Saturday, August 28, 2010

To Repair ACLs--Or Not?

Wow--Michele of Just A Thought posted on a really confounding study, cited by the New York Times earlier in August, that found people who just went through rehab after tearing their ACL had just about the same outcomes in terms of pain and function of their knees as people who, like Michele, me and lots of others, went through ACL reconstruction surgery.

My first reactions were 1) that can't be true, and 2) I went through all that pain for nothing?

I don't know what I think at this point. I do know that I was repeatedly collapsing on the floor in martial arts class due to the instability of my knee--and it's highly likely that those collapses contributed to the meniscus tear that also got repaired during my ACL surgery. Perhaps immediate physical therapy would have strengthened my leg enough I wouldn't have had those collapses.

There's no question that a leg with ACL reconstruction is more stable, it seems. The question is just how important that stability is.

Part of the back and forth about ACL surgery in the article was:

“Most subjects can do in-line activities” like running or biking “without an A.C.L.” He [an ACL surgeon] adds, “On the other hand, we believe that A.C.L.-deficient subjects that do return” to sports involving cutting, pivoting or planting the leg “can consequently injure the meniscus” or other cartilage in the knee and would benefit from a replacement A.C.L.
The authors of the study are less sure. “On the basis of our study results, we’d tell patients” that “there is no apparent downside of starting a good rehab program and waiting with the surgery decision to see if it is needed or not,” the authors wrote to me.

Well, I've done ACL surgery, and I feel it allows me to pivot, balance on one leg, and absorb blows better than I would have been able to do. But there clearly are some downsides to ACL surgery, including intense pain and a long recovery period. As Black Belt Mama's horrific experience shows, not all ACL surgeries work out--she just had to have new surgery to repair damage from unsuccessful ACL surgery.

And frankly, it's a little creepy to me that my left leg has never quite grown back in size to match the right leg--it's not that I look like I had polio or anything, but if you look closely you can usually see the difference.

There's one black belt in our school who had a torn ACL years ago and who never got it repaired. She's a terrific black belt, and has all her functionality in sparring (she's a "little thang," maybe 5'3" or so, but she can kick me in the head!). She does wear a brace when she spars. She doesn't grapple, where I assume the brace would get in the way.

I'm not going to regret getting ACL surgery and having a more stable knee. But I think I will advise my friends who have injured ACLs and who haven't gotten surgery yet to consider physical rehab before they decide on getting the surgery.

Many thanks to Michele for pointing this article out.

Wednesday, August 25, 2010

End of Summer

A lot of changes are in the works here. Our daughter moves into her dorm in New York City on Sunday, and it's going to be really tough seeing her go, though she's nearby. Our son is starting to take a full course load farther out on Long Island, along with work and his own apartment, all of which is great.

To help pay for all this college, we're trying to live a bit more simply. For one thing, we've gone down to one car, which I kind of like; my wife gives me a ride in the morning to the train, and it's nice to see her even if she's sleepy.

New beginnings for my kids, and the fall season, call for new beginnings for me. In martial arts, my goals are to improve my close-range sparring, boost my conditioning, flow better in grappling, and shave off a few more pounds to get down to a fighting weight below 190. I'm not specifically aiming for my second-degree black belt--that may require more effort than I can put into training right now, given the growing commitment my work is requiring.

Cheers to everybody, and enjoy the end of summer.

Monday, August 23, 2010

Best Laid Plans

Was planning on going to grappling class last night. Long Island Railroad exploded instead. Made lemon out of lemonade--took the subway to my old neighborhood in Queens, my wife and daughter met me at a restaurant there. But got home way too late to make it to class.

I figure if I shoot for exercise six days a week, I'll get there four or five days.

Friday, August 13, 2010

Back from Vacation: Training

Back from vacation, I plunged into work, where it felt like I was two weeks behind after one week of vacation. But I also got in some good training, including a couple of mornings running in the gym at work on the treadmill as cross training.

My school has new students from another school nearby that combined with ours, so there are new folks to spar and train with. I got a brown belt in a triangle choke, woohoo!

I put in extra time after my two grappling classes, working on my jab on the heavy bag and trying to practice close-range sparring. Last night, did standup sparring, and my jab and head movement were a little better; but I'm dropping my right hand (from exhaustion? from feeling like my opponents are juuust out of range? from concentrating on other things?) among other flaws.

I wouldn't keep coming back if there weren't always things I could improve, I guess.

Friday, August 6, 2010

DudeBro Bob

Second day of surfing lessons. I got up early while Jeanne slept. Waves were much bigger today.

I didn't stand up all the way, best I did was get one leg up under me. It occurred to me that my reduced flexibility after ACL reconstruction probably makes it a little harder to bring that left leg up under my body the way it's supposed to.

I was nervous. I kept thinking about an older man I know who, some years back, broke his neck body surfing and is paralyzed from the neck down. I learned how to use the surfer's helmet (both arms cradling the head to cushion any impact), and that I should tumble with the wave instead of fighting it. I wiped out repeatedly. The first time, I actually felt my gorge rise from tumbling and nerves.

Surfer dude Matt, my instructor, said if you're not wiping out, you're not trying.

I don't think I'Ll be trading in my day job for the surfing circuit anytime soon.

Thursday, August 5, 2010

Surfing Lesson

My wife wanted to take a surfing lesson on vacation and I joined her. While waiting, I saw a guy come out of the water with half a board and joked, "ooh, a shark bit it!" And my wife looked me right in the eye and said,"Don't scare me any more than I already am," and I realized how nervous she was.

We were the only two students. Chris, our instructor, was right out of central casting, a blond California surfer dude with sunglasses and, he told us, a girlfriend from Spain.

We wore wetsuits due to the surprisingly cold water this season. On shore, he showed us where to lie on the long surfboard, how to paddle (arcing the chest and head up as in a "Superman" stretch) and safety practices like protecting your head with your hands when you've fallen off and come out of the water. We learned about wind, tide and how they effect waves for surfing. To our surprise, high tide was bad for surfing, but good for our lesson, because the waves are so close to the shore--you could break your neck falling off the board surfing, but it made it easier to get past the breaking wave zone for our lesson on the boards.

For me, the scariest moment was after I had first paddled past the breaking waves and the instructor went back in to bring Jeanne out also. I was in deeper water than I'd been in absent a boat, and while the waves weren't breaking there were a lot of big swells. The board felt unstable. I wondered how deep the dark-green water was and what was swimming under me.

In the water, we practiced paddling, turning the board, sitting up on the wobbling board and, of course, getting back on after falling off.

My wife got tired and the instructor brought her to shore. We had drifted, so I started paddling against the current and wind, parallel to the beach. Man, that's where I realized what a good workout you can get from surfing.

Back onshore, the instructor showed us how to pop up to actually ride a wave. The stance is sideways--closer to what I saw in a kenpo class (even more sideways than that, however) than the more forward-facing boxing/muay thai stance I naturally took.

As for actually riding a wave--maybe tomorrow when I take another class!