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4.29.2009

Never has something so simple looked so beautiful

That's right we have our selves a runner

After only a few short months of me saying: "It is my professional medical opinion that not securing these mats with an edge of some sort constitutes a significant potential health hazard," the powers that be did something spectacularly beautiful. One can only conjecture that such safety engineering might mean I only would need unilateral ACL repair.

4.28.2009

Team mates

On my way home today I hit a pot hole in the freeway while doing 70 m.p.h. This dented my driver's side rim and cracked the wheel, deflating the tire. I replaced this useless automotive appendage with the emergency spare, a bike tire on steroids, and limped home my regular 50 minute commute now nearly an hour and a half. I went to teach class and relayed my tale of woe to my team mates.
Travis is a blue belt who has been training with us for a couple of years, good athlete and always willing to wrestle. He's also apparently always willing to get a team mate out of a jam. Travis' non-combatitive expertise is in cars, he customizes and modifies automobiles. Without missing a beat he asked me what the radius and size of my tires where as if this was common knowledge that I was supposed to retain. He then furled his brow as he searched an encyclopedic cerebral repository of car measurements to conclude that he might be able to slap some wheels from one of his old cars onto my car until my new rim could come in.
After open roll Travis drove into my driveway with his truck and proceeded to slap two tires onto my car while giving an impromptu tutorial on tire fits and measurements. He then test drove the car with me, despite a little wobble near 75 m.p.h. his replacements were significantly more robust then my spare (and it's maximum rating of 50 m.p.h.) Interestingly Travis felt that he was paying me back for what little coaching I'd done in practice and some occasional extra sessions we've held in the Bugeishako.
I'm humbled and amazed at such friendship and loyalty, I train and coach because I enjoy it. Because of doing something I enjoy, my team mate bailed me out of a significant jam without thought of recompense. It's nice to be reminded that the closest friends we make are the ones that we sweat and bleed on.

4.22.2009

Noujitsu

On Monday I met my orthopedic surgeon. In conjunction with my sports medicine doc they've seen a significant percentage of my team mates, all of whom have been satisfied with the results. Orthopedic surgeons perform vigorous physical exams of the joints, so when he snapped onto my leg it was difficult for me to relax. The proper response for any fighter placed in a submission is to get out of it. Anyway if I didn't need operative management of my knees (yes pleural) it was a certainty after his tender mercies. Anyway we planned for my right knee in early May and my left knee at the beginning of July. This should allow me the necessary mobility to take care of important events in my life, like my new job.
The other question was when would I be back to being well...me at least physically. I have as much restraint as a puppy despite my seemingly aging demeanor. He cautiously estimated my recovery at between six and 12 months. I'm giving it four. I'll follow instructions explicitly and rehabilitate like its my new religion, but I cannot be if I there is no do. I plan on working non-resistive technical motions within three to four weeks (I think I saw literature that said that was conceivable).
In the meantime I will train in my mind or do what I call cerebral technique (noujitsu). This is actually pretty fun after being medically advised not to be an @$$hole and destroy either knee further. I'm essentially ambulatory sensory organs and central nervous tissue. I cannot show what I want, my latent fear of genu instability coupled with the bilateral inflammation precludes any sort of graceful or effective demonstration (getting up from the mat is a foal-like struggle against gravity's tenacious charms). Instead I'm having to rely on more astute observation of optimal and suboptimal technique combined with finding verbal, tactile, and gesticular ways of conveying information. I have to describe concepts while trying to sculpt stick figure representations of technique with my fingers. I have to point and tap on limbs or bodies to mold them into semblance of technical versatility. This has been leading to even greater analysis of what I am coaching and what I see being taught. In the last week I've been sketching out functional focus mitt drills using three people...more later. As I was watching Jack teach tonight I started seeing anime arrows in my head directing the flux of competing and syncroness force vectors that effortlessly sweep an opponent or change a submission from discomforting to lethal. A fun project would be to sketch these arrows on film or video, maybe even blog about them...
One thing I'd like people to do is use technique or even roll while counting, reciting a speech or delivering a poem. If they adjust their tempo, change their tone, or get short of breath, then they are probably muscling the move rather than using effortless technique. Sensory deprivation and being benched for months may just make me a better fighter. It certainly has already made me a more grateful one.

4.16.2009

If a picture is worth a thousand words, then a radiograph is worth a thousand dollars


Normal ACL


Oh for fucks sake


Sagittal MRI of a knee showing a normal anterior cruciate ligament. Image courtesy of Carleton University Sports Medicine Clinic, Ottawa, Ontario, Canada. For more about knees check this out.


Sagittal MRI of my left knee

My imaging experience today confirmed for me that getting imaged is not nearly as fun as imaging somebody else. So glad that I have a little bit of discretion and didn't try something foolhardy because everything feels pretty good.

4.12.2009

4.11.2009

Bas Rutten: They don't listen, I don't coach


Bas Rutten Interview - Watch more Funny Videos

The End

In the fall of 1996 I started training in Goshin Jitsu. During my first semester I was escaping from a rear bear hug and as I sunk my weight, my right exploded and vanished sending me in a heap to the floor. I had to hold my knee to keep the smallest vibrations from causing my knee to throb with nauseating agony. Surprisingly it went away within minutes and I was up to try again, but with one careless step the pain came back with biblical vengeance. I eventually went to the student medical center and then their sports medicine service who recommend rehabilitation exercises for a partially torn anterior cruciate ligament (ACL). I don't think I was ever offered an assessment by an orthopedist or even got an x-ray.
For the next year I would have intermittent episodes of right knee pain and instability. Ignorant, stubborn, and uneducated I worked around the problem, using an inexpensive ACL knee brace, odious Chinese liniments, shark cartilage which was eventually replaced by glucosamine and chondroitin, prolotherapy, as well as careful modifications to my stand-up and ground game. My knee would lock, once for 18 hours I couldn't flex it far past straight, until I gritted my teeth and tried a little bit harder.
My friend Bart coaxed me into lifting, especially Olympic and HIT style lifts which strengthened my legs so that the supporting muscles and their attendant tendons took over for the crippled ligament inside my knee. I remember grappling and fighting both MMA and muay thai on a right leg that had buckled or locked days or hours before the event. Despite this I got pretty good at Brazilian jiu-jitsu, muay thai, and mixed-martial arts. I've won national and international level tournaments in separate combat sports and can hold my own with professionals. In the words of my coach Jack McVicker, "you move around pretty good for a guy with an ACL tear".
This spring I had grandiose aspirations of competing at three large jiu-jitsu tournaments, my few months of residency carried a fairly light schedule. Approximately six weeks ago I was drilling clinch work when my left knee felt like someone cut it out from under me with a really large sharp object. It too was a little unstable but I thought that this was due to the swelling. I cancelled my tournament plans and trained around this injury until last week, when feeling full of spit and vinegar I grappled more aggressively than I had in some time. I actually mentioned to my partner that my knee felt pretty good. As I bridged to move my partner off my back my left knee twisted, stopping its rotation only because of the shrieking protest of my lateral and medical collateral ligaments. I screamed and a bunch of shocked faces turned to me, seeming to disbelieve that I could be laid low. I held my knee, try to squeeze the pain out of it as well as look for the magic bullet that must have suddenly been blasted into it. My team mates gathered around me, Dan Hornbuckle held my smote knee as he directed my immediate care. The bag of ice laid on top of it was like mom's cool kiss when I'd hurt myself as a kid. The pain subsided and I hobbled home.
The next day things were fine as long as I walked slowly in a straight line. By favoring my acutely injured left knee I placed greater strain on the right, causing into grumble like a spoiled child suddenly called to pull its load after years of being coddled. I was referred to a sports medicine doc who I saw yesterday. One of his therapist assessed me first, poking and tugging on my knee in a disconcerting fashion. When you're used to wriggling out of submissions allowing someone to twist on your knee takes an abundance of will power. He quietly told me that both my knees felt about the same and that the doc would be in to see me. The sports medicine doc did his exam a the end said, "That doesn't feel so good".
I obliviously said, "Oh that's not so bad."
"No I mean on my end." His diagnosis was that I had bilateral ACL tears, serious enough to need both sides replaced. He explained that my knees were the same on exam because of damage to both. On the x-ray he showed me that the right sided injury was chronic, even I could see the loss of joint space on the medial side. Arthritis and degenerative joint problems of my right knee was a certainty, my left was a new injury, more amenable to surgery in the immediate future. He set up the MRI and mentioned that two approaches were possible, a patellar graft or a hamstring graft, the latter of which he thought was a better choice given my gender, age, idiot proclivities, and inherent need for symmetry.
I've read a little bit about ACL replacement surgery, I have no need for an immediate procedure, it appears that waiting for the inflammation to decrease improves outcomes. That means aggravating it as little as possible, i.e. not training, which is probably a good idea since I already know it hurts when my joints try to disassemble themselves. The choices between the two graft types have different pros and cons, I'll be discussing those with the orthopedic surgeon if the MRI comes out as predicted.
Life is about risks, I accept the ones my lifestyle encompass. Everyone gets hurt doing what I do, its not a possibility it is a certainty. Words cannot express how grateful and relieved I am that I can still walk albeit slowly and gracelessly. That does not change the fact that after the injury the choices still abound they simply change in context. I can chose not to undergo surgery, keep training while I wear my knee cartilage to the bone and keep tearing strands of ligament. Or I can chose a more sedentary route that still does not halt my arthritic progression but without training ever again. I can undergo surgery that would keep me from training for 4 (one knee) to 6 (both knees) months, but even then a not insignificant proportion of patients do not return to their original sports activities because after the pain and expense of their surgery they value knee health over their extracurricular activities. No doubt a 4 to 6 month hiatus would allow me to build strength, agility and flexibility but I would losing timing, technical expertise, and repetitions so crucial to maintaining superior martial skills. I wonder if I have the humility to accept not being at the top of the heap anymore. Would I have the willpower to show-up at practice to watch, coach, and help teach, or am I too selfish for that? Given the demands on my time already, adding a rehabilitation routine would mean budgeting time in new ways, most likely shifting my practice schedule to time in rehab. All these choices may be moot in the highly improbable circumstance that my ACL is flawless. In the end this is a beginning, a chance at reexamining the beautiful kinetic chess of training to fight, a moment to relearn how I do things, a lesson in the humility of injury.

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4.05.2009

Dawg Fight


Dawg Fight from rakontur on Vimeo.

Fighting is as primal as breathing, but everything primal costs something.