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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