Who Ya Gonna Call?
"If it's somthin' weird an' it don't look good..."
Letting Aramis Ramirez walk for the 2012 season was the easy part. The new Cubs braintrust loves supplemental round draft choices. Picking up the one year, $16 million option on ARam, with the expectation that he would decline and lead to a supplemental 1st rounder (which turned into pick #43, college pitcher, Pierce Johnson from Missouri State U.) was highly predictable.
The more problematic other side of the coin was to replace ARam for the near term. If the cliche' buy low, sell high... doesn't do it for you, at least Jedstein believes in buy low. Here's the checklist: 2003 1st round draft choice (10th pick), 2005 overall #4 prospect from Baseball America (after Mauer, King Felix, and Delmon Young), hitting setbacks because of injuries (knee contusion then left wrist) but with recovery possible based on medical reports, still young and relatively inexpensive, left handed bat, decent defender. OK, that all checks for Ian Stewart (no not that Ian Stewart, just checking to see if you use the links).
Here's where things jump the tracks. He's had a bad wrist for over a year and nobody in Colorado or Chicago has a diagnosis.
Ian Stewart's 2009 season was pretty interesting for a young-un (age 24). As in 25 HR's and 70 RBI's. His 2010 season was better in terms of batting average (.256) and OBP (.338) and about the same in OPS (.781 vs. .785). I found a series of articles on Ian Stewart from the 2010-11 offseason from Purple Row Blog by Andrew Fisher (part 1, part 2, part 3) and a followup article on his 2011 disaster season where his wrist problem started. Yet, even in that article the Rockies fans considered unloading Stewart an act of selling low:
The problem with Stewart, not only in 2011 but in his career, however, is what is found off of the paper. Without directly pointing his finger at the Rockies 2003 1st round pick, Dan O'Dowd has essentially made Stewart the face of this offseason's roster purge of nefarious characters. Preaching the need for accountability and proper focus, O'Dowd sold "low" on Stewart by sending him with Casey Weathers to the Cubs for outfielder Tyler Colvin and infielder DJ LeMahieu, neither of whom are guaranteed a roster spot in 2012.
So I understand why Ian Stewart is here. The picture is now clearer. He's broken. The more important question is, can he be fixed?
Having a sore wrist for a professional hitter is a bad thing. I remind you of Derrek Lee's broken right wrist from a collision with then Dodger, Rafael Furcal, in 2006. Lingering effects on Lee seemed to result in the loss of much of his power for the remainder of 2006 and it didn't rebound until 2009.
Now to the medical side. Supposedly all diagnostic imaging (MRI, X-Rays and EMG which is a nerve conduction test) are all negative. Stewart said in a CSN interview with Patrick Mooney:
“It was just always there in the back of my mind that there’s something not right, even though nothing showed up on the MRI or the X-rays. That was the frustrating part, because I still feel it there bothering me.”
Stewart described a tingling sensation, and having trouble with his swing on inside pitches. He said nerve tests came back negative last season when he played for the Colorado Rockies.
Previous medial opinions from Colorado and Chicago say nothing is structurally wrong. That doesn't mean it is a psychosomatic , somatoform or a malingering problem. Monday, Stewart will be visiting a doc at the Cleveland Clinic for another opinion. Although names have not yet been mentioned in the media, the biggest name that makes sense to me for a tertiary opinion is Dr. Thomas Graham, aka "hand surgeon to the Professional Athlete."
Dr Graham did a hand fellowship at the Indiana Hand center then did special training at the Mayo clinic in elbow surgery before started his careeer at the Cleveland Clinic in 1994. In Cleveland, he blossomed into the superstar hand specialist to the stars.
Graham was hand surgery consultant for professional sports teams in
Cleveland — still is for the Cleveland Indians and the Cleveland
Cavaliers. He also consulted for the Cleveland Symphony and the Rock and
Roll Hall of Fame and Museum.
In 2000 he went to Baltimore's renown Curtis Hand Center (the world's largest hand center). More recently he returned to Cleveland in 2010 as the head of the Cleveland Clinic's corporate venture called "The Cleveland Clinic Innovations." Graham is more than just a surgeon, he's well known as an entrepreneur and holds patents on several products for elbow joint replacements and upper extremity fractures.
Rock & Roll Hall of fame credits include David Crosby's hand. Make's one wonder if CSN&Y reference is to both Dr. Graham and Graham Nash.
"although Dr. Graham eschews the mantle, "physician to the stars, " usually two to five pro athletes are coming in per week to see him."
What could be wrong with Ian Stewart's wrist? Supposedly he's had pain and swelling of the left wrist and some tingling in his hand only upon certain activities but not all the time. From a Cleveland.com article on Stewart (and quoting Stewart):
"He said his wrist feels fine much of the time, but certain movements cause the pain to pop up again. It's more when it gets into certain positions," he said. "I dive for a ball and have to put the weight on my hands to push myself up. Certain swing path. Balls in, not so much balls away. But nothing where it's just hurting as we're talking right here."
So that might explain what has been a complaint by posters here at TCR about Stewart's "one-plane swing"
What possible diagnoses are under consideration? Remember this is just my speculation list of diagnoses. It will be Dr. Graham's job to sort out what where nobody so far has been able to do.
The most common cause of tingling at the wrist level is Carpal Tunnel Syndrome. Sometimes the symptoms can be quite subtle. CTS is a compression of the median nerve on the palmar side of the wrist underneath a thick transverse carpal ligament. The median nerve provides sensation to the thumb, index, long and half of the ring finger. It also provides motor function to the thumb. Symptoms usually develop gradually over time. Diagnostic studies such as EMG are often negative so it's often a clinical diagnosis but certain provocative maneuvers on exam can be helpful to make the diagnosis. More recent use of ultrasound imaging of the wrist can show if the median nerve is compressed or has unusual anatomic patterns. The treatment is on a conservative basis (for an athlete) probably a cortisone injection into the carpal canal but more reliably a surgery that decompresses the pinched nerve. Recovery for a hitter would depend on the surgical technique but could be as little as a month. The prognosis here is very good if that is the diagnosis.
Other pinched nerve syndromes exist as well. The ulnar nerve can be compressed causing tingling into the little/pinky finger at an anatomic site called Guyon's canal. Surgical release of this nerve is the treatment when the problem is chronic.
The wrist joint proper is complex with eight carpal bones. Medical students trying to learn their anatomy have used several clever Mnemonic tricks to help recall all eight (please check out this link). The wrist bones are arranged in two rows of 4. Proximal row: Scaphoid (or Navicular), Lunate, Triquetrium and Pisiform. Distal row: Trapezium, Trapezoid (thumb side), Capitate and Hamate. Not to be forgotten are the two bones that end the forearm, the radius and ulna. There are multiple significant ligaments that connect the carpal bones permitting stable transmission of forces and permitting the foundation for hand function ranging from precision fine motor control to power grip activity.
Carpal bone injuries often show up on MRI imaging, so this is less likely unless it's really subtle. Baseball players have sustained scaphoid fractures and hamate fracturess, pisiform and triquetrium fractures are rare but not unheard of. Phillies OF Domonic Brown had a hamate fracture in 2011. So something more subtle might turn up yet in diagnosis with more expert evaluation.
One diagnostic test not mentioned is the wrist arthrogram, which is either an X-Ray with contrast material injected or an MRI with contrast material injected. Much had been written on shoulder injuries that get worked up with MRI imaging that can be more useful when dye is injected to add contrast to structures in the joint. The same is true for the wrist. Tears of a specific cartilage known as the Triangular fibrocartilage/TFCC can be seen better with this imaging. Also more subtle wrist ligament tears can be assessed since the wrist can be moved after the dye injection and the pattern of where the dye tracks can be useful.
Wrist arthroscopy is used to sort out and treat several conditions that might not show up on diagnostic imaging. When Stewart refers to needing surgery on his wrist. This is a very probable possibility. From the American Academy of Orthopedic Surgeons (AAOS) website on Wrist Arthroscopy:
Chronic wrist pain: Arthroscopic exploratory surgery may be used to diagnose the cause of chronic wrist pain when the results of other tests do not provide a clear diagnosis. Often, there may be areas of inflammation, cartilage damage, or other findings after a wrist injury. In some cases, after the diagnosis is made, the condition can be treated arthroscopically as well.
Monday in Cleveland, I'm betting that Ian Stewart gets a recommendation that will lead to a diagnosis and treatment...and maybe more than one plane to his swing.
it's day old news, and it's got nothing to do with the cubs, but ichiro signed a $2m deal with MIA (with a $2m option for 2017).
neat. 41 years old and damn close to 3000 hits.
also, rain delays suck.
take that giants
I think that if a team objects to the 1-game wildcard playin game so much, they could just win the pennant and avoid themselves the trouble.
Per Jesse Sanchez at mlb.com, Cubs reportedly have signed 20-year old Cuban OF Eddy Julio Martinez for $3M bonus.
BLOCK: Of course any advantage is an advantage. An MLB, NBA, or NHL team getting the extra game at home in a seven game series is an advantage, I just don't think it is enough of an advantage for winning a division and/or having the best record in a conference or league over the course of an 82-game season (NBA and NHL) or 162 game series (MLB).
TEX takes the opening game from TOR (@TOR) 5-3.
TOR lost bautista + donaldson in-game due to injuries...TEX lost beltre...dunno if any will be lingering issues leading to missed games.
Ride the Kid Magic! Schwarber hadn't homered in a long time before last night.
Greg Maddux was 8-18 in his rookie season. Kyle has the 8 wins down pat.
Think Baby Maddux.
Prof. Harold Hill's THINK system at work.
Kyle is on the far left.
I support this. Hendricks has not only looked better lately but seems to start struggling after a few innings which is better than the 1st in the playoffs.
Just tweeted via Jesse Rogers: Hendricks starting Game 2. Wow. Just wow.
That was good!
Well said. On one hand, I thought the HBP was a bad baseball play -- down 4 runs, put a runner on for a red-hot Fowler. On the other hand, they needed to do something -- I hadn't thought about the warning/pitching inside point. Is Hurdle that smart? He does not strike me that way. By the way -- not clear which fan base you are referring to in your "first" 3rd point.
My unsolicited opinions on topics covered in this thread:
1. I hate the fact that after 162 games, a team could be out after 1 game. However, I think the system is pretty close to perfect right now. 2 of 3 isn't feasible unless they shorten the regular season, and it ices the division winners for way too long. This creates excitement, and rewards the division winners.
Personally, I think the game could have had a very different look had the Pirates held onto the ball and tagged Fowler out on the steal in the first. Cole was clearly frazzled, but if they took that runner off the base, it could have relaxed him a lot.
Football games are played once a week. There are 16 games a year. I'm not even remotely following at all how you can compare the two leagues and playoff systems. It is physically impossible to play a home and away series. The idea of not having any road games in baseball playoffs is certainly a head scratcher.
How is not having the first and last game at home a benefit for the division winners and team with the best record? How is it not an incentive to win the division when a WC team has to blow their top pitcher?
Call me lost.
Two 97+ win teams in a do-or-die, great bullpens, overpowering starters, plenty of pop--hard to believe that game wouldn't be tense. A 4-0 lead is not a blowout, especially in that situation and with the Cubs' young bullpen. Not only would a defensive play here or there make a difference, but you get the win there also on the home plate umps strike zone (generous strike calls for Arrieta, including a couple Ks), and on Schwarber sitting on the right pitch at the right time.