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.
Ryan Kellogg is still a fringy prospect despite being very old for low-A. He's putting up very good numbers no matter who he's facihg.
Great article on Yosh and Nobe. Thanks for including it Trans.
Phil, it looks like Kevonte Mitchell has made some progress this Spring. Your thoughts please, thanks.
so far ryan williams (AAA) is the only system prospect on the "could be ready soon" horizon doing well...that said, he's not very exciting and he's assumed to be an end-rotation talent at best.
paul blackburn is getting great early returns in AA, but he's getting surprisingly low K numbers doing it. he throws lot of low/sinking stuff with good control...also assumed to be an end-rotation guy, but he's got room to be better, especially given his control as base to build on.
Speaking of pitching -- another ugly outing for Underwood at AA. Through 6 starts: 5.19 ERA, WHIP 1.69. Yikes!
Man, do we need starting pitching depth. Our best hopes are still hanging with AZ Phil in Arizona. Very scary.
jeebus... that's terrible.
*clap* *clap* *clap*
Thanks AZ. If you like him, I like him.
Awesome report, and good to see Beeler on his way back.
I'm also very happy to hear about the bi-level bump for Daniel Lewis. In the Name of Theo, he was the Last of the Full-Season Cuts, and There Will Be Blood for those who unnecessarily slow his development. Sure, he might end up in independent ball pitching for Lincoln. But if everything breaks right, he may even have a shot at joining up with the Gangs of Chicago. I wouldn't bet My Left Foot on it, though.
CHARLIE: The Cubs did the same thing with LHSP Eric Jokisch last month, and it has nothing to do with needing the player's 40-man roster slot.
The hope is that another MLB club will claim the player, so that you aren't on the hook for any termination pay (which you would be if you release him) AND you pick up $20,000 from the claiming team, all for a guy you don't want going forward anyway.
Moosetacos, I like it. All I can think of is a bearded lumberjack dude operating a Mexican style taco truck with a Canadian accent.
How strange is this for May? Is it insignificant, or does it suggest some sort of trade might be in the works?
The Cubs have sent LHRP C. J. Riefenhauser outright to Iowa.
Cubs MLB 40-man roster now stands at 37 (three slots open).
yow...the a.gordon/m.moustakas collision now makes the schwarb collision look minor in scope.
gordon broke his wrist, expected to miss 4+ weeks...and today moosetacos has been diagnosed with a torn ACL. fun times in KC.
dodgers calling up julio urias for tommorow's game. neat.
fernando-mania might have a new heir...dude is 19 (turns 20 in august) and he's got a legit argument for being MLB-ready.
Tony LaRussa, still an idiot