On Static vs. Dynamic Exercises and Stretching*

"If you can't explain it you don't know it well enough." -Einstein

It's been three years since my last belt test. I tested for 1-kyu in Goju Ryu Karate on November 11, 2020, via Zoom online. My tests are adapted to suit what I can physically do, which is largely kata (forms) and solo kihon bunkai (basic applications). I also need to understand what others can do with the system, and I need to be able to adapt what I can't do in such a way that it would work in the street. This was set from Day One with my Sensei in a meeting that lasted for four hours while we sussed out what my training was going to look like. That was about nine years ago. That's a long time to be a kyu-level belt (non-black). But some people never get this far.

The notes below are a summary of what I've learned about muscles locking up intensely and painfully. My port and daily IV fluids must have been preventing these problems for years. I'm grateful for seven years with my port, it's unprecedented. My medical team is incredible and the value of a supportive Primary Care Physician cannot be understated. For over two years I've been in Physical Therapy and Occupational Therapy, among other rehabilitative efforts. I've also beaten the grave four times, retired, started a small business, bought a new-to-me mustang (I love mustangs, it's like getting a limb back), while also living through the pandemic and attending karate to the fullest, safest extent possible. (That's another story worth telling and this little note is to remind myself!) None of this is medical advice and don't trust everything you read on the Internet. I haven't even run this by my PTs yet.

The Ehlers-Danlos community has already benefited from my Sensei's leadership by observing and trying these methods. My Sensei has also been actively outspoken beside me, and others, teaching people with all sorts of abilities that martial arts is for everyone, that our school welcomes everyone. He's helped lots of us unpack negative experiences with instructors who pushed EDSers to the point of injury or quitting. 

Indomitable acceptance in the dojo is founded in the school's Christian values, and people of all backgrounds are welcome. If I were Jesus that's what I'd want to see. Anyway, on with the science notes: 

On Static vs. Dynamic Exercises and Stretching*

• Given
• When the muscle must contract it's happy to do its job, even if that job is a little tougher because of instability.
• When the muscle must relax, those fibres have no idea where to stop because tendons aren't stabilizing or providing usable feedback. So, the muscle is inclined to remain contracted: "Any time now, tendons.... Guys?"
• Interventions: milieu approach, e.g.,
• Isometrics give the muscles a chance to practice both strength (muscle's ability to contract)
• Short, sustained reps for tone (muscle's ability to remain contracted), and 
• ...also releasing and relaxing in between reps (except they suck at relaxing).
• Manual therapies aid in the physical release of muscle fibres which can only relax passively.
• Pharmacology aids in the chemical release of muscle fibres, which are chemically gated by extraneous sympathetic activity, hormones, diet, exercise, psychology, family hx, etc.
• Things I couldn't fit elsewhere
• Timing - time of day/month; interventions before/after activity; last meds, food, hydration, electrolytes
• Psych - last boost of oxytocin or dopamine; last interpersonal reaction; psychological flexibility; emotional regulation; cats?
• Environment - weather; climate; physical safety risks; fall risks
• Adaptive equipment - tapes; braces; splints; mobility aids, environmental mods
• Support - care team; community members; friends; family, and access to them all
• Misc - what else is hurting (and what isn't!); energy levels; cognition; quality of above factors
• If a muscle group isn't working right, check the opposing muscle groups.
  
• Ongoing "learning opportunities" (that aren't necessarily functional goals, but are more qualitative)
• Emotional endurance when things look bleak for a long time
• When I get sick, any of this knowledge that isn't rote goes out the window.
• Prevention and managing crashes (exhaustion, injury)
• I forgot how to know when a muscle is fatigued vs. exhausted, and when that's a useful vs. hazardous.
• WTF, diet/guts?
• Consistent exercise program
• Managing kinesiophobia and coping without a port like a freakin' boss
• WTF, mind/body connection?
• Communicating with providers succinctly ;)
• Things to remember
• "If you can't explain it you don't know it well enough." -Einstein
• I didn't come this far just to make it this far
• I must rest when my rampage is over
• Didn't cause it, can't cure it, might bitch about it, can endure it.
• Nourish to flourish
• Take your meds. Your doctors know they're not prescribing Jolly Ranchers. (that's mine!) :)
• Sometimes to let it heal you have to stop fuckin' with it. (also mine) :)

Be well. Whatever you celebrate, Happy That!

*I am not a medical professional, so check with one. Don't believe everything you see on the Internet.

Zooming In On My Progress

Online learning is getting to me. In karate tonight over Zoom I tried Sepai kata for the first time. I miss my dojo. It'll be interesting to see how my body tolerates karate with no port and overall reduced activity after the pandemic ends. I look forward to building back up because looking back won't do me any good.

I've been in physiotherapy for a year and a half now since sepsis ended. I've been out of the dojo since before the pandemic hit the United States, where I live.

Learning karate online has been a lot of fun because it's different and I get different things out of it. I can turn the volume way up on my Sensei's voice, for instance, whereas in the dojo I'm almost totally deaf. Learning online I can write notes down and scribble out my questions and their answers. I can rest, add a fan, hydrate, and manage blackouts more easily. The cats are distracting but that's only because I want them to meet my dojo family.

It's frightening that my body has deconditioned in so many ways because of sepsis. My muscle memory is carrying me further than my actual memory in some cases, and in other cases I'm choked up from drawing a blank.

My Sensei is extremely generous with my schedule and my abilities. He has things he wants for me and I have things I want for myself. At the end of the day we're glad to be alive and we have faith that this is the foundation for anything else we can imagine to come true. :)

Sepai, though, which is thought of as the oldest kata, has a lot of moves in it that are new to me. It looks like Sepai bunkai might be easier to perform than the kata itself (at least, kihon bunkai).

I'm frustrated most moments of the day with the pain, which is a lot worse, a lot sooner. Pain control in the U.S. is a strange racket. With Ehlers-Danlos Syndrome it is unrealistic to expect that one may ever be completely out of pain. But it is realistic to expect that I can learn to defend myself. I don't need every kata to be lovely. I don't need every bunkai to work. I need to practice and ingrain a few solid techniques that will work for me in different situations against different types of people. I choose to see my life as worth defending. There are many people in my life I wish saw themselves that way, but I can only control myself and invite others to join me in the adventure, in the work. And boy, is it work.

Eventually, everyone gets seasoned at working toward or fighting for something, so long as we do not give up and check out. And even that is another type of fight altogether worth besting.

Saifa Kata and the Clavicle Strikes

I'm relearning to perform Saifa kata at full speed and power without dislocating my clavicles. It's funny that one of the Saifa bunkai is a clavicle, too.

PT and I think it was fine when my port was anchored to my chest but now that it's out and there are all these pockets cut into the muscles they aren't holding my clavicles in place anymore. It's not supposed to be the muscles' job to stabilize the clavicles, but in lieu of connective tissue to do the job, the muscles aren't really capable of doing both while also full of pockets. So, strengthening and toning. It'll sort out. Saifa was my best kata for a while so I'm eager to get it back as best I can.

In Defense of Self

Karate is about self-defense. Period. It's not a sport.

I've convinced myself that the grief process for how far I've slid in the past two years won't be as severe, so long as I can keep on partying with aggressive dance moves in my funny pajamas. For most of the last ten days I've had intractable pain. I can't wait to get back to karate in any possible way besides reviewing in my head. I need to believe I'll get back to it because without my port I've been at a tremendous loss. Karate is a huge part of me that I haven't lost, and I don't intend to.

Retirement due to disability isn't like voluntary retirement at retirement age. For one thing it's guaranteed poverty. It's means-testing for every bit of support. It's nursing and medical re-evals a dozen times a year just to make sure you're really not going to improve. Same questions over and over. Same paperwork. Same signatures, scheduling, hours and hours of life spent on enough  paperwork to make you ask yourself, "can I really not work if I can do all this paperwork?" But then the symptoms stack up, everything you swear you've washed still smells like puke to you, the mail says you're overdue for more medical exams, your best splints won't close over the cat fur in their Velcro, and it's hard to tell what day it is because you can't remember the last time your sleep schedule was diurnal. That's on top of actually staying alive and uninjured, splinted appropriately, meds, physiotherapy, occupational therapy, medical appointments, paperwork for those, blood work, pharmacies, insurance, prescriptions, bills, diagnostic imaging, durable medical equipment, residential mods, vehicle mods....

Suffice to say, I'm having a hard time.

When I'm at karate that falls away for a while. I'm enchanted by the physiology, the safety, the methodology. My Sensei delivers this balance of humour and heft that level off the risk of death or permanent injury similar to the risks I live with day in and day out. Things slow down and I'm not thinking about how close I am to a joint dislocation. I'm just doing one thing at a time and when something pops out I put it back in. Easy peasy.

There's no paperwork, no evaluation. Nobody is going to check to see how functional I am. They're just other people on the floor on their own journeys, and we're just doing the same thing together for a time. We're all pushing our own limits. There's no competition, only partnership. There are no cliques, only karate family. We're a tight-knit dojo and your body or intellectual ability does not limit you in our school. We are inclusive and I am included.

In my school I don't feel invisible. When I can't be on the floor I have extra projects to participate, in character development or in projects that help our school grow. I get to do really cool things with every language I know, with technology, building, and crafting. There's never a break in growth and strengthening, and that's what makes karate invaluable.

Karate is about self-defense. You have to believe in your life and develop a life that's worth defending. You have to build a self to defend. I've lost a tremendous lot of my self in my retirement. Karate is as good a mode as any to get that back or grow a new sense of self. So you see, I'm eager to get back.

Tai Sabaki and Shifting Directions

Tai sabaki is a shift but it is not a final destination, you have to keep moving.

PT didn't clear me for karate this week so I'm watching videos of Higaonna-Sensei. My goal is to find one physiotherapy modality that will help me develop the functional muscle movements and stability to perform one thing a little better than before.

My focus has landed on tai sabaki, body shifting, which can also be translated as body management. Defensively, tai sabaki is used to move quickly out of the way and often includes facing a different direction.

Since my last three hospitalizations I've had to dramatically switch directions in my life. Switching directions shifts one's vantage point, which allows for refocusing. In fact, it requires refocusing, if you're going to get anything done. Tai sabaki is a shift but it is not a final destination, you have to keep moving.

The hips drive tai sabaki. The more stable your core, the better the control. Faster, stronger, easier, smarter. Less easily fatigued. More readily engaged.

PT has been incredibly hard and slow to progress. I feel less likely to fall but I'm still too weak to do a number of functional tasks. For instance, I can't go out to buy groceries and then also put them away when I get home. It has to be done in steps with rest in between.

With tai sabaki you have to stay relaxed, "not too busy", as Higaonna-Sensei explains it. If you get anchored down you can't move or change when you need to. My PT is good at changing directions and finding new approaches. It's not easy work to manage my frustration when a task doesn't work out; a quick shift of focus keeps my time in PT productive and developmental, even if it's not the original task I set out to accomplish.

The goal is to get through, not to land a particular punch. That's why you have to be able to shift, and to practice all different kinds of things. A little at a time, all those little efforts add up to the win.

https://youtu.be/8Ru-fQ10c3Q

Recently I had a nurse evaluation, one of many. "Staying alive, is that what your goals are with your doctors right now?" she asked. Yes, that's the primary goal right now. But it's leveling off and the shift is toward recovery and functional goals for Activities of Daily Living (ADLs). Karate isn't on the list as a method right now, even though it involves exercise. But that doesn't stop me from asking for clearance to go each week. That's the direction I want to be facing, even if I have to shift now and then.

Physiotherapy-Do

Physiotherapy (PT) has its methods. It takes time and commitment. It takes energy and resources. It's for a better overall sense of being. In that sense it is just like karate-do, another way of being. It's hard to walk both paths at once because my energy is limited, so I've been foregoing karate in order to repair my body at PT with that much more focus and efficacy. When I pushed myself to do both I felt like I was working against myself because I was too sore and exhausted, and I was getting weaker from doing too much. (I do not enjoy admitting this.)

After physiotherapy today I had to sit in the parking lot to collect my emotions. My physical therapist is so knowledgeable, so humble, and so unafraid to try to help, that I get overwhelmed by finally having a place to go where I can get relief. (I get even a little more overwhelmed to think of how few EDSers get this far.)

Thanks to my PT's help, I take less medicine for pain. I am getting through more of a day without needing a major rest period. I'm not throwing up every five minutes. I'm passing out less often, and less severely. I'm able to hold my own head up without a brace more often.

Regular access to competent physiotherapy is helping me get ahead of my pain. He not only helps me understand what's happening, but he challenges me to think through why it is happening. Then, he gives me options for what to do about it, and I am 100% included in my own care plan.

My PT meets me where I am in managing my symptoms. By that, I mean that he genuinely listens to my confusion and frustration, which gives me space to work through the emotions that need care on the way back to logic. It's a holistic approach, invaluable to a "PT lifer" like me.

I look forward to physiotherapy because it's where I go to get better. Today I was anxious because I knew I was going to be able to make it, but I didn't know how much I was going to be able to do since I had been dealing with POTS all morning. I had a "painsplosion" last night, too, which was not helpful. What I did know was that I would be okay, and that I would be in less pain after. I would not be judged as weak and I would not be ridiculed for using dramatic terms to describe my pain because it's so complex a feeling to convey. I knew there would be things to laugh about and that I would have some serious work to sink my teeth into. 

I like working with my PT because he is a natural teacher like I am. He lifts up everyone around him because he is constantly educating. Patient education is essential to long-term results. I leave with lots of ideas to look up each week. I wish I could stay and take more notes during or after sessions, but I really need to focus on my body so I can get back to karate. That means I don't get to spend as much time in my head as I'd like, to process it all. With hearing loss it takes extra time to commit verbal exchanges to memory.

Physiotherapy has been a long road for the last several months. It's taken effort, tears, trust, time, and patience. Not once have I left there feeling like I haven't raised the bar; I am always a little better off than I was when I went in, regardless of where I was when we began our work.

Because I'm able to get this care, in able to stay employed. I'm able to earn a living wage, pay my bills, contribute to the economy, and even make a few modest donations here and there. Ehlers-Danlos Syndrome costs a fortune to manage, even with Employed Individuals with Disabilities Medicaid buy-in to cover my insurance copays. A significant portion of my wages goes into my care. But at least I'm getting adequate care now, which is especially true with having found a qualified and competent provider.

Last year was a rough year for my health. This year I'm going to keep working on improving myself. I will work to remember that I can only do one thing at a time, and I will try not to work against myself.

I'm so grateful that the trend is upward that my eyes are leaking. You could fill a city with the number of people who are a part of my progress. If we could measure compassion in raindrops I'd need an ark!

The foci of our work this time around in PT has been on shoulder stabilization, stabilizing and integrating the paraspinals, improving vestibular resilience, resisting syncope and recovering sooner, and a few other odds and ends.

I am so eager to get back to karate, I must think about it at least 20 hours a day. But I don't want to overdo it and end up injured again because I'm working hard on PT to come back from a really harsh year. Every day that I don't go to karate I have to resist kicking myself. But I'm trying to be patient with myself because I still study and I still practice at home, which has value. My dojo always welcomes me to try everything I think I can do. But I think I'm doing the right thing to let myself recover. It's so hard to not go.

I'm so very grateful. How I wish I could give this experience to others who desperately need better care and better results. Maybe by writing it up, others will know what to expect, and they will know to aim for a higher level of care.

Be well.

On the Balance of Kata, Bunkai, Kumite, and Iri Kumi

The first iri kumi of a martial artist with disabilities is the battle to seek and find a school and instructor who will take them on, without preoccupation for their disability, their ability, and any perceived potential liability.

At the bottom of this post is a list of people of all sorts of cool abilities. I thought about them during this post and think it will enrich this post if you check out the links.

[Image: a river bank in Japan with trees in the foreground and a stone lantern in the background. Colours are different shades of green under a mid-day overcast sun. Text in picture:
"Karate becomes a sport when those who are teaching it forget that it is an art."
-Karate Viewpoints]

A facebook thread of friendly  "chest thumping" got unexpectedly philosophical with questions about who is practicing something martial and who is practicing art.

Loosely defined, here is what the words mean from the title of this blog post:

• Kata - a series of movements commonly referred to as the textbooks of karate
• Bunkai - ways to use movements from the kata in fighting
• Kumite - "grappling hands" 
• Iri kumi - free, controlled exchange of technique, often continuous hard contact

It was said, paraphrased, that those who do not practice iri kumi are not learning to fight, they are learning an art.

For a second, it hurt to think that, if I didn't practice iri kumi I was not practicing the martial part of the art that preoccupies my life. I am used to being told that I am some one way or another, as are most people with disabilities. But the more I thought of other martial artists with disabilities who motivate and challenge me, I became anxious about our inherent right to learn to protect ourselves by any means possible. 

Probably I will spend the rest of my life contemplating the following four questions, on and off again.

1. Where is there room in how martial arts is defined for different people--from within and from without?
2. Are people with disabilities who can't regularly practice iri kumi, then, only practicing an art? Is there room (and there may not seem to be) that it may also give them a fighting chance?
3. Everyone is fighting a battle, and people with disabilities are at constant iri kumi vs. life. But so is everyone else, so how is our existence framed when viewed from the non-martial arts lens?
4. If I didn't have so many projects already I would take time to to look through my materials and see what Higaonna-Sensei has to say directly about kata, bunkai, kumite, and iri kumi. Beliefs grow and develop over time, like it or lump it, but it will be helpful for me to keep looking both back and forward. Any particular points of interest?

I am especially grateful for every person, group, school, and organization that welcomes students of all ability levels.

-=-=-

People I've thought about during this post:

1. My Sensei, who took me on and we made a plan to be safe; who requires that I (we) understand the techniques as they were written for able-bodied majority, and that I (we) find adaptive ways to perform techniques effectively at any functional level: http://www.warriorsofgracekarate.com
2. Higaonna-Sensei, who remarked that it looked like I was having fun; who took time to make suggestions about how he would like to see kata and techniques performed. https://en.wikipedia.org/wiki/Morio_Higaonna
3. The ever-growing number of karateka with disabilities in my dojo, which we all celebrate with joy that we can be such a place where all are welcome.
4. John Marrable-Sensei who paved the way as a Goju Ryu karateka with a visible disability and looks to be absolutely lethal: http://johnmarrable.com/self-defence/
5. Ikkaido Federation http://ikkaido.com/
6. Olando Rivera's Warriors for Autism: http://olandoskickboxing.com/
7. SuperCelu, my hero: https://www.youtube.com/watch?v=q8cygU1x6RM
8. Andrea Harkins, The Martial Arts Woman, who featured my narrative in her first anthology: http://www.themartialartswoman.com/
9. Chris De Wet-Sensei, who helps me face the reality that not all experts will have the answers I need, and that I have a responsibility to find those answers for myself, which will empower me to help others grow: https://www.youtube.com/watch?v=nSNDxjADH1E
10. Michael Downs-Sensei who helps me focus on helping others grow by acknowledging both my disabilities and capabilities: http://defensiveartsdojo.com/
11. Me (here I am! Hi! I did think of myself.)

Higaonna-Sensei's Time

I dreamt that Higaonna-Sensei visited my dojo on my testing day. He looked so healthy, happy, and energetic that I kept my nervousness about testing in front of him under control because staying calm and collected in times of conflict is his #1 lesson.

In my dream I passed to my 2-kyu, but he had much to say about what improvements I needed to make. He gave me a technical analysis of what to modify so that my disabilities weren't in the way of my efficacy. He a gave me strict feedback about where I was clearly getting in my own way for fear of injury or fainting.

How I wish I could remember anything he'd said! We spoke mostly in Japanese and I was preoccupied with translating, and with not getting overwhelmed by how generous he was in his time with me, when there are so many people who would kill for that kind of time with him. The only way I could focus was to know that the only way to honour those people was for me to focus, work extremely hard, and to do everything I knew to make Higaonna-Sensei happy with his student. I received a glut of his time and attention.

---
This has got to be, in part, a manifestation of how I felt during MCF2014 in Tampa, Florida, USA. I'd had a number of difficulties and was driven to tears several times from the complications.

On the first morning of training I had accidentally come to black belt training. I arrived late, so I wheeled to the back and parked my chair against the wall, doing gentle juunbi undo (karate warm-ups) and trying not to draw attention as the karateka in the wheelchair with lights on it. Nakamura-Sensei politely informed me that this was the black belt class and I'd read the schedule wrong, but he invited me to sit and watch, which I did, soon finding myself a fish out of water. I was 5-kyu at the time, a blue belt.

The day before I found myself sitting in the dining room of the hotel at the table next to the senior instructors. Higaonna-Sensei and I faced each other from our respective tables and exchanged informal head bows, with smiles throughout our meals. I knew who he was and now I knew he was curious about who I was. At the time the only other wheelchair user I'd ever heard of was John Marrable-Sensei in New Zealand. I'd only seen Marrable-Sensei in pictures, but I knew he was out there in the big world, and from his representation I gained infinite gusto about representing myself in my wheelchair to break barriers and stigma.

Within seconds of Nakamura-Sensei's invitation Higaonna-Sensei walked up to me, cutting right through the lines, all the way from the front of the class. He did not rush, and his face was neutral. He did not look at other students as he walked, but came straight to me. We bowed. With no delay he held out his hands. They were covered in scars, knobs of arthritic and glycated tissue, and dry patches where I presume blood and water could no longer compete with the chronic assaults on the capillaries that carry nutrients to the surfaces of his hands.

"Whatever you do, do it a hundred times," he said, as he rapidly opened and closed his massive paws into fists. "every day. Then you will be strong. Just one hundred times. Okay, good."

Just as quickly as he came he was gone, back to teaching the black belts.

Later, outside in the Florida sun, we were taking photos with him and with students from our respective countries and I passed out from the heat. A fellow karateka happened to be a paramedic and helped me inside to safety. I collapsed on a patch of floor off to the side of the stairs and he helped me start my IV pump. It became apparent that I had worried Higaonna-Sensei because he came to me when he was through with photos, an entourage behind him, to see if I was recovering okay. When he saw that I was in good hands he gave me two thumbs up and went on with his day.

It isn't easy to be "the one in the wheelchair." It can feel like I'm getting extra attention I don't deserve, and like I'm taking away from other students. Someone's I just have to be humble about it, other times I have to fight for it to get my own needs met. It's important for the instructor to be aware of your needs, especially in matters of safety, but also in matters of equally access.

Higaonna-Sensei teaches so many people that he can't possibly get to know all of us. And yet, he took much time to meet with me, to talk with me, and he even asked Nakamura-Sensei to take a picture of us so I would have one. "You look like you are having fun, I see you smiling when you practice," he said.

How I wish I could see him again. I wish he could see how much stronger I am. I wish he could know all that my Sensei has done for me, how Goju Ryu has changed my life, thanks to his proliferation of the practice.

We only get so much time on this earth. May we all use it to change and improve lives.

Shisochin, The Great Ankle Biter

https://youtu.be/ejQ-KyRTvEU

My ankles aren't happy. It's like I can feel every booboo I've ever had.  This kata and I are going to become good friends and I'm going to learn how to use my legs better.

My last PT showed me how to modify my gait and it may be applicable here. Because I have Pes Planus (flat feet), my feet pronate (turn inward). That puts valgus (inward) stress on my knees. As long as I turn my feet out a little bit more when I walk it widens my gait and reduces that valgus stress.

The footwork in Shisochin kata is 99% zenkutsu dachi, a long stance which puts a great deal of stress on the ankles. I couldn't do a single stance without my metatarsals separating, so I'm going to have to modify it.

Here's the thing about modifying moves: Mark Twain advised that we learn the rules, then break them. Zenkutsu dachi is one of the stances I struggle to master because it's big and it's painful. However, it's going to take getting this stance right to learn what I truly can do, so that I only adapt what I truly cannot do safely.

More research will be necessary! It's exciting! Still, at this point in the discovery process it's pretty painful, it would be nice if I could sleep. :)

Be well.

Swimming In Zanshin

Higaonna-Sensei says in an interview, "when I get a knee injury, one would normally think, what to do? [...] One should learn to live with it. [...] Stress is a person's biggest enemy."

This is a very hard lesson to get behind, though I understand his point. Learning to live with it is easier when the injury doesn't change and is localized. I suppose if I had one bad knee, with pain that didn't change much in severity, or didn't require an immediate and improvised adaptation to my day, I probably wouldn't get choked up.  This is something to work on.

But Ehlers-Danlos Syndrome does change, and it changes from moment to moment. A lesson that speaks to me more is the concept of Zanshin. This is not a word we shout for a stronger punch. It is not a kata, a level, or a formality at the beginning and end of class. It is not a part of our uniform, or a move, or an application. Zanshin is integral to our very way of being, and translates to the concept of residual awareness. That is, after a match has ended, or after a kata has finished, one still does not let one's guard down. Zanshin is the concept of always being ready for more, never being unready when the next adventure begins.

Zanshin can be overwhelming for me to follow because I get tired. I get physically, intellectually, and emotionally tired, of always having to take care of my body. If it's possible to have clinical compassion fatigue for one's own body, I've waxed and waned through that state of mind like ocean waves change with the weather and tide. Those waves range from gentle, rippling nonchalance to thrashing, wild swells that can even drown me in their whitecaps. My world becomes very small as I dive into managing my needs. Luckily, at some point I always manage to come up for air. It is in those moments when I break through to the surface that, even with all the air I need, I am forever preparing myself for the next time I will go under. All people experience certain aspects of their lives in waves. With EDS it can be rapid-cycling, or lingering, or stormy for a long time, so it is best to be ready.

What can we do? We can practice the best habits as often as possible: eating well (or managing our tube feeds/TPN), staying hydrated, managing our energy levels, keeping in contact with a healthy support system, and so on. We can educate ourselves: read an anatomy and physiology 101 book, learn basic medical terminology so we can communicate with our doctors, get proper testing to establish baselines for our most vulnerable body parts and systems.

No enemy is going to worry about whether I am ready for the next blow. No ocean concerns itself with the swimmer. The more I learn, the less effort it takes to be ready. Knowledge is power. Zanshin is the practice of being ever ready to use that power when necessary. Zanshin is how one learns to swim through the waves.

Talkin' 'Bout (the Circle of) Willis

Let's talk about the back of the head.

The Circle of Willis is a series of arteries connecting critical feeds of blood to the brain. When a connection like this is created in the body--whether it developed that way or was created--it is called an anastomosis. An example of a synthetic anastomosis would be if someone had a section of intestine removed, and the two remaining sections were joined together.

In the Circle of Willis there are smaller arterial sections that would allow certain sections of the brain to be fed at least a little bit by arteries that wouldn't normally be tasked with doing the job, in the event of a failure like a stroke or other trauma. Smaller segments within the Circle of Willis are fed by the internal carotid arteries and the vertebral arteries. The internal carotid arteries are split off from the carotid arteries.

Here's a video. If anatomical terms aren't your thing, just watch as the video highlights where the blood goes.


We always talk in martial arts about protecting your face. Keep your hands up. Protect your jaw. Keep your chin slightly tucked. But all we say about the back of the head is not to let anyone get behind you. We know it's important not to get hit in the back of the head, or in the spine. Perhaps a lot of us would get psyched out if we all knew how catastrophic any blow can be.

Some of the people I support at work have survived a traumatic brain injury. Knowing the science behind their situations may not be at the forefront of my work with them in rehabilitation, but it does help me to be compassionate about what they may be going through, because I know what is damaged and why. I also know more about what can be rehabilitated and what can't. Because I am not a neuroscientist I cannot allow my novice understanding of anatomy to impact the recommendations I make, but it can help me ask better questions of those who are qualified to provide better information, and /that/ can improve my outcomes.

In karate, I use my knowledge of anatomy and physiology--and my knowledge about how my body breaks so many of those rules--to learn, grow, and adapt. When I know how serious a consequence can be, I know to sit out. Knowledge is power, and as Uncle Ben said in "Spider Man," "With great power comes great responsibility."

Last night I made it to karate and I'm glad I did! I did my first successful groundwork. It feels good to have studied anatomy and physiology. It feels incredible to see it in action. Best of all, it feels sublime to watch my lawless body doing what other bodies can do.

There are so many factors involved in success as a martial artist: how my body is built; how bodies are supposed to work; how bodies don't work; how bodies can be improved; how bodies can degenerate; how adaptions can be made; how practices can be improved; and so on, that it makes sense to say that karate is a cradle-to-grave activity.

The body has a lot of little fail-safes like the Circle of Willis. I enjoy learning about those redundancies, and I think it's a worthwhile use of study time because it also reveals the vulnerabilities.

Adapting Gekisai Dai Ni Kata

https://youtu.be/0Uydn4yEXe4

Gekisai Dai Ni is my hardest kata. It's extremely hard on my joints because of the rounded techniques, which take place on all three planes of motion: coronal, sagittal, and transverse.

For Ehlers-Danlos Syndrome, movements on one plane of motion are best. Movements on two planes of motion are okay. Movements on three planes of motion are a no-no because they most strongly force the joint into a closed-pack  position, with the highest congruency. In plain English, they mash the joint into its socket or capsule the most tightly, which gives it lots of opportunities for the stabilizing tissues to snap, tear, break, sprain, and so on.

Coincidentally, in a hypermobile person, a position at the end ranges of motion, with the most joint congruency, is often the most comfortable: everything is as tight as it can get. Many EDSers enjoy sitting with our legs contorted in unusual positions because, if we pin our legs down as far as they can go in any direction, we at least know where they are, and that they're tight. It gives a false sense of hope that our limbs will stay put. Over time, repeated activity at the end-range of motion will lead to further laxity and weakness. Then, when we need to do normal things in more reasonable ranges of motion, we fall apart easily and don't know why. (Well, now you know why.)

All kata in Okinawan Goju Ryu Karate feature rounded movements ("tripled" movements, when referring to planes of motion). It's one of our fundamental ways of moving, and for some applications it is indeed the most stable and effective.

With EDS, I reduce a lot of my dislocations by simply reducing my range of motion to five degrees fewer than the average person would move (which is 15-20 degrees fewer for me, and I'm EDS Classical Type, not even Hypermobile Type). It took six months to learn to walk this way, and six years to learn to live this way.

In karate, I reduce my stances, especially Sanchin-dachi (Three Battles stance), by just a few degrees. I have three goals with my stances:
1. Don't dislocate
2. Get the same functional outcome
3. Get the same aesthetic outcome

There are times when, curiously, I lose control of my legs. I can be standing, but unable to move. My fellow karateka will sometimes remind me what to do or encourage me to take the next step because the delay is very noticeable, but I'm stuck! EDS is given to neuropathy and radiculopathy, but I've never seen research on momentary paralysis. (Perhaps it's a Chiari-I Malformation thing. I haven't jumped down that rabbit hole of research because I don't have it yet.) I finish the exercise and then take a break. Lack of control of major muscle groups is at least a sign of fatigue.

For upper body movements I have the same goals with my thumbs, shoulder blades, and wrists.  It's even harder with my upper body and I stand a good chance of being sore in the clavicles and ribs for weeks if I ignore those goals. It can interrupt my breathing, and make me even more susceptible to blacking out. I'm getting pretty good at managing it, though. I keep my knees bent and my eyes open until my vision comes back. I don't fall over anymore.

Gekisai Dai Ni is my hardest kata. I took second place in a tournament two days ago, but popped my ankle in the middle of the first neko ashi-dachi (cat stance). Stupidly, I finished the kata, because I didn't fall over, and my head was in "the zone." When I stepped on my busted ankle for the second neko ashi-dachi, I knew I'd made a big mistake. I took care of it immediately after.

My ankle already been coming loose for days and I ignored it, since that's not uncommon. Rookie mistake. I was so pumped for the tournament that I didn't pay attention to my body, and that's where I went wrong. I splinted the next day, but the pain crept up into my knee and hip, so that the whole leg was wrecked by Saturday morning. I missed out on Spirit Training and the karate family Potluck, both of which are highlights of my entire karate life. Instead I'm in bed with my leg elevated, blogging about planes of motion.

For some joints I've learned to finish kata with a dislocated joint, and put the joint back in place later on. It just pops out again if I stop and try to fix it in the middle of a kata. My fellow karateka are used to hearing me popping bones around, so they don't freak out, which is great for my emotional health.

Gekisai Dai Ni is my hardest kata. I need to practice it. I need to modify it and practice that. I could always ask for a different kata, but I want to master it in my own way, even--especially--if I can get through it with adaptation. That's the name of the game.

The best part about my second place ribbon is that the person who took first place has been working very hard on his performance, and he's worked with me on kata a lot! He deserves that blue ribbon, and I'm proud to take second. What a great memory, to compete next to someone who has worked so hard, and for much longer than I have!

Be well.

Some Nightmares Come True, So Do Some Dreams

Five years ago I was facing cervical fusion, going into shock every other day from venous access, stuck to an IV pole for nine hours a day in a nursing station. I couldn't turn my head without passing out and the diagnostic process for Dysautonomia was cloudy. I underwent testing for Chiari-I Malformation, lived in my cervical collar, and suffered overwhelming amounts of physical and psychological pain 24 hours a day.

I didn't know how much time I had left to go on like this or who could help me, but it tanked my life. It bled my savings and retirement dry.

My (ex-)wife was miserable, I was miserable, I was just a few months away from graduating from college which had taken me ten years to complete. My family was furious and "disgusted" with my IV fluids, not convinced that drinking more water was not working. My work was very compassionate but worried about my ability to perform. My friends were scared. I was scared, and fed up. I could not continue pre-med studies.

Three years ago began refusing treatment and my doctor stood up for me (again) to tell my insurance that this was not working. I got my port 28 June 2012 and things got immediately better. By August I could get my port accessed once a week at the nursing station and run my IV fluids at home, during which time I rested, worked, and did physical therapy to rehabilitate myself. I still could not regulate my body temperature or stay conscious over 65°F.

I started practicing karate on 9 October 2012. That was the day my real life began. I could stay conscious if I ran fluids. By November 2012 I was able to access my port by myself (which saved a lot of money!) and I got an IV pump which allowed me to run IV fluids on the go with a backpack. I still follow sterile procedure like my life depends on it--because it does.

My physiotherapist told me, "While you have time, go live. Because when you're lying in that bed, you're going to want those memories."  I had wanted to practice martial arts all my life. No dojo would work with me because they were afraid of liability. Finally I met my Sensei, who let me try, and we were very careful. The rules were (and are) strict, to ensure my safety and success. Everybody was worried about whether I could do it, and I didn't care. I was on death's door with blood pressure collapses and had lost a hold of my dreams. What if this port thing was my last chance at living?

I wanted martial arts. I wanted EDSers to be able to protect themselves. A martial arts seminar showed me there were things I could learn to do; once I knew there was a dream within my reach I wanted it. I told myself that if I died after that, I would conclude that I had been a useful person in this world. I asked God to just give me this one dream, give me one merciful gift before I fell to ruins. I begged for strength, and my port was just enough to bring strength back to me.

I proved to myself I could do it, and set out to inspire others with EDS to learn what they CAN do. Today my dream came true, thanks to my Sensei, my doctors, and my friends.

Today, on 14 August 2015, I co-taught, beside my Sensei, a session on Self-Defense and Martial Arts with EDS and Dysautonomia. We showed people that everybody could do /something/. 

At first people were nervous about what they couldn't do without dislocating. Sensei dispelled their fear using the same basic techniques that I found so grounding: he started with curling the toes. So small a thing, but so simple. I watched a room full of antsy people wiggling little tiny toes, watching those toes intently, and succeeding. The tiny toes curled down into the floor, curled up, and down. The corners of mouths curled up and stayed up.  If only for a moment, a room full of people with EDS found a physical thing that they /could/ do.

It was like we'd unlocked a treasure chest, and the doubtsstarted coming: what about my ankles? What about my balance? What if I can't stand? What if I can't take my shoes off?

Within minutes, those doubts became wonderings: "How can I do this if my ankles are loose?" "Can I do it this way?" "Will it work if I do this instead?"

I understood for a brief moment that what I had done in pursuing martial arts was larger than just overcoming my Dysautonomia and chronic dehydration. Today I changed the way at least one person perceived their body.

Die when I may, I finally feel like I've made at least one satisfying change in this world, one real act of gratitude for all the kindness that has cushioned me along the ridges of a very, very hard life.

Thank you all for your help along the way, and for helping make my dream a reality. I think I  finally feel brave enough to dream again. Yes, I'm ready now.  Onegaishimasu.

Be well.

When It Gets Tough

Doubling over in full spasm may make it seem like I did my best in karate, and maybe I did! But I missed a cue somewhere that it was time to stop, so I will work on it! It's hard to know when something like that is a one-off or if there's something wrong with what I'm doing.

Since achieving my 4-kyu karate has gotten particularly hard. It used to be challenging, now it's hard. My skin tears open, my feet get shredded from movement, and I am so tired after class that I have to go right to sleep when I get home. But I'm satisfied with my effort, I've had a healthy amount of social interaction, I've had fun, and I fall asleep happy.

Even though I seldom get through a class without breaks I love to be there, and I look forward to going. To manage the pain I take breaks to stretch, manage pain, and hydrate. This morning I had taken a stretch break, and perhaps it would have been better if I had stayed on the bench afterword, but I ask myself, how am I to improve if I don't challenge my boundaries?

Testing boundaries is something we all do from the time we are little and we learn the word "no." The way I grew up, everything was a boundary, the boundaries moved, and it was dangerous to cross those boundaries. The only residual part of that muss with EDS is that the boundaries change, relative to my health that day. But some of the fights and stamina exercises are starting to remind me of those days. It's an opportunity to let those feelings come up and to work through them in a safe and positive environment. However, working with a counselor helps me unpack those memories, so I don't have to worry about sorting them out during a workout. I can acknowledge that they're there, make a mental note to process the memories later, and get back to my exercise. A lot of people start karate because of a traumatic past, whether it be ongoing abuse or an isolated event. It's important to keep those feelings in check because they can make you vulnerable or distract you. I keep it simple by telling myself those are yesterday's feelings, and then I take a second to connect with today's feelings, all infinitely more enjoyable.

My feet and ankles hurt a lot in class. I stop often to put bones back in, or to give them a break. I try not to let it interfere with my kata, and I work through the physiology of kata movements to see if better precision with foot placement can help. It usually does, much to my delight!

Breakfalls are still scary.  I think strategically about whether or not to let my partner drop me to the floor, and most times they do so very gently.  I haven't thought of safe ways to practice falling, but I'll come back to it.

I'm not worried that I won't be able to get to a black belt level. I'll work hard on the technical aspects and do everything I can to maximize my moves. That will take practice, my meds put me into a stupor, and I can't always decide which move to do next. But I think I'm at the proper level at which anybody with my rank would be if they had my challenges, and I trust my Sensei's judgement. He wouldn't promote me if I didn't belong in that rank because it would be unfair and unsafe. We don't work that way in my dojo; egotistical risks are rightly frowned upon.

My greatest ally is my Sensei, of course. With all of this, he is well aware of my situation and he has an incredible way of helping me through. Not once has he ever cut me down, complained, or yelled at me for not being able to do something. If I bring it up he says to just keep coming. He never makes a big deal of it, and it's never been a big deal. I need that. I need a place where my health is not going to cause a big ruckus that comes down on my head unexpectedly.  My whole karate family is great about it.

Not the best blog post, but it's where I am at the moment. Other than that, food is staying down thanks to Phenergan and I've got a little bit of energy back. I just need to keep eating, which I never want to do. But if it helps my karate, I'm in. :)

On my way out of the dojo today one of our teens held the door for me and said, "Good job today." Then I knew that I was on the right track. I love working with our teens. Every time I see them I greet them with genuine enthusiasm and eye contact. They've all picked up on it and they now return the gesture. I love it! They are all working hard to grow into good people, and though my part in that is small, I'm thrilled to have one. They brighten my life, and that's one of the million reasons I love karate!

Be well.

Back In Action!

Since I started karate in 2012 this month is the longest I've gone without attending class. The meds have been too heavy and I have been too sedated to do anything satisfying, let alone the most satisfying thing in my world. I've kept up with my studies, practiced my kata, and made every effort to navigate the medical mess of Ehlers-Danlos Syndrome.

It's been seven years since I began refluxing everything that I ate or drank. I'll spare the details, but it's been a long road. I'm finally getting some answers, or at least a working diagnosis, which is better than having them throw handfuls of pills at me in ill-conceived, but well-intended, attempts at controlling the emesis.

When I read my own descriptions of what I'm going through this sound awfully severe. I've learned to get through it without really noticing, which probably makes it more tolerable. However, in karate we are challenged to face what is hard for us and to gain control of the situation. On some level, it is important that I stay aware and reflect on how my body is changing so that I may take good care of it.Tonight was the first night I got back to the dojo! It was very exciting, I get like a little kid! Karate is the thing to which I most look forward, and some people don't look forward to anything as much as I look forward to karate. I let myself appreciate it with every possible ounce of joy that I am capable of feeling.

My goal tonight was to get through warm-ups. Strategically, I had plans to manage my participation by restricting it to half of what I was asked to do. Imagine my delight when I figured out that a month off from karate has given several joints time to heal, increasing my performance! I did rest, but I also pushed myself. I feel great about it!

It's hard to know when to push and when to rest. There are so many benefits to be gained from both, and just enough danger in too much of either to keep me circumspect. This was a constant problem in physiotherapy. At some point my physiotherapist intimated that she had stopped trying to guess what was wrong, and jumped straight into helping me recover. That little bit of information has been quite useful, in that, I am finally using less brainpower to find the source of problems, and allocating that headspace to resolve, recover, and adapt.

One might consider me a highly sensitive person. As such, it can be so overwhelming go through my body's changes that I somehow detach from having feelings about it, just so I can get through it. That may not be a bad thing, because much of it is a sense of loss about which I can do nothing but grieve. Maybe grief will be useful later, but I don't see it helping me right now. Hopefully it won't creep up on me!

On Femaleness and Flight

I've never met Marchant-Sensei, but from what I've read of her life and times she is a Dame of ever there were one. I'm grateful to be a part of IOGKF, humbled to share a /mon/.  There will always be cups for tea at my table for her.

Linda Marchant-Sensei is the highest ranking female karateka in IOGKF. She had a high-paying job in the UK, and left it behind to pursue her passion as a martial artist. She succeeded, too. Like every rounded pebble that tumbles over Niagara Falls, you don't become so well rounded without tumbling a long way, getting knocked around and bumped, before becoming just as smooth as the waters that carry you through time.

On the other side of this thought trail stands a fellow karateka in my dojo, a /Senpai/ to me, also dedicated beyond compare. An artist, she studies the body in total, learning to read every curve and arch, working in the dojo to see how those angles change and shape the /gi/ which shroud the figures inside. She is so young to carry this largesse of curiosity, with shoulders already conditioned to bear such weight on a very thin frame. She could remind us all that "thin" and "frail" are not synonyms.

The feminine side of karate is so often characterized by a white crane. To stand before a white crane demands respect for every such creature that ever put itself through the rigor to learn to fly.

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These days it is impossible to say just what I mean. As I continue to fight nausea, pain and fatigue, my feelings and thoughts have the impish drive to swell in my head and demand to be known. I have only a fraction of the energy I need to host them all, barely enough. My blog posts may be short for a time but I will continue writing them. It makes me sad to report that I'm still sick. Even though Ehlers-Danlos Syndrome is a cradle-to-grave companion it is still very much unwelcome.

This is a tournament week. I'll harden my thoughts to the point that, even if I don't fight this time, I truly have yet to spread my wings. I must believe that old axiom that says, "the best is yet to come," because I am nowhere near as fierce as I shall be when I finally fly. If femaleness of what I've got to work with, then truly, I am in the downy company of the finest flock.

Be well.