The Aha Moment
I'm getting more mileage out of this story than Ian Stewart will get out of his dismal 2012 Chicago Cubs season. In historical terms for 2012, third baseman, Ian Stewart will be just a small foot(wrist)note at the bottom of the media guide.
Stewart came to the Cubs in a "damaged goods" type trade. He didn't have a diagnosis for his 2011 bad left wrist woes and multiple doctors could not find any "structural" damage. Theo and Jed figured that a "non-structural" problem would get better with an off-season of rest. We all know that this is not the way Cubbery works.
In a trade that made sense at the time because Aramis Ramirez was being converted into a supplementary round draft choice, Ian Stewart was acquired from Colorado as damaged goods and the Cubs took that risk. I've written on this topic BEFORE Stewart went to the Cleveland Clinic for a teritary opinion with the medical history of an undiagnosed painful left wrist problem. I won't rehash the pre-Cleveland Clinic information. You can recap it here in the TCR post, "Who Ya Gonna Call."
Sports medicine Doctor to the pros, Dr. Thomas Graham, finally diagnosed the problem. The reason for this sequal is that it seems that there was an "Aha moment" when the diagnosis was made. Both doctors and patients really like those moments. It's the medical equivalent to what both Mr. Burns and his long lost son (courtesy of Tim Souers) would say in a similar situation: "Excellent."
Carrie Muskat at mlb.com posted the first article on 7/2 that acknowledged that Dr. Graham had diagnosed Stewart's problem and then detailed the surgical plans here. She related that Stewart in a prior injury a few years ago may have injured or even fractured the navicular wrist bone leading to his problem.
A few years ago, Stewart had fractured a bone in his wrist, and Graham determined that another small bone was in contact with the larger one. Removing it should alleviate the pain.
MLB.com writer, Rowan Kavner quotes Stewart in a Sunday, 7/15 article:
"Over those two or three years, there's a lot of cortisone shots, a lot of MRIs, X-rays, with nothing ever showing up," Stewart said. "It had been weighing on me a lot, especially over here, being with a new team and wanting to prove myself."
Even Dr. Graham didn't figure out the problem until he examined Stewart's wrist under fluoroscopy. Fluoroscopic imaging is an X-Ray unit with live time imaging, including the ability to image the wrist bones while the wrist is put through movement. In fact, Dr. Graham needed to examine Stewart's other wrist under fluoro to make sure what he saw was specific to the injured side.
The Aha Moment:
"On the screen, he saw one of the bones on the outer part of my wrist was overlapping the bone next to it, which really means it's touching it and they're kind of rubbing together," Stewart said. "He kind of went from there and realized that's not what's supposed to happen."
That makes this a structural problem. It was just difficult to diagnose, without going the extra mile (just like Theo's scouts are supposed to do). Finally there was a diagnosis: DWI or dorsal wrist impingement. The anatomy here is the dorsal (or top, not palm side of the wrist) portion of one of the wrist bones, known as the scaphoid (aka navicular) impinges on the capsule (connective fibrous coating) of the joint and a nearby tendon (the extensor carpi radialis brevis) or an adjacent wrist bone (probaby the capitate). It's seen most commonly in gymnasts and obviously uncommon (or not something often considered) in baseball.
(Note: the blue mark on the wrist where Dorsal Wrist Impingement occurs)
The surgery included a wrist arthroscopic exam, which was mostly to make sure there was no additional abnormalities in the joint. Then there was an open/incisional part to the surgery which including taking out a segment of the wrist bone that was impinging on other structures.
Kavner's more recent article says this about his postop treatment:
Stewart, who had a bone taken out of his wrist, said there's no timetable for his return. He will get the sling removed in a couple of weeks, when he'll return to Cleveland to take off the wrapping and progress into more movement.
Though his status this year is still unknown, he thinks a return next season is definite.
The earlier Muskat article related:
When could he return? Doctors said it might not be until early or middle September.
“You don’t know if there’s enough time [to play],” he (Stewart) said.
As a patient, Ian Stewart has to be thrilled to have his mystery problem (hopefully) solved. As a professional baseball hitter, we all know that that the wrist is critical for bat speed and control of the swing. What the Cubs do regarding Ian Stewart's contract for 2013 is yet to be seen but with his 2012 season mostly being a non-event, at least Jedstein should get some credit for getting him diagnosed and treated under their watch. Because of this good deed, on their baseball deathbed, team-Theo should receive Total Consciousness (which is nice). I'm hoping, Stewart will come back for the same money in 2013 and everyone gets a mulligan. Unfortunately, the Laws of Cubbery would predict that Stewart will have his best seasons soon after leaving the Cub organization.
Good Hendricks sure is fun to watch. He was hitting all his corners today and the Phillies couldn't do anything with his changeup.
Bryant and I believe Zobrist both did that too.
Soler BB acumen and plate awareness is excellent. Not unusual for even the best players to react as if they were about to hit them, "even though they weren't that close" from your vantage point sitting on your deck, or wherever.
soler vs inside breaking balls is scary.
he's had 2 inside curve balls today where he reacted as if they were about to hit him even though they weren't that close...one he bailed out of the box on, it was a called strike.
j.urias optioned back to AAA...guess we wont be seeing him in the LAD series.
so is him actually getting 2 hits in a game (2 doubles!)...first time he's even been on base 2 times in a game since 9 games ago on his 3/4, 1bb day.
im ready for him to at least look like a 2-slot hitter since he's gonna be slotted there no matter what he does.
That Heyward move to avoid Bryant's ball hit at him was a thing of beauty too.
9 pitches in and this game already rules.
HR, double...bryant's turn (who came out to a Kris Kross song for some horrible, horrible reason).
...2 run inning...zoobrest hitting streak at 14.
First time I saw Herrera was yesterday. He took like 100 pitches, fouled off a ton off Lester.
Very nice young player and perfect leadoff guy.
Obviously not Phil. But he mentioned this on Wednesday.
"Dominican Summer League (DSL) Opening Day is Saturday June 4th, so probably about 8-10 pitchers and position players presently at EXST in Mesa will be sent to the Cubs Dominican Academy (probably sometime this week) and be assigned to either DSL Cubs #1 or DSL Cubs #2."
In the comments here: http://www.thecubreporter.com/05242016/cub-power-d...
Per FanGraphs, Cubs have a 72.5% chance of winning today. Jinx! Next highest percentage on today's games is D-backs with a 64.7% chance (Greinke vs. Cesar Vargas, in Arizona.)
Phil, when will the Cubs start moving international players from EST to the Dominican for the start of the DSL season?
It was a nice barehand pick-up but he was close enough to 1st where he could underhand the ball to Bryant. The trouble he's had has been with the overhand throw. He's definitely working on it, but I don't know if that play was a good example of progress made.
Phil, have you heard anything about the condition of Oscar De La Cruz's elbow? Has there been talk of a time table? Is he throwing?
i was distracted for most of the game and also missed the first few innings.
but yeah, any time he makes a good fielding+throwing play on D it's worthy of praise and a trip to pizza hut for a personal pan pizza and $1 worth of songs on the juke box.
seriously, i'll take it.
BTW, CRUNCH, Lester made a nice bh pick-up and toss to Bryant. Did you catch it?
He's been workin' on the D!