The Spirit is Willing, But the Flesh is Weak…But Sometimes the Spirit Needs to Chill Out and Listen to the Flesh

lower back pain

Part One: The Taekwondo Spirit is Annoyingly, Overachievingly Willing

Last night in class, which is affectionately known as “cardio night,” my chief instructor tried out a new drill. Instead of setting us up in three lines to do drills straight back and forth across the middle of the room he had us make one long line that snaked around to the side. I wasn’t sure what was going to happen, but I knew it was going to be high-energy.

For the next 15-20 minutes we continuously moved along the two long sides of the training room as my instructor yelled out kicks and eventually added combinations: double punch, snap kick. Okay, not bad for a warm up. Roundhouse, spin kick. Ugh, okay, I can do this even though I hate my spin kick (and what do you know, somehow magically it improved, at least for that night). Snap kick, spin kick, sliding side kick. Wait, what?…ugh…alright, let’s go. Then we moved onto flying kicks…continuously without taking any extra steps in between: jump, jump, jump, jumpFlying snap kick, flying roundhouse, flying side kick, and ki-yahp louder!

My mind and body were having an “on” night. I don’t know if it was having a more consistent flow of movement, or if a break from routine was confusing my brain and muscles in just the right way, but I was doing well, better than I expected. My kicks improved with the repetition, and I wanted to see what I could do next. No, I mean I really pushed myself. I’m always gross-looking after a tough workout, but this time I started getting those little mucousy gobs around the corners of my mouth, and my ponytail stuck to my sweating face every time I whipped around for a spin kick. But I wanted to keep pushing. I was doing so well! I’m leaping! I’m flying! Look at me, I’m getting both knees and feet high in the air!

I’m…hurting.

My lower back, which made its nefarious debut on the blog last November, had been giving me what I called “warning signals” for the last several days. I’m very aware of my body and listen to it carefully, but I don’t always heed its suggestions in a timely manner. I’d felt a dull aching along the lower muscles and a sensation just above my sacrum and sometimes a little flash, like when you get the shivers that run through your body. It wasn’t sharp pain, but It, my suspected bulging disc, was reminding me of its angry presence. (I’m too chicken to get an MRI, so for now we’ll just say a bulging disc is my physical therapist’s prime suspect.)

In my mind’s eye I began to picture the dull, aching sensation as a rock, hard and lumpy, and pouting at the base of my spine. Eventually the sensation morphed into a spiny sea urchin, prickly and cranky. I knew if I wasn’t careful it would turn into a  very pissed off teeny version of Mount Vesuvius…mind you, all this stuff came from my imagination without the help of any painkillers. Told ya I have good body awareness.

About halfway through Monday night’s class, Sea Urchin/Mini Mt. Vesuvius was speaking up louder. I had already planned on stopping when the aching turned into pain in order to avoid another excruciating strain and had even told my chief instructor that I would have to stop at some point, but the little devil on  my shoulder encouraged me to keep kicking and jumping. I felt so strong and agile, dull ache and all. Why stop now? I try to go 100% in every taekwondo class because I love it so much, and this night I was crushing it.

Meanwhile I could have sworn I heard something like, “Bitch, I said be cool!” emanating from somewhere around my lower spine.

I can’t deny the fact that the body my high-octane taekwondo spirit is inhabiting is pushing forty. I have had hip problems since my late twenties, and in the past four years I’ve severely strained my back three times probably thanks to the angry Sea Urchin at the base of my spine. The first two incidents were non-TKD related, and the third was likely a build-up of everything in my life, including taekwondo to having a sedentary job. The first two times were incredibly painful and greatly limited my movement, but I could still drive and walk. The third time kept me bedridden for three days, and I couldn’t walk upright for a week.

That evening  I stayed on the ground during the next series of drills involving jump kicks. I ended the night with an ice pack and started the morning with a heating pad. I decided to be proactive and fess up to my physical therapist so we could avoid another back blowout.

Part Two: The Flesh Is Grumpy, Or My Back Pain Has a First Name. It’s L5/S1.

“L5/S1.”

My physical therapist Cody, who was introduced in September of last year, was jabbing his thumb between the vertebrae at the bottom of the spine and the top of the sacrum while I frowned and winced. We were in an exam room at the clinic and were joined by a sweet-natured blonde PT student who was doing a clinical rotation under Cody’s supervision. I always enjoyed when the students tagged along because I got to listen in on Cody’s explanations and Socratic questioning, plus I got to be a live demonstration of the art and science of physical therapy.

The downside was that I was going to be a live demonstration of how the wonderful ligaments, tendons, and muscles attached to the pelvis respond to an irritated L5/S1 disc, and I knew that would involve pain that was much worse than any of my injuries.

Cody began what had become a regular part of my treatment: digging his fingers into the area of my psoas muscle, more commonly known as the hip flexor. Working on that area has in my case been very effective in loosening up everything around my hip and lower back. It also hurts beyond anything I’ve ever experienced.

I’m serious. A psoas “massage” (ugh) goes far beyond the aching and pressure of a typical deep tissue massage and turns into an unholy, white-hot searing pain that makes the room spin and will make you wish for the quick relief of death…or at least the quick relief of this jerk unhooking his fingers from your pelvis.

I’ve been through this many times, but knew I was in trouble when the pain began not long after his fingers began sinking into my flesh. I sipped air, grunted, and did a few slow blinks. I’m a tough little soldier and knew that this monstrous manipulation was for the greater good, so I just grimaced and screwed my eyes shut, focused on steady breathing, and occasionally snapped something sarcastic at Cody.

“What happens when you get a hand cramp?” the student asked. Cody paused for a moment mid-red-hot-poker-probe and thought for a moment.

“You’re probably just using your hands. I rest my arm on her knee and use my body weight to dig in. That way the pressure isn’t on your hands.”

“Oh God forbid the precious physical therapist has any pain during this! That would be so traaaagic!” I piped up, my eyes still shut and my breathing still shaky and shallow. Cody chuckled and dug his fingers in deeper.

“You can do it, you’re a black belt,” he said soothingly, doing what I call the “fishhook” and curving his finger under the lip of my hip bone…or at least that’s what it felt like.

“I’d still be a white belt if I had to do this in taekwondo,” I moaned and covered my face with my hands.

When it was all over, I shakily stood up with a very loosened up hip, and Cody drummed his fingers along my spine and the surrounding muscles. Once again he dug his thumb into the area covering the L5/S1 disc.
“Does it still bother you?” he asked. There was a huge difference. No irritation, no lumpiness. I turned around and tilted my head at him.
“Nope! It feels good as new. I should thank you, but I also kinda want to kick your ass.”

The moral of the story is: Listening to your body and practicing preventive care is just as important as challenging it. 

Reconciling passion with physical reality is something many athletes and martial artists face. When is giving 100% too much? When do we need to back off even when our minds and spirits are on fire and ready to rumble? When does safety and sensibility override endorphins and energy?

Before the cardio class I mentioned at the beginning of this post, I got a hint of what my flesh was trying to teach my spirit. I was chatting with a thirteen year old girl who had competed in the past weekend’s tournament. With a worried look on her face she told me that the side of her foot was still hurting from her sparring match a few days earlier. She was looking to me for answers and reassurance. I asked her if it increased when she walked and if she’d done anything to relieve it. I recommended using ice and letting our instructor know if it hurt too much to continue working out safely.

“Stop if it hurts. That’s the smart thing to do. Listen to your body and take care of it,” I cautioned her before I trotted off to change into my uniform.

Sounds like I need to listen to my own advice.

 

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The Inevitable Slump

sad dog

“It’s January and February right now. Spring will come.”

My dad was offering me some words of comfort the other night as I sat curled up in my bed, sobbing and dredging up one ridiculous worry after another: regrets of things I did long ago, a reopened wound from a bitter breakup, letting go of pieces of me that I couldn’t get back. I felt lonely, vulnerable, and hopeless. I didn’t really have a rational reason to be upset, but it felt like the flood gates had been unleashed. Damnit, I was going to give myself something to cry about.

Dad suspected that I was feeling some post-black belt test depression, and he and Mom had even wondered before my black belt test if the crash was inevitable. Dad likened it to the depression some people feel after the hustle and bustle of Christmas is over: the excitement has died down, the fanfare has quieted, and now you’re back to life as usual in the suckiest months of the year. What’s the fun in that?

Apparently I am in a metaphorical January.

While I am thrilled to be a new black belt, I know I’ve lost some of my excitement, drive, and focus. Being waylaid by an injury hasn’t helped matters. Exercise always makes me feel better. I experienced that when I started to get a hint of the crash a few weeks ago, but an invigorating (and slightly insane) workout from a senior black belt student nipped that in the bud. Nothing like the sweet combination of exhaustion and endorphins to make you feel on top of the world.

I’ve been stuck at home recuperating for much of the week from severe back pain that struck last weekend. Other than some healing sessions with my physical therapist (it was almost worth hurting my back for all the lovely care and treatment), I haven’t moved around much, and I know my mood plummets whenever I become more sedentary. Obviously I hadn’t been able to go to taekwondo class, but I was also in too much pain to swim, do yoga, or my other normal actives. Even walking for long distances was difficult until yesterday.

It’s frustrating to feel this way and to have it possibly adversely affect my approach to taekwondo because life as a new black belt has hardly been ordinary—there’s no same old, same old as a newly minted Jyo Kyo Neem. I’ve barely learned one of the two (two!!) new forms I get to learn, and there is still so much to practice with hand-to-hand combat and defense against weapons. I’m not even used to seeing myself in my fancy new black-lapeled uniform and embroidered belt.

So what the hell?? I’m really not that upset about the back pain. I get injured all the time, and I know I always bounce back. I can handle physical pain. Emotional pain is a much stickier matter.

I really hope it’s a case of an emotional slump because I’ve been forced to be inactive and confined to my home (other than when I wasn’t at work or PT) and NOT due to a more elusive and dangerous habit I thought I had kicked: constant dissatisfaction. In the Bad Old Days, when I had low self-esteem, I was searching desperately for happiness in all the wrong places. I wanted other people, material possessions, work, academic achievements, and even my superficial looks to fill that void in my heart that I eventually learned to fill from within.

Nah, I’ve made it too far in my journey of self growth and kicking life’s ass to have gone back to my old destructive ways. I know I haven’t lost that little glimmer of inner peace, contentment, and newly found confidence. I’m just cranky that I can’t kick teenagers for a week or two.

This will pass.

 

It’s TendonOSIS Even Though Spellcheck is Being a Jerk About It

hamstring

“So, even though I’m not getting an MRI I’m still curious about what’s wrong with me. The doctor said it was either a tear or tendonosis. What do you think, based on what you’ve seen with me so far?” I asked Cody*, my physical therapist, during Tuesday’s session.

A little backstory: I had turned down my orthopedic doctor’s suggestion from two weeks prior to get an MRI of my right leg.  It seemed unnecessary since my pain in both the front of my hip and top of my hamstring had lessened quite a bit thanks to therapy, and the thought of being shoved into a tin can coffin for forty five minutes was a big NOOOOPE. I’m not anywhere even remotely close to needing surgery, so all we’d get out of an MRI was a confirmation that my leg’s f-ed up. Yeah, I know already.

The only solution the doctor had offered was a shot of lidocaine into the front of my hip or hamstring, whichever hurt more. What good would a temporary numbing agent do for true healing? The impingement on the front of the hip was barely noticeable anymore and was something I could live with, and I’d already seen vast improvement with my hamstring with only eight weeks of therapy. Besides, the last time I had a needle shoved into my ass was a vaccination as a kid, and I wasn’t exactly looking for new opportunities. No thanks.

I brought up the subject to Cody while I was lying on my stomach on a padded black table in a small exam room and resting the side of my face on my hands. Cody had just started a deep tissue massage of the back of my leg in response to the sharp pain I’d felt the night before in taekwondo class when doing a flying snap kick with the right leg.

When executing a flying kick the TKD student takes a running start, jumps into the air, and pops the leg into a kick. It’s our one little moment of feeling like we’re in The Matrix. I felt a sudden burst of pain when I jumped and shot my foot into the air, and my leg remained irritated for the rest of the night. I hadn’t felt that type of pain in several weeks.

I was very disappointed that I was still having intense pain, but I reminded myself that we weren’t really warmed up for highly aerobic and explosive movement. We had spent most of Monday night’s class doing forms, which is a workout on its own but very low key compared to repetitive kicking and jumping. Even though I’ll only have to do flying snap kick on the right side once during my black belt test on Saturday I wanted to figure out what I could do to minimize pain that might linger during the rest of the test after the long kicking portion was finished. Cody and I were on a mission.

“Well, I’m not sure it matters at this point since you’re not getting an MRI, and the treatment would be the same…a rose by any other name, you know…hmm…” Cody’s hands lingered in one spot for a moment while he thought of what to say.

“Based on where you’re feeling the pain, it presents itself as more of tendonosis. ‘Osis’ means a degenerative state, in this case of the…” He waited a beat for me to answer.

“Tendon!” I replied, playing along with the anatomy lesson.

“Yes, and we’re doing exactly what we should do for tendonosis: repetition, strengthening, and damage control. Tendon-itis, which is inflammation of the tendon, is usually treated with the RICE method: rest, ice, compression, and elevate. If it were really a tear you’d feel it more in the belly of the muscle.” Cody dug his sharp elbow into the meaty middle of my hamstring as if to illustrate his point.

“How long do you think it will take to heal?” I shifted my hands out from under my head and rested my cheek against the pillow. Cody paused from stabbing me with the point of his elbow for a moment and considered my question.

“Six to ten months, maybe a year,” he murmured as he began making deep circles in my thigh with his fingers. “High hamstring tendonosis can be the kiss of death for a sprinter. They injure themselves when they’re pushing really hard towards the end of the season, or in your case, for a black belt test, and if they don’t treat it properly there’s a chance they’ll re-injure themselves during the next season. The tendon likes consistency, so we want to continue doing repetitive exercises. It will also get cranky if you completely stop what you’re doing with it, so you have to keep doing at least some kind of activity. What we’re doing and what you’ll need to continue doing on your own will minimize the risk of re-injury.”

“So…is he comparing me to a sprinter?” I thought as he continued massaging the back of my leg. “I guess I kind of am given the short bursts of speed and power I have to exhibit for sparring and the more demanding jump kicks…Cool.” 

“How does that feel?” Cody asked as he shook the back my leg a few more times and gave my ankles a reassuring pat.

“Good and painful at the same time if that makes sense.” I grimaced as I groggily sat up on the table. Cody smirked and ushered me out of the exam room so I could do my usual exercise routine on my own: side leg lifts while lying on a table, one-legged dead lifts while holding a kettle bell, and stepping up on a box with one leg while raising a kettlebell and lifting my opposite knee.

I took a break from the routine to try a little experiment Cody suggested for dealing with front snap kick, the current bane of my existence. I positioned myself in fighting stance, fists raised and all, and did a short series of front snap kicks with the right foot: ten to the ankle, ten to the torso, and ten to the face. I had to clamp my mouth shut so I wouldn’t ki-hap on instinct and startle all the other patients in the clinic. I felt a sharp burst of pain when I did the first few low kicks, but the leg seemed to relax once I’d warmed it up. By the time I got to the face kicks I could do them without the ripping sensation I’d felt the night before.

I excitedly ran back to the office and told Cody what I’d discovered. We both determined while I wouldn’t be magically healed by the weekend, it was likely by the time I reached the flying kicks portion of the test I’d be fully warmed up, and I shouldn’t feel the amount of pain I’d experienced the night before. Hooray!

So perhaps the saga of my messed up hip and hamstring is coming to a close (for now). We’ll continue therapy until the end of the year, and then I will fly from the physical therapy nest. I have enough exercises in my arsenal to address the problem on my own should it flair up in the future. Or I can call Cody again; I won’t let just anyone poke around my ischial tuberosity.

Now I can focus on other things athletes above a certain age have to worry about: not throwing my back out or getting the flu before the test on Saturday.

And then I can have cake.

*Name changed