The past year has been rough for me. From November 2012 until probably September 2013, I had consistent pain from my lower back all the way up my spine to the base of my skull. I tried numerous therapy methods but nothing worked.
After the bed I had been sleeping on was replaced, the pain abated and I was able to roll again. But then I sprained my LCL (lateral collateral ligament). After a couple of weeks, I was able to roll normally with the BioSkin Hinged Knee Skin (review coming next week), but a shoulder injury took me off the mats again. Now, I’m back, following a couple of shots and the Bauerfeind OmoTrain brace, but I’m doing it right this time.
Dealing With the Injury and “Rehab”
I sought advice on how to recover from injury and prevent new injuries from strength and conditioning super genius, William Wayland (pictured below). My situation is not unique, so William agreed to answer a few questions to help all of us stay healthy.
William has had to rehabilitate his own injuries, but he’s also worked with clients who suffered from a variety of afflictions:
I’ve had athletes with torn ACLs, broken wrists, separated shoulders, torn LCLs, broken ribs, bulged discs, temporary paralysis, and of course, the occasional black eye. Obviously some call for longer layoffs, particularly Achilles tendon ruptures, pectoral tears, and disc injuries. I wouldn’t wish these on my worst enemy. BJJ and MMA athletes have a culture in which having something “niggle” is considered normal.
Sometimes what are worse than the physical injuries are the psychological aspects of being unable to train at full capacity. William explained:
Suffering an injury, especially when very serious, is akin to going through mourning in miniature – anger, depression and denial being hard for the athlete and coach to work through. Staying positive and drawing on experience is crucial. If you are optimistic, the athlete will be, too. I try when I can to work with an athlete’s physiotherapist and work their recommendations into what I do.
Unfortunately, William has had experience with clients whose physiotherapists are talented in rehabilitating injuries, but who don’t have a lot of performance knowledge. Rather than encouraging the athlete to try to work around injuries and continue to train using alternative exercises, some physiotherapists prescribe immobilization and avoidance. Said William, “I have had athletes telling me they shouldn’t squat, deadlift, or pick up anything heavier than a pint of beer thanks to physio ‘advice’.”
Instead, William recommends they do as much as is reasonable to try to avoid the development of weakness, as that will make the return to full training much harder:
Obviously adherence to rehab and approach on a case by case is important. Hand injured? Then do cross arm front squats and Zercher good mornings. Anterior knee injury? Then do stiff leg work and isolation work on the healthy leg. It’s been demonstrated that training uninjured limbs can decelerate loss of strength in injured limb. We have an adaptability protocol that allows injured athletes to work around problems. You might remember strongman Mark Felix hitting a 429lb one-handed deadlift while recovering from a biceps tear.
Check out this no-hands fighter workout:
Getting Back in the Game – Safely
Once the injury is healed, coming back full blast is the athlete’s biggest mistake, especially if he or she hasn’t done as William suggested and worked around the injury:
Repeat injury is the athlete’s worst nightmare. This is caused by a few things, but mainly due to a layoff. Often athletes, especially the recreational ones, do nothing. This obviously causes detraining and a systemic weakening of the whole body. Grave assumption comes when they jump back into training with the vigor that they had done in the past and something else breaks. The other issue is compensatory mechanisms that kick in, largely neurological. These are the body’s defense mechanisms to guard an area against re-injury, tightness, stiffness, and altered mechanics. This then throws force on to structures ill-equipped to deal with them and something else winds up hurt.
What can you do to ensure your recovery from injury is effective? William advised:
Get stronger. Seriously. Nothing guards against injury better than being strong. If a strength coach is doing his job right, then physios, sports therapists, and doctors should be without a lot to do. Pick exercises that require you to generate a lot of stability and bracing action. Hypertrophy has been disparaged a lot in recent years, seen largely as the domain of bodybuilders, however back and shoulder hypertrophy are worthwhile time investments for combat athletes. Dan John talks about “armour building” and I’m in agreement. Snatch grip deadlifts and RDLs, Zercher variations, and thick grip work and loaded carries are variations we lean on a lot. Strive for stiffness and mobility in the right places.
The other key is a proper recovery routine: ten to fifteen minutes post training, loosening out shortened tissues and tight hips, deloading the spine, and quick reestablishment of parasympathic dominance. Chronic elevation of cortisol for instance can keep inflammation markers high and dampen immune response, all potentially increasing injury risk.
Supplementing for Injury
I’ve been taking the Q5 Combat Krill Oil, Vitamin D and Joint Armour daily for about a year now and I found that my recent knee injury healed much faster than the knee injury I had a couple of years ago when I didn’t take supplements. I asked William what supplements he would recommend:
My main recommendation after many years, is still that a high quality fish-oil product is invaluable. I have discussed glucosamine and chondroitin in the past and my experience with usage, compounded by the science, is just not very compelling. Celadrin and curcumin are somewhat compelling, as is supplementary vitamin D and calcium for bones, but the science is all over the place. We are talking small margins, whereas effective training and recovery routines will do more for you than supplements can. Still, medicine offers us better solutions for acute problems. Chronic tendonitis for instance is best treated with a short course of ibuprofen purely, so the athlete can start moving again and rehabilitative and preventative work can begin.
When an athlete feels ready to begin training again, William’s advice is:
Don’t be a hero, but don’t be a coward either! This depends on the injury, and it should always be a gradual approach. General conditioning should be built back into training slowly. Patience at this stage is everything. If a coach is sympathetic, he or she will let you build up the length of time and intensity of what you do gradually. Focus on specifics, a full “play” situation maybe too much early on. Grabbing an understanding partner you can drill specifics with is important. It is a personal decision; you know your own body. Experts can only weigh in so much. For instance after injuring his C4 and C5 in ADCC and managing one MMA match two years later, Braulio Estima made the decision to quit MMA. The risk being just too great. Hopefully, that’s a decision none of us will have to make.