Monday, October 28, 2019

Injury Prevention in Grappling Sports - Part VD

Last week we began our discussion on exercises you can do to prevent lower limb injuries in grappling sports.  In this discussion, we talked about some hip strengthening, hamstring strengthening and core.  This week, we will continue that discussion by looking at some exercises for the core and knee.

Physioball Sit Ups and Obliques:  this is  great exercise for the core and I personally feel this one has a lot of carry over to my sweeps from guard.  Since doing these on a regular basis, I feel definite improvement in my bump sweeps and flower sweeps from guard. 

First thing is making sure your physio ball is the right size and inflation.  The majority of time that I see people do these at the gym, most of them are doing them with the wrong size of ball and/or wrong inflation.  When sitting on your ball, your knees and hips should be at 90 degrees.  With your weight on the ball, the ball should not deform too much.  You want some give to the ball (so not rock hard underneath you) but should not be so deflated that it deforms a lot under you.  One reason we use a ball is that the unstable surface of the ball increases core activation.  This means much more of the core is active to stabilize the ball.  With a properly inflated ball, there is less contact area with the floor which makes this more unstable.  The more deflated the ball is, the more contact area and more stable the ball is.

When performing the exercise, the feet should be close together and you roll your hips and butt back onto the ball.  This further decreases the area of stability and makes the ball more unstable and the exercise harder.  From the start position to the end position, there is not a large amount of trunk flexion that needs to occur (as depicted here).  Sitting up much further than this range kicks in your hip flexors and recruits less of your core.  The arms behind the head are just to ensure proper cervical position and should not be used to pull on the head.  Typically, I encourage folks to super set (do one set and move right into the next exercise) of sit ups followed by obliques (taking right elbow toward left hip and vice versa).  Typically I will have people start with 10 reps each direction for 3-4 sets and progress to 10 sets.

Single Leg Squat - single leg squats are a great exercise to help strengthen the quads and hamstrings and at the same time help us on execution of power and speed with shooting for single leg take downs.  This is also another exercise that I see done incorrectly all the time and when done incorrectly not only decrease the overall impact your training has on performance, it can actually cause you an injury. 

I am just going to say it and it is not going to be popular, but I am not a fan of the pistol squat.  For those of you that don't know what it is, good.  For those of you that do, sorry.  Functionally, there is no need for it.  Does it work your quads more, yes.  Does it carry over to sport more, no.  If you look at the position of the core and the contralateral limb (opposite leg) during the execution of the single leg squat shown above and the pistol squat, the position above mimics sport, running and shooting in for a take down much more than the pistol squat. 

The key to this exercise is to make sure you control the motion at your hips and your knee.  Do not allow your knee to go in toward midline (this is called valgus and is bad for your meniscus and ACL).  In addition, watch the position of your hips.  Your hips should not rotate out.  This puts a lot of stress on the hip joint and is commonly associated with core weakness.  When doing this exercise, should shoot for 2-3 sets of 10-15 reps.

Side Stepping with Theraband: This is a great exercise to strengthen your hips, quads and hamstrings.  For this exercise, you want to have a band around your ankles.  This band should be tight enough that when your feet are shoulder width apart, you get a fair amount of resistance from the band. 

While in a semi squatted position and your feet pointing straight ahead, start side stepping to your right.  Make sure you keep your feet pointing straight ahead the entire time and pick your opposite foot off the floor when you step to the advancing leg.  Keep in the semi squat position throughout the exercise.  Step 15 steps in one direction and then repeat in the opposite direction for 15 steps.  Make sure to remain in the squatting position the entire time.

This exercise focuses a lot on glut medius strength which is really important for preventing ACL injuries as well as meniscus injuries in this sport.  In addition, strengthening this position will have a positive impact on your scramble and your take down speed and power. 

Fatigue State Training (FST): FST is a concept that I developed several years ago to prevent injuries in sport.  In sports, if I have a routine that is too long, athletes and coaches are much less likely to include this in their practices and routines if the program takes too long.  Research indicates that if a a program takes more than 15-20 minutes, they are much less likely to do.  So how can I have a program that has the training volume need to create change and yet is efficient enough to be less than 15 minutes? 

What we found is that if we use the fatigue that you create in practice and then do the exercises at the end of your practice, that we get a better training effect with less exercise.  So instead of doing 3-4 sets of an exercise, now I only have to do 1-2 and I still get the same training effect (because you are tired).  At the same time, what we found is that by training in this fatigued state, this actually carries over more to your performance when you are fatigued.  What does that mean?  It means you are not only less likely to get injured, but you are moving better, faster and with more power.  In a match, this can be the difference from getting your hand raised or not.

So how do you incorporate FST into your training?  Considering all the exercises I described, what I recommend is pick your problem area (neck, shoulder, legs or back).  Pick the stretches to do before practice.  Show up 10 minutes early and do them.  At the conclusion of practice, take an additional 10-15 minutes to do 1 set of the key exercises for your problem in a fatigued state.  Do that after every practice and you will start to see some amazing results.

This concludes this series and I hope that you enjoyed it as much as I did.  I hope you found this information valuable and that it helps you keep on the mat.  Most people quit this sport as a result of injury, don't let it be you.   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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