I'm a skeptic.  When I studied philosophy, I called myself an empiricist.  Essentially, I don't believe in things unless they're proven.  This is especially true when it comes to medical fads:  vitamins, supplements, dietary changes, alternative medicine - you name it.  Unless I can see some double blind studies that show solid evidence of their efficacy, count me out.  

Of course sometimes my skepticism goes too far.  I like to think that I'm well-read and well-informed, but the reality is, you can't know everything, no matter how hard you try.  So what about the things you don't know about?  Me, I try to do the research, but it's usually only after I bump into these unknowns in some way or another.  

This was the case with Osteopathy.  I knew Karen's son (Victor) and daughter (Sabrina)  had enrolled in medical school and I knew that each of their schools specialized in Osteopathy.  From my rudimentary understanding at the time, it seemed like it had something to do with manual manipulation to supplement standard medical care - something like chiropractic.  But, since it didn't affect me, I didn't pay much attention.  

Fast forward a couple of years.  It's the day after Christmas and I'm surfing with a couple of friends on the north coast.  Perfect morning, excellent uncrowded waves, good company.  I climbed the cliff, drove home, and took a shower.  Within an hour, I couldn't raise my right arm. The funny thing was that I couldn't remember hurting myself in the surf.  Sure there were some tough duck dives and a few rail grabs, but usually I know when I've pulled something.  Not this time.  

It was officially a holiday and I knew my sports-med doc wouldn't be available so I went with the standard RICE treatment (Rest, Ice, Compression, and Elevation).  I also loaded up on Ibuprofen. The next day it was worse, not better.  I called the Doc's office and found out they were closed until after the first of the year.  I called back-up sports-med docs and all were out for the rest of the year as well.  All I could do was continue my RICE treatment.  

At one point, I tried some stretching, but no luck.  I had to eat left-handed, drive with one hand - do everything left handed - I couldn't raise my arm more than an inch or two and then, only with extreme pain.  

Of course I went to the internet and quickly determined that the main area of pain was the coracoid process with radiating pain into the scapula and bicep, but I was unable to find anything that seemed to relate to my specific problem.

The following weekend, Karen and I were on a call with Karen's daughter, Sabrina (who now runs Resilience Health in Eugene, Oregon) and soon-to-be son-in-law, Steve (another Osteopath focusing on Family Medicine).  I described my problem and Sabrina proposed the following: "Lie on your back. Have my Mom put the index finger of her right hand on your coracoid process and simultaneously lift your right arm into a fainting woman's position - palm outward on your forehead.  Have her re-position the arm until you have minimal pain in the coracoid process. Have her hold that position for ninety seconds.  Then have her return your arm to your side and rest for five or ten minutes."  

We did as she asked.  Ten minutes later, I sat up and raised my arm to shoulder level.   After an hour, I could raise my arm over my head with zero pain.  Later that afternoon, Karen and I were Salsa dancing at Salsa by the Sea and I had no recurring problems.

In between we called her back and she explained how this worked.  I'm not an Osteopath, so I'll paraphrase.  Basically, sometimes nerves send bad signals to the brain and the brain reinforces a problem by trying to fix it.  Swelling and pain may increase and your body gets into a feedback loop.  The technique she used is called Counterstrain.  The pressure on the specific point and re-positioning sends a reset signal to the brain allowing the body to move on.  It certainly worked for me.   After a week with a paralyzed arm, this instant recovery seemed truly miraculous.  

As I often do when I find something new, I went crazy doing research into Osteopathy.  I discovered that Osteopathic physicians are regular physicians - they can do family medicine, psychiatry, surgery - anything an 'Allopathic' doctor can do.   But, during medical school, in addition to the standard medical training, they study Osteopathy.  They also are trained to do more holistic evaluation and treatment of patients, focusing on causes, not just treating symptoms.  Osteopaths try to tap into the body's ability to heal itself before moving on to more aggressive treatments.  Officially Osteopathy is:

a system of complementary medicine involving the treatment of medical disorders through the manipulation and massage of the skeleton and musculature.

You can recognize Osteopaths by the 'DO' after their names as opposed to an 'MD' for an Allopathic doctor.  

A year and a half after that first incident, I was surfing the same spot. I pulled into a barrel which collapsed on me.  I held onto my board and felt my left shoulder tear.  By time I got my wetsuit off, my shoulder had swollen to the size of a grapefruit.  I raced home.

Fortunately, Karen's son, Victor, an Osteopath who focuses on Neuromuscular Medicine and now runs Seek Optimal Health with his wife Lee Ann (also a gifted Osteopath specializing in Neuromuscular Medicine), was visiting.  He stretched me out and started working on me.  He discovered (without an MRI), a small rotator cuff tear and a misalignment.  He treated me for about 45 minutes (most of it was painful), after which he explained that he had opened up passages (my word) to release the built up fluid (swelling), and had re-positioned my shoulder and upper back.  He suggested I follow up with RICE and Ibuprofen for 3 days after which time I could get back in the water.

As I got up, I discovered that at least 90% of the swelling was gone as was most of the pain.  I followed his advice and sure enough, 3 days later, I was back in the water.  

In the years since, Osteopathy has become a regular part of my treatment for acute injuries.  It has proven very effective, especially when combined with good physical therapy.  Most Osteopaths suggest regular treatment to keep the body aligned and fluids flowing.  I haven't gone that far yet, but I may well be on my way.  

If you're like me and injure yourself from time to time, I strongly suggest consulting an Osteopath. Of course, check to see if your family doctor or Sports Medicine expert is a DO.  I think you'll be pleased to find that miracles still exist in modern medicine.  

It was a spectacular day on the north coast.  A friend I hadn't seen in years came up to surf with me and there were only four of us out in perfect shoulder-high waves with a few plus sets.  An hour into the session, I raced down the line hoping for a barrel in the section ahead, but at the last second, the water under the section drained with the dropping tide and I tried to turn down and out. 

Unfortunately, the back rail of my board hung up and did an el-rollo with my foot while my knee went in the opposite direction.  I felt a major tearing.  I paddled back into the lineup and talked to the physical therapist who was surfing with us.  He suggested that from the symptoms, it was a MCL tear - one of the most common surfing injuries.  He also said that if the injury didn't involve other ligaments or the meniscus, it likely wouldn't need surgery.  

Ironically, a few minutes later, my friend hurt his back, so we hobbled up the cliff together, disappointed at the number of uncrowded perfect waves we were going to miss.  

I raced home, showered, iced, and elevated my leg, then waited patiently for the arrival of Karen's son and daughter-in-law, both Osteopaths and specialists in Neuromuscular Medicine. They were planning to spend part of the weekend with us.  Two rounds of disc golf were scheduled for the next day and I envisioned being able to play.   Little did I know.

By the fifth week, I was feeling pretty good.  The swelling was almost completely gone and although my knee would get stiff if I sat for a while, doing the passive knee extension and flexion after getting up seemed to work well.  I bought a brace with a strap, and decided to try to surf.  The strap is cool because you can wrap it around the weak parts of your knee to provide much more support.  It stretches so you can make it really tight and it velcros to itself.  

I paddled out into easy, mushy rights and lefts.  My first wave was a right (backside for me), and as I started my bottom turn, I felt my knee give and pull.  It hurt like hell but the pain subsided quickly,  I decided to try a left and had no pain at all until I did an aggressive cutback.  I stuck with lefts for the next hour and surfed cautiously.  Unfortunately, I discovered that when you duck a wave, the wave pulls at your legs, sometimes to the side, and when that happened it definitely hurt.  I was sore after the session but I was glad to have surfed.  Still, I knew I wasn't ready.  It wouldn't take much to re-injure my knee in the surf.  Anything unforeseen would do real damage.  

I worked hard with the exercises and the gym the following week and tried again.  This time the waves were small but quick and mostly lefts.  I had a great time until I tried a right.  Again, driving off the back leg hurt.  It wasn't unstable like it was the week before, but still.  

It's now been eight weeks.  This past week, I was able to make full backside bottom turns and aggressive cutbacks on my lefts.  I surfed four really fun days.  On the last day though, I punched through a large set and got tossed around by the last wave.  I really felt it in my knee.  It didn't tear, wasn't any worse later, but I know that I can't let up on the strengthening exercises.  I still have a ways to go for 'full recovery'.  In the meantime, I can hike, dance, and play disc golf (took 4th in a tournament yesterday with no pain).  

Mistakes I made.

Realistically, Karen's son was right.  It's going to be 12 weeks for full recovery, particularly for surfing.  I seriously underestimated how much inward force you put on your knee in a backside turn or frontside cutback.  I seriously underestimated the force of the ocean, which is a very stupid thing to do.  And at the beginning, I tried to do too much too soon.  I'd try to push walking and tried to do the harder strengthening exercises when I wasn't ready.  Each time I did, it set me back a couple of days with renewed swelling and loss of flexibility.  

Overall though, I'm almost there.  Still, perhaps you can avoid some of the mistakes I made.

Set your expectations - it's going to take longer than you think.
Don't do too much too soon.  Be very cautious as you restart any activity.
Spend the extra for the best brace possible.

And, I think the main reason for my successful recovery is the dedication to the daily (or more) stretching exercises, and consistent and progressive strengthening exercises.  

The good news is that if it's an MCL tear with no other damage, you can rehab it yourself. But above all, you need Patience, Patience, Patience!

Update January 2018.

It's been a year and a half since I first injured my MCL as described above.  The rehab program worked, and I was back to full activity with maximal stress (surfing, extreme skiing, etc.) within 4 months (with a lot of hard work in rehabbing it).  Everything seemed fine and then, six weeks ago, while Salsa dancing on a rough surface, my foot caught in a fast turn and I felt my MCL pull.  It was too painful to continue dancing so I stopped.  By time I got home, my knee was hugely swollen.  I started the RICE treatment, but underestimated the severity of the injury.  Yes, it was only a grade 1 injury - there was no looseness under the Valgus test, but almost any activity caused huge swelling.  I consulted my muscular medicine doc and he informed me that re-injuries are often worse from the point of view of healing time.  Unfortunately, he was right. 

I hate being sidelined from the surf during one of the best seasons we've had in years.  And, not being able to run, dance, ski, etc. is depressing at this time of year.  

So here I am, six weeks later.  The pain is gone.  Most of the range of motion has returned (with lots of stretching), and I'm working on strengthening.  The plyometric exercises are still tough.  I did try surfing and easy front side is okay but I can tell I'm not quite ready for more aggressive turns.  I will be giving skiing a shot this week (now that there's a bit of snow in the Sierra).  In the meantime, I'm working hard on the strengthening and I now realize that to avoid re-re-injuring my knee, I need to keep up these exercises even after I'm back to 100%.  They're going to become part of my daily routine, much like core strengthening has.  Core strenghthening  resolved all of my back problems and I expect I can avoid further knee injuries if I keep up these knee exercises too.  

So, a final word of advice.  Once you're back to normal, don't stop your strengthening and range of motion exercises.  Do them regularly and hopefully, you can avoid a re-injury that will sideline you for several weeks.

If you liked this blog, please check out my novels.
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When Karen's beloved Subaru died three years ago, we knew we needed a new car.  Since my Audi could handle long distance and snow trips, we decided to go with an electric car.  It's primary use would be to take me up the coast to surf so a Tesla was out of the question: there was no way I was going to leave a Tesla on the side of Highway 1.  

​Aside from the Tesla,  the Ford Focus Electric was the best looking Electric Vehicle (EV) and had the best range.  Knowing technology would improve dramatically, we decided to do a three year lease.  For more on our initial impressions and experiences with driving an electric vehicle, see my post Our #EV (Electric Vehicle) Pros and Cons.  

​Three years have passed and we've loved our Focus.  Yes, there have been times where range anxiety took its toll, but after understanding its limitations, we realized that even with that limited range, we could do 80-90% of our driving in the Focus.   We were looking forward to a Focus with better range once our lease expired.

Unfortunately, as of early 2016 Ford had done little to improve the Focus's range.  So, knowing our lease was expiring in November, we were excited to hear that the Chevy Bolt, with a 238 mile range, would be available by the end of the year.  

I read the reviews and looked at videos of the first test drives by the various car publications and it looked like there were some great enhancements to the EV drive train.  Even better, it appeared that the official 238 mile range is a conservative estimate.  Several of the test drivers went much further, even with mostly highway driving (note that EVs get better range in the city than on higways).  

I looked at Chevy dealers in the immediate Bay Area and it appeared that Capitol Chevrolet had the best reviews and seemed to have the most inventory.  I contacted them in the spring, and Kevin Rodriguez told me that the dealers didn't know much about the Bolt but that he would keep me informed.  In August, he let me know that they would be able to take orders in November with some limited deliveries in December.  He said he could also now put me on a wait list for a Bolt.

In September, he reached out to inform me that they could take orders sometime in October - things were moving more quickly than expected.  Then, on Friday, I got the good news:  we could place an order on Monday.  And sure enough, he and his GM, Scott Jobe, made ordering the newest electric car a smooth, painless process.  

Since I haven't seen pricing for the Bolt and its options anywhere on the web, I thought I'd include them in this post.

The base model, the LT, at $37,495, comes with what you'd expect in a modern vehicle.  It includes a rear vision camera, a 10.2 inch touch console for car systems, entertainment, and EV information, keyless open and start, climate control, etc.  Its phone interface allows you to run music, apps, and Google Maps from your phone on the console.

The  Premier model, at $41,780, adds a rear mirror camera, surround vision where images from 4 cameras show the front, sides and rear of the car, roof rails, leather seats and steering wheel, front and rear heated seats and steering wheel, lane change alert, parking assist, rear traffic alert, and more.  

Options include a Fast charging port ($750), the infotainment system ($485) with premium quality audio, wireless device charging, 4G LTE hotspot, and additional USB ports, and the driver confidence package.  The driver confidence package ($495) includes front collision alert, optional automatic braking, lane assist, and Intellibeam headlights.  

GM has officially confirmed our order order and has promised regular updates as our car moves through the build process.  Scott told us to expect delivery in January but said he had hopes that we'd see our car before the end of the year - so far GM is beating expectation on their dates.  As soon as we get it, I'll post again to give you our first impressions of the new Bolt.   

Update - blogs about our new Chevy Bolt:

Chevy Bolt vs Ford Focus EV - First Impressions
We Love our new Chevy Bolt!
Our Bolt EV's First Longer Trip and Fast Charging Surprises
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