Ai on Health

by Dale Nordenberg, M.D.

You are a legend in your own mind. You feel good, exercise frequently, throw twenty-somethings around, and when you look in the mirror you're sure that you look as young as you feel:

A few years ago I was sitting next to Kanai Sensei on the airplane returning from an Aikido seminar in Lesneven, France after attending a summer camp with Tamura, Yamada, and Kanai Senseis. I imagine that I had that tired and sore feeling because I remember turning to Kanai Sensei and asking him at what age is it reasonable to stop taking break falls. Being in my late thirties, I was sure that my reprieve or grant of immunity couldn't be far away. After just the slightest hesitation he gently said: "never". "If you can do it today and you continue to train" he explained to me "then there is no reason why you can't do it always".

Faced with Kanai Sensei's unexpected suggestion that one should be able to do breakfalls forever, I peppered him with questions about how to do ukemi until the plane landed in Boston. By then, I had realized that I must be prepared to do ukemi for life. However, being a physician, I knew that as time went by there would be physiologic limitations to my practice. John Glenn may be preparing to become the oldest man to fly into space, but I don't think that he or many other folks his age would volunteer to take breakfalls.

The study of martial arts is an injury epidemiologist's dream. A martial artist trains to perfect techniques designed to control, subdue, and if necessary cause injury to a violent aggressor, that is, to cause intentional injury. However, the study of Aikido is done in a fashion aimed at minimizing unintentional injuries. The "accidents" or unintentional injuries that frequently occur in the course of daily practice include musculoskeletal injuries, tendonitis, muscular strains and sprains, minor fractures or dislocations. But accidents also occur that affect the cardiovascular system (e.g. heart attack) or the central nervous system, (e.g. stroke).

One of the unique aspects of Aikido practice is the age distribution of aikidoka. In many dojos, the mean age of aikidoka is in the thirties and there are often many individuals in their forties, fifties, sixties, and older. Aikido may be unique among vigorous contact physical activities in that practitioners expect to train for decades and continue into their old age. As time passes, and the number of older aikidoka grows, it becomes increasingly probable that heart attacks and strokes will occur on the mat.

In the past four years there have been at least two incidents where aikidoka have experienced cardiac crises on the mat that resulted in respiratory arrest and pulselessness; in other words, the person stopped breathing and the heart stopped beating.

In one instance the person was in good cardiovascular condition and had no known history of cardiovascular disease. He was a runner. While being an uke for a kyu examination, and in the middle of an attack, he fell to the mat. Some people thought that he had injured his leg or arm, but to others it was clear that he wasn't coherent and after about fifteen seconds he lost consciousness. While two physicians initiated CPR (cardiopulmonary resuscitation) the expressions on the faces of the bystanders revealed a very high level of discomfort. It is likely they had never seen a person "die" as they stood by shocked and helpless. Soon the paramedics arrived, our friend received multiple electrical shocks and medication, and after what seemed an eternity, he started to breathe and his heart began to beat. After three days in intensive care he woke up. He is still practicing Aikido today.

The second case involved an individual with a history of asthma who was practicing in moderation. He was sitting in seiza when he suddenly slumped over. He was very lucky to have medical professionals present, including a cardiovascular surgeon (i.e. a heart surgeon) and cardiac nurses. As in the first story, he was resuscitated and is practicing Aikido today. These two stories both illustrated a significant statistic: bystander initiated CPR results in recovery for about 15% of individuals who experience a heart attack.

These two stories have a common theme and teach an important lesson: accidents do happen and properly trained people can save lives. In addition, a trained person on the scene can prevent significant damage after an injury that might be inflicted inadvertently by well-intentioned but untrained lay people. It should not be forgotten that moving somebody with a possible neck injury, trying to reduce (or reverse) a dislocated joint, or realigning a fracture all may result in making the injury worse.

These incidents also suggest that instructors should be properly trained in first aid. Some courses have already been offered at major seminars and more are planned. Instructors could also consider offering first aid course at their dojos. Regardless of where training is offered, however, basic life support certification and first aid certification are achievable by everybody. Listed below are web sites containing information on how and where courses are available.

The Aikido community has a responsibility to care for its practitioners. If we put this together with what Clint Eastwood said in one of his film roles, "a man must know his limitations", we come out with a prescription for action. Aikido contributes to our quality of life in many ways; we should work to never let it become a threat to our lives.

Note: Sources of information about risks of heart attack or stroke, as well as information about courses on first aid and CPR: American Red Cross at www.redcross.org and the American Heart Association at www.americanheart.org.