Thursday, January 26, 2006

Shake, Rattle, and Kick: A Visit from an Okinawan Master

After about six weeks, the leg exercises seem to be working. My kicks are not exactly pretty, but I'm able to lift my legs better, execute better, and I actually have more stamina. What I've found very interesting is as I've been developing muscle and improving muscle tone, my stretches are indicating that I have much more flexibility. Leg weights have really made a big difference. There's a desire to execute kicks or lifts quickly, but with weights on, and exercising my legs slowly really makes the muscles work. Since existing muscles have to get tired before they can be convinced to start enhancing themselves, regular use of weights accelerates the process. Pushing yourself past being tired is necessary, and it's always the case that you can do more repetitions than you did the day or so before. I've noticed increased speed in my kicks, too. This has been very encouraging. They're still bad compared to everyone else, but they're better for me, and that's all that matters.

It is odd that the standard course of stretching before exercising doesn't seem to work for me. I'm fairly stiff when I get up in the morning, and moving around before I stretch really seems to help. Doing a few kata, emphasizing moving around and not worrying about how hard punches are or how swift blocks are, but just executing the movements in moderate speed and doing them well really seems to loosen my joints and prepare them for a good stretch. I never thought I'd have to warm up to stretch, but sure enough, as I chat with doctors and read more, it seems that once you get into the 40+ area, morning stiffness is rather inevitable, and some light activity prior to stretching reduces stiffness considerably.

We recently had an Okinawan master as a guest instructor, Sensei Takamiyagi . He's not directly of our style, but knew our master, Sensei Odo, and he regularly checks up on Sensei Toma, whom we understand is in deteriorating health. Not that Takamiyagi needs my endorsement, but he's quite entertaining. He knows enough English to joke with the students to put them at ease. His personable nature is quite sincere, but you still know that he's the boss when he's holding class and you know it's in your best interests to please him. Though his commands are sometimes misunderstood initially, he's quite able to get students to act in the manner he wants with a movement of hands or a quick "like this" actions of his hands. He's quite a character, and well-worth seeing in action, if you can. I just watched; in retrospect I wish I had taken the class. There was concern that his skills at "palace hand," which manipulates positions of hands and arms of attackers would not be a good idea for me. I was concerned that if I was paired with a student in the class that I would just get in the way because my range of motion issues of my shoulder would come into play. The techniques he showed, like so much of karate, have stunning and elegant simplicity, with the potential to cause significant pain, especially if the attacker resists. All that aside, there was something else very valuable that I took away from the class.

Takamiyagi is an advocate of shaking one's body to loosen it up. There were a few people sitting in the dojo just to observe (family and friends of the students, and yours truly), and he even got us up at the beginning of the class to try it out. It turns out that I had seen what he was showing before. When I go to a baseball game, I enjoy arriving when the gates open so I can watch batting practice. Players are in the field stretching and loosening up while at the same time batting and fielding practice is underway. For many years, I have seen a few players doing exactly what Takamiyagi professes. His contention is that muscles in most people are never sufficiently relaxed. People have a tendency to have tensed muscles, and that's what contributes to physical symptoms of stress. To be scientific about it, if stress is that one's instinctual "flight or fight" impulse is always turned on, sending various adrenal chemicals through one's body, then muscles will always be tensed and ready for action. Since that action that the body is getting ready for never comes, the muscles stay tense. It's also one of the underlying aspects of CPPS. The combination of building up muscles and getting them to stretch and relax is essential to deal with CPPS, which is why my taking of karate has made it so much better.

So Takamiyagi had everyone stand up, get into a comfortable stance, and then relax their face, just letting it hang and relax. The face is hard to relax for some people, it seems, and he went right to it; after all, no one ever thinks about relaxing their face!

Gradually, he worked various movements around the body so that everything would be relaxed. He had us shake our bodies; perhaps rattling them is a better description. I've been doing this a couple of times a day, and it's amazing how it relaxes the back and shoulders, especially in the morning. So I now do this before my kata. On days when I can't get to kata, just a minute or so of doing this helps incredibly.

Tuesday, December 27, 2005

A Prostatitis Setback, But Progress

I had quite a prostatitis shock when I got back from a trip early this month and went through my dirty laundry: blood in a very undesired place. You never expect to find blood anywhere, but when you've had prostatitis, you know what it is and you're not spooked by it, you're just annoyed. That is, unless it's a lot, and that's what I found, a 1 inch diameter of dried blood. I had felt some discomfort on my plane ride back home, but it was nowhere near what I experienced before my karate adventure. And the stain was in clothes worn the day before, so I was asleep or otherwise did not know when it was happening.

Thankfully it was bacterial this time, but with prostatitis one is never certain. Let's just say that the conclusion of three weeks of antibiotics and absence of pain coincided. Whether or not the relationship was causal, we'll let time decide. Most prostatitis is viral or chronic pelvic pain syndrome, but if you ever get bacterial, you should consider yourself fortunate. Strong antibiotics can work on it, eventually.

Luckily, I was due for a physical and blood tests showed my PSA reading was very low; sometimes prostatitis can throw the PSA into higher territory which initiates an investigation for prostate cancer. It is claimed that the medical literature indicates that having recurrent prostatitis virtually insulates you against ever having prostate cancer (80% of men get it, and it's usually at the end of life but it moves so slowly you end up dying of something else; it's when you're in your 40s or 50s or 60s that you need to act quickly; I'd rather be in the 20%, but there are times when I'd love to have it yanked out like a bad tooth and take my chances, but they don't do surgery for prostatitis, and prostate surgery is loaded with possible downside issues in and of itself, so it's not even a remote option). I've asked doctors and researchers what the literature indicates what the prostate cancer risk is if you have chronic pelvic pain syndrome and not true prostatitis. They just shrug. The topic is so understudied that no one really knows for certain, and the people who had been diagnosed with prostatitis in the studies may have had CPPS all along.

December has been a strange month for karate because class schedules were affected by Christmas, business, and family schedules. After November's changed schedule and December's lighter one, it's pretty clear that karate's might be contributing to my esophagus irritation, but not so much I should consider stopping class. I told Sensei that I would be popping some antacid during class (various generic versions of Tums, which is basically just calcium), and he said to do whatever I needed to do. Some students have wondered what I was doing during our minute-long breaks but no one has asked or commented about it. I'd much prefer to be eating chocolate throughout the class, of course, and if I was, I'm sure they'd ask for some. The regimen has helped quite a bit. So if this condition was caused by or aggravated by karate movements scrambling my stomach contents, this seems to have helped deal with it. I am hoping to attempt stopping my daily medication in a few months and just use antacids in class or as otherwise needed. Last time I tried to discontinue it, before I had my detailed diagnosis, within two weeks it was overwhelmingly clear that I still needed it. It's been ten months since I was diagnosed, and five months since my endoscopy, and this is the first month that I feel that things are subsiding.

A new issue emerged that affects my study, but it's a good one. Five years ago I sold a business and my non-compete agreement with the buyer expired. Five years went quickly (I'm reminded of the old saying "the days are long and the years fly by"). With two business partners I'm starting a new business again, and I'll start traveling once more, usually no more than overnights. I've learned to do kata in hotel rooms (it's strange having a coffee table or lamp in the way as your opponent), by hotel pools, and in fitness centers. On some occasions, it's even outside. For the past couple of years I've avoided fitness room equipment, realizing that kata and other exercises give me a far better workout. I almost get on treadmills to rest, it seems. I now know that after years of treadmilling, I never really got any benefits until I started working on karate.

Saturday, October 22, 2005

You Can't Be Flexible without a Rigid Plan

I've been working hard on leg stretching the last few weeks, and I'm finally starting to see some progress. It takes me a good half hour to get to where I want to be for that particular day, but every few days I do notice some extra flexibility. Not much, but enough to be encouraging.

I saw a book called Ultimate Flexibility: A Complete Guide to Stretching for Martial Arts by Dr. Sang H. Kim. He is a martial artist (Tae Kwon Do) but has a masters degree in physiology. His doctorate is in communications. He's not a medical doctor or even a physical therapist, but he's certainly thorough in his understanding of the body. Much of the book is pictures of exercises, but the best parts are in the front and in the back. He really gets into explaining the nature of muscles and flexibility, and even explained why after stretching or exercising it sometimes seems that you don't get anywhere, that things may actually get worse for some time. He explains how to get past those periods. Comments about what happens as your body ages were particularly encouraging, as he explained how there were things you could do and that there were no reasons to get discouraged. He did explain that starting older you will never get the flexibility of younger students, but that with diligence you could make some rather significant strides. That made me feel better.

His other book, Martial Arts After 40, did have some of the same matter in it, but it did have other insights, such as dealing with teachers who are much older than you. I found that to be funny since I was a college professor when I was 25; virtually all of my night students were older than me. Now the shoe is on the other foot, that is, if we wore shoes in karate, that's where it would be.

One of the best features of the Ultimate Flexibility book is that it outlines, visually, exercise and stretching routines that focus on particular problems. The exercises are described with multiple photos and usually identify ways of executing them for beginners and advanced students.

I was not aware that stretching after class could be valuable, and he is a big proponent of that. After all, your body and muscles are already warmed, and getting a little extra out of it would not be a big deal. I've tried it a couple of times, and it seems to work. I feel kind of dumb for not realizing it. I wonder how many months I wasted by not doing it. So now I just take a few minutes after class to stretch some more.

He also emphasizes that you can't get flexibility unless you develop more muscle strength. In my situation, unless I can build up the muscles that allow me to lift my leg, I can never expect to throw higher and better kicks, no matter how much I stretch. So in addition to stretching, I'm also doing more basic leg lifts, and soon I'll add some leg weights to it. I've been told by some of the other students that all I have to do is just do more kicks, and I have to say that I think it's too simplistic and short-sighted. There are muscles that just doing more kicks can't really get at. After all, athletes have known that cross-training helps them considerably, and this is the principal reason why.

I've still been dealing with the gastric issues, but things are managing okay. For business reasons, I'm changing my class schedule and I'll have four days in a row without a class pretty regularly. It will be interesting to see if the condition starts to recede with that much "rest" in between classes. I certainly hope so. It would be nice to get off the medication, but that may not be possible at all. That kind of decision is months and months away.

Sunday, September 11, 2005

Somehow It Happened; But an Unexpected Setback

Yesterday I made it through a tough class and then our dojo's "moving up" day. It's not referred to that way, but that's the name of an event I remember from college. There would be a small ceremony at the end of one academic year, marking the senior class' moving out into the world and everyone left behind going on to their next academic year. Selected juniors would walk in procession in a central part of the campus, and there would be a handoff of some symbolic document. I'm not sure of any other details of the event, just that I happened to be sitting on a park bench watching this on a sunny May afternoon.

I made Green 4, the level before Brown 3, and now the task of moving up again just gets harder. In a lot of ways I'm well over my head, with my out of shape legs giving me problems with making effective kicks. Over the last few months I've been able to work hard on my kata (discussed more below), and it's been noticed in class. I've adjusted on the placement of my gaze (more firm, raising my chin a bit), getting my shoulders back (I've had a habit of leaning forward too much and would often be off balance), and getting lower in my stances (not much good in leaning forward and being low; all of these things go together). I also worked on making each movement more convincing and harder,and working on the constant "loose-tight" movements and getting the stiff robot-like movements out of my kata. Concentration makes things better of course, and I can't say it's really concentration the way I thought it was, but more learning to ignore everything around you and stay on course no matter what.

For my "moving up" kata, I was assigned Wansu, and I'm told I did it well. It's just a blur in my memory, the kind of blur that just happens when you trust what's happening but perhaps think too many movements ahead. I remember taking a deep breath and a slow exhale to start and that my side block and punch felt good. I have no idea if they actually were. My turn and throw with my kiai weren't what I wanted, but seemed to be functional. I remember feeling that I wasn't low enough in the kata. At the end of the event I was told my kata extremely good by some of the black belts,who are always encouraging me, and not prone to hyperbole; or at least I hope they weren't.

I thought it was interesting that I was assigned this kata, since I learned it when I was a yellow belt. But as one learns fairly quickly in karate, your kata are never the same as you progress upward in rank. There as subtle things that are introduced as your technique becomes better, and as you become stronger and more confident physically. Punches and blocks are harder and firmer, and execution of them is much better because your body is more relaxed and looser. You also lose unnecessary windups and wasteful movements.

The past summer, I worked hard on my kata, but for an atypical reason. I've been afraid of losing them. A student who had attended for a while had left and then returned. It wasn't all that long, but it was clear that even the earliest kata seemed uncertain or just forgotten. I was afraid it might happen to me if I wasn't careful. After all, the more kata you learn, the more you have to remember. Kata is not like riding a bike. It's far too nuanced for that. When you don't ride a bike, what you lose is mainly stamina and strength. You can quickly adapt to bicycle operation, and unless you are big into cycling, there is no real aspect of subtlety or nuance: if you haven't fallen, you're functional, and you don't have to concentrate all that much to get where you want to be.

Punching and blocking are generally much easier to remember. Sure there are fine points to them, but the gross movements are easily remembered since they are discrete movements, not attached to any others. Kata is different; it's all about sequences and each movement builds on the past one or prepares for the next one,while retaining the integrity of each movement. It would not surprise me if someone were to stop practicing for months and in about 15 minutes be doing decent blocks and punches again. Not the best, but functional at least. But kata? Not at all. My fear of forgetting them, to get to higher level of muscle memory with them seemed to have paid off in interesting ways. I found it allowed me to concentrate on specific issues more easily. The frequent repetition seemed to let my kata "happen." I was able to concentrate on stances, or on hardness, or on focus, without having to obsess about what the next movement should be.
There's much to work on, and if I ever get to Brown 3, it will require totally different conditioning than I have now. It's no different than so many things, as you have to graduate from arithmetic to understand algebra, and without that you can't go near calculus. The skills are different, but you build on them, and the older skills improve as you learn new ones.

It seems that karate has presented a new challenge. Physically, I've been managing an unexpected gastric issue. Back a few months ago, I was having chest pain. After a night of hospital observation, tests indicated my heart was just fine, and the pain was from something else. After some more tests, it seems that I have developed a permanent case of heartburn. After looking at various potential causes, I now strongly suspect that hard karate practice makes some stomach acid splash into my lower esophagus. Biopsies taken during an endoscopy in August. They were negative for other conditions, like the precancerous "Barrett's esophagus," thankfully, but the idea of another physical setback is yet another reminder of the problems one can have starting to get in shape so late in life. No food had ever given me heartburn, and this is a factor that makes me think working out is a likely the cause. A problem has been that two of my karate classes during the week are after dinner. So in addition to taking a prescription medication every day, I take antacids before class; I even pop a Tums now and then during short breaks. I also eat less before class and try to eat earlier. So far things are manageable. Two steps forward, one step back. That's common when you start this kind of study when you're not in your teens or twenties.

In this case, the esophagus is so irritated that it will take weeks for it to "calm down" and determine what's working or what's not. It might not even calm down at all. Knowing it's definitely not heart-related means that I just ignore the pain (one of those situations where you acknowledge that it's there and you just move on) and keep going. But at least there's a plan, and by trial and error some optimism I'll find the right balance. Or perhaps not.

It's been strange dealing with this because people in the dojo think I'm out of breath when I stop doing something and that I still struggle with stamina. Instead it's significant and painful discomfort of my latest complication (it was obviously enough to send me for a heart evaluation). I was "written up" (and verbally "dressed down" so to speak) by one of the young black belts for putting my hands on my knees when waiting my turn in line for some kicks across the dojo rather than standing straight up in immediate seisandachi, or even standing up at all; I didn't explain what was going on; if I need to stop I just have to stop, and I have to deal with it.

One of the problems of being an older student is that younger ones with higher belt levels haven't been this age before (but there's hope: I had a business mentor who used to have a notepad that said "old age and treachery will overcome youth and skill"). In most cases, if they stick with karate to this age, they'll avoid all kinds of physical problems, since they won't have to overcome these problems I've had because of neglect. Stamina is hard for older students, but it always gets better the more you push yourself consistently. As far as the "dressing down," I know it comes from a desire to get what's best for me, and to reach to a higher level of karate. I've been chewed out plenty of times in my career anyway, deserved and not. You just keep pressing ahead. Nil illegitimus carborundum.

Karate is full of surprises, and this gastric thing is certainly an unwanted one. All parts of life are connected, and we have to accept that progress in some areas create setbacks in others at times. That's just the way life is.

Sunday, August 28, 2005

Legging it Out: Baseball and Karate

Hanging in my office is the scorecard for a game from August 1969 (I think it was the 19th) where Juan Marichal pitched 14 innings against the Mets in a losing cause, as he gave up the game winning home run with one out in the 14th, to Tommie Agee, who was 0-5 until that point. Marichal was an incredible pitcher, a short man from the Dominican Republic, who had a high leg kick as he pitched, and probably about 20 different pitches. I always marveled watching him, because he could give up seven or eight runs and Giants manager Herman Franks and later Clyde King would always leave him in. I could never figure out if Franks and King were afraid of him (Marichal had hit Dodger catcher John Roseboro in the head with a bat during an argument one time; they supposedly made up years later, but Roseboro was never really the same player after that) or if he realized that when Marichal was tired, he would still be able to throw off speed junk that would dart and dive better than anyone he had in the bullpen. Once he found his stuff, the lineup of Willie Mays, Willie McCovey, Bobby Bonds (Barry's father), and Jim Ray Hart would eventually pound away at the opposing pitcher. I saw him interviewed recently when he said he threw over 220 pitches that night.

Gary Gentry and Tug McGraw held the Giants at bay (sorry about the San Francisco pun), but Marichal kept striking the Mets out or baffling them with his crafty mix of overhand, sidearm, fast, off-speed, and breaking pitches. He even struck out the side in the 11th inning. He struck Agee out three times as part of his 13 strikeouts for the night. He only allowed 5 hits all night, and 4 of them were singles, with 1 of those an infield hit.

Tommie Agee was known for his stolen bases and outfield play, but he always looked like he was tired. He looked slow and lumbering when he ran, but he was actually very fast. There were players like Lou Brock of the Cardinals, or even Willie Mays, who could look fast when they were on a Sunday stroll, but Agee was the opposite.

Legs have been the hardest part of karate for me. I wish I could kick like Marichal, or be sneaky quick like Agee, but it's just not there. My hips seem locked and my knees that always find new ways to be sore; I can't get elevation or look smooth in my kicks. I talked to my doctor about it, and he said, "you're over forty... join the rest of us."

The style of karate I'm studying has a lower posture than many other styles which tend to be a bit upright. The stances are distinctly old style, as feet are turned in, back legs are locked, the floor is grabbed hard with your toes, the butt is kept low with shoulders back, and your gaze is high. I never understood the difference until I saw films and pictures of other styles. I was once doing punch and block practice with one of the black belts, who seemed to suddenly disappear from view when he got into his stance. He dropped a whole eight inches, I figured out, and was nearly unmovable. The center of gravity drops so low that it's hard to get one to tip over.

You don't realize it at first, but in the process of making firm stances it's almost like there's a hidden isometric exercise in process, and over time your legs just start getting stronger. The harder and firmer you keep the stance, the stronger you become. (This also happened with my pelvic floor muscles, discussed in my first post, which has been a major reason for my virtual cure of prostatitis/chronic pelvic pain syndrome).

I had a leg setback earlier in the year. In the quest to improve my stamina and strength, I worked my way up to 100 sit ups a few times a week over a couple of months. I would shove my toes under the sofa, and start the exercise. A couple of months later, my knees were killing me, like a burning inside them. I finally realized it was the moronic way I was anchoring my feet was putting stress on my knees. It also meant that I was pulling my chest to my knees with my legs and not my abdominal muscles. Rats. This getting in shape thing can drive you crazy with unintended consequences.

Whatever it takes, practicing kicks isn't the only answer. My leg muscles are so out of balance that I need something in addition to that. I've wondered if my treadmill time has made my legs strong for walking with good front-to-back strength and flexibility (my front kicks are better and can be high once I stretch out) but has not done anything to strengthen other parts of my legs, and perhaps hindered my chances. My agility moving sideways is not the best. I've pretty much stopped treadmilling since I hurt my knees, since the constant grinding on the knees may just start the problem up again.

Gradually, things should start to improve by just sticking with it. But this seems to be such a frustrating and lagging part of my karate experience that it's easy to get discouraged. Since I see progress elsewhere, there is nothing else to do except press on. It seems when my legs are an issue, going slow seems to make more sense. More than one black belt keeps encouraging me to concentrate on the right mechanics and the speed and height will come. The most important thing is to remember all of the other benefits that have been accruing, especially my cardio health and the decline in the instances and severity of my pelvic pain.

I'll always remember Tommie Agee's 1 for 6 effort on that amazing August night where the 0 for 5 start and striking out three times just didn't matter. It's a reminder to keep pressing ahead and never give up. And I remember Juan Marichal, who despite his setbacks with Roseboro years before, and his heartbreaking loss that night, is in the Baseball Hall of Fame, and is considered one of the game's most visible ambassadors. His stats for 1969 were just incredible.

Tommie Agee
Juan Marichal and also

The Cold Shoulder

Having started this level of exercise so late in life, it's clear that some parts of my body respond better than others. The more I follow the karate regimen the more I wish I had started sooner. There's so much to catch up on.

I really fell out of shape when I had shoulder surgery in 1995. From the time I was 15 or so, my left shoulder would fall out of its socket. I remember when it happened the first time quite vividly. I was away at a sports camp, minding my own business trying to sleep after a hard but fruitless day on the baseball field. Suddenly, we heard a common chant "Cabin 1, this is cabin 2; we're coming to take you on!" (Come to think of it, no one in camp was capable of shouting with a semicolon, so I should have used an exclamation point there, but I digress...) We were cabin 2, so we knew someone was trying to hoax us into trouble. The various cabins had some competitions at camp, but nothing to make this vicious. This was just a well-executed prank.

It was executed well enough that Vanderbilt, a red-haired, chunky, 16-year old counselor with thick horn-rimmed glasses, strutted in to our cabin of old wooden bunks and ordered all 30 or so of us onto the floor and into push-up position, the common group punishment at the camp. I've long forgotten what cabin Vanderbilt was assigned to, but he went to school with Ryan and Day, our cabin's assigned counselors, as did most everyone else. It seemed everyone was recruited from the same Bronx high school. Vanderbilt was probably ticked because this prank interrupted the counselors' campfire and soiree that they had every night by the basketball court. Everyone knew not to get him riled. Teenagers always poke the sleeping giant, so if they could get him riled and have him direct his anger to someone else, it provided unmatched entertainment.

After a couple of minutes,I remember my left arm collapsing under me, and also being very confused. I had no idea that it was falling out of its socket, it seemed like a huge muscle twitch, and by relieving the pressure on the shoulder, it stopped. I never thought of it again until about seven years later at college, when I was walking down a short flight of stairs, twisted my body in some way to switch my books to my other arm, and it happened again. About five years later, it fell out of socket again when I was bending over to pick up a Sunday newspaper at a store; I nearly fell over trying to get it back in socket, but it went back quickly. Sometime around 1992 it started happening often, usually when I was turning over in my sleep. It would wake me up immediately. I would jump up out of bed, scaring my wife, grabbing my shoulder and gently nudging things back into position. The night that it took five minutes to get it back into place was when I decided to do get serious about doing something about it.

A visit to the orthopedist let to some physical therapy sessions and exercises to strengthen the muscles to hold it together. After about six months it was clear that it wouldn't work, so we scheduled surgery.

The most memorable part of that February 1995 day was reading the legal forms down in admissions. The phrase "patient recognizes that medical procedures are an art, not a science" or some weasly waffly sentence like that just struck me as hilarious. For about five weeks I was in a huge cast and spent the time wearing sweatpants and XXXL Wal-Mart flannel shirts cut to allow for the cast and the sticks coming out of the plaster around my waist and supporting my arm, which was at a 45 degree angle to my body. It became an adventure to get through doorways. The only time I left the house was to go to the doctor. I got into our Accord wagon by going backside first into the back seat and hoping for the best. Somehow, I managed to keep up with hygiene during that time, but I knew that the first shower once the cast was off would be unimagineably good, and it was. Our house still has some gouges in mouldings that indicate what an adventure turning and walking through doorways would be. I did manage to keep working, typing with one hand. Since I had never been taught how to type correctly (nor did I ever have the initiative to learn), it just meant that hunting and pecking took a little longer.

The day they took the cast off at the end of March was quite an event. My back muscles and arm muscles had atrophied, so a got a shot of pain that was so unbelievable that my eyes started to roll back in my head. Somehow they kept me from fainting. They got me back on a gurney and took x-rays again. I was convinced my arm was falling out again, but they assured me that it wasn't. Vicodin became my best friend that week.

To keep my arm in, they set it higher in the shoulder socket and a little forward, after they put the cartilage sack back in place, and tightened the tendons to the point where I could not lift my arm off my chest. (It's not noticeable unless you're looking for it, at which point it becomes obvious that something's not right). From there on in it would be physical therapy for about six months. Somehow all those years of neglect necessitated an open shoulder repair, and not the more simple arthroscopic surgery that would have been much easier to recover from. Recovery was slow. I tried swimming, which helped (though it looked kind of funny), but those sedentary weeks really put some pounds on, too, and they were tough to get off. The physical therapy was quite painful, but eventually we saw progress after a few of weeks wondering if anything was going to happen.

To this day, I have trouble lifting my left forearm to my head, so I'm always wiping karate sweat on my right sleeve. Any kind of left arm side block is never in line with my body, giving me what looks like bad form, but it's one of those "best as you can do" kind of things and I just have to compensate some other way to protect my exposed area since my elbow can't get in position the right way to protect my ribs, nor can my hand protect my face correctly.

I've always believe that I incurred some nerve damage from the operation, which still haunts me to this day. After the surgery, while I was in the cast and out, it was always dangerous to hold a glass in my left hand. I dropped a few of them, and what was always funny about it was that my hand would remain in the position it was when the glass was originally there. My fingers and thumb would still be curled in the exact position around a phantom glass, but there would be spilled liquid and glass pieces on the floor around me.

Today it manifests itself as a numb arm that is tough to describe. I have plenty of feeling in my arm when I start working out or start a class, but after some hard punches or hard blocks, the arm goes numb. I know it's there, and I can command it, but pain radiates up and down it and I lose some fine motor movement in my fingers. I can make a fist, but it's not a hard fist, and if it is, I can't feel it. It's not that my fists are all that good anyway, but at least in my right hand I can tell when I'm making a good one. It's all very strange, but usually goes away a few hours after class is done, and the next morning it's fine.

After taking karate seriously for a few months, I was hurled out of bed one night with a loud noise and a shot of pain. It was the "ping" sound that I had after my surgery when scar tissue adhesions would break free in the repaired socket. These adhesions would limit my movement, but once they popped with a shot of intense pain, the arm would always feel better, and I would have greater range of motion, and a strange sense of euphoria that comes with progress. This happened quite a few times for a couple of months, and it was clear that karate practice was starting to stress the shoulder much like my physical therapy had done, and it was helping me out considerably.

There are still some things I'm not allowed to do, like extensive push-ups or anything that presses into the shoulder. I've often wondered if I had started something like karate when I was in my teens if I would have had a better-rounded athletic experience than just phys-ed class alone (where I was just one of the nerdy kids picked close to last when picking sides). Perhaps I would have been able to avoid these problems.

It's amazing how all these things come back to haunt you years later. There are times during class that these events flash in my mind, especially when I see younger students doing things so effortlessly and smoothly, untinged by adulthood's problems and aches and pains, and all the stuff that happens to us that we thought at the time is kind of meaningless. Things have a habit of compounding over time, don't they?

Monday, August 08, 2005

How Karate Helped "Cure" My Prostatitis and Caught My Interest

This is my post to the Prostatitis Foundation web site about how my prostatitis / chronic pelvic pain syndrome (CPPS) has been managed to near-disappearance by the stretches and hard workouts of traditional Okinawan karate. I'm only disappointed that my interest did not develop sooner. I'm posting it in full here in case the PF changes the address one day in the future.

For thirteen years I suffered with chronic prostatitis, from 1990 until 2003. “Prostatitis” was only once a bacterial issue, the other times I had nothing to indicate anything except viral or “abacterial” prostatitis. I went through Floxin, other antibiotics, Prosed, drainage, Flexeril, cranberry juice, hot baths, hot compresses, and saw palmetto; eventually a cystoscopy which ruled out other issues (my urologist called down to my wife after the procedure and said “Joe has magnificent flow”; yes, but I still had prostatitis). I was very frustrated.

As I read about my condition, I began to learn about the diagnosis du jour “chronic pelvic pain syndrome” (CPPS). With the suspected origin as tightness of pelvic floor muscles, I saw all of my symptoms listed on Internet sites regularly: debilitating radiating pain from the back, through the groin, and down one or both legs; urinary urgency forced me to learn where all of the rest areas and restaurant rest rooms were on I-95 between Rhode Island and New York. Before getting on a plane I would pop three or four ibuprofen and just hope to get through it. I would cancel business trips just not to sit on planes, affecting my income. I would have to take time out of each day to rest and hope the pain would subside when an attack would come. I would skip going to church to avoid the hard benches. I fit the profile of how one gets this way: lack of activity, such as sitting for hours at desks or in cars, which builds up over time, causing the pelvic area to fall out of condition. If this was muscular, I decided that acting aggressively was needed, and soon.I bought hemorrhoid rings to use at my desk, car, and kitchen. Things were better, but I still had attacks. In December 2001, I decided to get out of the house for a weekly karate class at the same school my son would go to on Saturdays.

After a few months, I happened to notice my symptoms got better, but they were still there.Another complicating factor came on the scene: I had serious side effects from statins. I stopped taking them and decided to take karate another time during the week, and to change my diet to lose more weight (I had put on 40 pounds on low fat diets through the 1990s; I started a low-carb/low-fat diet in May 2000 and to date I have lost 50 pounds). My cholesterol readings got better; my semi-weekly karate classes got me into better shape, and my symptoms subsided some more.My cardiologist (whom I no longer see) had me start Niaspan, which caused me to have liver toxicity (it was described to me as “drug hepatitis”; it took six weeks for me to feel normal again). I decided I would take three karate classes a week, and I swore off cholesterol medications for good, but that is another story.

Around that time I learned of the book “A Headache in My Pelvis” and purchased it from the Prostatitis Foundation. As I read the book I was very skeptical, as I became skeptical of all prostate “cures” (when I saw 40%+ of placebo groups getting better in some studies, which was just a bit less than the treatment groups, I knew something other than the supposed innovative treatment was up). As I flipped through the pages I saw the exercises the authors suggested. They looked suspiciously like some of the stretches and muscle relaxation techniques we were doing in our karate warmup. I showed the book to my teacher, and they looked a lot like yoga to him. We had a short discussion and tried some floor positions. I started to include the exercises in my pre-class stretching and at home. The difference was incredible, in just weeks.I have not had to take any painkillers or analgesics (like ibuprofen) for two years for a “prostate attack.” (I do take it occasionally because I am an out-of-shape middle-aged guy [49] taking karate classes with people half my age, and I get sore when they don’t).

I heartily recommend increased physical activity as a principal means of working with CPPS. The karate I take is traditional Okinawan karate; it is not American-ized, nor is it Japanese. “Fighting” is not stressed as it is in many schools. The workout is intense, and it increases in intensity as your ability and stamina increases. As one who treadmilled about three times a week, I can say I have never had a workout like karate offers, which implies to me that one must become exhausted and drenched with sweat regularly before one can really say they are working out. Keeping a good karate stance and executing the various kicks, and practicing regularly, in addition to the stretches seem to be what help the pelvic symptoms most. Importantly, I am not good at karate (I am currently a green belt, and students with less tenure regularly pass me for promotion to brown belt; but they don’t get the benefits of karate that I have had, and I hope they never have to). No one should be intimidated or embarrassed about how they perform; if they are, it means they are in a poor school.I would be pleased to discuss my experiences with CPPS/prostatitis with anyone who desires to.

This is a debilitating problem, and people who have it are subject to the claims of many charlatans and quacks. While I have had a good experience with a non-medical cure, it is not a simple one, as it requires much dedication to stay on top of the problem. Not everyone can afford karate class, nor the six hours a week to do it. I am lucky that I find it interesting (my son has since quit taking the classes; it is unusual for a parent to keep going for class, I am told), and I am lucky that I have an understanding family and work situation to explore it.

The karate dojo I attend is Branchaud Dojo in North Smithfield, RI , which is run by Sensei Dennis Branchaud and his wife, Kim. He is familiar with my situation. He is very serious about his craft and his art, and I have found him very open to discuss physical issues and problems. I heartily recommend him to anyone who wants to try dealing with CPPS by this route.

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