A Big Week 12

That Mental Thing

“My life has been full of terrible misfortunes most of which never happened.”
– Michel de Montaigne

First off, I have to state that, recoverywise, the last two weeks have been great.  Nothing but progress, physically.

Mentally, though, I have spent a lot of time worrying about the knee.  Too much, considering the evidence.  Of course, the joint seems stable.  It just still feels weird and weak.  I haven’t had any of those occassional subluxations that I did before surgey, so it’s really just a muscle thing.  Still, I haven’t really challenged the knee (and won’t just yet), so I have doubts.  They’re more niggling than gnawing, but I have found myself engaging in what I know are pointless tests of recovery, like watching the injured knee when going down stairs to see if it wobbles more than the other.  Or standing on one leg to detect whether I can feel the tibia going more forward than it should.   Like I could really get a good read by just eyeballing it. 

I don’t want to make too much of this.  I have noticed I am not alone in experiencing these fears and doubts midway the through process.  You see it time and again in blogs and in message boards.  I even read about one ACL recoveree whose distraction led him to self-administer a Lachman-like test with, I gathered, a rope and a drawer.  (Where’s an arthrometer when you need it?)  The description was vague, so I don’t know exactly how the person did it.  I understand a video of it was posted somewhere, but based on the reactions, I thought it better not look for it.  

The moral of this is, it’s natural to fear the worst, but mostly it’s for naught.  During ACL recovery, you’re constantly asking the knee to go a little further, to do a little more, so it’s no surprise that it constantly feels off.  Come to think of it, it’s a lot like karate.  Because you’re always refining your technique or learning new stuff, it often feels like you’re getting nowhere.  You’re always at the edge of yourself.  

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And now for the good news . . .

Full Flexion!

Yep, that’s right.  I got my heel to my bum earlier this week after a good warm up.  They’ve been apart for more than four months now, ever since that fateful Blech Thursday.   The effect is still only temporary; by the time I’m ready to go home or get to work, the flexibility is gone.   Still, it is SOOO cool to be able to actual sit in a kneeling position, if only for a brief minute or so.

Running Man

I can run now, too.  That is, my therapist is making me run.  Sort of.   I can only run straightaways.  Which, on the 1/16 mile track at the gym, means I do this spastic series of 10-second runs in the straights and 20- second walks around the curves, interrupted every so often by a full walking lap until I hit a half mile.  It must look really silly and kind of pathetic.  And what’s worse, it really tires out my injured knee.  After a couple of laps, I feel like the calf and foot are just going to fall right off.   Honestly, I’d rather be swimming, but I know this is important.

Home Balancing Act

While I getting some nice e-stim and ice at the end of my last physical therapy appointment, I overheard one of the therapists explain to a patient new to the balance board that people either hate the thing or want to go home and make one for themselves.  

Which was funny, because I had made one just a few days before.  In truth, I probably wouldn’t have done it just for myself, but my wife needs to use one, too.   She’s been a runner for as long as I’ve known her, but during the past few years she’s been dealing with the aftermath of three meniscectomies and hasn’t been able to run much. (We currently have just one good knee between us.)  She isn’t able to get to our gym everyday.  So, one $7 piece of plywood and a half-hour of labor later, we had one serviceable balance board ready for squats.  My sons love it, and even Nurse Josephine got a little curious about its construction (she’s the black blob on the left).    And now I can help my wife work on her balance and proprioception by tossing her a ball while she wobbles, and she can do the same for me.  It’s a new stage in our relationship :-)

Week 12 Benchmarks

Other than full flexion and running, there’s not much new to report.  Basically I’m doing the same stuff as as Week 10.  It’s just really a matter of doing it a little better, a little longer, or with a little more weight.

Week 10, ACL Recovery

It looks like I am way overdue for a progress report. But a slowdown in PT visits and a scheduling snafu left me without any good numbers to share for the last three weeks.

I’ve cut back physical therapy to every 14 days.  I’m still going to the gym every day or every other day, using the weight and aerobic machines and doing my balance exercises. I haven’t changed much on the aerobic machines, staying on them only about 10 minutes and rotating through the bike, elliptical, and step by days. I have been steadily adding weight on the abduction, adduction, leg press, and hamstring exercises. Too much so, possibly. I’ve had some hamstring soreness, and my PT has warned me about developing tendonitis, which is apparently very common with the hamstring graft. So, I’m going to back off for a bit on the weights and maybe not squat so low on some of my balance work.

Swimming

I’m still not allowed to run, which is not a big deal for me because I’ve never really liked it that much. But I have started swimming, which is a very big deal because I always thought I disliked it even more. Now, however, I think I like swimming more than just about anything except karate.

I’ve actually been thinking about starting to swim for a long, long time, mainly because the worst part of my karate is my breathing. And what is swimming if not controlled breathing? The benefit seemed obvious, but my last few attempts to swim always ended me gasping like a fish on a sidewalk before finishing even just one (olympic-sized) length. With my knee injured, the challenge, the benefits, the opportunity, and even the necessity of swimming all came together to push me into action. Right now, I’m just doing the crawl, using only my arms, and am focusing on form and breathing (and not drowning). By taking numerous breaks during each session, I’ve been able to go from 1/6 mile to just over 1/4 mile in less than 2 weeks. I’m still sucking in water pretty frequently and feeling that momentary panic, but my overall sensations are of focus, peace, luxury(!), and accomplishment. It’s pretty cool and I’m hoping that it improves my karate when I return.

A fist away

A couple weeks ago, I started using a new measurement for flexion. I found that after exercising and stretching, I could get my heel with a fist of my butt (using the atomic wedgie method). Who needs degrees when you can measure progress in digits? Right now, I can get to within three fingers, after warming up.

Goodbye Pacino?

Well, it’s too early to say goodbye to Pacino. Really, he won’t ever be gone. But he has diminished a great deal recently (though a good shave would bring him back to the fore). The swelling around my knee still ebbs and flows, but it is down significantly, and my kneecap is starting to be its old protruding self again. Especially noticeable is how much that “bursitis” on Pacino’s right “eye” has gone down. At my last visit, I asked the surgeon about it. His explanation was that the scope hole was larger lower down than the visible scar implies and that sometimes (maybe when the patient aggravates it by nearly falling of his bike) that part takes longer to heal. He recommened wearing a compression brace, which I think has made a big difference.

Week 10 Benchmarks

Exercises

• Aerobics: Stationary bike, or Elliptical, or Step Machine, 10 minutes.  Swimming, 1/4 mile.
• Weight machines: Abductor, Adductor, Leg Press all at about 100lbs. (up 50lbs. from week 4) and Hamstring curls at 17.5lbs. (up 15lbs. from week 4).  Each about 2 sets of 10-15 reps.
• Balance board squats while moving a 4lb. ball side to side, 10-15 reps balancing side to side and 10 front to back.
• Balance on one leg standing on blue TheraBand pad doing star drills and, starting day 68 leaning forward and touching the ground with each hand. (My injured leg is actually better at this in than my good leg now).
• Lunges on the squishy half-circle Bosu ball, about 25 each leg.
• Stretches!

Flexion

• 143 degrees flexion (passive) day 68 (compared to about 148 on the uninjured leg!).   I could only get to 125 degrees just using the muscles of the leg itself.

Walking/Navigating Stairs

• No brace with metal support (except when lifting a heavy object) but wearing a soft brace for compression.
• Ascending/descending stairs is not a problem.  Can even ascend two steps at a time, but wisdom typically prevents me from doing so.

Swelling

• Generaly, the swelling is about 5 millimeters above my good leg.  Much improved.
• R.I.C.E. - Not resting too much, these days.  Icing at night and if swelling merits. I’m wearing a neoprene ACE brace for compression almost all the time.  And just for good measure, I’m still elevating when sleeping.   

Karate

• Trying to do some kata in my head every day.
• Using flash cards to keep sharp on what our techniques are.  (I’m supposed to know 15 punching combinations, 15 one-step (block/evade and counter) combinations, 15 self-defense moves, and 15 knife defenses in addition to 16 katas and a good number of kicks.  They can get kind of confused if you don’t constantly do them or think about doing them.)
• Learned first half of handwork for our third Niage (Naihanchi/Tekki) when stopping by karate class for a visit :-)

Tiger Woods ACL

I was at the gym during lunch going through my exercises when I saw the news that Tiger Woods will be having surgery to reconstruct his ACL.    It was difficult to watch videos of him limping around and to think about all that rotation and torque his knees go through in every long-shot swing.  At first I was confused, because just this past weekend, I’d read he’d recently had surgery to clean up some cartilage in his knee and there was no mention of the ACL.  

According to his official website, he tore it last fall while running and waited to get surgery.   The article also said he’s suffering from stress fractures brought on by rehabilitation following the surgery to repair the cartilage damage that had “developed as a result of the ACL injury.”  Can we say repeated subluxations? 

Now, I don’t want to fault him.  I know why he waited.  He’s a great competitor, and I wish him a speedy, painless return to play.  Gosh knows he deserves it.  But I think it’s a good lesson for anyone facing a possible or diagnosed ACL injury and who wants to continue their sport.   Think seriously, and think quickly, about getting your ACL fixed, so you don’t risk ripping your knees and legs apart. 

Kick the can

One of my physical therapy assistants likes to entertain her clients (and herself) by picking on them, lightheartedly cajoling them during their exercises or pretending that her tasks are overly burdensome.   It’s all in good fun, really, but I once told her that the only reason she does this is because most of us pose no physical threat.  Even if she really angered one of us, she can quite easily move out of our range of motion.  “Just wait until I can move again,” I said as she was feigning impatience with my lack of speed.  “You’re gonna get kicked.”   She laughed at that, and we decided that, a la Kwai Chang Caine snatching the marble from Master Kan, when I can do that, it will be ‘time for me to go’.  

It’ll still be quite awhile before that happens, but I did recently make a small step toward that goal.  Sort of.

I should mention that one of the great things about studying a martial art is the sharpened sense you develop of the physical space around you and the movements of others.   Outside of the dojo, this is useful for many things, such as working with someone in a small space, like a kitchen, where you make lots of quick movements, often with hot or sharp objects.  Or with the simple act of picking up something that’s fallen near a table where you’re liable to hit your head, if you’re not careful.

Since my injury, though, I’ve noticed that this sense of space has diminished somewhat for me, and I’ve banged my head more times in the last two months than in the previous three years.  Mostly, the only results have been a bit of pain and some mild chagrin, but it did hit a comical note a few days ago when I was working on my physical therapy excersices at my gym.

I was balancing with my injured leg on one of those the soft blue TheraBand stability pads (like the ones you see being used at right) and reaching out with my good leg in four directions.   I’d positioned myself away from traffic near a trash can and was concentrating on a focal point and on bringing up my knee as a high as possible between each reach.  I was starting to feel pretty confident in my balance, so I decided to also extend as high as possible.   Kick forward high.  Kick oblique high.  Kick side high. Trash can.  Bang! Ooops.

It was classic lesson in spacing and targeting. Aiming down I wasn’t reaching that can. But with little upward adjustment, bingo! A more than palpable hit. Sure it was embarrassing. It turned a lot of heads, and I certainly felt like it was something shouldn’t have caught me off guard.

But you know what?  It felt kind of good, too :-)

Squirrels and Rabbits

A few days ago one of our black belts e-mailed me to check on how I’m doing and to tell me about about a neighbor’s dog, Susie, who had torn the equivalent of her ACL and had surgery to treat the condition.  She appears to have made a full recovery and is again out “chasing squirrels and rabbits like a pro.”

I was fascinated by the idea that the canine knee was susceptible to this kind of injury and that veterinarians are able to repair it surgically.   (I also wondered if there were any professional canine physical therapists out there.)  I did some research and found that human and canine joint structures are indeed similar, though not exactly the same, and that, for dogs, there are three distinct surgical options. An explanation of the canine knee structure and the surgeries are at http://www.petroglyphsnm.org/caninecorners/aclrepair.html.

Two of the procedures sound similar to human ACL reconstruction, and the third sounds very different. So, depending on what kind of surgery Susie had, her recovery may have little to do with mine.  Still, she’s kind of hero to me, because I imagine her running around in her backyard, throwing herself headlong and un-self-consciously into her play. 

That’s the mental state I’d like to acheive at the end of my recovery, when I, too, am back out chasing squirrels and rabbits again.

 

Week 4, ACL Recovery

Sore muscles.  After 2 1/2 months of pains and aches only around my injured joint, I have sore muscles in my legs.  Dang, but it’s a wonderful feeling!

The reason,  of course, is PT.  I’ve had weight machines added to my exercises and am getting the chance to work muscles that have been out of commission since my injury as well as a few that I never really worked before (karate doesn’t work your leg adduction much, for instance).   It’s not a lot of weight, mind you.  In fact, it’s an embarrrasingly little amount of weight.  I find myself looking furtively over my shoulder as I sit down at each new machine and adjust the load, invariably downwards, sometimes by as much as 100 pounds.   I have to laugh at myself for feeling this way and for entertaining such silly notions as limping the first few steps from each machine just to make sure everyone knows I’ve got a bum limb and that I’m not really a weights wimp.   I’ve never been much into weight training, but the benefits here are obvious.   I can see how some extra strength and toning work could be very helpful to my karate, so I may try to make it part of my regular routine, whenever it becomes regular again.

Beyond the return of sore muscles, the past couple of weeks have been good.   The knee still feels very tight almost all the time.   But I think that’s mostly that I’m always judging it at the edge of its limits, which are constantly being pushed further out.  (Reminds me of how I often perceive my own progress in karate, during those periods when it seems like I’m going nowhere.) 

My only worry is that ‘bursitis’ afflicting Pacino’s right eye.   I’m not certain it really is a bursitis at this point.  But whatever it is, it sure is taking its sweet time going down and will sometimes even puff up a bit after the weight training.   When it does, it can feel like there’s something stuffed in the front of the joint below the patella.  I don’t like that feeling, but it doesn’t really hurt and seems to go away after a bit.   I’ve got another post-op with the surgeon next week.   I’m hoping it won’t be an issue by then,  but in the meantime, it’s ice, ice, ice.

Week 4 Benchmarks

Exercises

• Weight machines: Abductor, Adductor, Leg Press all at about 50lbs (yeehaw) and Hamstring curls at 2.5lbs.  Each about 2 sets of 10-15 reps.
• One leg balance on mini-Tramp with ball toss (I go into a zone on this one :) )
• Leg raises (slow descent), 3 sets of 15, 1 times per day; added 2lb weight on day 24.
• Still doing most of the exercises from Week 2.

Flexion

• 130 degrees flexion on day 31.

Walking/Navigating Stairs

• Brace only when carrying heavy items or walking on uneven ground.
• Ascending stairs one step at a time, starting day 14 but getting comfortable around day 21.
• Descending stairs one step at a time, slowly and only after warming up, days 24-31.

Swelling

• Depending on the time of day, there’s a .5 cm to 1 cm difference between my two knees, except where the ‘bursitis’ is.
• R.I.C.E. - still elevating when sleeping and using an ace bandage for compression.  I’ve cut down on the number of full icings but have been rubbing the ‘bursitis’ area with a piece of ice (typically frozen in a Dixie cup) for five minutes every hour or two.

Say hello to my little friend

The Steri-Strips on the graft incision below my knee finally curled off this weekend, unveiling the handsome dude to the right.  He doesn’t seem to immediately click with those around him, but I actually like his impish, lopsided grin and have taken to calling him Pacino. Once he fades a bit and the hair grows back, he won’t be so fearsome and might not even be too noticeable. But for now, he seems to live up to the name.

This is especially true right now, thanks to a bit of stupidity on my part. Yesterday, I was at the gym riding the stationary bike. About half way through my 10-minute session, I got kind of bored and started going through handwork for the first two forms of naihanchi (which my school calls ‘niagie’). At one point I lost my seat a bit and, since I wasn’t holding onto the handle bars, I was forced to seesaw my feet into the pedals to keep upright. Something on the outside of my injured knee did not appreciate this. And sure enough, just a short time after, a focused little bit of swelling started to appear in the skin under one of the scope holes, making it look like someone had punched Pacino in the eye. It’s not black and blue, just noticeably swollen. Apparently, I irritated a bursa. Luckily, it doesn’t appear to be anything to get worried about. In fact, except for the bursa, the rest of the swelling was way down today. Still, I do feel a bit foolish and somewhat chastened. It’s just that kata can be so addictive and my PT fix does little to take the edge off my kata craving. I’m going to have to be very careful in the next few months.

Because of the bursa, we took it easy today at PT and didn’t take any flexion measurements. So I’ll save the end-of-the-week report for the four-week mark.

Week 2, ACL Recovery

I started off the week with a milestone by going back to work (a desk job in web development). To my chagrin, there was already a message when I got in from my physical therapist cancelling my appointment that morning.   Now, my next appointment was Wednesday, just two days away.  But I had to have my  PT fix, so I quickly got a new appointment for Tuesday, leaving me with two days in a row of PT.   For the most part this was a good thing, but the Tuesday workout left me so sore and tight that I’d actually lost a degree of flexion by Wednesday.  Horrors!  On Friday things were much better, but we forgot to measure my flexion, and there was no way I was going to report a negative progress until I had better numbers, which I got today (see below).

Overall, the PT was once again fun and challenging, with a lot new exercises for balance, proprioception, and gait, all stuff where my background in karate really helps.  However, there were two exercises—introduced to me on Tuesday (Day 11)—that were a bit more challenging. The first had me sit on a stool and pull myself forward using my heels.  I just couldn’t do it with my injured leg at first.   I kept trying until my calf muscles cramped and my hamstring graft started hissing at me.  I probably worked it more than I should have and pretty much did myself in for the PT session the next day.  But I got some more time on my beloved NuStep and a nice calf massage as a consolation prize.

The second exercise is a flexion stretch that has me lying on my stomach and pulling my foot back towards my butt using a rope (a leash works great, too).  I call this one the Atomic Wedgie Stretch because it reminds me of how my friend’s older brother would ratchet up the intensity of wedgies he gave us when we were in middle school by pulling back our calves and hooking our underwear over our feet.   While less painful (and certainly less demeaning) than those old wedgies, this is the most difficult of my exercises.  It doesn’t really hurt.  But pulling against the tightness in my knee requires concentration, relaxation, and deep breathing.   I love doing it because I can feel it stretching my knee.  I dislike it for the same reason.

By Friday, things were back on track (despite missing the flexion measure) and I was psyched enough by how things were going to pull out an old piece of equipment that we bought in the early 90s and have neglected ever since. It’s a stand that turns my wife’s ancient Nishiki ten-speed into a sort of poor man’s stationary bike for days when I can’t get to the gym.  The bike’s tires are flat, and the whole thing looks a little rickety.  But it’s stable enough to hold me, and the crossbar is low enough to let me get my injured leg over.  My physical therapist explained that the motion is key to pumping synovial fluid—the main source of nutrients for the knee joint—in and out of the knee, helping with swelling and healing. Kind of fun to find such great use for what has essentially been garage filler for the past decade.

All in all, another good week with measurable progess and new and interesting things to work on.  So without further ado, here’s the week in stats.

Week 2 Benchmarks

Exercises

• Leg raises (slow descent), 4 sets of 10, 1-3 times per day; added 1lb weight on day 11.
• Balance on injured leg for 15 seconds (sometimes extending good leg forward, to side, and backward), 2 sets of 10, 1-3 times per day.  Started on day 11.
• Treadmill, 10-minute session, walking forward – and starting on day 17 — walking backwards.
• Steps (real ones!), ascending with no brace, day 14.
• Step down from 4″-block, 2 sets of 10 at PT sessions.
• Balance board, side-to-side balance with 15 squats and front-to-back balance, day 14
• Still doing most of the exercises from Week 1.

Flexion

• 115 degrees on day 11.
• 114 degrees on day 12 :-(
• 124 degrees flexion on day 17.

Walking

• Brace most of the time, days 8-17.
• No brace, mostly in the house, days 8-17.

Pain and Meds

• Some Muscle pain, usually around hamstring graft.
• Ibuprofen as needed, but I often forget it.
• R.I.C.E. - continuing to rest when I can, ice 3-5 times a day, wrap with an ace bandage at night, and elevate when resting and sleeping.

Week 1, ACL Recovery

Meet my new love.  No, not the guy.  The machine.  It’s called a NuStep.  We met at Physical Therapy, on my second visit, and I want to move in together.   Well, I’d at least like to have one at home for a few weeks.  It’s a reclining step machine.  And, it’s great for getting that knee moving in a controlled way. Unlike a bike, the pedals just go back and forth. No rotation.   You can sit back and take it nice and slow.  Very relaxing and rewarding.  I can feel that knee stretching oh so nicely.

To be honest, I kind of feel that way about a lot of my physical therapy.  So far, the exercises haven’t been painful (except maybe pushing the flexion), and usually feel quite good. I enjoy being able to impress the therapists with some of the things I can do and appreciate getting encouragement and feedback.   The only hard part has been trusting the leg when working on weight bearing.  It’s the ‘couples therapy’ part of the process. So far, the knee hasn’t let me down, and I haven’t pushed it too far. We’re starting to build up trust again.

Mostly, it’s just been mental.  It’s been beautiful out, and I’m starting to get a bit of cabin fever.   I miss not being physically active.  I miss karate.  I miss being able to pick up my sons and tickle them to the floor.  I’m sick of sleeping on my back with my leg elevated.  I miss being able to check out the karate-induced callouses on the bottom of my left foot. (Yeah, I know. Yuck.) Thank god for books, blogs, the rest of the Internet, and DVDs.

It’s been tough on the family. My wife’s been pulling a lot of extra bedtime and morning duty.  I’ve been doing most things for myself, but I am kind of in the middle of everything down here on our first floor. It’s probably been hardest on our two sons, neither of whom is used to having a father who doesn’t run around with them having pillow fights or playing with foam swords and armor.  The only member of the family who still seems to be enjoying this is our cat Josephine, who has yet to cease her furry ministrations.

Still, it hasn’t been as bad as I might have thought.  The phantom leg stuff seems to have stopped.  The knee seems good and strong.  It’s still tight, but  it seems to be getting a bit looser and less swollen every day.  A good start.

So with all that said, here’s the week in stats:

Week 1 Benchmarks

Exercises

• Hamstring and calf stretches, 4 each for 30 seconds, at least 3 times per day.
• Ankle rotations, 20 each way, at least 3 times per day.
• Ankle pumps, 20, at least 3 times per day.
• Leg raises (slow descent), 2 sets of 10, 1-3 times per day.
• Heel slides, 2 sets of 10, 1-3 times per day.
• Weight shift, 1 set of 10, 1-3 times  per day.  (Standing on one leg on day 7).
• Step and lean, 1 set of 10, 1-3 times per day.
• NuStep, 10 minute sessions at PT, days 5 and 7.
• Incline squats (80% weight bearing), 20, days 5 and 7.
• Bike machine, 10 minute session, full rotations(!), day 7

Flexion

• 90 degrees on day 3.
• 100 degrees on day 5.
• 105 degrees flexion on day 7.

Walking

• Two crutches, days 1-3.
• One crutch, days 4-7.
• No crutch, day 7.
• Brace, days 1-7 (and continuing).
• No brace, occasionally in the house, days 5-7.

Pain and Meds

• Pain worst around stitches the first few days.  Some aching and tightness from swelling.
• Brace, which wasn’t fitted correctly, caused my calf and hamstring to tighten when I first started trying to walk properly.  Very counterproductive. Make sure to ask your physical therapist for help!
• Percocet, days 1-2, 5mg every 4 or so hours. 
• Vicodin, days 3, 5, and 7 before physical therapy.
• Tylenol, days 3-7 (ibuprophen prohibited by my surgeon until post-op visit).
• R.I.C.E. - days 1-7.  As much as possible! Ice before exercises has been especially helpful. 

My Phantom Leg

A strange, kind of cool thing has been happening since my surgery.  I’ve been having an “out of leg” experience.

“Huh?” you may ask. Well, what I mean is that often, when I close my eyes or can’t see my injured leg (like when I’m typing on my laptop), I get the distinct sensation that the leg is not where it should be—that it’s in the wrong position. Not by much, mind you. But enough to make me look.

And when I do look, I am invariably surprised to see that it’s still up on the pillows, where I’ve been keeping it elevated, and not down level with my other leg, where I had just been sure it was. But what’s really weird is that I feel it momentarily in both postions and, for a split-second, I have three legs.

So, why? Why should this be happening? My best guess is the post-op swelling (and maybe some lingering effects of the nerve block) is interfering with the proprioceptor nerves in my knee, greatly reducing the number of signals they send to my brain.

The job of these specialized nerves is to send information about where the various parts of the body are in relation to each other. And when the brain stops receiving signals from them, strange things can happen, such as feeling a phantom limb in place of one that was lost.

But of course my leg is still there, and I can still feel it when I touch it or wriggle my toes. Which is why this only happens when I’m not paying attention to it, when I’m just letting it sit there and not looking at it. I think my brain just kind of loses track of it and slips into a default mode, placing my leg in a kind of at-rest position.

Now, this all theory, I know. Some of it comes from talking with my physical therapists and with a researcher at the local university who’s looking at how better to revive the muscles surrounding injured and swollen joints. And some comes from a book called The Body Has a Mind of Its Own by Sandra and Michael Blakeslee about proprioception and ‘body maps’. But whatever the cause, I’m hoping it goes away soon. As helpful as a third leg might be in karate, I’ve already had more than my share of trouble with the two I had before.

And so, back to exorcising this phantom through R.I.C.E.

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P.S. If you’re studying a martial art (or really engaged in any kind of sport), I especially recommend The Body Has a Mind of Its Own, which includes some intriguing research on things like how, when you pick a tool like a sword, the brain actually appears to start mapping it as if it is an extension of your hands, a part of your body. It took me a good while to find a copy in my area, but here are a couple of podcasts about the book and a link to a short article by book’s authors.

• BrainScience podcast on The Body Has a Mind of Its Own.
• Science Friday podcast with Sandra and Michael Blakeslee.
• The Body Mandala — Or Maps, Maps, Everywhere