and third ribs, likely connected to the thoracic outlet syndrome he dealt with last summer.

Because he can’t attempt to begin throwing or beginning a rehab program until that stress reaction heals, there isn’t much urgency to proceed with a larger plan for now.

“He can’t do anything until he’s pain-free and feeling good,” Rizzo said prior to tonight’s series opener against the Rangers. “He’s not there yet, so there’s no rush to put a plan together when he’s on rest now anyway.”

Strasburg’s rehab from last summer’s thoracic outlet surgery seemingly had gone quite well, with three minor league tune-up starts and then his return to a major league mound June 9 in Miami. Though he surrendered seven runs in 4 2/3 innings to the Marlins, Strasburg threw 83 pitches and was highly encouraged by how he felt physically during his first big league start in more than a year.

The Nationals had already announced Strasburg as their starter five nights later against the Braves, but during his between-starts bullpen session he felt discomfort and alerted the training staff. A subsequent MRI revealed the stress reaction, sent him back to the 15-day IL and then to California to get a second opinion from ElAttrache (who performed Joe Ross’ Tommy John surgery earlier in the month).

Strasburg still has four more years remaining on the seven-year, $245 million contract he signed after winning World Series MVP honors in 2019. He’s made only eight starts since, spending considerable time on the IL in each of the last three seasons.

* Top pitching prospects Cade Cavalli and Cole Henry are both currently shut down with Triple-A Rochester, though Rizzo said those decisions were somewhat calculated and that both are expected to return to pitch after missing only a couple turns through the rotation.

Henry, who has made two starts for Rochester since his promotion following seven dominant starts for Double-A Harrisburg, was placed on the minor league IL with “some shoulder soreness,” according to Rizzo. Cavalli, who has made 12 starts for Rochester, is not dealing with any physical ailment but is taking what the GM called a planned midseason break as the organization has done with other pitchers.

“You’ll see each starting pitcher will be skipped throughout the season; usually at the 10-start mark we try to skip a start or push a start back,” Rizzo said. “That’s the situation with Cavalli, (Rodney) Theophile, (Cole) Irvin and those guys. They’ll get pushed back a start or two, just to give them a blow. No physical abnormalities there (with Cavalli). And with Cole Henry, because of his injury history, we’re being extremely careful with him. He’ll be no-throw for about a week, and then we’ll ramp him back up.”

* Top infield prospect Brady House, meanwhile, was placed on the minor league IL with back soreness. House, last year’s first round pick, hasn’t played for Single-A Fredericksburg since June 11.

Rizzo said the 19-year-old shortstop will be shut down for 7-10 days, “and then we’ll ramp him back up to playing again.”

House is batting .278/.356/.375 with eight doubles, three homers and 31 RBIs in 45 games in his first full professional season. The organization is taking a particularly cautious route with him, given his lack of experience.

“Yeah, instead of having a 19-year-old kid in his first full season of everyday baseball, grinding through soreness of the back, we take the decision away from him and do what’s best in the long term for him,” Rizzo said.