Wilson Ramos sat with his right leg outstretched, the bulky black brace engulfing his knee visible beneath his athletic shorts. As he stared out at the field where his teammates were taking batting practice, he slipped his catcher's mitt onto his left hand and tossed a ball to himself for a few minutes.
"Look," he said, motioning to his legs and straightening his left one for comparison. "See how much less swollen it is?"
It's been nearly two weeks since Ramos turned to his right to field a passed ball from Jordan Zimmermann, caught his cleat and collapsed in a heap on the field in Cincinnati. The anterior cruciate ligament in his knee snapped. His season was over.
But now, as the swelling continues to subside and the Washington Nationals' catcher prepares to put reconstructive surgery on his calendar in the next two weeks or so, his focus has turned to rehab. For a player whose knees and legs take more of a beating than any other on the field, it will be a long, grueling, arduous process.
Catchers tend to be less at risk for this type of injury, which is more common in athletes who make lateral movements frequently. Once it occurs, though, the fact that catchers spend the majority of their time in a squatting position — a "deep bend," as Nationals medical director Wiemi Douoguih called it — makes quickly regaining range of motion and flexibility paramount. Ramos will begin working on that with a physical therapist the same day he undergoes surgery.
But long after he feels physically able to return to his duties, Ramos' mind likely will still have doubts.
"It comes down to pain tolerance," said Chad Moeller, who caught for 11 years in the major leagues after twice tearing his ACL in college at Southern California and is well-acquainted with the rehab process Ramos is about to encounter. "The quicker you're able to get that range of motion back, the quicker you're able to move on with your rehab.
"That being said, he will feel fine at four months. He will feel better at six months. He will not feel normal and totally trust it for over a year."
Moeller described two rehabs. In one, Ramos will perform numerous exercises and movements, many minute but grueling, to strengthen the muscles in his legs and return his knee to full health. In the other, he will have to overcome the fear of recurrence, even though Douoguih said it is statistically unlikely.
Ramos isn't interested in slipping his cleats on now, viewing the spikes as the death knell for his 2012 season. But he knows, in order to return as the starting catcher next spring, he'll have to.
"It's totally mental when it comes to that," Moeller said, pointing to the 12- 14-month range for when those doubts diminished for him. "Because you're not getting in the batter's box without cleats on and you're not going to catch without cleats on. ... It's just going to mentally take him time to get over it. But he will get over it."
There will be other aspects of it for Ramos, who viewed this season as a chance to further distance his mind from his harrowing kidnapping episode in Venezuela this past offseason. The Nationals want him to stay in D.C. for the year, continuing his rehab under the supervision of team personnel, and are working toward bringing his family to the States during that time.
It's also been communicated to him that while the Nationals never viewed his 6-foot, 250-pound frame as overweight, and do not think it contributed to his injury, getting leaner will only help his rehabilitation and put less stress on his soon-to-be surgically reconstructed knee.
"We're going to encourage him to condition because he's had a major injury," Douoguih said, making clear that it was not simply about weight loss. "A lot of times, guys are able to get away with things because they're younger and they've never had a problem.
"We try to discourage them from going outside of our program to begin with, but once you've had an injury, it's usually often easier to get into the player's head about doing the right thing because they don't want it to happen again."
The Nationals don't plan to make public the timetable for Ramos' rehab. Douoguih said the range is six months to a year, though different for everyone. Much of it depends on how the muscles from the core through the hip and knee respond.
All are in agreement, however, it is an injury he can recover from as long as he dedicates himself to his rehab.
"It's a big deal," Moeller said. "It's a very big deal, because you miss time, and you have questions in your brain, and there's always things that can happen. But there is no real reason why, as a ballplayer, you shouldn't be able to come back, as long as you put in the time.
"It's not experimental [surgery] anymore. They do this daily. They're very good at it. There is absolutely zero reason why he won't come back just as good as he was before — if not better — because he will have worked harder."
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