WASHINGTON D.C. - Game 5 of the 2019 World Series was supposed to feature the star-studded pitching matchup of Max Scherzer and Gerrit Cole. Unfortunately for the Washington Nationals, Scherzer will not be making his scheduled appearance against the Houston Astros.

Rather, Nationals manager Dave Martinez announced prior to the game that Scherzer had been scratched due to neck and back spasms that he had been dealing with for a few days. Scherzer's condition was such that he had to roll out of bed on Sunday morning, and had to have his wife's assistance to get dressed. "He's very upset. He wants to get out there with his teammates," Martinez said of Scherzer. "Hopefully, we can get him back out there for Game 6 or 7."

The Nationals will start Joe Ross, who will be making his second appearance in three days.

Here are five things you need to know about this development.

1. Ross was better late in uneven season

Ross will be making his second career postseason start, and his third overall playoff appearance. He just pitched in Game 5, tossing two innings in a losing effort.

Ross split the regular season between the rotation and bullpen, making 27 appearances (nine starts) and accumulating a 5.48 ERA (84 ERA+) and 1.73 strikeout-to-walk ratio. He did pitch better after rejoining the rotation in August:

2. This won't be a bullpen game

Martinez suggested the Nationals will view Ross' outing as a traditional start as opposed to a bullpen-day scenario. "Hope that Joe can give us five, six innings, then go from there," he said. Ross worked six innings in his final appearance of the year -- that being the season finale. 

The Nationals asked a lot of the underbelly of their bullpen in both Games 3 and 4, with Anibal Sanchez and Patrick Corbin combining to cover just 11 1/3 of 18 innings. Fernando Rodney and Wander Suero appeared in each game, while Javy Guerra, Tanner Rainey, and Ross also made appearances.

If there's good news for the Nationals, it's that both Sean Doolittle and Daniel Hudson -- the most trustworthy of Washington's relievers -- are both fresh, having not appeared since the series shifted to D.C. It's at least possible Martinez could ask them to combine for three-plus frames.

3. Scherzer remains in play later in the series

Martinez noted that Scherzer will continue to receive treatment with an eye on potential starting Game 7, should the series go that far. Alternatively, the Nationals could call upon Scherzer if the need presents itself during Game 6.

Either way, Scherzer had previously made five appearances this month, posting a 2.16 ERA and a strikeout-to-walk ratio over 3.30.

The Nationals still expect to start Stephen Strasburg in Game 6, which will take place on Tuesday night in Houston.

4. Game 5 remains pivotal

The Nationals now appear to be massive underdogs in Game 5 considering the disparity in the starting pitching matchup, which isn't great news for the their championship hopes.

After all, the two sides enter tied at 2-2 in the best-of-seven series. The winner will be in position to secure the title in Game 6. The loser, then, will require consecutive wins to claim the World Series as their own.

5. The underdog can win

For as bad as Cole-Ross looks on paper for the Nationals, it's worth remembering that recent history has shown that the seemingly inferior pitcher can come out on top on the big stage.

In 2016, Cleveland won Game 3 over the Chicago Cubs despite an unfavorable matchup that saw Josh Tomlin go up against Kyle Hendricks. A few years prior to that, in 2012, the San Francisco Giants saw Barry Zito outpitch then-Detroit Tigers ace Justin Verlander in Game 1. And so on.

An Astros win in Game 5 is not a fait accompli -- the Nationals should have some hope ... just not as much as they had when it seemed like Scherzer was taking the ball.