Monday, March 31, 2008

The Knee Report

I had a telephone conference today with my PT. We discussed my concerns regarding my leg strength. I answered several questions about what I am capable of doing with my new ACL. She asked me how my new ACL is functioning. I told her that my knee is doing great during my daily activities. I mentioned a few karate specific functions that need work and my concerns about the leg press. She suggested some additional exercises and told me to keep up with the weights. I am going to work hard during the month of April and follow up with her at the end of the month. We determined that it was the higher level or karate specific activities that I needed to work on. It was a very reassuring conversation.

Right after surgery I was driven. I went to PT 2 or 3 times a week and did daily exercises twice a day. The progress was measurable. I had a protractor that I used to measure my ROM after each session. When the insurance company released me from PT, I worked hard on my own. I had a follow –up visit at the PT at 12 weeks and things were great. I know that for two months I was sidelined due to my work schedule. I work in a seasonal business and I was working all the time. I continued to rehab at home but not with as much vigor. Progress was more difficult to measure at this time. At the end of December, I was able to focus on my knee and that is when I started this blog. I have been working hard but now I wonder if I could have done better. The more “normal” my knee became… the less emphasis I placed on the rehab. I do not mean that I stopped working on my recovery. I consistently did exercises for my knee. I think that I should have taken my rehab to another level. The problem was that I did not know how. The leg press machine was an eye opener for me and the results are measurable.

I have work to do but I feel confident that I will meet my goal by the end of April.

Saturday, March 29, 2008

Leg Press Woes

I want to thank Jed for posting information about his weight lifting progress after ACL surgery. After reading about the leg press, I started thinking about the strength of my leg. I have been back to my normal activities including karate for several months. I was told when I started PT that it would take a full year to recover pre-surgery strength. I had the hamstring graft so several of my exercises had to wait until the hamstring healed.

Here is my problem, my health insurance only covered 60 consecutive days of PT from time of injury. At six weeks post-op, I was given a rehab plan to follow and sent on my way. I then saw my PT at 12 weeks for a consultation and additional exercises. I have been working on my rehab at home and adding additional exercises on my own as I felt ready. Now I am at 10 months and my knee feels good. However, there are times that my leg feels weak. I decided to find out the strength difference between my left and right leg.

My first try at the leg press was on Wednesday night and it was a disaster. I felt terrible about my leg strength. On Friday, I tried again with much better results. Based on the leg press, my right leg is still weaker than my left. It was time to call the PT to discuss my findings. I called but she was out for the day but will call me back on Monday. My hope is another consultation and a new "plan".

I must say that at first I was worried. Then I realized that I have been doing everything that I want to do. My knee does not hold me back. I am glad that I checked out how much I could leg press on each leg. It gives me a goal - to balance my leg strength.

Wednesday, March 26, 2008

Wiser Than Her Years

I have a wonderful daughter who will be turning nine at the end of next month. She attends a small Catholic school and is in the third grade. She has fantastic grades and is active in her school community. The teachers and adults in her school have nothing but nice things to say about her. She has a variety of interests, such as animals, the weather and cooking, and has an amazing vocabulary.

We had problems this past October with other kids picking on her. I tried to coach her to be more assertive and to tell the other kids that what they are doing and saying is mean. She will not say anything because she is afraid she will get in trouble. I assured her that she has her parents support and that she is not going to get into any trouble by standing up for herself. She has often told me “Mommy, I am a clique of one”. Yes, she said clique. I was floored to find out that cliques formed sometime during first grade.

Last night she had tambourine dance practice. When we walked into the cafeteria one of the girls looked at us and said “Shhh, she is coming”. We were the only people in the area. The girls quickly stopped talking. As we sat down at the table, I looked at my daughter and said “Shhh, she is coming”. The girl who made the comment looked embarrassed and the other girls were surprised. My daughter looked at me funny and I said, “I think the girls were talking about you and someone warned the others that you were coming”. Ok, maybe I should not have said that in front of the all the girls. Maybe I should not have been so blunt. Maybe it should not bother me. However, I did say it, and I can be blunt when necessary and it does bother me.

On the way home, I talked to my daughter about what happened. To be honest, I do not think she heard the girl warning the others. These are the same girls in her Brownie troop. My daughter has been asking to go camping with the group and has requested that I come along. I have been working on filling out all the necessary paperwork and reference checks. I said to her “Are you sure that you want to go camping with this group?” She responded, “Mommy, I am not going to let anyone ruin a fun time that I could have with you.”

Enough said.

Thursday, March 20, 2008

2008 The Year of the Big 4-0

Driving to work today, I was reminded that I am turning 40 at the end of October. I think it is time to set goals and celebrate.

What have you done to celebrate a birthday milestone?

Wednesday, March 19, 2008

Month 10 - ACL Update

It has been ten months since my surgery. I thought it was time for an update/recap. I was back in the dojo (limited - no kicks, sparring etc.) since month three and training again since month seven. After month six, I had no restrictions.

The hardest part of my ACL recovery:
1. Not being able to drive for 6 weeks after surgery (I had surgery on my right knee)
2. Limited wardrobe - I was in sweatpants and shorts until the post-operative brace came off
3. Using crutches
4. Navigating stairs
5. Attended my daughters First Communion on crutches and in a brace.
6. Limited summer activities 2007
7. The first straight leg - leg lift. This was practically impossible for me.
8. Sleeping with the post-operative brace - UGH
9. The time and patience required for recovery
10. NO Karate

Milestones of my ACL recovery:
1. The first straight leg - leg lift (3 days)
2. Removal of the post-operative brace (5 weeks)
3. Gaining back full ROM (12 weeks)
4. The functional brace fitting (14 weeks)
5. Walking up and down stairs "normally" (6 months)
6. Being able to stand up from a one leg kneeling position (8 months)
7. Jogging, skipping, jumping (4 -6 months)
8. Kicking (6 months), sparring (7 months), pivoting (6 months)
9. Use of the soft ACL brace (9 months)
10. Karate at the Honbu (8 months)

What I have learned about myself:
1. A positive attitude will get you through anything
2. I think I have a high pain tolerance
3. I try to be grateful everyday for what I am able to do
4. I have a renewed appreciation of karate and what it means to me
5. I like to spar - I did not before the ACL surgery
6. I surprised myself by starting this blog

I remember sitting in the doctors office and scheduling my surgery. It seems so long ago...

These are my personal experiences and reflections on ACL surgery.
03.21.08 I have updated my milestones with approximate timeline.

Monday, March 17, 2008

9th Kyu - Is Third Time the Charm?

Last Monday while I was working with the black belt class my daughter walked in the dojo. She motioned to me and whispered, "Is it o.k if I ask one of the black belts to work on my kata?" She worked on her material until class was over and then proceeded to show me her kata. She did really well. I could see that she was using more deliberate techniques and was paying attention to her form. I think this is the third time that she passed her test for 9th kyu.

I must be honest. I really want my daughter to study karate. I promised myself that I would never force her to take karate lessons. I have seen parents practically drag their kids to class. I want karate to be something she wants to be a part of ... not something she has to do. She has participated in soccer, cheerleading, tambourine dance and theater. She occasionally decides that she wants to start taking karate. This usually lasts for a few months and then her interest wanes. Last April, she asked me if she could start taking karate classes again. After some discussion, we decided to take her to the Honbu for class. Class went well but that was the same day that I tore my ACL. Needless to say, her karate training was put on hold ...until last week.

She has been around karate her entire life. When I was pregnant, I taught karate well into my seventh month. I have pictures of her sitting in her bouncy seat in the dojo. I even came across photos that were taken at a karate training seminar. At three months old, she had her picture taken with Hanshi Patrick McCarthy and Hanshi Chuck Merriman. She has traveled with us to tournaments and training camps. She knows many of my instructors and karate friends. She has been part of the dojo family since birth but has not steadily attended class. I always believed that she would start taking class when she was older ... when the time was right. She will turn nine at the end of April.

Maybe, just maybe, the third time at 9th kyu will be the charm.

Saturday, March 8, 2008

A Dose of Karate Medicine

I went to karate class this morning. Actually, I needed to go to karate class this morning. I may have mentioned before that I am involved with two dojos. My husband opened a school in 1995 with permission from his instructor and that is the dojo where I teach. My husband and I are both students of the Federation Honbu. When I first started taking karate my husband was a brown belt. He was in the advanced classes while I was taking the beginner classes. When he became a black belt, he started teaching classes. He made sure that he was never the instructor in the classes that I was taking because he wanted my training to be my own. I am grateful to him for that.

I packed up my karate weapons and headed to the Honbu. The workout was two and a half hours long. We ran through most of the weapon and open hand katas. We worked on defense against a bo ... very cool. Usually when we practice, we pair bo against another weapon. Today we practiced bo against an open hand opponent. Going to the dojo has always been an oasis for me. As I step through the dojo door all the concerns of the outside world are left behind and the only thing I need to focus on is karate. I feel great. The workout was a little more than my knee was used to but I did fine.

The best part of the workout happened about half way through. My instructor stopped and walked over to me and pointed at my knee. It was as if he suddenly remembered my ACL surgery and my injured knee. I told him I changed ACL braces and still could not jump too well. Then he said "I did not notice". Let me just say that it made my day, perhaps the whole week. I struggle, analyze and work at my movement during kata and I think it is finally paying off.

Today's class was excellent and just what I needed!

Wednesday, March 5, 2008

What is That Sound?

My knee has been feeling great lately. I only have one complaint, a consistent crunching sound in my knee. When I bend my knee or climb steps there is a noise right above my kneecap. A noise that makes me want to grimace but not in pain. It is an unpleasant rice crispy sounding noise. The crackling has been increasing and I have attributed it to an increase in activity.

This morning I decided to research cracking knees on the internet. The cracking noise I am hearing is a normal result and can increase after joint surgery. It even has a name …. “crepitus”, a terrible sounding name for a terrible sound.

As explained on the Johns Hopkins Medical website:
These noises with movement of a joint, particularly the knee, may sound like folding stiff paper, and are called "crepitus". These noises are increased frequently after surgery on a joint, although the exact reason is not clear.

One theory is that the ligaments (tethers that hold the bones together) make these noises as they get tight rapidly when the joint is moving. In some instances, popping may be due to a tendon snapping over or around the joint. Another theory is that nitrogen bubbles in the fluid inside the joint are rapidly brought into or out of solution when the joint is manipulated, such as cracking the knuckles in the hand.

If I put my hand on my knee while it is bending, I can feel it bubbling. I am used to the occasional joint noise. My elbows hyper-extend, my shoulders slip out of socket and my right hip occasional goes out. Wow, putting that on paper makes me feel old but the truth is that my joints have always been this way. I remember sparring and being tapped on my arm during an exchange. I immediately fell to my knees in pain. A small tap in the perfect angle pushed my shoulder out of socket. After a few minutes, my shoulder slid back in to place. I felt bad for my sparring partner because he had no idea what happened. My elbows are challenging for self-defense partners because they do not stop where they should.

Whatever the cause, these sounds do not need to be specifically treated. There are no long term sequelae of these noises, and they do not lead to future problems. There is no basis for the admonition to not crack your knuckles because it can lead to arthritis. There are no supplements or exercises to prevent these noises.

I guess I do not need to worry about my noisy knee but I may need a pair of earplugs.

Please note that I am not a doctor nor am I dispensing medical advice.

Monday, March 3, 2008

How Do You Learn?

When I was in college, I had a course on Cognitive Psychology with a focus on Learning Theory. I graduated in 1990 with a dual major in Political Science / Psychology. When I started college and decided on my major, I was certain I wanted to go to law school. During my junior year, I decided that being a lawyer was not what I wanted. My first job after I graduated was working in the “rag” business. I loved everything about the garment industry and I learned so much. I worked for 7 years in the industry until the company I worked for went overseas. I had a wonderful liberal arts education but I do not use my course of study for my daily work responsibilities. It has helped my karate and my ability to teach.

What does this have to do with karate? When I have the opportunity to work with students on an individual basis, the first thing I say to them is “How do you learn?” The response I get is typically a questioning face and shrugged shoulders. I then proceed to ask some of the following:

Do you learn better in segments or the whole kata?
Which do you rely on more: auditory or visual cues?
Can you learn from a video?
Do you need to watch the technique before you try?
Do you learn by repetition?
Would you rather mirror movements or stand in the same direction? (This is interesting because I find that young students would prefer to mirror the techniques while adults need to be adjacent.)
Does the bunkai help you remember the kata?

Let me give a personal example. I had trouble with left and right. When I first started taking karate classes this was a problem for me. If the instructor would call out the techniques using left or right commands, I would have difficulty learning the material. I needed to see the techniques and hear the techniques called out. Self-defense was even more challenging because I needed to be facing the same direction as the demonstrating instructor. I am glad to report that this is not much of a problem for me anymore.

During class, I try to offer students a variety of learning opportunities. I will count out a kata, and the next time I will call out the individual techniques. We will practice a whole kata and then we will break it down in to smaller pieces. We will review basics and look at the bunkai.

So, how do you learn?

Saturday, March 1, 2008


I study a traditional Okinawa Karate and Kobudo system. When we receive our black belt, we receive two certificates one for karate and one for kobudo. We wear a special kobudo patch on our obi when we reach Shodan. We spend at least one half of our dojo time working on weapons. Kyu rank students need to know weapons kata for testing starting at 5th kyu. There are 29 weapon katas and 21 open hand katas listed on the Federation website.

This is my first picture. Much harder to format that I expected.

Tunfa is my favorite weapon with bo a close second. The tunfa pictured above are made by Shureido. I had this pair since 1993 and would be heartbroken if anything would happen to them. Everything about them is perfect: size, weight, color and handle. I remember competing in an open tournament in a black belt weapons division and demonstrating the second tunfa kata. After the event, one of the judges came up to me and asked to inspect my weapon. I politely handed over my tunfa and the judge examined them looking surprised. He then told me that he never saw anyone swing tunfa like I did. My heart sank for a moment because I thought I had done something wrong. He further explained that he thought my tunfa were modified and "spring loaded" because I flipped the tunfa so quickly.

We have been working on tunfa in the dojo lately. There are several students who need the first tunfa kata for their next test. It is important that the weapon becomes an extension of the person holding it. A tunfa needs to be swung with the entire body not just the arms. I think that it is easier to learn how to use a karate weapon if you practice the practical application. The other night we worked on defense against bo attacks.



Thank Goodness it is March!