Was Strasburg susceptible to arm trouble? Or was it caused by his new MLB approach?

Baseball Prospectus's Will Carroll weighed in on todays stunning news that Stephen Strasburg will have to get Tommy John surgery:

"The Nationals announced that Strasburg has a torn ulnar collateral ligament as well as the strained flexor tendon. This couldn't be any worse—or more surprising. All the protections and conservative buildup to his career did not work, but we're not sure why. Strasburg's elbow is damaged enough that we have to wonder if he had any chance, if there was any methodology to keep him healthy. The likely answer is no. The Nats did not address whether the earlier focus on the flexor tendon was wrong, or whether the strain is an issue as well as the sprain. There's a comp here if both are an issue that should make Nats fans feel a bit better—Edinson Volquez. Then again, there's Ben Sheets if you don't want to feel hopeful..."

There's also David Wells, Matt Morris, Tom Gordon, John Smoltz...Chris Carpenter, Francisco Liriano...the list goes on...

Carroll brings up an interesting point here. Strasburg had been handled, at least on the field, as cautiously as possible. The Nationals monitored his innings in the minors, his pitch count in the majors, even a few weeks ago when he just felt "tight" they shut him down for 15 days.

There was no overworking, no pitching on short rest, nothing to indicate that the Nationals had put Stephen Strasburg in a position to injure his elbow. Conversely, there was nothing to suggest that the 22-year-old was susceptible to such an injury. As a late bloomer, Strasburg gained arm strength in college and was reportedly not overworked in high school.

That's what makes this all a little unnerving. Yes, Tommy John surgery is almost always successful these days, however there is a possibility that Strasburg's body was just not built to last as a major league pitcher. If there was no good methodology to keep him healthy now, then what does that say about the future?

However as former Nationals general manager Jim Bowden tweeted today, the injury could have been the result of the starters newly developed changenup:

"Rizzo just told us that his CHANGE was thrown more @WSH than as a collegiate & that that pitch could have put the extra stress on ligament"

While saddening news it would make sense that this could cause the injury. Many pointed out that a 90 MPH change up had never been seen before, and that it was almost unnaturally unhittable. It would seem to reason that throwing a pitch like that, which is held with the ball almost in your palm, that fast, could force stress on your elbow. When you hold a ball like that you surrender the traditional power you get from your fingers and wrist snap, which means you have to generate more form your shoulder and elbow.

In college Strasburg possessed the change-up in his arsenal but almost never threw it for lack of need. He was so dominant against Division I college hitting that he hardly had to dig deep to get the out. Coming through the minors and into the majors this year, he added the change up to have another "out" pitch to mix into his game plan. Which made sense, if you fool a major league hitter with a pitch one time around, chances are he will be able to pick up on it the second or third time. With multiple out pitches though, it's much easier to keep good hitters off balance.

If this was the problem that forced the injury, fixing Strasburg could be as simple as telling him not to throw that pitch anymore, or at least to throw it far less frequently (he threw it 17% of the time). Will that effect his overall ability to get outs? Maybe...but lets remember the kid will still throw in the high 90s with a mind-bending curve. We'll have to wait to see how the Nationals handle his arm rehabilitation and his pitch repertoire to really know what will happen going forward, lets just hope (pray) that he will be the same in 2012.