Everyone who practices Aikido understands the importance of their feet. We all know the warm-up exercise where the sole of the foot is massaged, slapped, and shaken, and most of us have probably had sore feet at some point or other. Here is a 9 minute video that gave me a deeper understanding of the structures of the sole of the foot. The video focuses on plantar fasciitis, but it is of general interest as well. I once had a case of plantar fasciitis (in both feet) and I know many of you have had it, too. So painful! Mine came about from stepping on rocks while clearing brush. In my case it took a year to heal, and some people’s feet never do. If you have never had it, be thankful, and take care of your feet so you never get it! Even though this video was made for plantar fasciitis, there are other injuries, acute and chronic, that may occur. This video will help you to understand what goes on with the bottom of the feet and hopefully will be useful as you go through your Aikido career.
It started almost one year ago with an injury from an idiot who never apologized. That was the beginning of everything.
The injury and everything afterward brought me to my knees physically and mentally. And I am lucky to have been forced to my knees. I’m lucky to have been so broken and so hurt. I’m lucky because I was forced into asking myself the question: what do you do when what you love kills you, breaks you apart?
And I found the answer.
You don’t keep going.
I’m a busybody. Meaning that I really don’t like to stop moving. At all. Ever. I write, I make yoga videos, I workout, I train in my Aikido (a martial art), I do homework, etc. You name it and I do it. I don’t like to sit still and do nothing even if it is for relaxing. Or at least I didn’t use to.
With introduction by Suzane Van Amburgh, Multnomah Aikikai
Have you ever incurred a strain or sprain? What’s the difference really and what can one do about it?
During an intensive training session we sometimes push a little harder, reach a little farther and an injury can occur.
After a period of intensive training (such as Aikido summer camp), there is also a risk of suffering an injury as you return to your regular training schedule. Even regular daily activities can trigger an injury after a period of intensive training. People often report that they were “doing nothing” at the time they incurred the injury. After further inquiry it is revealed that the person recently engaged in intensive physical activity or an unusual use of self (eg. we moved last weekend or I went white water rafting for the first time).
Whether you have an injury now or you recently trained intensively, I encourage you to read this excellent article below by my colleague Mike Doren.
Along with being a Guild Certified Feldenkrais® Practitioner, Mike’s background in construction, mechanics, bodybuilding, martial arts, and professional marksmanship provides a deep knowledge base to draw from, regarding the physical/mechanical aspects of the work. Learn more about Mike Doren at: http://www.feldenkraisinstitutenw.com/Michael_E_Doren.html
posted by Suzane Van Amburgh, GCFP, 5th dan, shidoin, Multnomah Aikikai
Sprains and Strains
By Mike Doren
Sprains are injuries that affect ligaments. They occur in response to a stretch or tear of a ligament. Sprains are an acute type of injury that results from trauma such as a fall or outside force that displaces the surrounding joint from its normal alignment. Sprains can range from a mild ligament stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs.
Sprains occur most often in the ankles, knees or the arches of the feet. Sprained ligaments swell rapidly and are painful. Generally, the greater the pain is, the more severe the injury is. For most minor sprains, you can probably treat the injury yourself. If you heard a popping sound at the time of the injury, have a fever or aren’t improving within a couple of days, seek medical treatment because inadequate or delayed treatment may cause long-term joint instability or chronic pain.
Strains are injuries that affect muscles or tendons. They occur in response to a quick tear, twist, or pull of the muscle. Strains are an acute type of injury that results from overstretching or over contraction. Pain, weakness, and muscle spasms are common symptoms experienced after a strain occurs.
What Causes a Sprain?
A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position and stretches or tears the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into a baseball base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.
Where Do Sprains Usually Occur?
Although sprains can occur in both the upper and lower parts of the body, the most common site is the ankle. More than 25,000 individuals sprain an ankle each day in the United States.
The ankle joint is supported by several lateral (outside) ligaments and medial (inside) ligaments. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This type of sprain is called an inversion injury. The knee is another common site for a sprain. A blow to the knee or a fall is often the cause; sudden twisting can also result in a sprain.
Sprains frequently occur at the wrist, typically when people fall and land on an outstretched hand. A sprain to the thumb is common in skiing and other sports. This injury often occurs when a ligament near the base of the thumb (the ulnar collateral ligament of the metacarpo-phalangeal joint) is torn.
What Are the Signs and Symptoms of a Sprain?
The usual signs and symptoms include pain, swelling, bruising, instability, and loss of the ability to move and use the joint (called functional ability). However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. Sometimes people feel a pop or tear when the injury happens.
A grade I or mild sprain is caused by overstretching or slight tearing of the ligaments with no joint instability. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint.
A grade II or moderate sprain is caused by further, but still incomplete, tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has more difficulty putting weight on the affected joint and experiences some loss of function. An x ray may be needed to help the health care provider determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament, or can be recommended to rule out other injuries.
People who sustain a grade III or severe sprain completely tear or rupture a ligament. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x ray is usually taken to rule out a broken bone. When diagnosing any sprain, the provider will ask the patient to explain how the injury happened. He or she will examine the affected area and check its stability and its ability to move and bear weight.
When to See a Doctor for a Sprain
•You have severe pain and cannot put any weight on the injured joint.
•The injured area looks crooked or has lumps and bumps (other than swelling) that you do not see on the uninjured joint.
•You cannot move the injured joint.
•You cannot walk more than four steps without significant pain.
•Your limb buckles or gives way when you try to use the joint.
•You have numbness in any part of the injured area.
•You see redness or red streaks spreading out from the injury.
•You injure an area that has been injured several times before.
•You have pain, swelling, or redness over a bony part of your foot.
•You are in doubt about the seriousness of the injury or how to care for it.
What Causes a Strain?
A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is associated with a recent trauma or injury; it also can occur after improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse: prolonged, repetitive movement of the muscles and tendons.
Where Do Strains Usually Occur?
Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.
What Are the Signs and Symptoms of a Strain?
Typically, people with a strain experience pain, limited motion, muscle spasms, and possibly muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.
How Are Sprains and Strains Treated?
Reduce Swelling and Pain
Treatments for sprains and strains are similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. The sooner you treat the sprain, the sooner you will recover. Take a hint from the pros: By getting immediate attention, they are back out there in a matter of days. If you do nothing, keep playing and then put some ice on your ankle later that night, you will end up with a sprain that can take weeks or months to heal properly. Most of the damage from a sprain comes from the swelling. Your main goal is to reduce swelling as much as possible, and to do that, every second counts. It’s also helpful to use an nonsteroidal anti-inflammatory (NSAID) medication to help control inflammation. Studies have found that patients using NSAIDs after ankle sprains had less pain, decreased swelling, and a more rapid return to activity than those who didn’t take any medication.
For people with a moderate or severe sprain, particularly of the ankle, a hard cast may be applied. This often occurs after the initial swelling has subsided. Severe sprains and strains may require surgery to repair the torn ligaments, muscle, or tendons. Surgery is usually performed by an orthopedic surgeon.
It is important that moderate and severe sprains and strains be evaluated by a health care provider to allow prompt, appropriate treatment to begin. This box lists some signs that should alert people to consult their provider. However, a person who has any concerns about the seriousness of a sprain or strain should always contact a provider for advice.
The second stage of treating a sprain or strain is rehabilitation, the overall goal is to improve the condition of the injured area and restore its function. The health care provider will prescribe an exercise program designed to prevent stiffness, improve range of motion, and restore the joint’s normal flexibility and strength. Some patients may need physical therapy during this stage. When the acute pain and swelling have diminished, the provider will instruct the patient to do a series of exercises several times a day. These are very important because they help reduce swelling, prevent stiffness, and restore normal, pain-free range of motion. The provider can recommend many different types of exercises, depending on the injury. A patient with an injured knee or foot will work on weight-bearing and balancing exercises. The duration of the program depends on the extent of the injury, but the regimen commonly lasts for several weeks.
Another goal of rehabilitation is to increase strength and regain flexibility. Depending on the patient’s rate of recovery, this process begins about the second week after the injury. The provider will instruct the patient to do a series of exercises designed to meet these goals. During this phase of rehabilitation, patients progress to more demanding exercises as pain decreases and function improves.
The final goal is the return to full daily activities, including sports when appropriate. Patients must work closely with their health care provider or physical therapist to determine their readiness to return to full activity. Sometimes people are tempted to resume full activity or play sports despite pain or muscle soreness. Returning to full activity before regaining normal range of motion, flexibility, and strength increases the chance of reinjury and may lead to a chronic problem.
The amount of rehabilitation and the time needed for full recovery after a sprain or strain depend on the severity of the injury and individual rates of healing. For example, a mild ankle sprain may require up to 3 to 6 weeks of rehabilitation; a moderate sprain could require 2 to 3 months. With a severe sprain, it can take up to 8 to 12 months to return to full activities. Extra care should be taken to avoid reinjury.
Reduce regular exercise or activities of daily living as needed. Your health care provider may advise you to put no weight on an injured area for 48 hours. If you cannot put weight on an ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.
Apply an ice pack to the injured area for 20 minutes at a time, 4 to 8 times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes.
Compression of an injured ankle, knee, or wrist may help reduce swelling. Examples of compression bandages are elastic wraps, special boots, air casts, and splints. Ask your provider for advice on which one to use, and how tight to safely apply the bandage.
If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.
Nutritional and Herbal Therapy for Muscle Strain and Sprain
• Vitamin C (250 to 500 mg two times a day) is important for keeping collagen, ligaments and tendons strong. It helps reduce swelling, repair tissue, support connective tissue and promote proper healing.
• Omega-3 fatty acids can help reduce inflammation which is important for strains and sprains.
• Bromelain (250 to 500 mg three times a day between meals) can help reduce swelling.
• Turmeric (250 to 500 mg three times a day between meals). If taken with bromelain, it can make the effect of bromelain stronger.
• Zinc (15 to 30 mg a day) promotes wound and tissue repair and is very important for bone health.
•Be sure get enough protein in your diet
• Calcium (1,000 mg a day)and magnesium (500 mg a day) are very important for bone and muscle health.
•There are some very good Chinese herbal patent formulas that help reduce inflammation and swelling and promote healing: Jin Gu Die Da Wan
Paolo Propato and Grace Rollins, licensed acupuncturists at Bridge Acupuncture, discuss the energetics of acupuncture and what it’s like to work and train in their field of Chinese medicine.
Paolo: What is qi?
Grace: Many people think of qi as “energy”, but I think that’s too materialistic of a translation. Qi is basically a very useful term that sums up complex processes that together create recognizable phenomena in the body. If you try to think of qi as some kind of literal substance or force you’re just going to frustrate people interested in scientific backing; you won’t find a measurable “energy” that corresponds to what people who practice Asian medicine are talking about.
“Qi” for acupuncturists is “weather” as it relates to the body. Weather is electromagnetic and gravitational relationships between elements and molecules; it’s pressure dynamics,
thermodynamics, radiation; it’s many processes, all overlapping and influencing each other. We can study it, characterize it and make predictions about it. The same way that we recognize many patterns in weather, we learn how to recognize patterns in qi, so we can influence bodily functions and promote health.
P: What do acupuncture methods actually do?
G: The traditional answer is that they stimulate special points that harmonize qi in the body, thereby promoting proper function and health. Scientifically, stimulating acupuncture points with needles and moxa has been shown to generate complex responses.
Needling causes distortions in chains of connective tissue throughout the body, which linkdifferent muscle groups, joints and organs. It also fires nerve endings that light up vastly
different areas of the brain and spinal cord. Acupuncture causes an electrical distortion in the body’s electromagnetic field—you’re putting a metal needle into an ionic solution (the body) which immediately creates an electrical polarity. The micro-injury caused by needling and moxa heat is also a very powerful method of stimulating the immune system and cytokines (chemical messengers). Plus, with acupuncture needles you can physically loosen tight muscle and connective tissue to release restrictions and improve blood flow.
I think one of the challenges in studying acupuncture scientifically is that its methods do so
much, all at once. One exact mechanism eludes us. That’s why, even though I have a very
scientifically oriented mind, I still prefer the traditional Chinese and Japanese pre-scientific
theoretical concepts. We still haven’t discovered a better way to describe the complex
processes happening here.
P: What makes acupuncture unique compared to other modalities that work with the subtle energy of the body?
G: Acupuncture is old, people! Over 2,500 years old! Moxibustion, the practice of heating
acupoints with the ember of dried mugwort, is even older. So even though acupuncture is
dealing with complexities that resist the scientific method, it has withstood a very important test with its continued use over such a long period of time.
A good scientist remains open-minded to the things that science doesn’t yet have the tools to measure and explain. That applies to a lot of what happens in healing. But that doesn’t mean you have to be open-minded to everything. Innovation is good. It helps our medicine get better and better, but with a methodology that is mainly observational, you have to be careful not to be led astray.
For this reason, I approach change cautiously, and I gravitate toward Japanese acupuncture, which monitors feedback during the session. We’re always checking diagnostic qualities in the pulse, the abdomen or a symptomatic area for signs that our treatments are having the desired effect. Vetting my methods this way gives me confidence.
P: What are you feeling for before, during and after needling?
G: Patients like to ask me if I can “feel the energy,” and if you think of it like qi, the summation of complex processes, then the answer is absolutely yes. We rely on touch, smell, sight and sound to collect information about the patient—especially touch in Japanese acupuncture. If I have to wear a Band-Aid on just one finger, I feel like I have a hand tied behind my back—it affects what I can feel.
Before needling, I’m feeling diagnostically for areas of restriction, imbalance and dysfunction in the patient. This might be structural, as in certain muscle groups or vertebral bodies that are too tight, twisted or compressed. Often internal imbalances will also be represented by certain qualities in the pulse, on the tongue or in reflective zones of the abdomen and back. For example, cardiac problems often show up with specific tender points on the upper torso and back.
Next I’m feeling for an appropriate point location; there are traditional anatomical locations as well as certain qualities that identify a “live” point. Depending on the point, it might be a
recessed area, a tight spot, a tender spot, thicker skin or connective tissue—qualities that
indicate a more effective point. When I insert the needle, there is a feeling I seek that
acupuncturists call the “arrival of qi”. To me it’s like a density on the end of the needle, like it’s connected well. Learning to recognize it is part of our craft.
After needling I will re-check the diagnostic signs to see if the acupuncture was successful at balancing the qi. If I did a good job there should be signs of improvement; if not, I might need another point, or a different one, or to add moxa, for example.
I’m also feeling the qi of the person as a whole. This is the intuitive part, synthesizing the input from all of my senses.
P: How do you cultivate the necessary skills?
G: I started studying acupuncture at the same time I started studying Aikido and Zen meditation. Like acupuncture, Aikido trains the various senses of the body to harmonize with another person’s qi. These practices help me to be more centered and attuned to my patients, and to myself.
An invaluable part of my training is a regular apprenticeship with the acupuncture master Kiiko Matsumoto. I spend at least two or three weeks a year shadowing her here and in Japan, taking in practical knowledge as well as the qi of her practice—the complex combination of qualities that allow her to be a dynamic, effective practitioner.
Taking my own health seriously is also a critical way that I stay attuned to the balance of qi in others. I believe in it, I live it! I work on my posture throughout the day and study how to move in a way that’s healthy and efficient. I try to eat in a way that’s balanced ecologically, that doesn’t do me harm and that fills me with vitality. I get outdoors and experience the natural world to help keep those areas of my consciousness and humanity alive. I meditate, do yoga and exercise a lot, and I try to play and have fun. Last but not least, I get regular acupuncture!
Bridge Acupuncture, located at 30 Garden Alley, in Doylestown, is a Legacy Advertising partner of Natural Awakenings of Bucks and Montgomery Counties.
To schedule an appointment with Paolo Propato or Grace Rollins, call 215-348-8058 or visit BridgeAcupuncture.com.