Under The Knife: Upcoming labor deal may open door to more testing

One of the stories of Week 1 in the NFL was HGH testing. No one seemed to notice in the stands, but while people focused on games or even the ceremonies before most games, Congress was sticking their nose into the dispute between the NFL and the NFLPA, pushing for the players to accept testing.

What's that? This is my baseball column? I know.

Don't think the NFL is alone on this issue. Congress, led by led by Henry Waxman, seems to be using the NFL's situation to put more pressure on MLB, as well as the NHL and NBA. Waxman's letter, obtained by several sources, is pushing the NFL to accept WADA's standards for blood testing as well as the HGH isoform test. This is the test that is being used in the minor leagues, but has significant scientific questions, according to experts that include Don Catlin, the man that developed the test for THG ("the clear.")

With a positive finding for hGH not contested by minor leaguer Mike Jacobs, testing advocates are seeing a window of opportunity to push through further testing. There is a positive result in European cycling that is being contested, though it could be quite some time before the Court of Arbitration for Sports hears the case, which will be the first time the procedure itself will be questioned.

Bud Selig has advocated for this kind of testing before and has mandated it in the minor leagues. With the CBA expiring after the season, Selig may make a stand on the issue. Congress is not going to want to hear "we'll discuss it" but that likely is the best result. It wouldn't re-open the current agreement and it would give baseball another year to see whether the cost, privacy issues, and the efficacy of the isoform test is worth trading for something in negotiations.

The only way to put the so-called steroid era behind us is to be able to come to terms with it, in terms of defining it and learning the lessons from it. I think we'll see that move forward soon, but we have to ask the right questions. Powered by one of the longest weeks I've ever had, on to the injuries:

Youkilis has a bruised hip on top of an ongoing situation with a sports hernia. The hernia has been going on for a while as Youkilis thinks he can make it through the season and playoffs before getting it fixed. The problem is that the two conditions together are a real issue, kind of the worst cascade that feeds on itself. The Sox have to sit him until they get both situations back under control. It's hard to be patient while being swept by a surging rival, but it's the smart play. It should just be a few more days.

How can you sprain your ankle without spraining the ligaments? This isn't a zen riddle. When the Red Sox originally said that Beckett had a sprained ankle, but no ligament damage, I thought it was a mistake. Turns out it's semantics. Beckett didn't have the typical sprain where the typical supporting ligaments were strained.

Instead of guessing, the Boston Globe's Peter Abraham asked the right questions and got the answer out of the Sox. What Beckett has is a sprained joint capsule, which is made of a ligamentous material. It's "correct" to call an injury to any ligamentous material a sprain, but it's more commonly called a lesion. Like any ligament, time and rest will help it heal, as will the treatment he's been getting. This explains why he'd never felt anything like it, but it is essentially a one-off injury. There's nothing like this in my database, and doctors and trainers I spoke with were at a bit of a loss on how this specific injury would affect this specific kind of pitcher. Worse, they weren't even sure how this could happen. It will be a real test for Beckett and for the Sox medical staff, perhaps a pass/fail test for October.

Swisher has missed the better part of a week with what is only known as some sort of elbow injury. He's had something that reads like a hyperextension, with a sprain or strain and associated issues, without the actual event or trauma. An MRI over the weekend showed no structural damage, but that's such an amorphous phrase that we didn't learn anything. The Yankees think Swisher will be back soon, so the problem appears to be improving, if not clearing up entirely. Swisher missing a few games here is the smart play with the team heading into October. I get the sense the team feeds off Derek Jeter's spring stint on the DL. If the Captain can do it, so can anyone. That's smart.

Utley has been making progress after his concussion and appears on track to return shortly. He's been doing some light workouts and on Monday will take another ImPACT test, which the Phillies expect to lead to full clearance and a return to the lineup. There is some question as to why he's not on the seven-day DL. It's the same reason almost no one's on any DL at this stage; it's no help right now. Utley should return without issue, but concussions are tough things to judge. Utley's career path over the last couple years seems a bit like Chipper Jones, though when I look at the stat line, it's not quite there.

Across second base, Rollins will be back in the starting lineup Monday. He's already been activated, but this is a good signal that he can be put back in fantasy rosters. He will likely get some extra rest, but the Phillies won't do too much of that.

The concepts of catcher ERA and catcher defense are one of those things that are pretty poorly understood, even in a world where the movie Moneyball is coming out next week. Avila is still a young catcher and has had a huge workload increase in this breakout season of his, for obvious reasons. The danger is in overusing him. Avila took a foul ball off his chest this weekend that left a "giant [bleeping] bruise," according to one source who described the mark as covering "half of his chest and [had] all sorts of colors." Avila was off Sunday, but the Tigers may give him a few more days off to heal up. For the Tigers, they need Avila heading into October, so they'd be smart to find ways to rest him as much for protection as fatigue.

Santana will throw another rehab outing at Savannah on Thursday. Rehab starts in the midst of a playoff are of questionable value, but that's what the minors are there for and so far, Santana hasn't been dominating even at the low levels. The Mets are just looking for him to get some work. He's expected to go four innings and could move up to New York as soon as next week. He's going to be very limited, closely watched, and likely on long rest if he does come back, but the Mets do want to get some showcase/confidence starts in if it's medically feasible. Santana's second run at rehab has gone pretty well, though scouts have been much less impressed than the medical staff.

"Athletes don't live in a bubble." I wish I could credit that quote to someone, though it probably wasn't original to that person when I first heard it in 2002 or '03. It's something that's stuck with me, both when something like Affeldt's injury happens and remembering that athletes are people, with lives, duties, bills, and clumsy accidents. Affeldt injured his hand while trying to separate frozen hamburger patties. If it makes him feel any better, as I was getting ready to grill, I started to pry some hamburgers apart, but thought of Affeldt and put them in the microwave for a couple seconds, just to separate them. Affeldt needed stitches for a deep gash, but the worry is that there was nerve damage as well. The Giants will watch him closely as he heals, but there's no way to tell yet whether this accident will affect or even end his career.

Stephen Strasburg wasn't as efficient in his second start back, going three innings with his 60 pitches. Someone tell me why the Strasburg-Gorzelanny tandem couldn't be something we see all season from a team. When I look at the Nats, I see a team desperate enough to try anything for an advantage ... Tommy Hanson threw a bullpen that went well, with his shoulder responding well. He'll have one more before an instructional league outing. The Braves want him to have one start before the playoffs ... Nelson Cruz is expected to come off the DL on Tuesday. He ran well over the weekend ... The Yankees are going to give Alex Rodriguez a few days off to rest his thumb. Sounds like there might have been another cortisone injection, which means it could be an issue in October ... The Marlins held Mike Stanton out, just to make sure the hamstring doesn't get to be a chronic thing. Smart ... Logan Morrison played through knee pain, which is nice in that Jack McKeon learned his name and Morrison learned the organization cares little for his long-term well being. Rumors of his name coming up in a trade for Ozzie Guillen have already started. Again ... Rickie Weeks was back at 2B for the Brewers on Sunday. He's not 100 percent yet and probably shouldn't be in your fantasy lineup this week ... Vance Worley will shift to the pen soon, so that Charlie Manuel can see him there and get Worley used to the warmup routine ... Coco Crisp will have further tests on his injured ankles. If you have him for steals, he's not likely to have more this season ... Barry Zito was activated, but will not return to the rotation. There's some discussion that the Giants may finally eat a significant portion of his contract and deal him somewhere that can use a back end starter ... Drew Pomeranz was very good, considering it was his first start, it was at Coors, and he's only a few weeks removed from an appendectomy ... The Jays might shut down Jon Rauch due to a knee injury ... We tend to notice peaks and feats rather than consistency over the long season of baseball, but the Rays being in this thing is one of absolute steadiness. Coolstandings says there's only an 11 percent chance of them making the playoffs, but it feels like more.