- Overuse - Having the type of talent that he has, Strasburg has probably been throwing way too many pitches since he was a high school student. With the climate of college baseball what it is today, and what it was while he was coming up as a youth, he was most likely involved with PLAYING baseball year round. For a pitcher, this is a big no no. As the old saying goes, "There are only so many bullets in the gun," and I think that rings true to some extent for him. By pitching year after year after year, he never gave his body the proper time to relax and heal. To me, fall baseball for pitchers is not necessarily the next step to success. While I do believe you need to work on your game year round, it doesn't mean you should be out on the mound pitching competitively year round. I believe the fall is the perfect time for guys to get into a great strength and conditioning program, by building up for next season, and allowing your bodies to correct the weaknesses and imbalances that the spring and summer seasons have built up. If you are still young (sophomore and younger), go play another sport. Until you have your scholarship opportunities on the table, there's no reason to give up any other sports. Go be a kid!
- Poor Assessment of Strength Weaknesses - A lot of players I've seen over the years, who develop shoulder and/or elbow problems, generally have a lot of weakness and imbalances in their core, hips, and scapula (back). Over time, if they are not corrected, a continual deterioration of the soft tissue quality in those areas, will lead to the deterioration of other areas that may be compensating for those imbalances (i.e, elbow begins to breakdown due to a weak back). Perhaps if he had been assessed a little further, he may have been able to correct his imbalances and prolonged this injury
- Poor Mechanics - Here's where number 2 and 3 run together. Because of the way he throws (extremely high scapular load with his elbows above his shoulders), he puts a huge workload on his back. His legs aren't huge, but that doesn't necessarily mean he's weak. I think because of his mechanics, he should have been doing a lot more back strengthening, along with mobility and flexibility work, in order to put himself in the best position to succeed and be healthy. If you watch him throw, he doesn't use his legs as much as his upper half and core. Let's break it down and take a coaching perspective, post op. Option 1) He can rework his mechanics to allow his legs and core to take a brunt of the punishment. Option 2) He can spend more time on his upper back, using a 2:1 or 3:1 ratio of every back to chest exercise, and still stay in his mechanics. It's a tough decision either way you look at it, but if I were in that position as a coach, I would go with option 2. For him to make such a dramatic change to his mechanics, would take even more time added into his rehab, and he would have to develop a strength and conditioning program that would suit those mechanics.
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