Monday, September 24, 2012

Shoulder Locks Master Class

The core of all learning is the identification of similarities and differences. One of the four methods of identifying similarities and differences that has proven to be highly effective is classification. I have developed a classification of shoulder locking techniques.

A joint is where two bones meet. The glenohumeral (GH) joint, or shoulder joint, is where the head of the humerus of the upper arm meets the glenoid fossa of the scapula. The bony arrangement of the shoulder joint consists of a shallow socket (glenoid fossa) to which is joined the one-half-spherical head of the humerus. It has been likened to a golf ball (head of the humerus) on a golf-tee (glenoid fossa). Less than half of the humerus is in the socket at any one time, and the bony arrangement is therefore weak.

A mobility-stability continuum has been proposed for joints. The stability refers to the amount of force required to dislocate the joint. The shoulder is the most mobile joint in the body and is therefore the least stable joint in the body.

What do hammer lock, figure four lock, reverse figure four lock, key lock, reverse key lock, kimura, ude garami, gyaku ude garami, ude garami henka waza, stappado and 'Palistinian hanging' have in common? They are all techniques that are designed to move a subject's shoulder joint towards or beyond the limits of its range of motion. What are the differences between these techniques? This is where classification comes in.

The classification of shoulder locking techniques is based on the intended movement of the humerus. The initial principle of division is rotation or extension. Rotation refers to the turning of a bone around its own long axis. Extension refers to moving the arm straight back behind the body. The rotation locks can be subdivided into internal and external rotation. Internal rotation refers to rotary movement towards the midline of the body. External rotation refers to rotary movement away from the midline of the body. The internal rotation locks can be further subdivided into adducted and abducted arm positions. Adduct refers to movement towards the midline of the body. Abduct refers to movement away from the midline of the body.

Where do we start? We start with the Apley scratch test. The Apley scratch test is a test that is used to measure shoulder flexibility. The subject reaches behind their back from the top and bottom and tries to get the fingers of both hands to meet behind their back.

The lower hand in the Apley scratch test is used to test the internal rotation of the humerus in the shoulder joint. This position describes a basic shoulder lock that is often referred to as a hammer lock. It is also the classic police 'come along' technique. With this shoulder lock, the person’s hand is forced up between their shoulder blades.

Jan de Jong was not a fan of the abovementioned shoulder lock because of the flexibility of some people. Some people can reach up behind their back and touch their hair line without experiencing pain. In addition, the method of holding a person in this technique is relatively insecure.

De Jong taught what he called ude garami henka waza (variant arm entanglement). In this lock, uke's (person who the technique is done on) hand is placed in the crook of tori's (person doing the technique) elbow, and tori's hand is placed in the crook of uke's elbow. Tori then moves uke's hand away from uke's back while keeping uke's elbow stationary. This movement internally hyper-rotates uke's humerus in their shoulder joint.

As it turns out, De Jong's ude garami henka waza is relatively unique within the martial arts world. The more common technique is a variation of this technique taught by Jan de Jong but which was little understood in his school.

The variation is similar to ude garami henka waza because it goes by the same name and has similar hand positioning. It is different in that tori's hand is placed on uke's shoulder and uke's upper arm is lifted away from uke's back. This movement hyper-extends uke's shoulder rather than hyper-rotates it.

In both variations of ude garami henka waza, the forces applied encourage uke to move in a particular way. Rotate back towards tori in the original version and to bend over in the variation. In both cases, additional forces are applied to resist this tendency and maximally stress uke's shoulder joint.

Hyper-extending a subject's arm is a common method of torture. It was known as strappado during the medieval Inquisition and has mysteriously been called 'Palistian hanging' even though torture monitors say it is used neither by Israel nor the Palestinian Authority. The same techniques are seen in some jujutsu systems where the opponent is lying on the ground as both arms are hyper-extended above their shoulders.

The top hand in the Apley scratch test resembles what De Jong taught, and many others, as ude garami (arm entanglement). The arm is abducted, the elbow is flexed 90 degrees, and the hand is superior (above) the elbow. It's in a position that resembles waving 'hi' or signalling to stop. With this technique, uke's hand is rotated to the rear while the elbow is held stationary resulting in an external rotation of the humerus in the shoulder joint.

This ude garami is referred to by the same name in judo, and is also referred to as key lock and figure four lock. Reverse key lock, reverse figure four lock, kimura, and gyaku ude garami (reverse arm entanglement) are similar to ude garami in that tori's hand position is similar, uke's arm is abducted and their elbow is flexed at 90 degrees. They are different in that uke's hand is inferior to their elbow and movement when applying the lock results in an internal rotation of their humerus in the shoulder joint.

The abovementioned gyaku ude garami is similar to De Jong's ude garami henka waza in that both techniques result in internal rotation of the humerus in the shoulder joint. They are different in that in the former uke's arm is abducted while in the latter their arm is adducted.

When teaching these techniques in my 'shoulder lock master class', I have found it useful to use a maglite torch to simulate the humerus. The bulb represents the head of the humerus and cupping the bulb represents the shoulder joint. I then move the torch in the direction of the internal or external rotation, or extension, to illustrate the intention of the technique to the students. I have found this visualisation assists the students in applying the forces correctly when they execute the technique.

Four further things to note. Firstly, judo competition rules forbid any kansetsu waza (joint-locking technique) that targets any joint other than the elbow joint. They consider these techniques too dangerous for competition. They specifically allow ude garami and suggest it targets the elbow joint. Given the same arm configuration and force application is used by clinicians of various disciplines to test shoulder flexibility, it would appear the technique is designed to target the shoulder joint and not the elbow joint.

Secondly, there have been some, relatively few, who have attempted to anatomically describe certain locks. They incorrectly refer to hyper-flexion as being a mechanism of dislocation of the shoulder and/or elbow.

Thirdly, the classification is an ideal. When the techniques are applied, they may include both extension and rotation.

Lastly, other injuries other than shoulder dislocation have been reported. The kimura is named after a famous judoka who beat one of the founders of Gracie jiu-jitsu using this technique (gyaku ude garami). It is said that he broke Gracie's radius and ulna, and dislocated his elbow using this technique. Antonio Rodrigo Nogueira's humerus was reported to have been fractured by Frank Mir in a UFC match when the latter applied a kimura to the former. A person trained in Jan de Jong jujutsu engaged in security work applied the variation of the ude garami henka waza which resulted in a fractured humerus in the subject.

The last point is intended to head off criticism of the above classification and description based on reported injuries other than shoulder dislocations. Unfortunately, accurate and detailed reporting of injuries while executing these techniques has not been forthcoming to date. Given the shoulder flexibility tests, it is safe to assume the shoulder joint is the target of these techniques. It is open to correction, based on future studies, if other injuries are more likely when executing these techniques.

Sunday, September 16, 2012

Real Heroes Walk Away

A friend commented that I hadn't written a post recently. He is right. A lot of things have been going on that have left me bereft of inspiration, or interest in writing a post on anything. Today I thought I'd address this situation with a meditation on a newspaper article in relation to the one-punch deaths. is running a campaign against one-punch deaths called: Real Heroes Walk Away. Today's article is

Why refer to heroes? Why refer to someone who hit another person without the other's knowledge of the threat as cowards? After all, one of the most applauded military strategies is the ambush. The answer is the need to feel moral superiority.

Mystery of Courage should be mandatory reading for all. In this current militaristic age, is a pacifist or dissenter a hero or a coward? Given human beings' desperate need to belong and be accepted, these individuals are 'brave' in going against the common consensus. Those that follow the mob, often led by manipulative governments and common opinion, could be described as being not brave, or indeed, cowards.

I tend to adopt Oscar Wilde's viewpoint: Whenever people agree with me, I always think I must be wrong. This is not a bad litmus test to apply to one's opinions; as long as one has a modicum of intelligence that shapes their opinions. After all, as the saying goes, opinions are like arseholes; everyone has one.

The terms hero and coward say nothing about the person they are used to describe, but they tell us a great deal about the person who is using those words to describe others(or themselves). A hero walks away is telling others that we respect their behaviour if they walk away from violence. The underlying assumption behind the use of this phrase is that other's seek our respect and approval. It is a strategy that is not without merit, for us emotionally driven human beings. After all, the military have been using this strategy since time immemorial to get people to fight when nature implores them to flee. Warriors seek the approval and respect of their peers which overcomes their fear of injury or death. The military and the government use this need for approval and acceptance to fuel their military campaigns. And it is a very effective tool. But what happens when a person does not seek the approval or acceptance of society? What happens when they seek the approval and acceptance of their peers who applaud violence? Will the reference to heroes walking away reach them? Or will it drive them further away?

It is estimated that nearly 3500 Australians are hospitalised every year with brain injuries caused by assaults. The direct cost to the nation is $25 million a year. This is how you gain action in today's society. It's not by referring to the human cost, it is by quantifying the financial cost. This is not simply a cynical statement. Yesterday I read an article on the lack of funding for a particular neurological condition. An authority in the field explained that death happens so fast with the condition that it didn't have enough time to have a large financial impact on society. Consequently, very limited funding is provided to solve the 'problem.' After all, there is no problem; 'problem' being defined meaningfully in financial terms.

Six years on from the king hit death of his son, Matthew, Brisbane father Paul Stanley is still grappling with the reason why a young man chose to end his son’s life with a single, devastating punch. Stop wondering. The young man more than likely did not 'choose' to end anyone's life. 'Do I think that Matthew's killer actually meant to do it? I reckon probably not. That never went into his mind. They just do these things.' He probably didn't even 'choose' to throw the punch. Once we stop the emotional and judgemental discussion we can start to find real causes and real solutions.

Professor Gordian Fulde is head of emergency at St Vincent's Hospital, Darlinghurst. He's spent his whole adult life repairing the bloodied heads of battered and drunk young men. He remembers a time when a man would knock a man down in a bar then shake his hand, commending him on his efforts. That was that. He now operates on young men who have been kicked 12 times on the ground by 12 different boots. "We are not nice," Professor Fulde says. "We are animals. We kill each other."A psychologist friend uses the phrase 'cavemen in suits' to describe human beings. My research into our evolved survival process, along with an evolutionary perspective, confirms that we are indeed primitive beings who do not 'fit' with the modern environment we have created.

A stimulus in the environment is first appraised which can then elicit an emotion. So we need to look at how the stimulus is appraised. Now we are identifying an intervention that may control this type of anti-social behaviour. And now we also understand the full extent of the problem. The appraisal process is shaped by so many things, including societal and family values, norms, etc.

Should society intervene? Should society attempt to shape behaviour? A strong argument in favour of the affirmative would be based on the fact that the only requirement needed to be a parent is working sexual organs. Religious fundamentalists, political extremists, emotionally vulnerable and flawed human beings, can all produce children which they then play a major part in shaping who the adults these children become.

Movies and video games, violent rap music, etc are often blamed as causes of anti-social behaviour. It is suggested they shape the way we view environmental stimuli. But are they causes or are they mere reflections of society? I would argue the latter, but also that they can reinforce anti-social behaviour. They may not be the initial cause, but over time they can come to be. A self-fulfilling prophesy if you will. If we address the anti-social messages, we may not address the underlying issue(s) because the situation that caused these movies, video games, etc to reflect society may still exist.

An understanding of the evolved survival process identifies another possible intervention. The appraisal elicits a feeling response with an associated action tendency. The 'impulse to act' decouples the behavioural response from the feeling response and provides 'latency time' according to Scherer. This means that we are suppose to not be mere amoeba with a stimulus-response chain. The decoupling of feeling and behaviour responses is evolutionarily designed to provide us with the opportunity to consider an array of behavioural responses rather than just our primitive urge. Obviously, for some, they are more amoeba then they are the evolved human beings with decoupled feeling and behavioural responses. They have, in the modern vernacular, very limited impulse control.

The issue of choice, or the lack there of, goes to the very heart of the deterrence debate. You can have the most severe punishment in the world which is intended to deter certain types of behaviour, but if cognition does not influence behaviour it reduces the deterrent effect of harsher punishments. Anybody who argues differently simply has to answer the question: did you not king hit the innocent, unsuspecting person because you feared being sent to prison, or did you not hit the person because that is not who you are? If the answer is in the affirmative to the first question, there are more serious questions to be asked and answered than the deterrence value of harsher penalties.

What sort of environment turns little boys who want to grow up to be builders, firemen and aeroplane pilots into monsters and violent thugs who hide in dark corners like trapdoor spiders, striking out at and killing innocent people for no reason?"
They are not monsters nor thugs. Those are terms we use to describe others which says more about the describer than the describee. We may not understand or agree with their reasons, but they had reasons that made sense to them at the time. Lazarus emphasises that emotions are always logical and reasonable - to the person experiencing and acting on those emotions. If we understand that fact, and respect that fact, we then gain the possibility of addressing the issue that arises out of emotional responses. If we simply judge and demonise, we become part of the problem rather than part of the solution.

Now the Buddhist philosophy of being non-judgemental is raised. Being judgemental satisfies an emotional need in people, but it doesn't necessarily address the problem. However, a Buddhist approach cannot adopt the supreme moral high ground on this issue. Us cavemen in suits are driven by emotion. Shaming a person is a time honoured, cultural and proven method of shaping 'acceptable' behaviour. The Japanese culture was shaped in part by Buddhist philosophy, but it is also considered the archetypal shame culture.

Now let us in the West look down upon the primitive cultures that use shame to control their member's behaviour. Gilligan explains that based on his more than two decades of experience in prisons and prison hospitals, that the cause of most violence is shame. Shame arising out a lack of respect shown by others. The chain of causality is that a person or society 'disrespects' an individual which produces shame that is so painful that anger is used to cope with the pain resulting in violence. You can hardly watch an American movie these days without 'respect' being a core theme. 'Dis'ing someone is considered just cause to engage in violent behaviour.

Now we can have the conservatives looking down upon the morally repugnant, violent individuals who engage in violence to gain or defend respect. The same conservatives that engage in violence to defend honour, pride and patriotism.

The Navy SEAL instructor in GI Jane quotes D.H. Lawence: I never saw a wild thing sorry for itself. A bird will fall frozen dead from a bough without ever having felt sorry for itself. Courage, bravery, cowardice, respect, disrespect, honour, pride, patriotism - all man-made constructs. They are used to describe behaviour for our own benefit, or to control the behaviour of others. Belief in their moral virtue is essential for their effectiveness; but it is also the cause of violent and aggressive behaviour in itself. To point the finger at others is to point the finger at ourselves.

"It is my belief that if you decide to unlawfully assault a person, and that person dies ... the prosecution should not have to prove that you were reckless or negligent. They should not have to prove it wasn't an accident." Oh how I would love to be a lawyer. I would produce experts in the relatively new field that studies the cause of injuries. The mantra of injury science is often quoted as being: there are no accidents. Injury science originated with William Haddon and his work on injuries arising from car crashes. Note I referred to car crashes rather than car accidents. Injury science is objective and recognises that injuries do not occur by accident.

I've raised this issue before. A coroner suggested that all 'neck holds' used by law enforcement officers should be considered lethal weapons because they have the potential of lethality whenever they are used. The same can be said, with more authority, with punches and kicks. Now consider the consequences of this viewpoint. Lethal force can be used in response to lethal force. Therefore, if neck holds, punches and kicks are considered to be lethal force, lethal force can be applied to defend oneself. You punch me and I am legally entitled to kill you in my defence. In addition, all combative sports would have to be terminated because modern society, for the most part, does not condone gladiatorial, death sports.

What about the 'doctrine of consent'? We are allowed to punch the living daylights out of someone in a boxing ring or mma octongon. We are allowed to assault someone on the football field. Neither of these incidents will result in an assault charge due to the doctrine of consent. Leigh Matthews, one of the greatest AFL football players of all time, was convicted of assault when he king hit a Geelong player during a football match. What many do not know is that Matthews' conviction was overturned on appeal, due to the doctrine of consent. King hits are not part of the rules of football, but the law, in its infinite wisdom, has deemed them to be acceptable as part of the game. They game may be self regulated by the game authorities, but the law accepts this behaviour.

What message does the courts send to society in relation to king hits? It's ok to king hit someone as long as the person doesn't die. Even if they do, the punishment will be minimal because often it wasn't your punch that killed the person. It was their head hitting the ground that killed them. This is the reason for specific one-punch legislation.

How absurd is that argument? It reminds me of the explanation by Tom Cruise's character in Collateral when he is asked by Jamie Fox's character if he'd killed a particular individual. 'Max: You killed him? Vincent: No, I shot him. Bullets and the fall killed him.'

Western Australia is one of the few Australian states, if not the only one, that has specific one-punch legislation. Former state attorney general Jim McGinty said: If you throw a punch that results in death then that ought to be severely punished. So throwing a punch that has the very real potential of killing someone is ok-ish as long as they don't actually die? Isn't this rather a confused message? Is it simply bad luck if the person dies after you punch them, and therefore you get punished due to your bad luck rather than a criminal act?

Education is everything, says Bill McCormack. "Get at them in pre-school," he says. "These kids haven't got the skills to equip them for life. Once they get to grade six, you've lost them. "Most of them come from broken homes. Learning difficulties. They've been in trouble from the time they were 11 years old. "We need to educate a whole generation." I agree. But education comes from knowledge, and who has that knowledge? Many have the moral, judgemental opinion, but who possesses the objective, informed facts?

What can martial artists and martial arts instructors do? Educate themselves. Educate themselves on emotional intelligence (for want of a better term) in addition to the tactics and techniques of their martial art. They can also provide leadership to not only their students, but to society in general. This will not come about through sanctimonious, pious attitudes and superficial references to Taoist, Confucius or Buddhist philosophy, but to deep reflective study of emotion and the issues.

Just my thoughts for the day.