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.
crunch 8 hours 40 min ago (view)
semi-interesting winter league note...
trey mcnutt (yes, that guy) is having a hell of a winter league in mexico (one of the less talented winter leagues) so far as a closer. 15.2ip 8h 4bb 24k, 0.57 era.
giants signed him to a minor league deal a couple weeks ago. he never went anywhere. he's been consistently playing ball in the minors and indie league ball since he was last a noteworthy player. last season he played in the OAK minor league system. 30 years old now...
jdrnym 15 hours 37 min ago (view)
Brad Brach signs with the Mets for $850K but the Cubs are paying $500K, per Ken Rosenthal. Wasn't his 2020 club only supposed to be on the hook for league minimum?
crunch 16 hours 14 min ago (view)
when he got to the mets he suddenly learned how to throw with control (small sample size etc). last year was not a fun bullpen year...
crunch 18 hours 31 min ago (view)
Yeah, I've made myself familiar with a lot of the changes, but AZP's posts have both added more information and cleared up stuff I didn't fully grasp. I appreciate the hell out of it. Thanks Phil, thanks TCR.
bradsbeard 20 hours 13 min ago (view)
Looks like Savant has his breaking pitch classified as a curve while Fangraphs calls it a slider. Suppose by ST he could have made everything over in the pitching lab, so who knows!
Arizona Phil 20 hours 29 min ago (view)
Again, none of these rules (including the one that requires a pitcher to face a minimum of three batters or else record the final out of the inning) have been officially approved.
I think one possible caveat that might be added to the three-batter minimum rule would be that the pitcher can be replaced prior to facing three batters or recording the final out of the inning if the other team puts up a pinch-hitter.
Arizona Phil 20 hours 33 min ago (view)
Ptchers would also be treated differently under the new rules as far as the Injured list and Optional Assignment to the minors is concerned, with pitchers having to spend at least 15 days (up from 10 days) on the Injured List before being eligible to be reinstated and at least 15 days (up from 10 days) on Optional Assignment before being eligible to be recalled (inless the pitcher is being recalled to replace a pitcher on the 26-man roster who has been placed on an MLB inactive list).
Arizona Phil 20 hours 34 min ago (view)
SONICWIND: As the rule is proposed, prior to the start of each MLB regular season a club must designate all players on its Opening Day 26-man roster as either a "pitcher" or a "position player." A maximum of 13 can be designated as pitchers (14 pitchers max when rosters expand from 26 to 28 beginning on 9/1).
For players who come up during the season, the club must designate the player as either a pitcher or a position player when the player is placed on the MLB active list roster.
Arizona Phil 20 hours 46 min ago (view)
BRADSBEARD: Fangraphs shows the CT as his primary pitch in 2018 with the SL & FB (and an occasional CH) as his secondary pitches, with no CV at all. I guess I'll find out for sure in Spring Training.
Sonicwind75 22 hours 3 min ago (view)
AZ Phil, thank you as always for the detailed information. How is the "cannot be a pitcher" part of the rule to be enforced? With a few two way players and the increasing amount of mop up innings being handled by position players it seems like there could be a gray area there. What is preventing a team from stashing an athletic relief pitcher as a "5th outfielder" that could be a pinch runner and play a passable OF when needed but could also provide them with extra relief pitcher. Anytime I hear of a new rule I always think of how Bill Billichek would circumvent it t
bradsbeard 22 hours 3 min ago (view)
AZ Phil, looking around Baseball Savant, it looks like Winkler now primarily throws a low 90s cutter, a 4-seamer that he throws a little harder (but is less effective), a curve and a sinker. The slider and change haven't been a major part of his repertoir the last two years. The cutter has been really effective the last two years but it looks like he lost command/effectiveness of his 4-seemer and curve last year For whatever reason
bradsbeard 1 day 1 hour ago (view)
They just signed this guy:
Hagsag 1 day 2 hours ago (view)
There seems to be a lot of player movement so far. Too bad the Cubs aren't involved.
Arizona Phil 1 day 18 hours ago (view)
Beginning in 2019, a club must wait a minimum of seven days before it can place a player who was claimed off Outtright Assignment Waivers during the off-season back onto waivers, so because he was claimed off waivers on Wednesday 11/27, yesterday (Wednesday 12/4) was the first day the Cubs could place LHRP C. D. Pelham back onto Outright Assignment Waivers, and so tomorrow (Friday 12/6) is the first day the Cubs can send Pelham outright to the minors (if he was placed back onto waivers yesterday).
Arizona Phil 2 days 15 hours ago (view)
A Competitive Balance draft slot can be traded only during a period of time starting on December 2nd and extending up until two hours prior to the MLB First-Year Player Draft (MLB Rule 4 Draft), so don't be surpised if these draft picks are traded during the off-season.
Keep in mind that the slot cannot be traded for cash unless it is a financial adjustment made to offset the salary of one or more of the players involved in the trade.
Arizona Phil 2 days 15 hours ago (view)
The active list roster limit changes scheduled to go in effect in 2020 have not yet been officially approved. Same goes for the three-batter minimum (or else record the third out in the inning) for relief pitchers.