Do Martial Arts And Coumadin Mix?
I’ve not been blogging much lately because of work craziness and traveling. One of my recent travels, however, was not for work but for pleasure. I’ve been studying karate (a traditional Okinawan version called Shorin-Ryu) for over fifteen years. There’s a national federation to which I belong and there are seminars three or four times a year taught by some of our more senior instructors. This was one such seminar, and it focused on joint lock and grappling techniques, some of which our style shares in common with other martial arts such as Akido and Judo.
At one point I was working with a fifth-degree black belt instructor, “Bill.” Super nice guy, and absolutely amazing in his speed and techniques. He was also very kind in teaching me a number of useful tricks and nuances of the techniques we were working on. There was a sequence which culminated in a choke-hold, and he was unhappy with the manner in which I was choking him. We stood facing one another, and he demonstrated on me, reaching in with thumb and forefinger held claw-like and squeezing behind my trachea towards the base of my tongue. It really hurt. As he demonstrated, several other students gathered around to watch. While Bill held on to my throat, I reached out and mirrored the choke hold on his. “Is this right?” I asked.”Not quite,” says he, “You need to reach up more, like this.” He squeezed a bit harder and I nearly went to my knees. I adjusted my grip and squeezed some more. “Like this?”“Yeah, that’s about right,” he gasped in a somewhat strangled voice, increasing the pressure on my throat once more.So I responded by squeezing a bit more, and he did the same.
I could feel his internal carotid pulsations quite distinctly underneath my fingertips. We stood there, pained smiles on our faces, and looked at one another for a bit. An unspoken question hung in the air: “How long are we going to let this go on?” It was only a matter of time (seconds, in all likelihood) before one of us lost consciousness. It seemed like it lasted forever, but after a few moments, by mutual agreement we pushed one another off to general laughter.In karate seminars, it’s always funny to watch people hurting each other. I don’t know why.
That evening, back at the hotel, a large number of us went down to the hot tub to soak our bruises. The warm water soothed the pain, as did the beer we imbibed. I noticed Bill was not getting in the tub, but sitting by the side. I asked if he was not going to join us, and he demurred: “I can’t use hot tubs,” flashing a medic alert bracelet, “I have a heart condition and I am on coumadin.”It took a moment for this to sink in.
Coumadin is a powerful blood thinner, and something of a mixed blessing. If you are prone to life-threatening clots, it can be life-saving. But it has so many complications, usually in the bleeding line: bleeding ulcers, severe bruising, and significant sensitivity to even minor trauma. My mind flashed back to earlier when my fingers had been wrapped around his windpipe.”Holy crap!” I blurted out, “You’re on coumadin and you let me squeeze your trachea? Are you out of your mind? What’s your INR?”"2.8,” he responded, confirming that his blood was indeed adequately thinned. He laughed. “It’s no big deal. I don’t even bruise.”
It was true. He showed me his forearms, free of the bruises that were already flowering on my own. “My doctor says it’s OK for me to do karate. He brags about me all the time.”"I’m going to brag about you, too,” I responded. “But I still think getting into the hot tub probably wouldn’t have been the most dangerous thing you’ve done today.” He laughed and handed me another beer.I checked his throat the next day — not a mark to be seen. I tried not to be too mindful of his anticoagulation when we sparred, but it made no difference in any event — he kicked my ass so thoroughly that I never had a chance to injure him!It still makes me shake my head. Is there a worse possible hobby for someone on coumadin than martial arts? The mind reels.
*This blog post was originally published at Movin' Meat*
As a long-time martial artist and physician, I think Karate is a lousy choice for someone on Coumadin. Arts with less regular striking would seem to make more sense; Aikido and Jujitsu come to mind. Well practiced, Karate strikes can be devastating without anticoagulant! Admittedly, joint manipulations and throws can also be dangerous in the other arts, though in my experience with Aikido, ’softer’ (a true misnomer) styles can be dialed up and down depending on the practitioner’s needs; probably more easily than Karate. I have a 3rd Dan in Tang Soo Do, and when I was younger and more aggressive, I feel sure Coumadin would have been my death had I been taking it!