Sparring – A medical implication – Part 2

October 11th, 2007 at 11:11 · Filed Under Injuries, Karate, Medical, Sports 

My post “Sparring – A Medical implication” has caught attention of some of my blog readers and they have sent me feedbacks regarding my post. I am not a medical doctor but I have followed every medical articles regarding sports injuries and diseases (sports injury related) very closely and have made contact with some sports medicine researchers who are doing their Ph.D. in well known medical university in the U.S.

My posts will certainly create some controversies among karate-do practitioners, instructors or coaches, parents and other groups. My intention does not mean to inflict any contention or harm to karate training as I am a karate practitioner and coach myself. My intention is to realize people’s awareness of the potential injuries and the after-effect when our body begin aging.

In part 1, I mentioned vaguely how an injury like bruises and thrombosis can seriously affect our health. In this post entry, let’s take a look at the type of injuries we can get from karate training.

Before I start to elaborate types of injuries obtained from karate training, let me emphasize on one thing. One argument is most likely to come from the mouth of those karate coaches/instructors will be “With proper training and strengthening of the physique, injuries can be avoided…”. This can be a very selfish statement to protect their coaching income. Even the Olympic sportsmen and sportswomen can sustain injuries during their training or while competing. Remember, they are pro!

For modern competition oriented karate training, the sparring (jiyu kumite or free sparring) uses bouncing motion to distract opponent and also to position body into maneuver for attack. This repeating bouncing motion during training and tournament causes overused injuries. These overused injuries are caused by repeated, microscopic injuries to a part of the body.

Many long distance runners experience overuse injuries even after years of running. For road runners, the surface is hard and sometimes uneven, and the running movements are repetitive. In addition, there are usually both up- and downhill elements, and these increase the stress on tendons and muscles in the lower leg.

The bouncing motion in karate sparring (kumite) has the same effect of running. Although there is cushioned floor mat, but karate kumite exponents perform without proper footwear. This induces pressure onto both feet and legs every time they land and bounce off the mat.

They are most likely to suffer:

  1. Achilles tendinitis – The Achilles tendon (the tough sinew that attaches the calf muscle to the back of the heel bone) is most likely to be damaged if performing repeated bouncing motion in kumite. The injured Achilles tendon feels tender when squeezed between the fingers. Pain is usually at its worst in the morning and improves with walking. Vigorous exercise will increase the pain for a bit, then improve it.
  2. Lumbar strain – The standard weightlifter’s injury can also occur in sports that involve sudden twisting of the back, such as kumite when the athletes trying to maneuver into attack or out of attack or performing mawashi geri (roundhouse kick). Sudden lower back pain appears with twisting. It may seem fairly minor for an hour or two, but carrying on the exercise will usually bring a sudden deterioration with extreme pain and back spasms.
  3. Metatarsal stress fracture – The second to fourth toes are vulnerable to breakage if you push off with your toes when bouncing and maneuvering into or out of an attack during kumite. Army cadets doing running and marching drills are likely to suffer stress fractures during training camps. Dancers, gymnasts and kumite exponents experience stress fractures because of frequent jumping. The front of the foot starts hurting during exercise, and the pain usually stops when you finish. With each subsequent bout of exercise, the pain appears earlier and earlier, and gets steadily worse. The fracture can take up to three months to fully heal.

These are the injuries which effects can be seen or felt immediately during or after training. Whether the injuries have been completely treated and healed professionally, the problems are most likely to emerge again when our body begin to age.

Another injury which gives the most terrible effect is head injury. It is not surprising that head injury is common in karate kumite and other sparring events. It is estimated that when a martial art exponent gets a direct blow to the head it is like being hit by a 12lb padded, wooden mallet travelling at 20mph!

Being hit on the head can cause fractures to the bone of the head and face and tissue damage in the brain. A blow can damage the surface of the brain, tear nerve networks, cause lesions, bleeding and sometimes produce large clots within the brain.

Famous boxer, Mohd Ali, who suffered repeated head traumas over his professional boxing career, is suffering from Parkinson’s disease (PD).

Quoted from Wikipedia:

Past episodes of head trauma are reported more frequently by sufferers than by others in the population. A methodologically strong recent study found that those who have experienced a head injury are four times more likely to develop Parkinson’s disease than those who have never suffered a head injury. The risk of developing Parkinson’s increases eightfold for patients who have had head trauma requiring hospitalization, and it increases 11-fold for patients who have experienced severe head injury. The authors comment that since head trauma is a rare event, the contribution to PD incidence is slight. They express further concern that their results may be biased by recall, i.e., the PD patients because they reflect upon the causes of their illness, may remember head trauma better than the non-ill control subjects. These limitations were overcome recently by Tanner and colleagues,[45] who found a similar risk of 3.8, with increasing risk associated with more severe injury and hospitalization.

The human brain is contained in the skull and is suspended in some fluid. An impact to the head can set the brain into forward and backward rocking motion, smashing itself onto the skull wall. This is the cause of concussion. The impact may cause internal bleeding causing tiny to large blood clots in the brain. This may also cause thrombosis in the brain. Repeated head trauma can reduce the size of the brain and surface grey matter become thinner. The ventricles within the brain enlarged because of the decrease in the brain’s white matter. All these increase the vulnerability to natural aging of the brain and diseases of the brain. Kumite exponents may suffer Parkinson’s and/or Alzheimer’s disease.

It is not necessary to have a knockout with a direct or indirect (with head protective gear) blow to the head to traumatize the brain. As quoted above, those who have experienced a head injury are four times more likely to develop Parkinson’s disease than those who have never suffered a head injury. The risk of developing Parkinson’s increases eightfold for patients who have had head trauma requiring hospitalization, and it increases 11-fold for patients who have experienced severe head injury.

Imagine traumatized the brain of a young child or adolescence and how they can develop Alzheimer’s and Parkinson’s disease when they begin to age. There are many medical cases involving people of young age who suffer Parkinson’s disease. One of them is Michael J. Fox, who has a young on-set of PD at the age of 29. The cause of his PD is not known, of course.

Would you like your child or yourself to suffer PD in young/old age? Would you compromise your health or your child’s health for the one-minute glory receiving a medal on stage? Would you compromise your health or your child’s health for displaying the male chauvanism during training and tournament? You decide your own or your child’s ultimatum.

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14 Responses to “Sparring – A medical implication – Part 2”

  • 龙 on October 12th, 2007 15:00 1

    Good mitigation! Indeed, the traditional old Chinese martial arts training do not have free sparring as their training syllabus. Free sparring is the by-product of Hollywood movies. The Wushu san-ta (free sparring) was added into competition to arouse interest in Wushu training overseas.

    Even in military combat fighting drills, there is non-contact, only repetition to improve accuracy and the speed of a strike. The military combat fighting is the deadliest which is designed to neutralize an enemy in shortest time and uses less efforts. The military cannot afford losing a man during combat training.

    In China, children and adolescence do not parctice free sparring. Adrian’s right about the potential risk in children. I do agree with him.

  • Jay B.simha on October 12th, 2007 15:01 2

    Hi Adrian,
    Nice post.

    I partly agree that bad practice of so called free fighting (sparring) introduces false confidence and bad habits. On the other hand, even though it has been taught by my sensei to practice kata like free fighting and fight as if doing kata says every thing about kata practice and its merits, it can not induce the dose of fear, if we are not doing jiyu kumite or as we do jiyu ippon kumite.

    In fact if health is the only reason for practicing martial arts then I prefer to practice yoga (which i incidentally do), which has minimum risk of injury or taichi (which I am learning now). Both of them are very good for several reasons.

    But if self defense is the strong reason for martial arts, then there is reason to introduce reality. One of the easiest method to introduce the feel of reality is to do free sparring. However, ‘a punch I get a point’ style of free sparring may introduce useless skills for self defense. Similarly, masochistic styles like Thai boxing, boxing may introduce brain, musculo-skeletal related injuries and cause permanent damage, even though they give commendable skills for self defense.

    The middle ground is to have benefits of both. Develop good breaking skills, pain threshold, presence of mind to thwart the attacks, good communication skills(surprising?)etc. The quality of a style of measured by 1.How long the practitioners live with good health? 2.How many fights they avoided so far? and 3.Can they really defend now?

    The strong and better approach to induce reality is mental and spiritual. As I have seen only few senseis ever teach these aspects. With good mental conditioning I have seen we can transform rats to cats and vice versa, without any physical contact. However, this is another type of bad practice, since we are doing it without checking the ecology of the martial artist. If he is mentally very confident but physically not strong, same results as of free sparring will result if he engages in self defense.

    But a dose of free fighting when participants have capabilities is required often to stay in touch with reality.

  • 龙 on October 12th, 2007 15:32 3

    I agree only 10% about introducing fear into martial arts training. I believe it is the training and the knowledge of applying the techniques and repetitive pratice of applying the techniques with great precision and speed and a good control of power will subdue fear itself.

    I fought two guys in the training camp when I was having my military training when I was 18. That was my first fight and I did not fear at all. This January, I fought a girl who was bigger than me and that was my second fight. Both fights have the same characteristic: 1.) My safety and well-being was in great danger. 2.) I was helpless in both situation. Admittedly, the 2nd fight occureed in a karate dojo and not as dangerous as the first one. You can read about it here.

    In my first experience, if not having martial arts training since childhood, I could have been raped! I was in critically dangerous situation. My martial arts training in childhood and the combat training in the military has saved me.

    Many great masters do not involve in a fight and many of them never have. But they still are able to defend themselve in dangerous situation. How? Their decades of hard training with immense knowledge that builds their confidence.

    Martial arts training is not to get involve in a fight. But when circumstances require a martial artist to do so, first, the martial artist will do at their best to avoid a fight and move away from the scene. Run for your life if you can. The martial arts training is the only last resort to save yourself and your loved ones if you can´t run away.

    Another factor is age. When a person gets older, he will have better control of his fear. This is eminet especially a person´s martial arts skills develop along their age.

    The last factor is the involvement in real-life situation. I have seen many masters with great skills who have survived the post WW2 era in China. These great masters, including Adrian´s grand master of Uechi-Ryu Zankia, have fought with their life in order to survive during the post WW2 era. During that time, it was really hard to survive on the street where robbery, rape and murder infested every corner of the country. These include my grand father and my father. Both of them have protected our family from harms way otherwise I would not be able to write this post today.

  • Jay B.simha on October 12th, 2007 18:56 4

    “….repetitive pratice of applying the techniques with great precision and speed and a good control of power will subdue fear itself.”

    I think it is an extremely rare for a martial artist or any body for that matter to have precision and control whenever there is an adrenalin rush (read fear). It is only the gross motor skills (like elbows, knees, palm pushes) which are reflexive in nature will be used. IMHO Precision skills are propagated by movies and anecdotes about great masters. Gross motor skills and great mental control (fear control) are the facts accepted by practical fighters.

    Further, for some people (called T-types), fight instinct comes naturally. Since, they already have good adrenalin management system, they fight without fear. But generalizing this to every body is not correct.

    I do not know how many people are like you, who can engage in fighting without fear. For most of us (including me) fear is the motive for learning martial arts. If I am not afraid,I would not have taken up martial arts.

    “..Another factor is age. When a person gets older, he will have better control of his fear. This is eminet especially a person´s martial arts skills develop along their age.”
    Again this is questionable. How do we test it? only through..
    “..Develop good breaking skills, pain threshold, presence of mind to thwart the attacks, good communication skills(surprising?)etc.” Is it not breaking skills development of techniques? But my bet is only on gross motor skills. Not breaking with finger tips :-) .

    “The last factor is the involvement in real-life situation.”
    This precisely is my point. The way you train is the way react . If you practice without real life stimulus how do you know you can react to a situation when it arises? either rehearse it mentally or simulate it physically. Sparring is one way to create physical simulation.

    I am neither against styles which believe in no sparring or which advocate sparring, but I embrace which is more practical for me. Still I strongly believe fear control is the ultimate martial achievement.

    Thanks for disagreement. It keeps our brains active.

  • Adrian Hoe on October 12th, 2007 22:26 5

    Hmmm A controversy in the making. Perhaps not. But it is a good food for thoughts. Indeed, both of you have good points.

  • anonymous on October 12th, 2007 22:45 6

    Bullshit! All bullshit! If no sparring, then it’s not called martial art. Better call it dance!

  • Seizan on October 13th, 2007 11:13 7

    This might be posted a second time – Adrian-san, if possible, please remove the repeated post. I wasn’t sure it got into the system the first time I pressed the “submit” button…

    Anonymous-san,

    Sparring was created for sports. Sparring, as we know it today, with all its lack of finesse, did not exist in the time of the founders of most of today’s karate systems. The Japanese term “jiyu kumite” translates to “freestyle meeting of hands”, descriptive of a match in a sporting context only. Nothing wrong with sparring if that’s what you like to do.

    In this blog entry, we are pointing out that quite often the sporting aspect escapes the participants, and injuries – severe, life-threatening, even fatal – occur. Some are long-term slow-acting injuries that return to haunt the injured person years later, though by then the origin of the “illness” is untraceable or indeterminate. All for sports. Is it worth it?

    The Chinese knew this when they determined Dim Mak. There are, actually, similar long-term-effect strikes in almost all martial arts systems, they just have be pointed out to the practitioners. You might be shaocked to find so many in your own system (what system do you practice?). You might hold back on some techniques in “sparring” after you discover the long-range medical implications of some of the strikes you presently so freely give and take in your youthful enthusiasm to “win”.

    “Sparring” wasn’t done 100 or more years ago. An entirely different method, purpose, and philosophy for honing and maintaining fighting skills was practiced that is largely forgotten today.

    What was that method? Good question for you to research, eh? You could ask your teacher’s teacher’s teacher, or go back to the source of your system and ask the old folks about their predecessors.

    Good luck.

    Regards,

    Seizan

  • My worries | Adrian Hoe’s WebLog on October 13th, 2007 11:53 8

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  • Adrian Hoe on October 13th, 2007 12:00 9

    I am for sure do not want to have PD at old age. I will not be the only one to suffer. My wife and my kids will suffer along with me because they take care of me. Yucks!

  • Adrian Hoe on October 13th, 2007 12:04 10

    Anonymous-san,

    What can I gain from my bullshitting?

    That’s not bullshit. Please read up about PD and I guarantee you will get a shock out of your life how PD can affect you in young/old age. At least consult a doctor about PD, ask the doctor if a head injury can cause PD and the potential risk of getting PD and the chances of getting it if you have got a head injury.

    Check it out. It is for your own good!

    Even if it is true, will you pay me money? I gain nothing but I just want to share what I’ve found out.

    Good luck.

  • Jay B.Simha on October 15th, 2007 0:32 11

    Wise man’s words. Thanks to Seizan Sensei for “..Nothing wrong with sparring if that’s what you like to do.”. As long as one can accept the risk associated with involvement in body contact sports, this blog entry is not for them. It is only for those who objectively direct the thinking and practice.

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