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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 3:38 am 
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I dont see any need to target the heart , as to the risks , I dont know

but I dont see whats to gain and I dont strike it in conditioning and I dont even hold a pad over it to give feedback.

similarly I wouldnt condition the kidneys and the liver , or the groin :roll: :? :lol: , or the throat .... im sure most would agree

I focus on the limbs predominantly and then to a lesser degree the body , but I work/strengthen all the muscles to build up the overall physicality.

Im a big fan of contact sparring for conditoning. I like sparring as a game and to develop skills between the cqb skills in the continuim.

another reason I would not strike the hear as its probably one of the worst places to get his as your caught in the centre and have little chance to naturally yeild anywhere except backwards , I dont want to program accepting force on a direct angle .

A level of conditoning and sparring covers most things, Im not concerned about any incidental strike becuase ive been hit so many times , and have never seen anything of the like happen , but intentional ... why take the risk?


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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 6:17 am 
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Good post Stryke.

To begin with…the dangers are there and are well documented so why take a chance. This is really critical to understand. Nothing may happen for a thousand hits, then on the next one you are dead.

But in free fighting we know we will be hit in the chest by kicks and punches and so some sort of 'toughening' of the rib cage and its connecting muscles is necessary, but as you also indicate this is best done with specialized weight training or other medium in a safe manner, avoiding 'chest thumping' that is dangerous.
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Imp a big fan of contact sparring for conditioning. I like sparring as a game and to develop skills between the cqb skills in the continuum.


True enough. When you think about it, training in martial arts presupposes close quarters engagement with opponents who are bearing down trying to kill you.

The karate practitioner who suddenly finds himself all alone, isolated in a serious confrontation, will require physical conditioning, courage, mental toughness, timing, power, speed, mobility and 'specificity principle' skills, or he will have problems.

Once a basic foundation is established, the training must reflect at some stage of it _the specific dynamics of engagement reflecting a survival street fight.

The right kind of conditioning drills will always be important, but it must be tested in the ring in order to optimize performance with a view to carry it over to the streets.

And the more demanding the free fighting and the less familiar the opponent and the environment, the greater the benefit to a student.

The need to simulate the actual event in training is critical. So contact sparring is as close to the real thing as we can get. Seems indispensable.

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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 6:50 am 
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We always avoided strikes over the heart for the very reasons stated in this thread.

What are the odds? :?

It only takes once. 8O

We get pounded lots, I don’t think missing that one spot is going to weaken us at all. :P

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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 8:54 am 
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In one sense it's good that this is so rare. On the other hand, because it's rare, we really don't know how much difference a defibrillator and someone knowledgable in CPR could make. I would guess they should be able to get the heart functioning again. I hope I never have to find out.

Statistically speaking, if there isn't an underlying cardiac issue, like genetics or heart disease, any correction of the circumstances that brought about cessation of heart function should return the heart to a functioning state in most cases. At least, that's my understanding from PALS, ACLS, and other medical training. The problem I could see is that it's possible the disruption from the chest contact is so absolute that no amount of CPR can bring about any electrical activity for the defibrillator to use. It won't shock Asystole (an absence of any electrical activity).

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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 3:20 pm 
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The problem I could see is that it's possible the disruption from the chest contact is so absolute that no amount of CPR can bring about any electrical activity for the defibrillator to use. It won't shock Asystole (an absence of any electrical activity).


This is the real fear out there, as there are reports of this possibility.
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Even worse, it seems to induce a from of cardiac arrest that is exceptionally resistant to resuscitation. The "stunned" heart muscle appears to be especially resistant to being shocked back into operation.

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 Post subject: Re: Commotio-cordis
PostPosted: Tue Mar 05, 2013 10:43 pm 
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I think that there possibly was a science of where and when to strike that has been lost over time. I believe that kung fu/karate etc was developed over many years and people just did things that worked and rejected things that didn't , over time such knowledge gets lost or misinterpreted, I've seen this with a few arts and styles. It's best though to do what you know works. many years ago an old judo man told me he had hit somebody in the chest this way, more to shock the guy, he said that you had to time it to your opponents breathing.


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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 4:28 am 
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If I were to target an opponent's chest with punches the impact points of choice would be the solar plexus and the areas just under the pectoral muscles using 'shovel hooks' ad or elbow strikes for a good chance to stop him.

I would not bank on causing commotio cordis for stoppage, even though there is a possibility, because the timing of rythm disruption must be exquisite.

My concern is allowing anyone to punch you in the chest for 'conditioning' reasons or other non descript reasons, because you run the risk that the very next punch will kill you.

Joe Graziano, a very strong and well conditioned student of the late Gushi sensei and also of Walter Mattson, whose sensei is Master Takara_ comes to my classes at the Bridgewater dojo, where we do much conditioning and impact training.

Tonight I asked him what Gushi sensei's views were on 'chest punching' for whatever reason, and he was quick to shake his head in replying ...no way...as Master Gushi warned against the CC possibility and other cardiac complications from the practice.

We also had Dr Mike Ross in the class tonight, and not only did he discourage the practice of getting hit in the chest or hitting students in the chest, he also said that when punching the abdomen we should stay away from punching the 'belly button' but to strike the sides of it where the longitudinal muscles are.

And Joe Graziano chimed in saying that master Gushi also taught to do it as Dr Ross indicated.

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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 5:13 am 
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Van Canna wrote:
Quote:
The problem I could see is that it's possible the disruption from the chest contact is so absolute that no amount of CPR can bring about any electrical activity for the defibrillator to use. It won't shock Asystole (an absence of any electrical activity).


This is the real fear out there, as there are reports of this possibility.
Quote:
Even worse, it seems to induce a from of cardiac arrest that is exceptionally resistant to resuscitation. The "stunned" heart muscle appears to be especially resistant to being shocked back into operation.


At some point, some brave doc is going to try to introduce electricity to the cycle manually. I dunno. There's got to be a treatment that can be figured out.

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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 5:40 am 
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Hello, Van! Sorry to take so long to come by. It's been a bit crazy lately at work. This being one of the worst flu seasons in years, they have me running 18 different experiments on getting people in a population to get vaccinated. And of course they want outcomes studies from each and every one of those "behavioral economics" experiments. Lots to learn and interesting stuff, but... Oy! 8O

Hope all you folks got your flu shots. It isn't too late. The H3N2 epidemic is waning, but now B Yamagata is making the rounds.

Back to cardiology - my research past.

- Bill


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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 6:08 am 
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Commotio cordis has been a favorite "exotic" topic for me. As a matter of background... After I finished graduate school, I did a 4 year research stint in the division of cardiology at UVa. My specialty was the relationship between regional blood flow patterns in the heart muscle (with various types of ischemia) and heart muscle contractility. I was in the lab doing open heart surgery (dogs) about 3 times a week, so I literally had lots of "hands on" experience with a beating heart.

Picture this... Some days when dissecting the blood vessels off the beating heart (to create artificial reduced coronary blood flow or complete occlusion), the act of just touching my hemostat on the heart would make it squirm as if tickled. Basically heart muscle is both "nerve" and muscle. It can start its own contraction by a wave of depolarization through the muscle, and has to be repolarized just like a neuron that has fired. Touching the hemostat could trigger a new cardiac cycle, starting at the point of contact and spreading from there.

When a heart muscle depolarizes and subsequently contracts, there is a latency period where it cannot depolarize again. It must "reset itself" through a chemical repolarization, like a battery recharging itself. At some point the latency period is over. But it doesn't happen everywhere in the heart all at once. Depolarization happens in a wave-like fashion, and repolarization follows in kind. So there is actually some part of the cardiac cycle where some of the heart muscle can be depolarized where other parts cannot. If and only if that "ready" part is triggered, everything gets out of synch. One part of the heart contracts while the other part cannot. Before you know it, it's like a long rowing skull with a dozen oarsmen where everyone has gotten out of synch and the oars are hitting each other. The label for the phenomenon is ventricular fibrillation. The only way out is to shock the heart, putting everything back in synch again. If you don't have a defibrillator, then you need to do CPR until someone gets one to the patient. And by the time that happens, the out-of-control heart can be so chemically exhausted that it may not convert.

If a hemostat touching the heart can cause it to start contracting at a point, then you can imagine that blunt force trauma on the outside of the chest wall can do the same. The force needs to be orders of magnitude greater than a hemostat touch, and it must be pretty much a point force (like the butt end of a lacrosse stick or a baseball hitting the chest wall). Obviously a well placed punch could do this.

This has already been mentioned before.

1) You have about a 10 millisecond window of time where part of the heart muscle is in the latency period whereas another part is ready to contract. And the part that is ready to contract must be near the chest wall.

2) You could never cause commotio cordis if you tried, unless you hook someone up to an EKG and have a machine fire a blunt object at the chest at just the right interval of time. These are laboratory conditions. You and I are not going to be able to pull this off on the street.

3) That said... if you make a habit of hitting thousands of chest walls in Sanchin testing over thousands of hours, one day you are going to hit the lottery and drop someone. It may happen 100 years from now, or it may happen on your next punch. You cannot predict it. But count on having your a$$ sued from here to kingdom come if you do it - assuming you don't also end up in jail. It's involuntary manslaughter, pure and simple.

How can you avoid it? Well the statistics reveal how. Who is most vulnerable? Young boys and teenagers playing sports. Why? Relatively thin chest walls. Thick chest walls act as low pass filters to blunt trauma. Thin chest walls? Not as much.

So...

1) Lift weights. That will build a thicker rib cage, and thicker pectoralis muscles. It also indirectly will make the osteoblasts in your bones deposit more calcium in them.

2) Do good breathing exercises. That will strengthen the intercostal muscles. Those are the muscles you eat in-between the ribs when you are eating a plate of barbecued ribs.

3) Learn to have a Sanchin torso - hard on the outside and soft on the inside. Like a good kicking shield, you should be able to release air when hit in the torso. This takes practice, but Sanchin is a good place to start.

4) Most importantly... try not to get hit in the chest. Period. I mean really... And don't go pounding people's chests in Sanchin. If you see it done, tell them to stop. And tell them I said they're morons for doing it. I don't care who it is, what color their skin is, what language they speak, and what extra long belt they have around their waist. Don't do it!!! And if you see this done and someone drops from it, you may call me as an expert witness. For the victim.

- Bill


Last edited by Bill Glasheen on Wed Mar 06, 2013 1:51 pm, edited 1 time in total.

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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 1:46 pm 
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Thank you Bill, for taking the time on this...what you write is really scary...
I just wonder why a number of Uechi masters have adopted the chest punching for either sanchin kitae or conditioning.

Since no explanation is really given for such a dangerous practice, students proceed on the assumption that there must be a safe reason for the teachers to do it, that we do not understand in modern times.

Dr Mike Ross, last night in class, specifically warned against striking the sternum because of easier shock wave transmission to the heart.

As to this latest flue strain, Bill, what the hell is it?

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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 2:01 pm 
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Van Canna wrote:
As to this latest flue strain, Bill, what the hell is it?


The really bad one that hit from about the 3rd week of December through most of January was predominantly H3N2. Mortality statistics from that wave of infection are still peaking beyond epidemic levels right now. As with most influenza strains, it is especially hard on the very young and the very old.

The new wave is actually an old one. It's a strain of B labeled "Yamagata" (as opposed to another variation going around labeled "Victoria") and actually had a little mini-wave in March of 2012 before flu season ended. It is rampant in Europe and Canada now, and spreading across the U.S. It isn't as bad as H3N2, but infants and the elderly are still at risk of hospitalization and death from it.

The good news is that almost all the strains of flu floating around this year are in the trivalent (3 strains) vaccine. The bad news is that - for some reason - the vaccine isn't working all that well in the elderly this year for H3N2. And nobody knows why. But even if there is "vaccine failure", there is still some protection. Typically people who have the vaccine and get influenza anyhow get milder cases. That happened in my household where influenza hit me and my boys during the Christmas holidays. We got sick, but did fine except for a couple of months of coughing. My oldest boy got the highest fever, but only because he got the vaccination too late.

- Bill


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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 2:08 pm 
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Van Canna wrote:
I just wonder why a number of Uechi masters have adopted the chest punching for either sanchin kitae or conditioning.

Since no explanation is really given for such a dangerous practice, students proceed on the assumption that there must be a safe reason for the teachers to do it, that we do not understand in modern times.


Given that none of these masters have taken physiology and/or have done open heart surgery, we have to assume that they're operating in an information vacuum.

"The practice" likely stems from "Sanchin checking." There's nothing wrong with checking the pectoralis muscles for tension to see that they and the lats are pulling the acromioclavicular joints down. And there's nothing wrong with some kote kitae and ashi kitae. But somewhere somebody got the idea that they could combine checking the pecs with beating on them. No, no, no!!!

You can clean with ammonia, and you can clean with bleach. But don't ever mix the two together. Same thing.

- Bill


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 Post subject: Re: Commotio-cordis
PostPosted: Wed Mar 06, 2013 3:26 pm 
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Thanks, Bill...hopefully the 'Sanchin vaccine' will protect us from Ms Yamagata's advances.
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"The practice" likely stems from "Sanchin checking." There's nothing wrong with checking the pectoralis muscles for tension to see that they and the lats are pulling the acromioclavicular joints down. And there's nothing wrong with some kote kitae and ashi kitae. But somewhere somebody got the idea that they could combine checking the pecs with beating on them. No, no, no!!!


How about if the punching impacts high on the sternum at the spot in between the pecs?

Dr Mike Ross, last night in class said it is even worse because the bone is a better conductor of the shock wave to the heart.

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 Post subject: Re: Commotio-cordis
PostPosted: Thu Mar 07, 2013 2:33 am 
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Van Canna wrote:
How about if the punching impacts high on the sternum at the spot in between the pecs?

Dr Mike Ross, last night in class said it is even worse because the bone is a better conductor of the shock wave to the heart.

Muscle, fat, and skin provide a better low pass filter to an impulse function than does bone. In other words... yes! :-)

It's also difficult to "condition" bone this way. We do a bit of that in our arm rubbing - assuming we rub ulnar bones on the extension and radial bones on the flexion. But the goal there is to build some connective tissue that covers the bone so we dampen the blow.

The thickness of the chest wall still helps. Lots of muscle tissue in-between and over top of those ribs does help to absorb some of the shock the way touching your finger on a guitar string can make the tone go away. But some energy makes it straight through to the other side of the sternum, and the heart isn't far from it.

So if you *must* get hit in a bad place, more muscle mass (hard on the outside) and an open epiglottis (soft on the inside) are key. The actual physics and physiology can be a bit nuanced, but the metaphors hold.

This brings me back to an old memory. Circa 1975 I was working with Rad Smith who was my first Uechi instructor. I think I must have asked an annoying question in class about the effectiveness of a technique, and so Rad was in a mood to break bad with me in partner exercises. For those who don't know the late Rad Smith... He was a sprinter and swimmer at Harvard, and he looked like it. After he got held up at knife point on a Boston subway over a leather jacket, Rad got his shodan from George with just one extremely intense year of training - and with Tomoyose Ryuko's blessing. Bob Campbell spoke of working with him, and said Rad was one of the strongest people he ever faced. (Rad would tell me though that Bobby always knew what he was going to do before he did it.) In any case... in a partner exercise during that class, Rad hit me in the sternum with a vertical fist punch so hard that it felt like all the air went out of me. It took about 5 years before I no longer felt that spot when weight training. (Muhammed Ali tells a similar story of having been hit hard in the chest during a match against a relative unknown.) I thought it was completely healed until a recent auto accident I experienced where the two vehicles involved were totaled. The air bag hit my chest, and Helllooooo!!!!!!! This time however it took much less time for me to rehabilitate myself.

Heart still ticking though... 8)

- Bill


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