The Winter Of ACL Discontent

Although the most pain from an ACL operation occurs in the first few days, I found that my lowest point emotionally came several weeks into recovery.

The analogy I would use is the children of our friend Lisa. A number of years back, when they were very small, they looked forward to the holidays (Hannukah in their case). When New Year's Day rolled around, with snow and ice everywhere, they turned to their mother in perplexity: The holidays are over, where's the springtime?

When I was first recovering from ACL reconstruction surgery, my mental attitude, to the extent I could think through the pain, was the equivalent of uttering some choice Anglo-Saxon words and vowing, "I am NEVER going to do this again!"

But pretty quickly I could see progress, which was so encouraging. The pain didn't end right away, but it decreased, and I could do things with my leg like raise it or make visible quad muscles tighten. I enjoyed going to PT and getting good feedback on my progress. One PT intern told me she would always remember me because I was her first patient who was zipping through ACL recovery.

But then I hit a point three or four weeks after the operation when I was ready, like my friend's kids, for springtime: I wanted things to be back to normal. I had been working so hard, and hurting so much, for weeks, wasn't it time for me to be able to do normal things normally again?

It was at that point when I realized that, yes, as I had read, ACL recovery does take a very long time, and even though I had worked really hard, I had a long time and lots of work left to do. My ACL winter would last a long time, and then it would be spring.

Bending The Knee

One of the most confounding things about recovering from ACL surgery is how difficult some very simple actions become.

Take, for instance, jumping and bending the knee.

I anticipated that it would be hard for me to bend my leg in the first few weeks after surgery. (It's shocking how much enthusiasm the physical therapists, who in my clinic all seemed like the girl next door, put into bending my leg to its extremely painful limit!)

However, I didn't anticipate that, a few months later, it would be difficult to support my body weight while bending my knee. Even just a little bit.

One of the first ways you notice this is how difficult it is to descend a stairway in normal, "reciprocal" fashion (right leg goes down a step, then left leg). This is something you feel long after you've begun walking again without a brace.

One of the exercises my physical therapists gave me later in my five months with them was to stand on a step or platform, weight on the recovering leg, and simply bend the knee enough that your other heel touches the ground. It's almost embarrassing how difficult it is to accomplish. As the exercise progresses, the therapist raises the platform higher.

Now, I don't know if this diffculty is unique to having gotten a patellar-tendon graft, rather than an allograft or hamstring graft. But I have a feeling it affects all types of ACL surgeries to some degree.

The most frightening thing my therapists asked me to do is to jump a couple of inches off a platform and land on my recovering leg. (This is clearly an advanced level of PT.) My therapists said it's very common for people to feel afraid about this. For one thing, before surgery, if you jumped and landed on your knee, you would collapse painfully because your knee was unstable. For another, you've just been through the most painful period in your life, centered on this knee--so you're very protective of it. Here again, part of the issue is you need to bend your knee to absorb the shock when you land, and that's hard to do.

I got my surgery in late March, and today I'm walking stairs reciprocally without limping or needing to hold onto a rail. But truth be told--this speaks to Michele's point about it taking up to a year to get your strength back--I still feel a little weaker in my left knee walking down stairs.

Back In The Saddle

Yesterday I went back to core "karate" class, and this afternoon I went to the gym for strength training--push-ups, pull-ups, crunches, dips, squats/lunges.

I thought about running on the elliptical machine for a bit, but passed on it because I'm still feeling the effects of my cold, though it's much improved.

I also did a "multi-planar" exercise my physical therapist gave me--stand with feet shoulder-width apart, keep the weight on the leg that had the ACL reconstruction, reach back with the other leg and twist the body--net effect is you're twisting the knee with the weight on it. (Note, this is NOT an exercise for newly reconstructed ACLs, I didn't start this one until I was fairly advanced in physical therapy.)

Martial Music

Finding good psych-up music for martial arts workouts or competitions is tough when you're taste runs to Stevie Wonder and James Taylor.

Much as I enjoy "Carolina In My Mind," I wouldn't say it gets me pumped for combat.

UFC combatants tend to enter the arena accompanied to what I guess is metal music, with shrieked lyrics. One of my not-yet middle-aged classmates favored AC/DC.

Not for me.

Some songs I have found that work with my middle-aged taste for psych-up music include:

Street Fighting Man (Rolling Stones)
Lucky Town (Springsteen)
Pride (U2)
Higher Ground (Stevie Wonder)
Mr. Jones (Counting Crows)
The Contender (Theme from the TV show, by Hans Zimmer)
and, of course, Gonna Fly Now (Theme from Rocky, Bill Conti)

Enlargement

Before martial arts, my weight was over 215, pushing 220.

The least I've weighed in middle age was before my tournament and black belt test, when my weight got down to 190 or, I think before the tournament, 188 (at age 48). I'm six-foot two. Interval sprints were a big factor in getting my weight down that low. I now find sprints hard to do because they hurt my knee and my feet.

I gained weight after my ACL operation, even though my left leg was visibly atrophying. When I got back to martial arts classes, I brought my weight down to around 194, where I had been before the operation, though it has fluctuated widely.

This morning I tipped the scales at 202.5. At most, the gunk in my sinuses could account for only a pound or two. (Yeah, gross, I know.)

Now, I have been doing more strength training, with a personal trainer and on my own, and that probably accounts for some of the weight gain--muscle weighs more than fat. But not all of it. At 51, I don't grow muscles like a teenager.

It's the holidays, and I've been eating.

At this point, I don't know what my fighting weight would be. More about fighting weight in a moment.

In terms of weight divisions: At a student competition my school holds, I figure I could easily (when I'm not sick and it's not the holidays) make the 185- to 204-pound division--the same division I was in at 48. (This weight includes equipment, which maybe adds four or five pounds.)

In amateur boxing, I figure I would be a Heavyweight (up to 201 pounds). I don't think I could make it down to light heavyweight at 178 pounds.

In IKF amateur kickboxing, I'd currently be, gulp, a heavyweight, or if I trained hard and got below 195, which I think is definitely possible, a cruiserweight.

In mixed martial arts, I'd be a light heavyweight (185 to 205).

But really the question is not what division I can squeeze into, but what is a good weight for me to be at. And right now the answer seems to be a bit in flux. I'll see what happens to my weight when I'm feeling well, I'm working out more regularly, and I"m not eating my way through the holidays.

Merry Christmas From Aetna

I just opened a bill from my physical therapists. My last session was in August.

It seems Aetna, my insurer, hasn't paid them a dime--the bills were denied. So either they want me to get Aetna to pay them, or I can pay them $3,583.

You can be sure I'll call Aetna today to wish them the very Merriest of Christmases as well.

Addendum: Upon calming down and examining the letter more closely, I saw that the payments weren't made from June 19 through the end of rehab on August 7 (my ACL surgery was March 27, and I started rehab two days later). I called Aetna, which said it sent a check on Dec. 6--three days after my therapists sent me their letter. So this little issue should be resolved--phew!

Key ACL Recovery Suggestions

As I think back on recovering from ACL surgery, some specific suggestions occur to me.

1. Showering: Get a plastic lawn chair, put it in the shower, and shower sitting down. This is really important. If you shower standing up, you risk slipping and wrecking your brand new ACL.

2. Vicodin: People at my work joked that I would be hallucinating on Vicodin. I wasn't; instead, the big side effect was that I was (there's no delicate way to put this) constipated, big time. Every body is different, but what my PTs and doctor suggested, and what worked for me, was drinking prune juice. It tastes awful, and sometimes it takes a couple of doses, but it's worth it. I just threw the prune juice out last week, I hadn't used it since, but for a week or so it was truly my friend!

3. Friends: Put your pride aside and tell your friends you need them to visit. If you attend a religious institution, tell the people there you need visitors--that's one of the things those institutions are set up to do (in my case it was a Unitarian Universalist congregation). When my wife had to go back to work after taking some time off to care for me, friends came by to help me with things like getting into and out of the continuous passive motion machine (which may not be used much anymore, from what I hear, but I did find it helpful), or refilling ice for my knee. And they just talked. It did my spirit so much good to have friends drop by. I still want to hug them every time I see them.

4. Exercise: As a martial athlete, when your body says you can start, begin doing push-ups, crunches and other exercises that won't strain your knee. You'll feel good about yourself when you can start working out again, even on a limited scale. The key phrase is "when your body says you can start."

Sick Sick Sick

I was so stuffed up last night I barely slept. It didn't help that a neighbor called at 2 AM looking for a teen who was out past curfew (I understood the concern, but the call woke me from a good sleep). I missed my usual Saturday core class, which is a real drag because next week, between school closings and travel for me, I won't have many opportunities.

I spent the day feeling like my sinuses (see photo) weighed a ton, drinking fluids and watching movies on the tube. I hope I can sleep more tonight.

ACL Recovery, Part II

I wish I could remember more details about the timing of my recovery from ACL surgery--I may have written it down in a paper journal, which I'll try to dig up.

I earlier wrote about some of my recovery. But with some fellow martial artists in recovery from ACL surgery or headed that way, I'm trying to remember more.

I wasn't supposed to put weight on my leg for a week because I also had a meniscus repair. But by the end of the week I was more mobile. In another week or two, if I recall, I was walking without crutches, but because I had to wear a rigid knee brace, I was moving my hip up and down like a peg-leg pirate.

One big step was when the physical therapists allowed a little hinging movement in my knee brace, first when I slept (which, believe it or not, is really nice), and then walking. The weirdest thing is, once they allowed me to walk with a little bit of hinging in the brace, they HAD TO TEACH ME HOW TO WALK AGAIN. I think it was three weeks after surgery, because I remember being amazed that I could forget how to walk in only three weeks.

Who Needs A Gym?

I got my resistance training in at home. I didn't want to go to the gym with my head cold.

I now do five exercises at the strength-training gym: push-ups, dips, crunches, squats and pull-ups. I had to modify things at home because I don't have a pull-up bar or a pull-up/dip machine.

Push-ups, crunches, squats--no problem.

For dips, I did dips using a chair for support. Photo above is from exercise.about.com.

Pull-ups are the hardest to imitate without the equipment, but I did dumbbell exercises called (I think) bench rows, which work some of the same muscles of the back.

I did three sets for each exercise. I did work up a sweat.

Now, it's back to Christmas shopping. I'll also grab some Airborne, which BBM suggested, though I'm afraid I'm too late in the process of the cold for it to help much now.

Sore Throat

I woke up last night with a sore throat. I felt better after a naproxen, but tonight I do feel like I have a cold. I had hoped to attend an extra class tonight, but I stayed at home, drank fluids and watched "I Walk the Line" on the tube.

Observation And Guidance

Our sensei really observes when we drill or spar and gives very specific guidance. Last night, we were working on a slip to the left and then throwing a left hook punch. This slip entailed actually stepping as well as moving the head to the side.

Sensei kept looking at what I was doing, and made three separate suggestions: 1) set my feet during the hook punch--I had acquired the bad habit of pivoting away during the hook punch; 2) rotate my body away from the punch after throwing it, to help me gain distance and protect myself; 3) step towards (or, really, on an angle grazingly past) my opponent, rather than to the side.

It was incredible the difference this advice made in my ability to slip and hook.

I sparred a bit with Larry, but we went at it pretty light to work on this move. I got hit pretty hard in the chin by black belt Brandon, who's about 22 and faster than lightning--I had to ask him to lighten up a bit. I was able to keep a brown belt at the right distance pretty easily--apparently he really relies on kicking and I'm not doing that yet. Gumba Frank posed his usual challenges, though I am more effective than I used to be in sparring him--he's really taught me to keep my right hand up. When sparring with a low belt, I was trying to focus on defense, but when he started headhunting me, I hit back--and probably too hard, I stunned him with a hook. It's so hard finding the right balance in contact sparring. Thanks goodness for headgear.

ACL Epidemic

Hack Shaft is a budding martial artist and aspiring middle-agester (below 40, but nearly there) who blew out his ACL recently. His blog is an account of his "journey from defeat in injury to victory in reconstruction," and well worth following. As of this writing, he's 14 hours away (CORRECTION: 14 days) from his surgery.

Black Belt Mama, a widely read blogger whom I mentioned before, just underwent ACL surgery and is recovering now.

Best wishes to both of them, and speedy recoveries!

Aikido v. Judo

Here's a very interesting post from Mokuren Dojo about Aikido v Judo.

Aikido sounds fascinating to me, and sounds like a very ethical form of self defense--you can defend yourself without hurting your opponent if you wish. However, it sounds like it doesn't provide much exercise, which is very important for my physical and mental health, and I don't see how I can take up yet another activity at this point.

Maybe some day.

Jump Rope Aftermath

My body is talking to me today, and it's saying, "Jumping rope is hard on my knees and feet!"

The most painful thing is plantar fasciitis, which has posed a problem for me before. It's an inflammation of soft tissue running the length of the bottom of the foot. In my case, oddly, it's my right foot that's hurting the most, though the left knee is the one that got the ACL operation.

My left knee doesn't hurt a lot, but I want to pay attention to any pain I have there.

I figure that doing half an hour of cardio workout in the morning, and then a core class at night, probably burned off an extra 800 or 900 calories for me yesterday.

But in the spirit of listening to my body, I'm going to work out just once today--no AM cardio workout. I will take kickboxing class tonight, and we'll see what I can learn and how I'll fare in the elite Wednesday class. How can I neutralize Larry's pressure tactics? Can I move well against Gumba Frank the way I learned about a month ago?

Maybe I can go back to two workouts tomorrow. But today, I'll be doing some Christmas shopping.

Nautical Cruise; Knots In A Jumprope

On Saturday night, about 140 students of my martial arts school and their immediate families went on a dinner cruise. My wife got to meet a lot of the people I train with, or see them again. While she's very supportive of my avocation, she has no interest in doing martial arts herself, beyond maybe Tai Chi.

I realized while introducing her to people how many of my friends in the school are, like me, at the Brown Belt Bottleneck. Many of them, like me, have had setbacks due to injuries.

The boat, on Nautical Cruise Lines, ride stayed close to Long Island and was fun. I think the boat pictured above is the one we were on.

I'm on vacation this week and getting to do some extra training and cross training. Yesterday I went through the push-ups, pull-ups, crunches, dips, squats and elliptical routine my trainer and I worked out. Today I just did cardio, doing the elliptical for 20 minutes and, for the first time since I wrecked my ACL, about 7 minutes of jumprope on a padded mat. The front of my leg below my knee hurt a bit, but not a lot.

I've forgotten a lot about jumping rope, but It was fun to do it again.

Tonight, I'm going to core class.

Words From My Sensei

I was talking with my friends at the Jersey City Fight Club about how much I had enjoyed the kickboxing part of my black belt test (shown in the photo--I'm on the right). Since I passed that part of the test (and in fact passed everything except grappling, because I got injured), I won't go through that again next time I test. I was wondering how I could have an experience like that again.

Suddenly I had an idea: I could volunteer at the black belt test to spar with the brown belts.

I talked to my new sensei about this on Saturday after my core class. I told him I didn't want to go to a tournament because, hey, I'm 51, the risk of injury is higher there--the one tournament I attended, I fought a young tiger so young he could have been my son.

My sensei said he wants me to focus first on getting my black belt, but he said the idea makes sense. At the tournament, head contact isn't allowed, so people go all out hitting the body. At the black belt test, it would be easier to pair me with other "seniors," technically for us 35 and older, and the tests are very closely supervised--they don't want people getting knocked out. (I know of one instance, but that was a young tiger fighting a professional.)

He even thought I could help out with sparring in the second-degree test.

I got nervous about that. I've seen those second degree candidates going at it with each other. I told him I would be worried about getting hit in the head too hard, due to my bad eyes and risk of detaching a retina.

He said they put the "young stallions" together in one group, and I would be there to help testing for the seniors. He commented that the young stallions don't always get the belt because they don't show good style, they're just out to pound on somebody.

He said I wouldn't be first in line to help with the testing. People doing preliminary work for their second-degree black belt get first shot. But he said he would look for places for me to join the kickboxing test where it's appropriate.

We talked about my plan to start grappling, and kicking in kickboxing, in February. He said he wants me to be confident and not afraid for my injured knee before I re-take the test. I'll have a red dot on my knee, indicating that it was injured, so my opponents will be instructed not to do locks that would hurt my knee such as ankle locks. But I have to also show that I won't get caught in such positions. He said he would like to see me work initially in grappling class with my friend Larry, who also had ACL surgery, and understands what it's like to return.

He was glad I was telling him what I enjoy, and he said he could see now I'm eager to get back into full form. He said he was impressed that my sense of proper distance in kickboxing class (I'm just boxing now) had returned very quickly--I felt happy to hear that comment!

Last night the whole school went on a dinner cruise, I'll post on that later.

Guitar Hero Homecoming

This was my last day of commuting to work this year--what a relief. No more three-hour round-trip commute for the next couple of weeks.

My daughter turned 15 today--I'm sitting within earshot and eyeshot of a bunch of loud teens playing Guitar Hero at our house. Her age is why I can't move closer to work. I don't want to take her out of high school and away from her friends. When she goes to college, we can move--my wife is willing--although by then, who knows where my office will be, given that my company was just taken over.

I stood next to a teen boy in our living room whom I don't know earlier tonight. Suddenly he looked at me startled, realizing I had been standing next to him for a few seconds.

"I was joking about that," he said.

I had no idea what he had been talking about. I should have said, "Good." Instead I said, "Don't worry, I didn't hear you." A missed opportunity to intimidate a teen, alas.

I have been more careful this week about when I work out, and I feel much stronger. My schedule:

Tuesday night: Core karate/martial arts
Wednesday afternoon: elliptical cardio and body-resistance training with private trainer
Thursday night: Core karate
Friday afternoon: Jersey City Fight Club
Tomorrow, at noon, I've got another core karate class. I missed sparring this week due to a friend's going away party Wednesday night.

My trainer at the gym downstairs from work came up with a new routine after I told him I was missing cardio training, and that the other workouts were taking too long for me to complete. He responded well. I start with 20 minutes on the elliptical machine. Then I go through a sequence of push-ups, pull-ups (on a machine that offsets some of my weight), crunches, dips (also on the http://www.blogger.com/img/gl.link.gifmachine), and squats. Being a personal trainer, he always scrambles things up, but this is something I can do on my own.

I've always since I was a kid wanted to be able to do pull-ups, but I didn't work on them for fear of being embarrassed by not being able to do them. It's good to be working on them--and they'll help muscles that the push-ups don't tap.

This coming week, when I'm off from work and not traveling, I'll be able to do at least two of these routines during the week. I've been too busy at work to do more than the one private training session a week.

I'm not going to be able to afford a private trainer all the time--I only have four lessons left. But I'm learning some cross training from him for my martial arts.

I'm also really enjoying the Jersey City Fight Club. The other "members" are editors, like me, at my job. A couple are true athletes: One's a marathon runner, one's a triathlete. We do through a warmup, push-ps and crunches, shadow boxing, and a bag workout. I'm teaching them punching, moving and, just a little, kicking from kickboxing.

I enjoy it for the workout, but also because I'm making friends. I realized earlier this year that I was too close socially at work to the reporters working for me--I am doling out limited resources, and they will inevitably be disappointed sometimes in what I can do for or give to them. To protect me from the emotional trauma of their disappointment, I realized I need to look to other editors more for my social circle. This is one way of doing that, and it's been a lot of fun. Everybody agrees, too, it's a great emotional release.

Exhausted

Listen to your body, people say. I'm listening, and it says it's exhausted.

Wednesday night: Martial arts (sparring)
Thursday AM: Private training, new routine
Thursday night: Martial arts (core, cardio, strength)
Friday PM: Bag workout (Jersey City Fight Club)
Saturday noon: Core class again

I went to my trainer at the gym near work a week ago and said I wanted to change up the routine. I need my cardio training, and since the time I can put into training is limited, I have to get some in his routine too.

So Thursday I did 20 minutes on an elliptical machine, interval training, with him really pushing me on the high-resistance segments. Then I did a sequence of push-ups, pull-ups, crunches, dips and squats. The push-ups and dips are on a machine in the gym I've never used, which gives you an assist. The upper body stuff was exhausting, I did work to the point of failure.

Usually I don't do martial arts Thursday night, but I had to cancel the Tuesday night session, so I did two workouts in one day.

I think I'm really feeling the lack of a day off anywhere in this stretch. There's so much work I need to do before my Christmas vacation that it's hard to get gym time in at work, which throws my schedule off.

Super Mario

My mind was reeling last Wednesday due to some family stuff that I don't think I can go into yet. Suffice it to say I told my wife before leaving for class Wednesday I would be happy if I just came out of sparring in one piece.

One of my favorite new classmates is a 24-year-old named Mario, whom I faced Wednesday. Henceforth, for reasons that will become clear, he will be known as Super Mario.

Super Mario hit me with a move that I'd seen on TV in mixed-martial-arts bouts, but never faced in sparring: The Superman Punch. The essence is that the attacker fakes a kick with his back leg, but then transitions into a cross punch. The natural reaction of the defender, upon expecting a kick, is to drop the hands--you know you're supposed to keep them up, but the reaction is hard to resist. And then, while your hands are down, the cross punch comes in--boom!--to your face.

Super Mario has good control, so he just sort of tapped me hard to let me know he got me. I should have kept sparring, but I just stopped and congratulated him on totally fooling me. It's going to take training to learn not to drop my hands.

Elsewhere Wednesday, I felt bad because I was sparring with my buddy Ilicia, and twice I "tapped" her in the head when she was moving forward. When you are moving forward into a punch, you effectively double the power--the punch is a LOT harder. She was just great about it, she said it wasn't my fault because she moved into it, but it was jarring for her, and I felt guilty.

Ilicia and Maria, from The Family That Fights Together, had both competed in a tournament the Sunday before. It was Maria's third tournament and Ilicia's first. It takes so much courage to compete, I'm proud of both of them. Ilicia used to be very nervous, so to compete took great courage. Some other students also competed--I heard that Tony, a father in his, 30s, did well but injured his previously-injured toe. I haven't seen him yet.

Busy

Life's been busy busy, and I haven't posted in a while. When I do have a little more time, I want to talk about a new training regimen at the gym, and my encounter with Super Mario, among other things.

owwwWWWW

Thursday night, a "core" class, we ended by doing 110 lunges--step forward, bend the front knee, let the other knee almost touch the floor. Sensei said we would hurt the next day. Friday, I felt okay. But at 12:20 Saturday morning, in bed, I got the most intense cramp in my right hamstring. Ouch.

Class today, Saturday, another core class, was very difficult for me. I'm still worried about hurting my ACL and knee, so my round kicks aren't very pretty. And I was tired from the first push-ups in class. I think maybe I didn't get enough sleep this week.