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.
My guy Addy
oh, another a.russell HR...whatever.
Dylan Cease throwing gas tonight for the Emeralds. In first three innings, has hit 100 mph six times, averaging 98 mph
Can I get a gif of Joe West's jowls waving as he chews gum?
/Asking for a friend
my gawd...that castillo-to-bryant pickoff was a thing of beauty. the knock on him in the minors being slow out of the crouch is looking less like a thing.
bless your heart. *pinches cheeks*
real shame I missed this week's episode of The Crunch Reporter.
It's highly unusual.
It does matter a little.
It matters much less than you think.
four winds field is awesome. it's crazy how minor league parks have "grown up" since the 80s/90s and that park was one of the late-80s models that showed a low-capacity ballpark could look like you're at something other than a highschool baseball game.
On another topic....I returned to South Bend last night for the 2nd time this season (still haven't tried either the deep-fried mac & cheese sandwich nor "The Porknado", as the drive home is over an hour and that could get ugly), and was pleasantly surprised to find D. Underwood pitching in a rehab start. He looked good -- although, to be fair, these are low-A hitters -- fastball consistently at 94-95 (if the SB scoreboard is to be believed -- several pitches were clocked in the 30s...) and with good location.
he gains nothing, no advantage, no saving of resources, nothing...there is not a cost/benefit tradeoff...him letting the running game go on around him for others to control isn't gaining him an advantage elsewhere. it's putting him at a disadvantage even if it's not cashed in with a run.
And out of respect for the rest of TCR, I'm done on this. I'm sure I'm not the only one in the other camp, but time to let it go. (Until the next Lester start. I kid.)
He is putting himself at a disadvanage. But how much of one relative to the rest of his game? He's not Justin Germano -- he's inarguably one of the best SPs in baseball, issue or not. It would be more of thing to discuss ad nauseum if it constantly caused him to give up runs and lose games. But it doesn't.
shouting down my points about lester with "well, it didn't hurt" is like saying it doesn't matter if a guy starts out walking 3 guys every inning as long it's followed by a K and a double play.
it's like elevating ERA and wins to a high level while ignoring what it took to get there.
I'm asking how much it has hurt Lester and the Cubs this year. Do you have that answer?
I legitimately don't recall you answering that quesion, apart from the condescending silliness you just posted. So if you did answer specifically about the impact of Lester's issue, I'd like to re-read it. Thanks.
if runner = on base and pitcher = j.lester then lead = large
if lead = large then probability of extra base on following hit > average of mean
okay, enough of that silliness...
...you can read more on the thread i copy/pasted this from the last time you decided you needed to talk to me about me.