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.
I've been wracking my brain to work a "Room With a View" reference in there but I just haven't gotten it to work.
Bryant might be playing SS during an infield shift, no? Usually he is moved to 2B but it could happen.
I won't really be happy until I see Bryant at shortstop.
Yeah, Underwood impresses the internet scouts more than the opposing hitters. Blackburn and Williams have pitched well but they would be more interesting if they missed more bats.
Myrtle Beach has a couple of guys--Trevor Clifton and Jake Stinnett--worth keeping an eye on.
South Bend has the best record in the Midwest League but it's more about their bats than their starting pitching.
Thanks Steve, I always forget about that.
Maddon spins the wheel-o-lineups and Bryant is playing 1B.
The line-ups, by the way, appear in the Twitter box on the left and usually very soon after they are made available.
Looks like no Heyward or Rizzo in the lineup today.
HAGSAG: Kevonte Mitchell has shown some improvement in 2016. He takes a lot of walks, shows occasional power, and he's an athletic defender capable of making the big play in the OF.
However, he strikes out way too much, he doesn't always take the most-direct-route to get to balls hit into the air, and he sometimes runs himself into outs on the bases. He is still very raw.
E-MAN: I don't think Dallas Beeler has a long-term future with the Cubs, but (when healthy) he has gotten the call over the past couple of years as the "26th man" when the Cubs needed an extra starter in a doubleheader.
PHIL: Thanks for the wrap. A 2010 early-ish round Hendry draft pick, why do you surmise the new management team just doesn't cut bait on Beeler? Not shown that much as a starter. Does he have a power arm when right? Is he another Schlitter? Or, is he rosyer filler while the org waits out the lower-level arms to surpass him?
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.