Why Has Josh Bell’s Rehab Taken So Long?

Josh Bell is still experiencing swelling in his knee.

One of the most anticipated debuts this year was the pro debut by Josh Bell, who signed for $5 M as a second round pick in the 2011 draft, and was slated to start off in West Virginia. That debut ended up being short-lived, as Bell went down in late-April with a knee injury. The outfielder ripped what would have been a double, but pulled up limping rounding first base, and was tagged out standing between first and second with an injury.

Bell ended up having a partial tear of his meniscus. The tear was on the lateral part of the meniscus, which can take a bit longer to heal. But right now Bell is beyond the expected return that the Pirates initially gave him. It’s been three months since the surgery and Bell hasn’t started a rehab assignment, with a lot of silence about his injury in the interim.

I caught up with Bell today in Pirate City to discuss his progress and see how the rehab has been going. The reason the rehab has been slow is that his knee has been swelling up each day, filled with fluids. He’s doing everything but playing in games, and the Pirates are waiting until the swelling stops before activating him.

“I’m running, I’m hitting everyday. I’m doing everything except for playing games right now, really,” Bell said. “That’s what it’s coming down to. They don’t want me to play with a swollen knee. I’m definitely grateful for that. They want me to be back at 100 percent before they throw me out there.”

Bell can do change-of-motion running and can cut with the knee, which is definitely a good sign. He’s been doing a lot of quad work to help rehab from the injury. He’s icing the knee about five times a day to counter the swelling. Today he took his first live batting practice, facing a few sliders in the process. The hope is that he can return in August, do some rehab, and get back to West Virginia by the end of the year.

“I just look down at my knee and there’s still swelling in there, and that’s unsettling for everybody,” Bell said.

The lost time is disappointing for the young hitter. He’s a switch hitter with plus hitting ability and plus power from each side of the plate. He’s got the offensive upside that you can dream on, with the potential to be a .300 hitter with 30 homers a year. Bell drew a lot of publicity and hype due to his record-setting and draft-altering signing bonus, but in that hype and publicity people forgot that he’s still got things to work on, unlike high school phenom Bryce Harper, who was drafted one year earlier, and made a quick rise to the majors at age 19.

One thing Bell appeared to struggle with early in the year was off-speed stuff. In the first series of the year, Wilbur Miller reported that Bell was facing a heavy diet of changeups. In the first half of April, Bell was striking out in about a third of his at-bats. The struggles might not have been as much about any pitch as adjusting to pro ball and some of the conditions Bell never dealt with on a ball field.

For example, there was the opening series when Bell went 3-for-17 with eight strikeouts in four games. Bell saw a steady diet of changeups in game one, and was swinging through fastballs in day two. But it might not have been the pitches, as much as the unusual conditions.

“Oh, Hagerstown? That was like 15 degrees!,” Bell said with a laugh.

The Texas native wasn’t used to playing in the cold conditions that come in early April in Maryland.

“We have a couple of cold games every year, but nothing like that,” Bell said.

To his credit, Bell immediately went on a run after that series. Following that four game set, he went 14-for-45 (.311) with four doubles and a homer, although he still struck out 28.9% of the time. That’s where the lost time really hurts. In his final ten games before his injury, he hit for a .300/.310/.450 line in 40 at-bats. Unless he can return in early August and get some good experience, he’s probably looking at returning to West Virginia next year due to the lost time. And that return this year will all depend on when his knee stops swelling, allowing him to get to 100 percent and get back on the field.

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  • Any idea on why the knee is still swelling? I’m hoping that there isn’t anything they missed. That was my first thought.

    • No, it’s just fluid in the knee. This has happened with other players in the past. Not something that’s uncommon.

      • buccotime57
        July 26, 2012 8:00 pm

        I am guessing based on the fact that it was a lateral tear he had a meniscectomy(removal) as opposed to a meniscus repair. The lateral meniscus has a much poorer blood supply causing it to take longer to heal. The repair is better long-term but requires a longer rehab. Removal of the meniscus can cause irritation of the articular cartilage which leads to swelling. Swelling in the knee will cause inhibition of the neural supply to the quads again leading to a slower rehab. Ortho surgeons are changing their approaches to these injuries to help preserve the articular cartilage of the knee. Back to baseball will we see bell in arizona this year?

        • Thanks for the input! Are you a doctor, or have you had the procedure done?

          • buccotime57
            July 26, 2012 9:35 pm

            I am a physical therapist student (almost done, year 6 of 6) and I did have it done when I was in high school.

            • do you think they removed the entire meniscus? For just a tear and partial removal of the torn piece, this still seems like an awfully long time to rehab. I’m not a professional athlete, but I had a meniscus tear and partial removal and was back up to regular speed with six to eight weeks.

              • buccotime57
                July 27, 2012 8:29 pm

                No they always try to conserve as much of the meniscus as possible. James Andrews(THE ortho MD) and Kevin wilk(his PT) in their studies suggest 12-16 weeks of rehab prior to return to sport activities…also rehab is guided by symptoms not timetables…one of the primary guidelines to return to sport is lack of swelling in the joint.