Friday the 13th Tale

My return visit to my orthopedic surgeon today was inauspiciously timed.

He bent my leg, shook it, made sure I realized it wasn't healthy, and rendered his verdict: If I lead an active life, eventually I'm not going to be happy with my knee and I'll come back for surgery. "You're not a potato on the couch," he said. He even said activities like running and sprinting--which don't involve cutting, pivoting or torquing the knee--would lead to knee pain, an assertion that left me, frankly, surprised and dubious.

My verdict: I'm continuing with physical therapy, and I'm going to see a physical medicine and rehab physician--a physiatrist--to see get suggestions on how to stay active without surgery.

No doubt, my body is conspiring against me. I caught a cold a week ago, which restricted my exercise and even PT; I twisted my knee again two weeks ago in an unlucky accident. (My orthopedic surgeon said a torn ACL used to be known as a "trick knee" that "went out" every once in a while. I've heard the term before.)

I take heart from a 2010 New York Times article, cited originally by in the Just A Thought blog, that cited research saying people with ACL tears who had physical therapy alone had improvements after two years comparable to people who had ACL surgery. The PT-only group had knees that were less stable, but that instability didn't seem to be a big deal. The study authors were quoted in the article:

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.

I figure that a physiatrist is much more likely to know what I can do, how much I can do, and how to do it safely with a torn ACL. My appointment is a week from tomorrow; I wish it were tomorrow.

That said, I do feel--and I sweat somewhat saying this in a martial arts blog--for the time being, I must interrupt my mixed martial arts training. I've suffered grievous injury twice to my knees from kicking or being swept in mixed martial arts, and that's a fact that looms very large at the moment.

The thought occurs to me that boxing might be a way of giving myself a similarly intense workout to mixed martial arts, but without kicking or sweeping. It might even offer me a way of continuing to spar, which has challenged and enlivened me in mixed martial arts (though I'd definitely want to talk to the physiatrist about whether and how to do that--e.g., would I need a knee brace?).

I'm facing lots of questions; I don't know where this journey will end up. The next step, when I get up from writing this entry, will be to do another set of physical therapy exercises, and to continue to be patient.

End of Vacation; Fighting

Alas, tomorrow the work week begins after two weeks off. I'll miss having so much time with my family.

I will return to training after taking one week off (I did train hard the week of Christmas), though I'm going to stay away from sparring and grappling for a bit more to be sure my rib is healed.

Martial arts blogger John Vesia had an interesting post back in November, which I'm only finding now, about boxers who could have been martial artists. It stimulated an interesting discussion about whether boxing is a martial art (many of his readers didn't think so), and whether fighting arts are martial arts. There's a boxing coach, Christy Halbert, author of The Ultimate Boxer, who makes the interesting argument that a boxing match isn't a fight because the boxers aren't angry at each other; they often have tremendous respect for their opponents in the ring.

An interesting perspective; but not the one in the movie The Fighter, which I watched today. Christian Bale in particular puts in a virtuoso performance as Micky Ward's crack-head brother. There's plenty of anger, and more fighting in the two brothers' family than there is in the ring. The crazy family dynamic, and Micky Ward's (Mark Wahlberg) effort to balance his needs with his need for his crazy family is the center of the movie.

Bale's performance was disturbing to me since it was reminiscent of a person I love who has a similar troubled personality though, thank God, not the addiction the character has. A very powerful movie.

A Pause

Things are developing that I'm getting a break from training in the last week of the year. The blizzard on the U.S. East coast kept my school shut Monday; I've been out of town on a mini-break with my wife since Tuesday. On Friday and Saturday, the school is closed for New Year's.

It's not an unwelcome break, given that I'm nursing a bruised rib. Last week I did train, including running two days, though I concentrated on "core"/bag training classes and not grappling or standup sparring, which would have hurt my rib. Time off also gives me time to reflect.

I'm becoming increasingly interested in the practice of mindfulness,a concept from Buddhism that also is growing in psychological circles. I associate it more with traditional martial arts than with my mixed martial arts school. One aspect I'm very interested in is the idea of not judging or trying to push away suffering and troubling feelings, but embracing them.

owwWWWW

I don't think I have a torn pec, I think I have a bruised upper rib. Took a punch there from Anthony while infighting; it hurt so much I couldn't move, even though the Joshu was yelling at me, "Punch back! Punch back!"

From an Internet article on bruised ribs:

Bruised ribs are notorious for their long healing time. Unfortunately, there is little you can do about bruised ribs as they tend to heal on their own. Typical healing time for bruised ribs is anywhere between 3 to 6 weeks. Once, you are diagnosed for bruised ribs, it is important that you prevent them from any further damage.

Tonight: Naproxen. Ice. Stretch. Hot shower.

Foreshadowing?

A classmate once observed the tradeoff for not having the ills of a sedentary life--aching back, diabetes-related ills, heart troubles--is having lots of little acute pains.

Today I still have a sore thumb which I jammed a couple of weeks ago, but I also have aches from three days in a row of class, including my first grappling class since August.

And, weirdly, I'm sore from falling out of the shower for the first time in my life. Yesterday, after grappling class, I was taking a shower at home, and I lost my balance; my feet slipped out from under me, and down I want, pulling the shower curtain down with me.

Fortunately I didn't do any serious damage--I didn't hit my head, and my knees bent normally, so no knee injuries. I remember putting a chair in the shower after my ACL surgery to avoid falling and tearing my new ACL.

But I definitely got bruised up. I don't know why I fell, but I quickly thought of how my father, at 89, fell a few months ago and ended up in the hospital. It felt like a foreshadowing of what's to come when I get old, and I didn't like that feeling.

Black Belt Blues (apologies to the similarly named blog)

(You should know that Black Belt Blues is the name of a blog by a recoveree from ACL reconstruction, and an excellent place to visit.)

It's been a busy fall so far for me. Last weekend was the first time in six weeks that I haven't worked on a Sunday--but I did go to Virginia to take care of my parents. A tree had fallen on their porch--and on my Dad's beloved 20-year-old pickup truck. The pickup was crushed, the porch was heavily damaged.

So my Dad, at 88, went out to try and clean things up. Instead, he fell, impaled his arm on some wreckage, and got a nasty, nasty puncture wound.

So I went down to spend the weekend. He needed more stitches, and he needed reminders to take his antibiotics every day.

Between work, family and the trip to Virginia, I am pretty sure that last week was the first time since recovering from my ACL injury that I didn't attend a single martial arts class (apart from vacation weeks spent out of town). That's how busy it's been.

When I got back, I went to class on Tuesday--and found that two of my contemporaries, Warren and Larry, both 51, had gone to the black belt test on Sunday and had gotten their black belts. I was thrilled for them, and they were so happy.

I would be less than totally honest if I didn't also say I was feeling a bit blue that I wasn't there to get my belt with them. They both said I should have been there to get the belt also. Between work, hurting my shoulder and just not having time to train, I knew I wouldn't be able to test this past Sunday. With everything still going on, I do wonder when I'll be able to test.

Tonight, I go to sparring class. We'll see how much of a hindrance my lack of consistent conditioning poses.

Shoulder Improving; Dance As Exercise

After my doctor visit, resulting in the torn labrum diagnosis, I spoke with some friends from my martial arts school who said this particular doctor is something of an alarmist. So I have been planning to visit another orthopedic doctor, but haven't had time to see one yet--the financial crisis is having me working six days a week and long hours each day. (My own view is that we're going to see what the Great Depression would have been like had regulators back then known more and acted faster.)

Due to this work demand, and due to my desire to also spend time with family despite all this work, I also haven't been able to make many of my classes. And in class, I've been mostly avoiding using my left shoulder whenever possible--not doing two-handed push-ups, for instance.

The good news is that the shoulder is getting better, whether due to this benign neglect or in spite of it. I actually recently started doing two-handed push-ups again, and my shoulder didn't hurt. I'm not going nuts and doing tons of push-ups, I don't want to push the envelope. I stopped Saturday at 50.

If things continue this way, I may not need that second doctor visit (or a $300 co-pay for an MRI) at all.

This past week I was only at two hour-long martial arts classes. The week before, only three hours. That's not enough to improve, and not enough to maintain a very high state of cardio, but It's enough, I hope to keep the rust off me.

And some of my off day time with family involves fun, moderate exercise.

On a couple of Wednesday nights, for instance, my wife and I have gone to dance class. The first 45 minutes we work on salsa--which really gets your feet moving--and then next 45 we work on a different dance--tango one night, waltz the other. According to this interesting calorie calculator, half an hour of salsa would burn (at my weight) 210 calories, and half an hour of waltz or tango would burn 140 calories. (I'm not calculating the whole 45 minutes because of instruction time.)

While this is only moderate exercise, there's a lot of evidence that moderate exercise leads to huge health gains--indeed, this article in Science Daily says there are huge health benefits to regular moderate exercise. I wouldn't use dancing to prepare for a tournament or black belt test, but if your goal is to be healthy, regular moderate exercise, from what I read, is really great.

Plus, dancing is fun.

Torn Labrum

My shoulder has continued hurting, so I finally got in to see a sports doctor. His diagnosis: I have a torn labrum. The labrum is shoulder cartilage, in the socket part of the joint.

I wondered how it could be a shoulder injury, when, in fact, the pain is in the upper arm, sort of where the arm and shoulder meet. That's because it's "referred pain," he said--it's being referred to that part of the body by nerves from the actual injury. And sure enough, when he presses on the part of my arm where I feel the pain, it doesn't hurt. It only hurts when I move my shoulder the wrong way.

I will need an MRI to confirm the diagnosis. More medical dollars spent--I think my health plan charges me $300 for MRIs.

I might be able to fix it with physical therapy, the doctor said, and I should try that first. But I may need it "scoped," he said.

What a drag.

Meanwhile, Wall Street is falling apart and I'm too busy covering it. Worked last Sunday, will need to work this weekend also, and it feels impossible--it IS impossible--to do as good a job on it as I'd like.

And I'm having heartbreaking problems with a family member. So it's been a tough week.

I did enjoy, though, my two classes this week (had to miss the others). Friday night sensei had us work on footwork in sparring class--there were six students, and we didn't work at all on free sparring. Today I went to a "core" class and got an excellent workout then as well. What would I do without this outlet.

Life, Training

I spent a three day weekend with my 80-something parents in another city. I went there to help my father after he got an operation, but he was recovering fine. Instead, I was helping them with other crises, health and otherwise. It was a good weekend for me to be there--and I was happy I could give a break to my brother, who lives nearby and who bears the brunt of the care for them.

I've missed three martial arts classes in the past week, due largely to my trip. First things first.

It's just killing me that my shoulder hasn't healed yet--I'm going to see a doctor about it.

In the one class I made this week, when I told my sensei I couldn't do pushups because of my hurt shoulder, he had a real kick-ass alternative: "Do one-armed pushups," he said, and promptly showed how easily HE could do them.

One of my friends in class said, "You should have told him you have TWO hurt shoulders."

Time to Heal

I'm going to take some days off from my martial arts classes to allow my shoulder to heal. It's been three weeks and it still hurts. It will start to feel better, but then I'll go to class and do pushups and jabs ... and it hurts again.

Above is a photo of the Hulk and me wrestling at last Sunday's day at the beach. Hulk's the guy without a shirt on.

Look at the arms on that guy--can you believe he's almost 60?

End of Vacation

Tonight's the last evening of my two week vacation. We had some good times visiting friends and going to the Adirondacks.

This morning I joined my martial arts school at a local beach for volleyball, swimming and hanging out. It was fun, and I think I mostly avoided sunburn. My left shoulder is still bothering me, however, and I think I'm going to have to see an orthopedist, it's not healing as quickly as I would like--I'm on my third week.

Swimming

Yesterday, at my wife's suggestion, I tried swimming as a non-impact form of cardio cross training. It may be something for me to pursue.

I'm not a person who loves being in the water, though I've been a swimmer since I was a kid. My swimming was complicated by my continuing shoulder pain--doing the Australian crawl was impossible, so I did the breast stroke, though that was also a bit of a strain. The thought occurred to me today I could even just get a half-board and kick to do my laps until my shoulder is healed.

I wasn't able to do lots and lots of laps, but I was able to do enough to suggest that eventually this could be a great form of cross training that could build my endurance. One thing I'll also have to build is the muscular endurance required to swim, not just cardio endurance.

The biggest limitation on swimming is getting to a pool. But it would be less expensive than a gym membership.

I'm thinking I might be able to swim once on a weekday and then again on the weekend--probably Sunday, given my martial arts classes on Saturday. Twice a week wouldn't make me an Olympic candidate--nothing would--but it would be a good addition to my training. And it would be easier on my middle-aged joints, feet, etc.

Sparring, Worry, Joy, ACL, Decisions

From a letter to a friend:

I recently told my sensei that I'm not going to test for the black belt this fall. I took on a very tough assignment in March, the kind of demanding assignment I avoided for years because I had to save energy for dealing with my son. He is actually back in the house now, and doing extremely well--in part because he's learned, in part we think because we've gotten back in touch with his birth mother (which is a real healing thing for him), and in part because he's just older. The job just has not left me with energy to prepare for a black belt test AND devote energy to my family. I would have to put in 48 hours of class in six weeks to prepare, and I just can't do that now. (What I have to figure out eventually is whether I will ever enjoy this demanding job that is running me ragged. I'm at the start of two weeks of vacation now.)

Stepping back from the test has allowed me to enjoy my classes more. I also returned to sparring class, which I left after I had a slight re-injury of my knee in the early spring. My thinking had been, I don't need kickboxing for the test, I already passed that part, and I didn't want to put my repaired ACL at risk.

But the primal chess game of kickboxing with people is what I enjoy the most about martial arts, and I've now been to two classes. I've got some ring rust, but I still can see sometimes when people are making mistakes I can exploit. And as my friend Larry told me, "You've still got your front kick," which was my signature move before I tore my ACL.

Part of the fun of the class too is that our sensei is an amazing kickboxer, and he studies you and gives you tips. He wants me to work on throwing my jab while I'm backing up in good form--keeping people at the end of the jab and frustrating them as they advance, instead of standing in place and jabbing while they get close enough to hit me. He's shorter than me, and keeps talking about what an advantage my reach is. I know I would trade my reach for his lightning speed and strength any day, but it's good to work with what you have.

I do wish I had taken all this up at 19 instead of 52. I do wonder how good I could have been--I don't think I would have been a great athlete, but surely I could have a higher level of skill. Would I feel the corrosive worry I now feel about so many things? (Probably so, just different things!)

But I also think about what I have gained--my health has vastly improved. I no longer have to take cholesterol medicine, and I've lost something like 20 pounds despite adding muscle. A nascent hernia in my bellybutton has vanished. I have new friends, and I love the feeling of physical motion again.

19 and 52, Continued

It's not just the body that's 52, it's also the mind.

I don't think I absorb new ideas as fast now as I used to. Grappling is very conceptual, in a way, there are so many things to learn, and you then have to think of applying them. I find that even though I have learned a new technique, I need to be reminded while grappling to use it--"he's letting you have his right arm, go for the choke." It's hard to see the tactical opportunities sometimes, especially in grappling.

On the other hand, I do think I often see the bigger picture more clearly now than when I was young and, say, playing basketball (I wasn't a martial arts student until I was 44, basically). For instance, in sparring: "Frank has a great left hook, so I should do the unusual and circle towards his right, even though he's right-handed."

My pulled groin muscle is improving, I can walk upstairs at a normal pace. I'm skipping grappling class tonight because I'm going out of town, but that's just as well, I need a bit more healing.

19-Year-Old Athlete In 52-Year-Old Body

Last week it was my shoulder; today it's my groin muscle that got pulled. I hurt it toward the end of class, and isn't intensely painful, but I did stop grappling, it hurts a bit going up stairs or trying to move fast. I'm icing it.

Somebody at work said to me, on hearing I had pulled a muscle in my shoulder, "The problem is, you're a 19-year-old athlete in a 52-year-old body." I got a laugh out of that, but she had a point.

It's good that I'm not going to test for the black belt in the fall; if I were, this groin pull would be a serious setback. But now it's just an annoyance. I imagine I'll be close to full speed in a week.

Grappling is so dependent on knowledge. When I grapple with somebody who knows less than I do, it's usually easy. When I grapple with someone who knows more, I have to tap out constantly. I do feel sometimes like it is harder to absorb and learn the moves now than it might have been a couple of decades ago.

But then again, a couple of decades ago, I wasn't doing anything athletic, so I have no real point of comparison.

Fortunately, my knee is doing just fine.