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Nationals ponder physical mistake

- The Washington Times - Tuesday, February 28, 2006

VIERA, Fla. -- Before the Washington Nationals finalized their trade with the San Diego Padres for Brian Lawrence in November, they had team doctors do a complete physical on the right-hander.

Lawrence, who never had an inkling of arm trouble, was tested for range of motion and strength. He was given resistance tests on his throwing shoulder specifically designed to detect a torn labrum or rotator cuff.

On all accounts, Lawrence passed the physical -- "with flying colors," according to one team doctor -- and the Nationals completed the deal that brought the 29-year-old pitcher to town for veteran third baseman Vinny Castilla.

Like the rest of his new teammates, he also passed a physical when pitchers reported for spring training less than two weeks ago.

So when Lawrence had to shut himself down nine minutes into his first bullpen throwing session in a Nationals uniform last week, the first in a series of events that led to his season-ending surgery Sunday, the club obviously was stunned.

It turns out he had extensive tears of both his labrum and rotator cuff, the kind of injury that has ended some careers. And, most agree, the kind of injury he must have had before being traded to Washington.

Which raises the following question: Should the Nationals, who will pay Lawrence $3.5million this season, have made him undergo more extensive tests like an MRI before officially trading for him?

The answer varied yesterday.

"Did we give him an MRI? We did not. That's our bad," manager Frank Robinson said. "We chose not to give him an MRI. The physicals should include everything. Why are we giving you a physical? To see if your eyes are gray? No. It's to see if you are sound."

General manager Jim Bowden defended the club's decision.

"It's expensive to do MRIs on every single transaction," Bowden said. "In the case of Brian, he had made every single start the last four or five years. We saw him throw a three-hit shutout [in his final start of 2005]. We were trading a player [Castilla] with a bad knee. We felt that there was MRI risk on both sides if the deal was made, and we made a decision not to."

It can cost several thousand dollars to administer an MRI to a player. But given the millions of dollars clubs hand out to top free agents and first-round draft picks, Robinson said it's worth the extra cost.

"Would you spend $2,000 to protect $3.5million?" the manager said. "Does it make sense to give every one of your guys an MRI or whatever? Maybe not. But for your draft choices, your high-profile free agents, it makes sense."

Bowden said the Nationals give MRIs to some prospective acquisitions but typically only if there's a pre-existing concern. In Lawrence's case, there was none.

His track record of durability was impeccable. He made at least 31 starts each of the last four seasons, averaged more than 200 innings and never had spent a day on the disabled list. He said he never felt any shoulder pain until his fateful bullpen session in Viera last week.

"We saw every single one of his starts the last couple months, and the guy looked healthy," Bowden said. "... You make the best judgments you can. They don't always work out."

Lawrence wasn't the first player acquired by the Nationals likely to have a pre-existing injury. In June, they claimed right-hander Ryan Drese off waivers from the Texas Rangers, then watched as he developed a sore shoulder and ultimately underwent arthroscopic surgery to repair a partially torn labrum.

Drese now admits he was pitching in pain all season.

"I felt it all year," he said. "Probably one out of every three starts, I felt good. The other two, I felt like I had to make 25 or 30 more pitches to get ready. I never really got loose, and I didn't have my arm angle."

Drese passed his own physical with the Nationals, and even though he was worried he might have been injured, he decided it was worth the risk to keep pitching.

"A lot of times you don't know," he said. "Especially when the doctor tells you you're OK, you still want to get out there and pitch. So you just never know."

The Nationals are hardly the only team in the majors facing these dilemmas. A quick sampling of other clubs yesterday revealed there are others who do not regularly ask their trade or free agent acquisitions to undergo MRIs.

But plenty do. Some teams require players with pre-existing concerns to undergo MRIs, several require them for all acquisitions and at least three will not trade for a pitcher until he has taken MRIs on both his shoulder and elbow, regardless of his injury history.

Perhaps the Nationals learned something from the Lawrence case. Last night the club announced it has signed veteran right-hander Pedro Astacio to a one-year contract pending a physical.

That physical will include MRIs on both Astacio's shoulder and elbow.

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