Monday, October 7, 2019

Injury Prevention in Grappling Sports - Part VB

Over the last 2 weeks, we have been discussing knee and hip injuries in grappling sports.  This was not an all inclusive list but did outline some of the most common injuries we encounter.  Although all injuries can not be prevented, there are things that we can do that will help prevent a majority of injuries. 

As much as many of us despise warm-ups, these are an important part of prevention.  This is even more important for the more mature grappler (older guy).  Having good mobility and range of motion is an essential part to preventing injuries.  If you do not have the appropriate amount of hip range of motion and adductor flexibility, you will increase your risk for a groin/adductor strain when someone does a hard knee slide pass on you.  This week we will discuss mobility exercises to put into your warmup that will help to maintain full range of motion. 

As with any stretch and if possible, these are great to do at the conclusion of your warm-up.  Having an elevated core body temperature will be beneficial to getting greater range of motion with your stretches and mobility exercises. 

Adductor stretch: I am a fan of the adductor stretch in kneeling versus standing and butterfly.  Performing this in the kneeling position allows you to use your body weight to stretch and the position you are hips and knee are in are more specific to the sport (versus standing position).

Using the picture here, you can stretch the adductor on the stance leg.  By moving the hips forward and back, you can hit different components of the muscle belly.  I would follow this by placing the knee on the mat then focus on stretching the opposite side in this kneeling position.  Again moving the hips forward and back will hit varying areas of the muscle.  I would repeat this cycle on the opposite side.

Dynamic Lunge:  This is a dynamic stretch that we do with most of our sports.  This is a great full kinetic chain stretch as this will work on increased hip motion in flexion and extension, spinal motion and ankle motion.  Since this is done with movement and in full weight bearing, you will see a quicker impact on range of motion versus traditional static stretching.  One key that you should pay attention to (which is pointed out in the video) is that you need to make sure you are not allowing your knee to go in toward midline when you step through or as you go through the movement.  If you allow this to happen, this will continue to contribute to some of the common weaknesses that we see that put athletes at risk for lower limb injuries.

I usually recommend this as a great preventative tool but also for those that are coming back from an injury.  Typically we will have them lunge down the length of the mats and back.  This is typically done before drills and live rolling. 

Dynamic Sumo:  This is another dynamic stretch that we do with a lot of our sports.  This is another great movement which works the whole kinetic chain.  This will focus a lot on hamstrings, lumbar spine and calves.  One key to keep in mind is during the push-up phase of this motion.  When doing this, make sure to keep the abs tight and walk it out to a hip and spine neutral position.  As you raise one foot up to push up, do not allow rotation at the spine and do not raise your hips up in the air.  With the toe up portion, make sure to keep your knees straight and walk up as far as you can to your hands.

I usually recommend this not only as a prevention exercise but also a great exercise for someone returning from hamstring strains.  This dynamic motion works on the full range of motion of the hamstring while also bringing in the core component which is essential.  Proper core strength helps to stabilize the pelvis so that the hamstrings can pull on it without becoming strained.  Usually I will have them perform down the mat and return to complete.

Hip Adductor Hamstring stretch:  This particular stretch is really good for working hip extension and opposite side flexion.  Since this is a position that are limbs get into a lot, creating mobility and flexibility in these opposing positions works well.  As pictured here, one leg is in the adducted position with the knee bent and the opposite leg is out straight.  Not shown in the picture is that I would have the toes pointing up to focus on the hamstring.  I will usually alternate from reaching out to the toes on the extended leg, which increases the stretch to the hamstring, and putting my chest toward the opposite knee, which increases the stretch to the adductor. 

With the two static stretches (pictures and not videos), it is important to NOT bounce when you get to the end range of motion.  This simply causes the muscle to contract which then limits the amount of motion you will get.  These should be held for 30 sec to 1 minute.  As you stretch, you should not feel pain but more of a deep stretch.  If you feel pain, simply back off the range slightly to relieve the pain and hold your stretch there.  Eventually you will be able to go to further and further ranges of motion. 

Next week, we will continue this discussion to talk about exercises you can do to prevent these injuries.  We hope you found this information valuable.   If you did enjoy, please share with your colleagues, training partners and BJJ enthusiast and please be sure to follow us on instagrm @ bjjpt_acl_guy and twitter @acl_prevention.  Train hard and stay well.  #ViPerformAMI #ACLPlayItSafe

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment and ACL injury prevention.  He is the founder | developer of the ViPerform AMI,  ViPerform AMI RTPlay, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject.  Trent has performed >5000 athletic movement assessments in the US and abroad.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams.  Trent has also been training in Brazilian Jiu Jitsu for 5 years and complete BJJ junkie. 

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