Stephen Strasburg Discusses Thoracic Outlet Syndrome

Anthony Franco

Anthony Franco

Stephen Strasburg has made just eight appearances over the past three seasons, which have all been derailed by injury. An ongoing battle with thoracic outlet syndrome has seemingly been at the root of it all, as the nerve issue has continually plagued him despite numerous attempts at mounting a comeback.

In a candid chat with Jesse Dougherty of the Washington Post this week, Strasburg conceded he’s uncertain if he’ll ever regain his pre-2020 form. “I feel like every time I’ve had an injury, I felt like I was going to be the best there is coming back,” the three-time All-Star told Dougherty. “This is the one that’s still definitely a big question mark. I realize the clock is ticking. It’s been almost three years since I’ve been able to pitch competitively, and it’s not like I’m getting younger.

Strasburg suggested he believes he’s battled complications of thoracic outlet syndrome since at least 2018, when he lost a month on the injured list due to what the club termed a cervical nerve impingement. A Botox treatment the ensuing offseason initially worked wonders, and he returned to post arguably the finest season of his career. The former first overall pick posted a 3.32 ERA across 209 innings in the 2019 regular season. He continued to excel during Washington’s run to a championship and collected World Series MVP honors that year.

After the season, Washington re-signed Strasburg to a seven-year, $245MM free agent deal. That, of course, looks like a major misstep in retrospect. Strasburg made just two appearances during the abbreviated 2020 season. He was shut down that August and underwent surgery to address carpal tunnel syndrome, but Strasburg now tells Dougherty he believes the actual issue was thoracic outlet syndrome.

Strasburg returned from the carpal tunnel procedure and opened the season on the 2021 roster, but he lasted just two starts before coming down with shoulder inflammation. He was reinstated a month later, made three more appearances, then was shut back down with nerve irritation in his neck. Last July, he finally underwent TOS surgery that brought an end to his season. He opened this year on the injured list and missed the first two months before debuting on June 9. He made one start, threw 4 2/3 innings, then landed back on the IL with a stress reaction in his right ribcage. Yet again, it brought an end to his season.

The 34-year-old tells Dougherty he’s done “very minimal exercises” in the three months since then. He hasn’t thrown at any point, and he noted that despite feeling “some improvements” in his shoulder, he still “(feels) like the strength is not quite there and (is) not really sure what the future holds.

It’s obviously not an ideal update for a player who’s both cemented in Nationals franchise history and could theoretically still be a part of the future. Strasburg remains under contract through 2026 at $35MM annually and expressed a continued desire to get back on a big league mound if he’s physically able. Dougherty also speaks to some former MLB hurlers (including current Rangers GM Chris Young) who’d battled TOS themselves in a wide-ranging piece that’s worth checking out in full.

Unfortunately, Strasburg isn’t the only Nationals hurler trying to battle back from TOS surgery. Veteran reliever Will Harris hasn’t thrown a major league pitch since undergoing his own procedure in May 2021. He’s spent the entire season on the injured list, and he continues to battle lingering effects of the condition. Dougherty’s colleague at the Post, Andrew Golden, tweets that Harris recently suffered a setback and is headed for an MRI.

The 38-year-old Harris is in the final season of a three-year, $24MM free agent deal signed over the 2019-20 offseason. That investment didn’t pan out, as injuries kept him to 23 2/3 innings in a Washington uniform. It seems all but certain he won’t pitch this season, and he’ll hit the open market this winter.

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