Sunday, January 24, 2016

The movement prescription

Back on New Year's Day, I wrote a long post about how I was in the process of making some big changes. A knee injury led me to some decisions that included leaving my CrossFit gym where I'd been a member for over five years, adding yoga and Core Align work to my flexibility regimen, and, most importantly, switching to a gym where my entire workout would be individually programmed for me. The idea was to have a trainer, who came highly recommended, set up a series of workouts, including specific warmups geared towards loosening up all my many immobilities.

It's all working really well.

Since last August when I tore the lateral meniscus on my left knee, I'd been sluggish, for me anyway. I was walking every day, but I wasn't lifting much, wasn't as active as usual and just wasn't moving enough.

Moving is good. Really good. A typical week for me now looks like three days in the gym, two or three days of yoga, a Core Align session and maybe a band practice (drumming is moving, believe me). It sounds like a lot (ish), but I'm still getting "rest days," and, honestly, the remedial (read: arthritic) way I do yoga makes it less energetic than a full-on gym session, so those days are more "active rest" than they are hardcore movement. But still... I'm MOVING. I'm moving a lot. As a result, I'm less dependent on caffeine, more energetic and generally in an absurdly good mood. And I am also not getting injured because I am riding that line between "Wooooooo yeah!" and "Damn it, I've overdone it again." Hell, I even ventured to New England for the 29th year of that glorious meeting of musician friends that we call Band Camp, played two gigs while I was there, including one that had me drumming on songs I'd never practiced or played before, and I not only survived all the late nights and madness without getting sick or run down; I loved every second of it.

I know... it's truly fucking absurd to have started all these big changes right with the new year -- cliché anyone? -- but, really, January 2016 has kick-started my engine. Moving: I highly recommend it.

Friday, January 1, 2016

F*ck resolutions, but changes are good

If there is anything more clichéd than a New Year's post about big changes, I don't know what it is. But I swear that it wasn't supposed to happen this way. This post has nothing to do with New Year's resolutions. Timing is everything, and mine sucks. Try to keep the barfing noises to a minimum, and I promise that we'll get through this as smoothly as possible....

Let's go back to late August 2015.

There I was, doing my thing at the CrossFit gym where I have been a member for over five years. My shtick for at least the past three years, and probably longer, has been that I am one of the first people you will see modifying a CF workout so I don't get injured. I've always been one of the older people at that particular gym, and the process of sensibly scaling workouts, or even completely changing and substituting various movements for others, has served me well. I sort of pride myself on being Captain Sensible in that regard (no, not that Captain Sensible).

That day we were doing some sort of three-round conditioning workout that involved 30 wall-ball shots each round. I remember thinking that 90 wall balls seemed like a lot of really repetitive grinding, but I didn't modify anything. Not so sensible after all, as it turned out.

At about the 75th rep, I felt this "snap" on the outside of my knee. It was as if something with some "give" to it ("Maybe the IT band?" I thought) got hung up on something else, stretched out, and then went "BANG" back into place. It hurt. It hurt a lot.

So, of course, being the eminently sensible human being that I am, I immediately went to the doc to see what was up.

Well.... no. 

I thought it was just the IT band. So my brain and I opted to not "bother" the regular doc -- because of course it really "bothers" a doctor when a patient comes to see him or her complaining of an injury (gahhhh, what the fuck am I thinking sometimes?) -- and instead I consulted with Dr. Google about the possible causes/symptoms/treatments. Dr. Google almost immediately had me convinced that I had "IT band syndrome," which is often cured through a stretching routine over quite a while. Dr. Google -- helpful, all-knowing physician at large -- even showed me sites where there were many of these IT-band stretches. 

I did them, sort of. 

I also went on a vacation to Oregon with my wife in September. As we often do, we did a lot of hiking. The uphills felt great. The downhills? Even with a knee brace, not so much.

So when I got home, in late September, I immediately consulted a real doctor!

Well... no. Not quite. Not actually at all. Not yet, anyway. I decided the knee needed rest.

But sometimes I'd try to exercise.

This pattern of unrelenting genius continued until mid-November when I finally decided to see my doc about the knee issues. That knee was full of fluid and not bending very far. I was immediately sent for X-rays and an orthopedic consultation. I was told not to wait so damn long next time. I might have seen the nurse practitioner write "stupid" in my file.

I went to see the ortho doc. I learned that Dr. Google is an asshole. I learned that I am an asshole for relying on Dr. Google. It wasn't an IT-band thing at all. I had torn the lateral meniscus in my left knee. As such things go, it's not a major tear. But it also can't be fixed with surgery. Meniscus tears, particularly in people my age and older, aren't easily repaired. A lot of the meniscus doesn't get proper blood flow to allow a repair to really work. So the only surgical option would be to remove it. That's a mess, my ortho doc informed me, and a last-resort kind of option, because, without a lateral meniscus, I'd need a knee replacement in the near future. 


But one decision was easy: No surgery for me.

Also, by the way, the doc informed me, my mobility sucks. He may have added "donkey balls," but I may have imagined that. He certainly made it clear that I suffered from an aggravated, extreme case of awful mobility, not just a minor issue. In fact, the injury probably happened because I was forcing myself into positions that my (lack of) mobility couldn't handle. 

He wouldn't let me leave his office until I sang this song to him start-to-finish:


So the prescription was, er, pretty simple:

Change everything.

The first step was going to be physical therapy, then a slow return to exercise. 

The physical therapist did a top-to-bottom movement assessment on me. She seemed, well, pretty horrified, but she was totally up for the challenge of mobilizing me. My favorite quote from the first session: "Most of the people I see with a torn meniscus are fat, weak and immobile. You certainly aren't fat, and you're strong. But, wow, do you have mobility issues! I mean really. Wow." I'm wow-worthy for all the wrong reasons. I've been working with her twice a week for the last seven weeks to get me on a less horrific track. She's also been assigning me (and I've been doing!) 30-45 minutes of mobility "homework" to do at home each night. Every night. Really. The results have been amazing. I've learned that my left ankle and left hip have been in an immobile conspiracy against my left knee for a while now. Like a long while. The physical therapist has also convinced me of the truth of something the orthopedist tried to tell me, but I didn't want to hear at the time: maybe I need to take a long break from CrossFit and get into something -- maybe a number of somethings -- that focus more on getting me mobile and also tailor my strength and conditioning work more precisely to my individual needs.

So I decided to try a little of everything.

I tried Pilates, specifically mat Pilates. Pilates is... interesting. First of all, not many guys do Pilates. I don't know if any other men ever go to the studio where I have been going. I certainly have never seen one. But it's not actually "girly" at all and one's Man Card is in no danger of being torn up and discarded at a Pilates studio. Pilates was designed by a guy -- Joseph Pilates -- and its emphasis is on core strength and alignment, which can lead to progress in mobility, but I don't feel like mobility is the primary goal. Pro athletes like Pilates. I like Pilates. I like it a lot, actually. But, trying to keep mobility as my primary goal, when my initial multi-class ticket was fully punched at the Pilates studio, I decided to switch gears and give yoga a shot, in order to compare the two.

Let's spend a moment to fully take in the enormity of what was about to go down.

Me doing yoga
For reals. 
My view of yoga has always best been summed up in this manner:

I signed up for a beginner class. I liked it. I liked it a lot. (You may sense a theme here). I even dug all the hippie-dippie shit around the fringes of the class. Hell, I even liked the little "You control your own happiness/Happiness is a decision" talk that the teacher gave at the beginning of that first class. At other junctures of my life, I would have gagged a little on the unrelenting joy of that spiel and gone home and blasted the first four Black Sabbath albums to cleanse my soul. Instead, it's like I walked in there, had my Sarcasm Card immediately temporarily confiscated from me, and not only didn't complain, but actually enjoyed it. So I went to another class, and then another one. I started inquiring about which yoga classes are suitable to drag my lame inflexible ass into and which ones would leave me in traction. I learned that using the phrase "my lame inflexible ass" is not actually favored in a yoga studio.

I soldiered onward.

Yoga is a really good thing for me. Yeah in a mental sense, it perfectly augments my meditation practice, but it's the physical angle that I am really digging, particularly the way it seems to be working in conjunction with my PT regimen. As soon as I started yoga, my PT could see even more improvement in my mobility. I also have to admit that I like the fact that it's so non-competitive and non-judgmental. Hell, I've spent my whole life being competitive and judgmental. The personal-growth opportunity here is seriously too much to pass up.

Then, cleared by my PT to do so, I signed up for individualized strength and conditioning with a trainer. I went for a Functional Movement Screen (FMS) with said trainer, who came highly recommended. I don't think it's possible to "fail" such a screen, but my score was low. If it were possible to "fail," I would have been the king of failure. I would have gotten my photo placed up on the wall under a motivational sign that says: "If he can do it, you know you can too." It was going to be a low score anyway, but Trainer Dude picked up on side-to-side imbalances that even my PT wasn't as focused on. Those imbalances made the FMS score even lower. It seems like 35 years of drumming has taken its toll on me in more ways than just wrecking my right elbow. I have my right side, from top to bottom, working much more efficiently than my left. It kind of figures. In fact, he said something that really clued me in to how, er, "lucky" I was to only have torn my meniscus. He said, "I can't believe you don't have back problems." Apparently, most people who are as out-of-balance as I am start to "corkscrew" their backs and injure themselves. I'm strong enough that I haven't done that, but, the trainer said, keep on going down the current path of out-of-balance immobility and back problems are in my future. 

So the score so far is:  

Physical therapy: Yes!
Mat Pilates: Not right now!
Yoga: Yes! (Yeah, I'm still trying to absorb that one).
Individualized S&C programming with Trainer Dude: Yes!
CrossFit: Not for a long while! (But I still love it. It changed my life). 
Drumming: Well, of course, yes!

But there was one thing still to try....
When I was finishing up my initial run of mat Pilates, my instructor -- who drives me sorta batshit crazy in a good way by being just as insightful about all my imbalances and immobility issues as my PT and Trainer Dude are; seriously, somehow I am lucky enough to have met three geniuses and entrusted them all with fixing me up -- said, "I think you might want to try Core Align." I'd never heard of it.

For something that looks so calm and sedate, Core Align is completely nuts. In a good way. You stand with one foot on each of two "carts," which you could consider to be a Nordic-Track type of deal, except so frictionless that it is like being on ice. You do all sorts of movements, focusing on balance and control, using not just the larger muscle groups, but the smaller ones too. It is so much harder than it looks, and, while I have not yet landed on my sorry ass, I've come close. Core Align forces to me to work through all the side-to-side imbalances and find some normality in my movement patterns. 

So yeah, yoga a couple times a week, PT a couple times a week, plus "homework" each night, S&C training two or three times a week and a weekly Core Align session. It's a lot of change. It's kind of time-consuming. I'm totally digging it. Because really, if I don't have time for my health and feeling good, what the hell am I spending my time on?

My sorry ass is on its way to getting fixed.

See? I told you this all had nothing to do with New Year's resolutions. Forward....