PHILADELPHIA - A week ago today, Dr. James Andrews saw Bryce Harper and confirmed that Harper has bursitis in his injured left knee. Dr. Andrews gave Harper cortisone and PRP (platelet-rich plasma) shots in the knee to try and get rid of the swelling and inflammation that had plagued him for weeks, and told the Nationals outfielder to rest for a week.
Today, Harper was examined back in D.C. by Nationals medical director Dr. Wiemi Douoguih, and was given the go-ahead to begin what head trainer Lee Kuntz called "ground-based activities."
The swelling in Harper's knee has decreased since the cortisone shot, and Harper will now start by doing some walking. He'll go through a progression that eventually will leave him ready to resume baseball activities once he's cleared a number of initial hurdles.
"He's improving," Kuntz said. "He was cleared to begin strengthening activities. We're going to start him doing strengthening-type things, ground-based activities. Walk, jog, progressing towards running. We'll evaluate him regularly as we go through this process and try to ramp up his activity.
"He's improved, and it's all good right now. Swelling is down and he was able to complete all activities pain-free."
Harper will be monitored on a daily basis, and the Nats will try and have him match what he did in his rehab work the previous day while adding on a bit more. Kuntz referred to that process as "adding bricks."
There aren't a lot of "bricks" between walking and running, Kuntz said, but the Nats will have to wait and see how Harper responds to the early levels of the rehab before moving him forward in the process.
"Running's the key for me," Kuntz said. "If he can run and do all those explosive type of activities where it doesn't have any swelling or anything else, he's in a good spot. And we can add all the other things. The hitting and throwing will come quickly because obviously there's nothing wrong with his arm or back."
For now, the Nats won't put any timetables on when Harper might be able to begin baseball activities or be cleared to go out on a rehab assignment, something they'll want the 20-year-old to do before he's ready to return to the lineup.
"Again, a lot of this is based on what we're seeing on a daily basis, and right now, we're just going through strengthening type things where you're loading it and making sure it's not irritated," Kuntz said. "Once we get through that stuff, this stuff will come fairly quickly. But again, I don't have a crystal ball. And we're going to try and do this as quickly and as safely as possible."
Harper initially injured the knee when colliding with the right field wall in Dodger Stadium back on May 13. He twice tried to return to the Nationals' lineup after that only to have the knee flair up both times and again land him on the bench. The Nats finally placed Harper on the disabled list on June 1 (retroactive to May 27), and have been waiting for the swelling in Harper's knee to go down since then.
It's clear that Harper is chomping at the bit to move his rehab process along - he did some range-of-motion exercises recently that led to some minor swelling - but the Nats will be sure to ease him along in the process. The setbacks that Harper suffered in recent weeks due to trying to play through pain and discomfort likely increased the amount of time he'll need to miss, and the Nats don't want to have him re-aggravate the issue again and take him out of action for even longer.
"Yeah, you've got to put the reins on him," Kuntz said. "He's a young guy. He's ... I don't want to say he's not been hurt, but (as a) younger guy, hey, I'm (saying), 'Let's go.' But like I said, you've got to walk before you can jog and you've got to jog before you can run. And again, he's a guy that wants to go from walk to run. So, we'll get it right."