Hip Resurfacing

[Green Cloud]

Hi all I'm going in for Surgery on my hip this weekend at Hospital for special surgery in Manhatten.

The adress is 535 East 70th st right off the FDR.

I will be in the hospital for several days so this is the last time I will be able to post anything till Monday unless I can sneak myself onto a computer at the hospital.

The reason for this thread is to share my experience with this innovative surgery and provide any info for other MA that have done extreme MA and might be in need of a hip replacement.

I will share my recovery on a daily basis and I invite any imput that anyone else might have to either movivate or help me with my recovery.

This is also a way for my friends and students to stay in touch with me.


greencloud.net

[BruceSteveRoy]

Good luck. Hope everything goes smoothly. Hopefully you wont come out from the anesthesia and in your semi-conscious state punch your surgeon in the throat because you think he is attacking you with a scalpel.

[Green Cloud]

Thanks bro, hopefully I'l be back kicking soon. Thanks to this new surgery that Sifu VA Thomas turned me on to I'l be able to. Tell Sifu Yim Tai that Gus sais hello:)

greencloud.net

[greencloudtj]

good luck sifu gus,

[neilhytholt]

Yeah, for people considering training and killing their joints, you should be aware that it's not like a painless thing and you have full mobility.

I know 2 people that had this thing done, one to their knee and one to their hip and they're still hobbling around. The knee one evidently isn't as bad, but the hip one even after 6 months the person's still hobbling around.

[greencloudtj]

always such positive people on this forum it's un reall

[Green Cloud]

Yeah, for people considering training and killing their joints, you should be aware that it's not like a painless thing and you have full mobility.

I know 2 people that had this thing done, one to their knee and one to their hip and they're still hobbling around. The knee one evidently isn't as bad, but the hip one even after 6 months the person's still hobbling around.


Yea it's a real ***** from what I hear altough I am only 39 and hope that my recovery will be quiker,and this is also a new cutting edge procedure.

[CLFNole]

My Dad had a hip replacement at 57 and was walking around the hospital the next day. He wasn't in any pain although the guy in the next room was moaning like a wounded dog. I think the whole thing comes down to how athletic you are and what kind of general shape you are in. My Dad said the pain was far worse prior to the surgery than after and he didn;t use much morphine or go to rehab classes at all.

Pops is real athletic and was a former hockey player, so since you do martial arts for a living I don't think you should have much problem.

[neilhytholt]

always such positive people on this forum it's un reall

Well the one lady was back at work a week later, and she's much better than she was, she's just still not 100%.

The reason I say this is that a lot of people these days seem to think that surgery can solve everything and they can do anything to their body they want and have little consequence.

It just isn't so. The reason this relates to martial arts is she destroyed her hip doing some type of dancing where she was doing the equivalent of a lot of like windmill kick motions.

So I'm just saying ... be careful.

Hopefully of course Green Cloud's will go better and he is younger (I think she's in her early 50s).

[kwaichang]

Are you having a total hip or what ??? KC

[Green Cloud]

Are you having a total hip or what ??? KC

No just the hip socket and ball joint, unless there are complications. The procedure is called hip resurfacing, as apposed to the normal hip replacement they don't cut as much of the bone away.

This surgery is also recomended for younger patients that are active.

And supposedly I'l have full range of motion.

birminghamhipresurfacing.com

[Green Cloud]

Yeah, for people considering training and killing their joints, you should be aware that it's not like a painless thing and you have full mobility.

I know 2 people that had this thing done, one to their knee and one to their hip and they're still hobbling around. The knee one evidently isn't as bad, but the hip one even after 6 months the person's still hobbling around.


Just to let you know, Kung Fu is not what did me in but a degenerative bone disorder that I was born with.

If it wasn't for Kung Fu I'd be in a wheel chair. But I guess all the butterfly kicks and flips didn't help not to mention the full contact I did in the 80's.

[neilhytholt]

Just to let you know, Kung Fu is not what did me in but a degenerative bone disorder that I was born with.

If it wasn't for Kung Fu I'd be in a wheel chair. But I guess all the butterfly kicks and flips didn't help not to mention the full contact I did in the 80's.

Well the one guy I met whose knee got done did a lot of stuff, rock climbing, sky diving, Hung Gar, motorcycle riding, you name it. I never found out what happened to his knee.

This woman (who had the hip done) is really banged up as well. She said she used to do a ton of mountaineering and stuff, and who knows what else, and then she got into competitive dance. I found out she's not in her 50s, she's in her 40s!!! She said she looks 10 years older because of her joint problems. (No, I did not ask her age, she volunteered that info).

Anyways sorry about your hip and I should not have said this. I just worry about kids that are messing themselves up. My grandmother's doctors are telling her she needs the same thing but in her shoulder but she doesn't want to get it done (she's in her mid 80s).

I hope it all goes well.

[Green Cloud]

Thanks Neil and don't worry I don't train kids the same way I used to train. back in those days it was more like hasing than teaching. I also received lots of cut kicks to the hip, even during practice it was always full contact with no protective gear.

[Green Cloud]

Tick Tock cant stop looking at the clock, I am getting pretty anxcious as I await my surgery. I know once I'm in the O.R. there is no going back and nothing will be the same again.

I know that how I handle the surgery afterwards will definatly define my character. I got to look at this like thraining for a fight, but I can't help thinking that I'd rather fight everyone on this forum with a blind fold on than have to go under the knife.

[BruceSteveRoy]

you only say that bc you dont have to face us all blindfolded. lol. but as far as going under the knife I am sure it will be fine. in the long run you will probably be very thankful that you did this and it will be worth the pain and rehab and whatnot. as long as they get the correct leg.

[BruceSteveRoy]

i just thought about my last post and realized how bad am i going to feel if they actually do get the wrong leg.

[yeshe]

Dear Sifu Gus
May the procedure go smoothly and may you make a fast
and complete recovery.
I have known people who have had full replacement surgery
report that the new parts woked better than the old ever did!
Medicie of today has the power to work miricles in this regard.
Imagine after a few months you might be able to side kick your mook jong in half!


P.S. I still aint had this chipped tooth fixed, Thanks

K.O.

[Green Cloud]

Thanks kenan, Sifu Ivan told me that you carry the chipped tooth with pride. Youre a good student and friend.

[Green Cloud]

i just thought about my last post and realized how bad am i going to feel if they actually do get the wring leg.


LOL you are too funny just when you put my mind at ease you give something else to worry about.:)

[BruceSteveRoy]

I have a great idea. Get a sharpie permanent marker and write "this is the correct leg" on the one getting fixed and "the other one dummy" on the leg not getting the work. also look into getting some extras put on. maybe some hydrolics or retractable spikes that come out of the hip. you'll just have to say "go go gadget leg" before each fight. ok i am done being stupid. i need to get some work done.

[TenTigers]

"we can rebuild it, make it stronger, faster, we have the technology"
Best wishes for a speedy recovery, Gus.

-Rik

[Green Cloud]

Thanks Rick, If you happen to be in china town and you happen to go to the wonton garden and just happen to buy some tender beef stew, I'l be on the fourth floor, room 450 the hospital is on East 70th st. York and FDR dr. ;)

Oh yea all peeps that happen to have Cha soo Bow or hog gow or anything of that sort are also welcome;) . It's funny all I can think about is Dim sum right now:D

[CLFLPstudent]

Best wishes and a speedy recovery Sifu Gus!!!

-David

[Green Cloud]

Thanks David make sure the guys don't slack off while I'm gone.

[richard sloan]

... I got to look at this like thraining for a fight...

wow amitabha, many blessings. you have the right attitude, that is for sure, because it is a fight.

I have no doubt you will come through stronger and better. Wonton Garden rocks!! We usually get some kind of gut soup there, but lately I have been devouring heaping plates of beef chow fun with black beans.

Try and eat spicy as you can, it will speed up everything. Hope you have a sweet young candystriper and endless spongebaths, lol...last time I went in I actually wished something more than a split lip was wrong with me, heh heh heh...

AMITABHA

[Indestructible]

http://news.yahoo.com/s/ap/20060615/ap_on_sc/artificial_hip;_ylt=Av7iHljkSCblEdVj0VwA23xxieAA;_ ylu=X3oDMTA4NmhocGZ1BHNlYwMxNzAw

Man has new hip resurfacing procedure

By CHERYL WITTENAUER, Associated Press WriterWed Jun 14, 10:24 PM ET

No way was Rick Jones going to be a couch potato. An athlete and youth coach who works out regularly, Jones dreams of someday hiking the Grand Canyon. A painful, arthritic hip started to slow him down, but at 52, he refused. Then he heard about a new surgical hip procedure that could restore his active lifestyle.

The procedure, using something called the Birmingham hip resurfacing system, won federal approval in May as an alternative to the total hip replacement for suitable candidates.

Last week, Jones, of Belleville, Ill., became the first person in the U.S. to have the system implanted. Nine days after his surgery, he's already walking a quarter-mile assisted by a crutch.

"My hopes are I'll be able to get back to running and playing tennis and racquetball and the kind of activities that require agility, speed and mobility that I used to have," Jones said.

Dr. Robert Barrack, an orthopedic surgeon at Barnes-Jewish Hospital in St. Louis, performed the surgery with the help of one of two British doctors who developed the system nine years ago.

It has been implanted in more than 60,000 patients in 26 countries, but until last week, never before in the U.S.

In total hip replacement surgery, which is still recommended for older patients, the top of the femur or thighbone is removed and replaced with a ball and stem. Over time, the stem tends to cause more bone loss and dislocations can occur as much as 5 percent of the time. That limits certain activities.

Such patients are usually advised to avoid yoga, aerobics or running, for example, or else they'd risk dislocation or early loosening, Barrack said.

But with this system, worn-out hip joints are resurfaced rather than completely replaced.

Some cartilage and only 10 percent of bone on the head of the femur is removed, the rest covered with a metal surface. The result is a more stable joint, with a risk of dislocation 10 times lower than with a total hip replacement. Patients also don't lose bone over time, and are at lower risk of fracture or weakening of the bone.

Barrack cautions that only 10 percent to 20 percent of patients are candidates for the Birmingham hip resurfacing system.

"You need good bone density to begin with, which eliminates older women for instance," he said.

Also not recommended for the procedure are patients with shortened legs or deformed hips from cartilage loss or arthritis.

"But for someone younger, who doesn't have a lot of deformity or leg shortening ... and who wants to return to an active lifestyle, this is the thing for them," Barrack said.

Barrack assisted with British surgeons to see the procedure for himself and gain experience.

He said it's the fastest-growing hip operation in Australia and Europe.

Since the St. Louis surgery on June 5, about 20 more U.S. patients have had the procedure.

Washington University School of Medicine, which is affiliated with Barnes-Jewish Hospital, will help collect data from the first 500 U.S. patients to have the procedure to spot and eliminate complications.

Jones, who learned of the procedure in January, said he was willing to wait for FDA approval as long as he had to. "Long term," he said, "it's so much better."

In 2003, the most recent year for which data were available, 325,000 people in the U.S. had either a partial or total hip replacement, according to the American Academy of Orthopedic Surgeons.

As the U.S. population ages, the number of such procedures is expected to increase by as much as 80 percent in the next 25 years.

[Jules]

We're thinking about you, Sifu! It should all be done by now. Hopefully you can post here soon and let us know how it all went. :D

~~Jules

[Green Cloud]

I just hacked into a compter at the hospital when no one was looking. The surgery was a success and I am already walking aeound on a walker. Can't stay on too long or I'l get caught.

tHE BIRMINGHAM RESURFACING IS THE BOMB.

[neilhytholt]

I just hacked into a compter at the hospital when no one was looking. The surgery was a success and I am already walking aeound on a walker. Can't stay on too long or I'l get caught.

tHE BIRMINGHAM RESURFACING IS THE BOMB.

Wow, that's really good. Guess you fared better than the other lady.

[Jules]

W00t! Awesomeness squared. So glad you're up and about. Keep us updated!

~~J

[greencloudtj]

glad all went well sifu,they havent thrown you out of the hospital yet hu lol talk to you soon

[Green Cloud]

CJURACKPT. yea just like I was telling you it is still experimental, I will be conting on your advise during my rehab so lets keep this thread going. While Ross is preparing for his fight I will be preparing for the fight of my life. Hopefully this surgery will help others that are in pain . Talk to you soo Joy gin.

[Jules]

Sifu, Lee couldn't get on the site, but she wanted to say Hi to you and wish you a speedy recovery. She's in China now, so I figured I'd just post this for her. ^_^

With luck, you should be getting out of the hospital pretty soon, yes? Can't wait till you're back!

~~J

[richard sloan]

awesome news.

start eating lots of vietnamese soup!!

especially the kind with tendon, and eat it as spicy as you can, lol...

amitabha!

[Oso]

I have a great idea. Get a sharpie permanent marker and write "this is the correct leg" on the one getting fixed and "the other one dummy" on the leg not getting the work. also look into getting some extras put on. maybe some hydrolics or retractable spikes that come out of the hip. you'll just have to say "go go gadget leg" before each fight. ok i am done being stupid. i need to get some work done.


that's actually not silly or stupid. When I had my shoulder work done last November they had me take a sharpie and write my initials on the shoulder that needed the work. I was like, '****, really?' and the nurse said it was just a precaution....the the dude with the foot long needle came in to stick that biotch in my neck!

Sifu Gus, definitely good luck and a speedy recovery. We are the same age and I've got a hip that gives me permanent low/mid grade pain daily so I'm definitely interested in how the process works for you.

[Green Cloud]

[QUOTE=richard sloan]awesome news.

start eating lots of vietnamese soup!!

especially the kind with tendon, and eat it as spicy as you can, lol...

amitabha![/QUOTE



Thanks for the advise, I've been stocking up on beef tendon soup. At the hospital I over dosed on Tender beef stew from the wonton garden.

I just couldn't stomack the hospital food so friends got me soup from there.

[Green Cloud]

Thanks for the support Oso, I've been in pain for 8 years and every year I watched my Martial skill deteriorate. I just kept on prolonging the surgery knowing that once I got a hip replacement that would be the end of my career.

A friend of mine and sort of older training Bro VA Thomas Told be about his surgery and he could pretty much do it all.

After that conversation and his pesistent lecturing every time I talked to him I finaly decided to do some research.

Finaly I narrowed it down to the Hospital for special sergery, the doctors name is Dr su. I didn't pick him because he's chinese that was just a coincident.

To date he has done 150 hip resufacing surgerys. If your hip ever gets worse I sugest going that route.

Anyway I started this thread as a sort of live testimonial and if all goes well I hope other MArtists that are suffering like me will get this surgey.

[Oso]

sounds about like me...had a distinct injury to the right hip in 99 on a 7 mile run (oh to be able to run again) that I never got really looked at and it's been degrading ever since.

looking forward to hearing about your recovery process.

if you don't mind my asking, how big are you? I'm 71" and have been over 200 since 1990 and spent most of the last 16 years around 225 except the last 2 as I've steadily increased.

[Green Cloud]

Dam Oso you sound like a big boy, I'm only 5'9 and fluxuate from 175 to 165 depends on if I'm training or not.

If you asking wether there are weight and hight requirements for this procedure, the answere is no.

Unless you are heavy for your size then the doctor might sak you to drop some weight.

Your health is also a factor, If you exercize and have good bone density than that makes you a good candidate for the surgery.

Remember this is not something that they recomend for older innactive people, usualy the full hip replacement works just fine.


greencloud.net

[Oso]

Yep, currently 253...down 9 pounds from a high of 262...the last six months since shoulder surgery have sucked....but started June 1 with the new 'plan' and have lost 7 pounds in 15 days...need to be back to at least 220.


but, yea, I was wondering if we were close to the same size...by your apparent experience I'd say you've being do martial arts somewhere around the same 2+ decades I have...in other words...the same level of wear and tear.

I know the increased weight has added to the degradation...just had a full physical and am otherwise fine...

but anyways, your thread...not trying to hijack...I'll be reading your recovery details in earnest.

good luck and a speedy recovery.

[Green Cloud]

The best thing to do is go in for a consult, I'ts not like it's a leap of faith or anything the procedure has been around seven years.

The best part is It's FDA aproved now wich means insurance covers it.

Once again I can understand one being cautious, that's why I'm posting so I can put your mind at ease. Just think of me as a guinny pig, I believe the failure rate is less than 2%.

[ShaolinTiger00]

best wishes and a speedy recovery.

[Green Cloud]

Thanks ST00

[Green Cloud]

My recovery time seems to be taking longer than I expected, I had the surgery on thursday and I am still in a whole lot of pain and that's with pain killers.

I'm not alarmed at the pain since Dr. Su warned be about it. Long term pain for long term gain. I'm not being a baby about the pain just honest.

The worst part are the pain meds, they just weaken the mind and spirit. I had them take me off the the demoral that was being injeted with a cathetor. I couldn't feel a thing, the problem was I couldn't move my legs.

They do it this way right out of surgery so you don't go into shock from the pain. Anyway I wanted off the hard core pain killers. This meant more pain for a longer period of time.

[Mook Jong]

Hey sifu, sorry to hear that. Hope you recover quickly.

[neilhytholt]

My recovery time seems to be taking longer than I expected, I had the surgery on thursday and I am still in a whole lot of pain and that's with pain killers.

I'm not alarmed at the pain since Dr. Su warned be about it. Long term pain for long term gain. I'm not being a baby about the pain just honest.

The worst part are the pain meds, they just weaken the mind and spirit. I had them take me off the the demoral that was being injeted with a cathetor. I couldn't feel a thing, the problem was I couldn't move my legs.

They do it this way right out of surgery so you don't go into shock from the pain. Anyway I wanted off the hard core pain killers. This meant more pain for a longer period of time.

Yeah, the lady that I know that had that thought she'd be back at work the next week.

But she was back within a week and a half, but I don't know if she was on meds or not.

So if her experience is the same as yours, you'll probably be back on your feet without a walker or anything in about another week. Not bad, eh?

[Green Cloud]

I started using my crutches last night witch felt pretty good. I've been doing Chi gung in liew of overdosing on pain killers. Deep breathing seems to work when I experience sharp pain.

I do as much as I can but I get tired after a hour or so, so I take frequent naps. Napping will eventualy be replaced with meditation.

I've also been using my bow flex and doing upper body stuff only and I make sure I never strain my hips. This type of exercise releases just enough endorphins in my body to keep me from getting depresed.

Sega play station is a must when stuck at home unfortunatly it's hard to play when loopy:(

[dougadam]

I hope everything goes well!

[Green Cloud]

Thanks, I started taking metrix about twice a day. there are other products out there that are beter if youre training for the UFC, but Metrix is awesome for rehabing after a surgery.

My recipee is vanila metrix mix with OJ and goes down like a smoothie em em good.

As far as meals I keep lite but eat more frequently, I basicaly eat beef broths, noodle soup, and ox tendon

[Green Cloud]

It's day 2 since I'm home the pain is starting to lessesn wich means less pain killers. I am still in pain when trying to move my right leg but as long I use the crutches it's ok.

The key thing during recovery is not to damage the ball joint while the bone is growing into the chrome ball joint. This will take aprox. 8 weeks so I can't afford to bear any weight on it till the bone calcifies.

This is crucial since this is about the time when accidents can accur and a break in the hip can happen this can be dissasterous.

Sitting seems to be a project since most of the stiches are on my backside. The other chalenge or should I say precaution is that for the next 8 weeks I have to make sure my hips are always higher than my knee. I need to make sure that I never have a 90% angle this can hurt me and cause a malfuction in the ball joint.

I've set up some bungees and devises so I can comfortably work out my upper body while in a chair. Of course the crutches offer a great upper body work out.

8:51 am and I'm bored out of my mind so I decided to start playing with my crutches. I remembered sifu chan showing us something with crutches so since I have nothing better to do I begin peacing the movements together.

If it sounds like of lost my mind keep in mind I'm still hopped up on drugs. If anyone else has any better suggestions I'm all ears

[im_dabich]

Good Luck hun I hope you have a speedy recovery.. :o

[Green Cloud]

Hey CJPT waass up hing dai, I had a bad day yesterday after overdoing it my knee swelled so I had to take it easy for the rest of the day. I am Feeling better today except I fell a bit nautious.

I can't wait to see ya unfortunatly I live about a hour east of Huntington, if you came out we would have to make the day out of it.

Hey what happen to Dave's training for a fight thread??? I blinked and then it was gone.

[richard sloan]

lol sounds like you are a perfect candidate for Halo II, and in 8 months Damo Cane...

one thing that helped my brother out immeasurably in the aftermath of his major surgery was keeping up his metabolism and keeping the blood flowing. SYM said this was all important and to eat eat eat. He also always kept on him to move and be as active as possible within reason. By the time my brother was ready for rehab he was already way beyond their regimen and they were amazed.

Makes sense since bloodflow is the mechanism that brings all the nutrients and takes away all the discard.

So if I understand this right, you have a metal socket now and the bone must grow some layers to secure a fit?- how do they get the bone- femur right? to stimulate new growth to fit the socket?

[Green Cloud]

Hey Rich how are you, as far as the procedure goes they just hammer it in on top of the ball joint after they shave the ball joint down to fit.

If you go to this link they show a picture of it. hipresurfacingcenter.com

[richard sloan]

wow- heavy duty.

security screeners are going to love you, lol...

[Green Cloud]

LOL yea I get a cool ID to go with my bionocs so I can get through security at air ports.

[Green Cloud]

It's saturday and the worst is over. I was having bad reactions to my meds so I decided to get off them.

Sounds easy but it's not, getting off the meds meant severe withdrawl symptoms. Feeling a lot better today and I'm off all the meds now I can start getting my focus back

[Green Cloud]

It,s six weeks since my surgery and I am recovering much faster than I thought.

I am now walking with a cane and have started working on my stances and Dr su who is my amazing surgeon has taken me off all restrictions.

The only thing I'm not allowed to do is high impact jumping. I started my PT and am working on developing my leg strength. Unfortunatly when undergoing this type of surgery the muscles atrophy fast and need some time to regain muscular control again.

I find that working on Chi Gung stretching, stance training for endurace, and ofcource the mundane task of working out with weights to develop muscle strength in my legs.

As far as my range of motion is concerned I have a better range of motion and it's only going to get better.

As far as kicking I'm like a beginer again in fact worse, but my doctor sais that's only temporary and should take about 3 to 6 months to regain my abilities.

Thank god for Kung Fu and it's wide variety of training tech. If I were a mixed MA guy Or a tae kwon do guy I'd be stuck to just weight training.

Since my style has a vast amount of fighting tech. I am actualy able to not only work out but also teach classes. I am simply working on basics stances with my students and working on long arm and short arm tech. Chi sao and trapping is my saving grace.

Iron palm training is something that doesn't require any impact on the legs and I am now incorporating it into my daily regiment.

Weapons training is something that doesn't require any high impact either, working on staff training helps work my upper body while helping me balace.

I don't mean to ramble but in the past I have had many debates with MMA guys about why kung fu is a very effective fighting style. Point being if I were a Jiu Jitsu guy I'd be stuck to PT due to the fact that rolling around would not be an option.

If I were to get attacked in the street my cane becomes a very effective weapon since it is part of ny system.

I'm not taking anything away from other styles but just pointing out the practical aspects of Kung Fu and why it's an all around effective style of MA, especialy when it come to injuries and age.


greencloud.net

greencloud.com

[Green Cloud]

Its six weeks since my surgery and I am recovering much faster than I thought.

I am now walking with a cane and have started working on my stances and Dr su who is my amazing surgeon has taken me off all restrictions.

The only thing I'm not allowed to do is high impact jumping. I started my PT and am working on developing my leg strength. Unfortunatly when undergoing this type of surgery the muscles atrophy fast and need some time to regain muscular control again.

I find that working on Chi Gung stretching, stance training for endurace, and of cource the mundane task of working out with weights to develop muscle strength in my legs.

As far as my range of motion is concerned I have a better range of motion and it's only going to get better.

As far as kicking I'm like a beginer again infact worse, but my doctor sais that's only temporary and should take about 3 to 6 months to regain my abilities.

Thank god for Kung Fu and it's wide variety of training tech. If I were a mixed MA guy Or a tae kwon do guy or some thing I'd be stuck to just weight training.

Since my style has a vast amount of fighting tech. I am actualy able to not only work out but also teach classes. I am simply working on basics stances with my students and working on long arm and short arm tech. Chi sao and trapping is my saving grace.

Iron palm training is something that doesn't require any impact on the legs and I am now incorporating it into my daily regiment.

Weapons training is something that doesn't require any high impact either, working on staff training helps work my upper body while helping me balace.

I don't mean to ramble but in the past I have had many debates with MMA guys about why kung fu is a very effective fighting style. Point being if I were a Jiu Jitsu guy I'd be stuck to PT due to the fact that rolling around would not be an option.

If I were to get attacked in the street my cane becomes a very effective weapon since it is part of ny system.

I'm not taking anything away from other styles but just pointing out the practical aspects of Kung Fu and why it's an all around effective style of MA, especialy when it come to injuries and age.