Posted by: chocolata | 19 March, 2010

Judo Therapy

Hi guys,

Have you heard the term ‘Judo therapy’ before?

Yes, it has something to do with the Japan’s traditional marshal art - Judo - now an Olympic event. What if I tell you that I’ve decided to see a Judo therapist in Japan for my further ATR treatment? Don’t worry! I haven’t gone mad (yet) and am not going to take Judo lessons as a means to cure my AT. ;-)

Judo therapists (JTs) are called ‘hone-tsugi’ (bone setter) in colloquial Japanese. They must acquire a state license and their treatment is covered by the national health-insurance program without a referral from a physician, since Judo therapy is understood to be proper medical treatment.

Judo therapists (JTs) use techniques similar to ones used by physiotherapists (PTs). For example, JTs provide “noninvasive treatment” to treat damage of bones, joints, muscles and soft tissues (including AT) without surgery. Juso therapy is based on Japanese traditional medicine and Judo therapy skills, which have been popular and trusted by peple from a long time ago, and Western medical knowledge as well. However, JTs are not allowed to run X-rays and operations on any parts of patients’ body and they have to refer patients to a doctor where necessary. One big difference between JTs and PTs is that JTs can run their own clinic, while PTs are not allowed to do so.

As you know, ‘Judo’ or ‘Jujutsu’ (art of softness, or way of yielding) is a collective name for Japanese martial art styles (originally including unarmed and armed techniques). It employed comprehensive combat techniques for defeating enemies, while the techniques were also used to cure the wounded. For instance, old Judo or Jujutsu masters cured injury which occurred during training and they were good osteopaths.  

After Kano Jigoro (1860-1938), the founder of Kodokan Judo, elaborated judo from Jujutsu in the Meiji Period (1868-1912), Judo masters appealed to the government to officially approve them to practice Judo therapy so that they could earn their living. Their requested was granted and the first Judo therapist license was issued in 1920. Nowadays, one doesn’t need to be a Judo master to be a Judo therapist, but lots of skills practiced by old Judo masters have been handed down over the years.

I’m now in the week 5 of my ATR treatment (non-surgical) and I can’t wait to see the Judo therapist I have contacted by email. His blog (in Japanese) includes some information about the treatment protocol he uses for his ATR patients and it is quite ‘aggressive’. The treatment is named ‘Hoko-ryoho’ (Walking Treatment). Patients are put in a series of special cut casts with a raised heel for about 6 weeks (with different angle ankle) and they are encouraged to walk ‘bowlegged’ from Day 1. They receive treatment using low frequency ultrasonic wave for the first 2-3 weeks after the injury to facilitate healing of their AT. Under this protocol, patients can do double leg toe raise in 3 months after ATR and single one in 5 months.

It’s obvious I cannot follow this protocol, but I’m glad I’ve found his clinic which is not very far from the flat I will be renting in Japan. I can tell from his blog that he is interested in improving his practice. He has been a great listener and has given me useful advice since I contacted him a week before. In the UK I have never had MRI and ultrasound scans to check exactly where and how badly I ruptured my AT and no examination was done by a doctor when they removed the previous cast before putting me in another cast. When I told my Judo therapist so, he understands my worries and has booked a MRI scan at a hospital near his clinic to examine my AT before starting the therapy, so that we can start my rehabilitation as soon as I return to Japan.

I’m also looking forward to my next appointment at the clinic in the UK because they will finally put me in a boot! Once in the boot, I will be on PWB and can carry a cup of coffee from one room to another room - one of my little dreams will come true. ;-)

Happy healing, and have a nice week, everyone!


this is very interesting to me as I’m going none surgical way.
I didn’t have MRI or Ultrasound.
Been told by doctor and PT that not much to see as MRI will show a blob and not much details.
And not many can read Ultrasound of AT - as it requires special skills to understand and explain results.
May be it’s just some restriction of my med insurance? I don’t know.
Also Ultrasound is not recommended to me for a while as treatment ether - area has to heal first.
Go figure.

Fascinating stuff, Chocolata! The judo therapists in Japan seem to inhabit a similar “ecological niche” to the Chiropractors in North America (and maybe elsewhere). Chiropractors have “cured” several members of my friends and family who have suffered for years with problems that resisted treatment by their “real” doctors. And they’ve also done some serious harm, like most health professionals.

I am also fascinating by your own “flavour” of daring (”derring-do” in the UK?): You are too cautious to apply a little Weight Bearing at 2 wks or 4 wks because your Doc doesn’t believe in it, but you’re happy to follow a judo program that you consider “aggressive”!

BTW, “double leg toe raise in 3 months after ATR and single one in 5 months” doesn’t sound “quite ‘aggressive’” to me. I was doing 2-leg heel raises (same thing, right?) several weeks earlier than 3 months, and I won’t be surprised to be doing the 1-legged ones before 5 months — though that latter landmark may be more of a stretch, judging by the last few weeks.

Finally, I’m with Mike on the MRI. I’ve heard too many horror stories about mis-diagnoses with MRI. At about 93 years old, my Dad was suddenly afflicted with the only serious (like excruciating!) back pain he’d ever had in his life. His docs sent him for MRI, which showed a terribly serious condition — bacterial infection of the spine, as I recall.

The bacteria didn’t show up on culture, but half of Dad’s experts were ready to do emergency surgery. The rest were hesitant largely because of his advanced age. By a week or two later, the pain seemed a bit less severe. At ONE month later and TWO months later, he was sent for repeat MRI scans. Each one was MUCH worse than the one before, just as the “let’s operate fast” doctors had feared and predicted. His kids and his doctors had a few really exciting conference calls, trying to decide what to do.

Meanwhile, Dad’s back pains had continued improving and in fact had completely gone away! He went home from the hospital soon after the third MRI, and never had another backache until he died of unrelated causes at 98!

I love information and knowledge, but I don’t think I WANT to KNOW what an MRI of my left AT would find — or my right one, for that matter!

BTW, one of the local experts on back pain — the media call him “The Back Doctor” — told a radio interviewer that we should all send our worst enemies for an MRI of their spines, because the MRI would find something terrible, but probably something that would never bother them otherwise!

If you make the expected progress toward your rehab goals and end up with strength and ROM that steadily approach your good-foot values, I’d personally assume that your AT also “looks” good! But that’s just me.

Chocolata, come back, and give us an update!