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.
Kershaw, Fernandez and Syndergaard are your current leaders and all will be pitching meaningful games down the stretch that could make or break them. Hendricks will not be and his saber-numbers aren't anywhere close to those 3 and he'd split votes with Arrieta and Lester whom all are basically neck-and-neck for WAR and FIP. If Kershaw pitches like just okay Kershaw in September he deserves to win in a landslide. Voters are pretty much saber-inclined now so it would take a crazy shutout streak or something for Hendricks to jump in the picture.
AZ PHIL: With starters the likes of Edwin Jackson, even Chris Rusin or Michael Bowden could look good on their staff. At best, he is a #5-6. But as always, LH are at a premium.
Sure we would all want consistency. He is not even 24, has played 5 (!) positions this year. Can you imagine what is in his head? He was only a part-time player at 2 spots last year. And THEN think about hitting?? Cut him some slack...You sure are picky lately. First wishing #6 NL RBI guy Russell have a better average, and now an "unncessarily fancy pick". Geez tough crowd!
it's going to be hard to take down scherzer.
kershaw is supposedly coming back soon, though he'll probably need a good amount of deep innings to match up with scherzer...probably too late at this point. tanner roark, bumgarner, and hendricks are probably going to steal some votes along with kershaw.
I absolutely love Javy's game, and I love the way Maddon changed the perception of him as a ballplayer, but I really wish he would just make the routine plays routinely. On the ground ball in the 9th, he made an unnecessarily fancy pick. He made the play, but tried the same thing last night and made an error.
How many wins does Kyle need for serious Cy Young consideration? Would 17 be enough if he leads the league in ERA? My goodness, what a season -- makes a Dartmouth alum proud.
hendricks WHIP drops to 0.98 over 159 innings after throwing 7ip 3h 1bb 4k, 0r/er
ERA down to 2.09 on the season.
I am pretty well fed up with the majority of home plate umps. Just terrible inconsistencies.
Oh shit forgot about that
Shark and Sczur right?
Yes, football player?- check.
If it was 2006 Hendry would be there w a Bible and a contract
he subscribes to my twitter, he's beyond TCR. #yolo #swag
Whoops. Maddon must have been reading TCR (for his daily crunch) and got confused.
kuhl is a righty, not a lefty.
i think maddon might think kuhl is a lefty, too. i wonder what the reasoning is for baez leading off vs a rightie.