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.
vogelbomb debut for tacoma (AAA SEA)... 3-3, 1bb, 1 HR, 1 double...DH'd.
while he mostly played 1st considerably more than DH for AAA CHC, DJ Peterson is probably going to see most of the time at 1st for AAA SEA.
Carl Jr.! Very nice!
Baez with another "WTF?" play trying a delayed steal with a runner on 3rd and one out.. Remarkable talent, needs to make better decisions.
m.montgomery up in the pen with a man on 2nd, 2 out, and rondon 20 pitches into the inning.
...and rondon ends it 22 pitches in with a popout to RF.
I gotta say with the crappy defense the Brewers have displayed outside of Fowler I'm pretty disappointed the offense hasn't shown more and Rizzo seems to be very swing happy lately. That said my god am I happy Madden has finally given Carl Edwards a chance after multiple times up with nothing. I don't think he could handle a starting role with his body frame but his stuff plays so well in a relief role and he seems to be able to handle high stress situations very well.
2nd at bat. Fowler is good for the Cubs run differential.
welcome back fowler.
More slow news...
Did Davey Martinez have to bring the shotgun?
glad to see almora going to AAA to get work.
.265/.291/.422 through 86PA...2hr, 7 doubles.
i don't expect too much of an improvement when he's taking over CF next year, but the team doesn't really need him right now as much as they need him to get regular work (imo).
CHITOWNMVP01: The Cubs MLB Reserve List (40-man roster) has had one slot open since 7/6 (when RHRP Joel Peralta was Designated for Assignment).
The problem with the September roster is all of the pitching changes. They should find a way to limit pitchers to twelve except for extra inning games. More pinch hitters or pinch runners do little to slow the game down and are more fun than endless calls to the bullpen. I also think the fans get cheated when they use position players to pitch because employed a half dozen pitchers with righty-lefty switches. Having as few as four positions players on the bench to start a game also leads to some pretty ugly defensive substitutions.
CHITOWNMVP01: Joe Nathan's 30-day Article XIX-C minor league rehab assignment expires tomorrow, but he doesn't have to be reinstated from the 60-day DL tomorrow.
Also, I think 40 man roster should be full, not at 39, unless I counted wrong. I'm in a hurry to leave the house.
Dexter Fowler is back! "You go, we go!"
He's being activated for tonight's game. Almora down and Montgomery replaces Patton.
Also, doesn't Nathan have to be activated tomorrow? Pitchers aren't allowed to spend more than 30 days of rehab and he was sent to rehab assignment on June 23rd. Tomorrow is July 23rd.
Yeah, last night was a bummer. I clicked on the espn Gamecast just in time to see the 5-2 score change to 5-5.
Their next 10 are Dodgers, Mets and Marlins.
Slow news day...