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.
Hmmm, my math might be fuzzy but if he retired 3 batters with 3 pitches, how did he get a 1/1 GO/AO ratio?
Pls DFA Peralta when Richard comes back. Richard 1 IP, O R, O ER, 0 BB, 2 Ks in first rehab appearance. We really need to trade for a LHRP.
"The Boston Red Sox were banned from signing any international players for the next year and had five of their teenage prospects declared free agents on Friday after a Major League Baseball investigation showed they circumvented signing-bonus rules last year, a source familiar with the situation told Yahoo Sports."
The thing with Heyward is its not just free agency. He is way under performing his career #s. He's making the same % of contact but his soft contact is much higher and hard contact much lower than all his previous years so there is something very specifically going on this year causing the issues. Chances are he will eventually get back to his previous #s and it's better to get the slump now and get that hot run later but I wish I knew what is different about this year. He's either just not seeing the ball as well or a swing change is causing it.
Only 3 pitches for Leathersich. Not much of a rehab outing.
Thanks for the reporting Phil.
He's the nastiest pitcher I've seen in awhile. I'm gonna give them all a mulligan on this one.
Coghlan's strike out was more disappointing. He was fighting off a lot of pitches and not swinging at crap, and on the last pitch, he swung at stuff he was laying off, and struck out.
And Heyward, too. I don't blame Heyward - I blame free agency. I hate it. You almost never get a valid return on the investment.
I look forward to the day when ball players own the teams. The current economics are not sustainable.
Oh, I'm sure you're right. He's not 27-27 in saves for nothing. But, man, I hope they learned last night that he didn't throw a single pitch in the zone to KB, Contreras or Baez, and they all just kept swinging.
Sounds like a much better game than last night's fiasco in Flushing.
I'm pretty sure it looks like a sweet pitch on the way in. How many sinkers like that are there at 98 mph? I agree that they should just do a Lackey and stand their with their bat on their shoulders until he throws a strike next time, but I can see how that's hard to do.
The bullpen, on the other hand, is a mess, and Heyward is starting to piss me off.
I noticed that too. He's getting to everything, but when he gets right under it on a high flyball he looks uncomfortable
Did you expect anything different?
Wow, did they blow this game. Stupid plays by the kids in the 7th -- Almora throwing to 3rd instead of 2nd to keep the DP in order (when a DP probably wins the game) and Baez throwing to 3rd (to a backpedalling KB) instead of getting the easy 2nd out at first - cost them the game. Also, Contreras almost throws the ball into RF on a nonexistent pick-off play. And Maddon, for using Peralta in the first place. Did they do a bunch of shots in the dugout before the 7th? Unbelievably bad baseball. I thought Almora had a high baseball IQ?
men on 2nd/3rd, 0 out...and nothing.
cubs lose :(
UH OH! RALLY TIME!
Getting tired of this Heywood weak sauce
Yep, can't say I disagree with that. His first batter and resulting walk was just brutal. Reminded me of a bit of Jacque Jones spiking his throws into the ground from RF.