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.

"Watch and Learn" is a Thing

"Watch and Learn" is a thing; I'm a hypocrite if I could do that thing, but then don't.

If you have Ehlers-Danlos Syndrome and practice Goju Ryu karate, you'll need to practice adapting. I am a star at adapting, with plenty of life experience. What you do on the floor has to work in the street or it's of no use. Observing gives me an opportunity to watch and think about adaptations without trying to stay conscious and upright.   

For both Monday's and today's appointments I did not get medically cleared by my physiotherapists to attend the once-in-a-lifetime Gasshuku (special karate group training) this weekend. The Gasshuku is with 8th Dan Paul Enfield, and it was the right call: my sacrum won't unlock. If I try to use my lower back I'll be very sorry for it later on. Throwing punches without full access to my hips is causing my clavicles and shoulders to sublux. Kicking with a fibula that won't stay in place unless it's taped, or suri-ashi (body shifting) with an ankle that won't stay in place, is not a good idea. All this, right after finally figuring out a way to reduce the blacking out from Dysautonomia. Any one of those things would be reason enough for any rational human being to sit the heck down.

But this is Paul Enfield, the man who brought all four volumes of Higaonna-Sensei's work to document Goju Ryu karate to the English speaking world. Sensei told me to come and observe, and usually I would be able to do that, and happily. PT suggested the same. But I'm deaf in the dojo, so it would be complicated and stepping into the dojo is already so emotionally charged that I can't imagine being isolated in two ways (movement; hearing). That's an error of thinking, though; I am never separated even when I'm just observing because my dojo family goes out of its way to make sure everyone on the floor is included.

I dread sitting out because I put everything I have into physical therapy to get back to karate. It feels like I'll never be done rehabbing, and it's true that I'll never be done with rehab. PT is a permanent aspect of life with EDS. But rehab without karate feels like I'm fighting just to live, and my quality of life feels pretty low since the third bout of sepsis.  I also miss my port and the freedom to roam whenever and wherever I want to go.

It's hard on the psyche to go to the dojo and not physically participate. Sometimes I have to step out to cry, which is fine, but tends to make others worry. "It's just hard," I tell them. And it is. The pain of knowing my body will work against me if I try to use it is agonizing in itself. It's arguably worse than the physical pain, but because the physical pain affects my overall functional level (like being able to use the bathroom), I have to respect the pecking order of matter over mind. 

It won't be forever. Sensei assured me that there will be plenty more Gasshukus. But my heart is in the dojo and I want to be doing karate. No matter how much I read or review while I'm physically rehabbing, it's no replacement for live practice. Not being able to practice also has a detrimental effect on how much I can learn through studying, too.

What I'm trying to say is that I'm upset when I don't need to be, and if I want to be a hypocrite I should stay home and not find ways to adapt what I'm seeing. And yet, I feel pretty rotten. But even when you feel rotten, you should go to karate.

Who cares about anatomy?

I think everyone, especially everyone with a chronic illness, should read at least one Anatomy & Physiology book, even if they won't understand it all. It has really helped me put the pieces together and keep the terror at bay. I can get through a violent muscle spasm in my "shoulder" by knowing, "well of course it hurts, it's right over my brachial plexus!" I know it sounds intimidating but it makes a huge difference.

The spasms on my brachial plexus on either side have become officially chronic. Last night one was so severe that I had to leave the dojo. When I got home I showered, took a beefy muscle relaxer, and my night was over. I lay awake surfing funny animal photos on Pinterest, waiting for the pill to deaden the hellfire in my neck.

When I can't get to karate it's a horrible time. My emotions go into a tantrum and I feel so lonely for my karate family. I try hard to be patient, but I reel on the fact that karate is the one thing in which I have ever physically succeeded, and it's all I want to do.

Sometimes I catch myself thinking that, if I could just arm myself with enough knowledge, maybe I could beat Ehlers-Danlos Syndrome. At those times it couldn't be harder to accept that such a plan is completely unrealistic. Although, knowing more does help me cope better, in that it helps me to communicate exactly what I'm going through, helps me interpret what moves I need to make next, and helps me push myself to do the therapeutic work I need to perform after I exercise.

My health has been on a frightening decline since July. But I'm stubborn and I'm working hard on this life, piece by piece, poco a poco.