@doctor_kickass

Mike Piekarski, PT, DPT, OCS @doctor_kickass

•Doctor of Physical Therapy •Orthopedic Clinical Specialist •Former MMA Fighter •Brazilian Jiu Jitsu black belt

http://www.doctorkickass.com/

Congratulations to @ismael_bjj_ on his gold medal at PansKids tournament this weekend. I’ve been using @functionalrangeconditioning concepts on helping him improve his hip mobility. Ismael won both of his matches from the guard where having adequate hip mobility is essential.

Repost @ismael_bjj_ with @get_repost
・・・
Great day today at PanKids 2019! In only my second tournament as a yellow belt I was able to come out on top of a three man bracket with 2 wins and 0 losses. I finished both of my matches by submission, the first being a triangle/armbar and the second being an armbar. Thank you to my parents @fotorey and @izo3 for supporting me and bringing me to this tournament. Thank you also to my coaches @bragiao_bjj_mma @derekgehrer and @andrew_coyne for preparing me for this tournament. A special thanks also to @doctor_kickass for the PT that I have been working with him on. It has greatly improved my flexibility and mobility and I am very grateful. On to the next one! @carlsongraciesacramento
@doctor_kickass

Congratulations to @ismael bjj on his gold medal at PansKids tournament this weekend. I’ve been using @functionalrangeconditioning concepts on helping him improve his hip mobility. Ismael won both of his matches from the guard where having adequate hip mobility is essential. Repost @ismael bjj with @get repost ・・・ Great day today at PanKids 2019! In only my second tournament as a yellow belt I was able to come out on top of a three man bracket with 2 wins and 0 losses. I finished both of my matches by submission, the first being a triangle/armbar and the second being an armbar. Thank you to my parents @fotorey and @izo3 for supporting me and bringing me to this tournament. Thank you also to my coaches @bragiao bjj mma @derekgehrer and @andrew coyne for preparing me for this tournament. A special thanks also to @doctor kickass for the PT that I have been working with him on. It has greatly improved my flexibility and mobility and I am very grateful. On to the next one!

Weight classes: Fighters who fail to make weight
••••••••••••••••••••••••••
Simply put: Size matters. Weight classes are used in all combat sports to keep competition as fair as possible. The problem with entertainment and combat sports is if a fighter doesn’t fight they do not get paid. So what do you do when a fighter misses weight: technically this means the fight is no longer fair.
.
Personally I feel the penalties for missing weight are too lenient: 10-30% loss of a fighter’s purse. In some cases there is a point where a fighter may decide further attempts to go down in weight will compromise their ability to win. Typical contracts have win bonuses so even if a fighter loses a portion of their purse they would still make more to miss weight and win the fight than exhaust their bodies to make weight and lose.
.
At @ufc Phoenix there were 3 fighters who missed weight. Barao missed by 3 pounds and Bermudez missed by 5 pounds! Their opponents are in a tough situation: win against someone who will have an unfair size advantage or not take the fight. This risks their ability to get their win bonus/potential performance bonus, prevents them from rising in the rankings AND will displease the company/fans.
.
As a professional athlete if you sign your name on a contract that you will be a certain weight you should be a professional and make the weight.
.
Good luck to my dudes @savage_530 and @coolhandmma who will opted to fight.
@doctor_kickass

Weight classes: Fighters who fail to make weight •••••••••••••••••••••••••• Simply put: Size matters. Weight classes are used in all combat sports to keep competition as fair as possible. The problem with entertainment and combat sports is if a fighter doesn’t fight they do not get paid. So what do you do when a fighter misses weight: technically this means the fight is no longer fair. . Personally I feel the penalties for missing weight are too lenient: 10-30% loss of a fighter’s purse. In some cases there is a point where a fighter may decide further attempts to go down in weight will compromise their ability to win. Typical contracts have win bonuses so even if a fighter loses a portion of their purse they would still make more to miss weight and win the fight than exhaust their bodies to make weight and lose. . At @ufc Phoenix there were 3 fighters who missed weight. Barao missed by 3 pounds and Bermudez missed by 5 pounds!

❌”No pain no gain”. I agree with this 💯❗️
.
There is very important distinction between the two.
.
This is something I’ve talked about in the past but my dude @trev1582 articulated it better than I could.
@doctor_kickass

❌”No pain no gain”. I agree with this 💯❗️ . There is very important distinction between the two. . This is something I’ve talked about in the past but my dude @trev1582 articulated it better than I could.

Attribute development
••••••••••••••••••
When learning martial arts the goal is to develop technical skills opposed to relying on physical attributes (strength, endurance, flexibility etc...). That being said the development of attributes will allow a greater expression of those skills. If your do not have the base requirements for a movement pattern (martial arts) you will rely on a compensatory pattern or will be unable to perform at all.
.
The continuum for performance:
1️⃣Mobility: you cannot develop strength or speed in ranges you cannot control.
2️⃣Strength: once sufficient mobility is achieved you can develop the necessary strength in those ranges of motion.
3️⃣Power: the ultimate goal for athleticism. To develop power you first need sufficient strength. .
If you are interested in developing the necessary mobility for martial arts I will be teaching a mobility workshop this Sunday at @capitalstrengthperformance .
@doctor_kickass

Attribute development •••••••••••••••••• When learning martial arts the goal is to develop technical skills opposed to relying on physical attributes (strength, endurance, flexibility etc...). That being said the development of attributes will allow a greater expression of those skills. If your do not have the base requirements for a movement pattern (martial arts) you will rely on a compensatory pattern or will be unable to perform at all. . The continuum for performance: 1️⃣Mobility: you cannot develop strength or speed in ranges you cannot control. 2️⃣Strength: once sufficient mobility is achieved you can develop the necessary strength in those ranges of motion. 3️⃣Power: the ultimate goal for athleticism. To develop power you first need sufficient strength. . If you are interested in developing the necessary mobility for martial arts I will be teaching a mobility workshop this Sunday at @capitalstrengthperformance .

Tai Otoshi: How to reduce the risk of knee injuries
•••••••••••••••••••••••
Collaborative post by @judophysio and @doctor_kickass
.
In the Art of Judo the ultimate goal is to unbalance an opponent so that they land on their back. While many injuries could occur due to the traumatic nature of the sport the knee statistically appears to be an area with a higher likelihood of injury.
.
While most most knee injuries occur to the defender there is one throw that may predispose the attacker to injure their own knee: Tai Otoshi.
. “The risk of injury by attempting tai-otoshi appeared to be higher when the judoka’s knee joint was in a full or almost full extension position in the preparatory phase (Koshida 2010).”
.
❌”Traditional” Tai Otoshi: Point of kuzushi and then direct contact of tori and uke with near full knee extension.
✅Alternative Tai Otoshi: Judo Silver medalist, @judosilencer, shoes a variation that may reduce the risk for injury.
1️⃣It begins from a traditional grip but requires only one grip which allows more rotation of tori during attack and is easier to bail if getting countered. 
2️⃣The angle of Tori’s knee is at a greater angle of flexion and the point of contact is less likely to be on the lateral aspect of Tori’s knee. 
3️⃣Creating a sort of “spring” moment helps in elevating uke and maybe helps decrease the likelihood of valgus collapse that is seen in the pictures provided in the article.
.
The risk of injury may increases:
1️⃣The further the backstep Tori takes, the more the tripping leg needs to reach across uke and will end up in more extension. 
2️⃣If tori does not create enough kuzushi and rotational force with either same side or opposite side grips
.
References:
1️⃣Kujala UM, Taimela S, Antti-Poika L, et al. Acute injuries in soccer, ice hockey,
volleyball, basketball, judo, and karate: analysis of national registry data. BMJ
1995;311:1465–68
2️⃣Koshida, S., Deguchi, T., Miyashita, K., Iwai, K., & Urabe, Y. (2010). The common mechanisms of anterior cruciate ligament injuries in judo: a retrospective analysis. British Journal of Sports Medicine, bjsports51425.
@doctor_kickass

Tai Otoshi: How to reduce the risk of knee injuries ••••••••••••••••••••••• Collaborative post by @judophysio and @doctor kickass . In the Art of Judo the ultimate goal is to unbalance an opponent so that they land on their back. While many injuries could occur due to the traumatic nature of the sport the knee statistically appears to be an area with a higher likelihood of injury. . While most most knee injuries occur to the defender there is one throw that may predispose the attacker to injure their own knee: Tai Otoshi. . “The risk of injury by attempting tai-otoshi appeared to be higher when the judoka’s knee joint was in a full or almost full extension position in the preparatory phase (Koshida 2010).” . ❌”Traditional” Tai Otoshi: Point of kuzushi and then direct contact of tori and uke with near full knee extension. ✅Alternative Tai Otoshi: Judo Silver medalist, @judosilencer, shoes a variation that may reduce the risk

Understanding the Mir Lock
••••••••••••••••••••
The Mir Lock is a rarely seen armlock submission, however it was used yesterderay by Kade @ruotolobrothersjiujitsu at the ADCC west coast trials. This armlock variation was first seen in the early @ufc days when @thefrankmir used this submission to defeat Pete Williams. This the armlock became coined “The Mir Lock”.
.
What joint is being attacked by this rare submission? Short answer is both, long answer is depends.
.
The Mir lock is a combination of two submissions, americana and armbar. Shoulder:
When attacking the shoulder the submission functions by imparting excessive external rotation and imparting a shear force to anterior translate the humeral head in the glenoid fossa. .
Elbow: While a traditional armbar works by hyperextending the elbow the mir lock works by creating a valgus force on the elbow. The traditional armbar attacks the anterior fibers of the ulnar collateral ligament (UCL), which are strong and thick, while this variation attacks the transverse fibers of the UCL, which are not as strong.
.
Since it attacks both the shoulder and the elbow, what will get damaged first? Generally the submission targets the weakest link between the two, which is dependent on the opponents biomechanics, joint mobility and how the attacker imparts force. It is also considered an unorthodox submission because it is rarely seen and it can catch an opponent by surprise.
.
Video credit: @flograppling
@doctor_kickass

Understanding the Mir Lock •••••••••••••••••••• The Mir Lock is a rarely seen armlock submission, however it was used yesterderay by Kade @ruotolobrothersjiujitsu at the ADCC west coast trials. This armlock variation was first seen in the early @ufc days when @thefrankmir used this submission to defeat Pete Williams. This the armlock became coined “The Mir Lock”. . What joint is being attacked by this rare submission? Short answer is both, long answer is depends. . The Mir lock is a combination of two submissions, americana and armbar. Shoulder: When attacking the shoulder the submission functions by imparting excessive external rotation and imparting a shear force to anterior translate the humeral head in the glenoid fossa. . Elbow: While a traditional armbar works by hyperextending the elbow the mir lock works by creating a valgus force on the elbow. The traditional armbar attacks the anterior fibers of the ulnar collateral ligament

Hernia forces Robert Whittaker out of UFC 234
•••••••••••••••••••••••••
The highly anticipated main event for @ufc 234 was @robwhittakermma vs @kgastelum . Unfortunately Whittaker was complaining of abdominal pain last night and was diagnosed with an abdominal hernia.  What is a hernia and why did he pull out?
.
What is a hernia?
When an organ, such as the intestines, push through the abdominal wall. .
Symptoms
Pain, discomfort and tenderness to palpation. 
In the context of fighting this would significantly impair his ability to absorb a body shot.
.
Why would he suddenly complain about this now? Wouldn’t he had noticed it during his training camp? [author speculation, no evidence]
Certain factors may predispose someone to have a weakened abdominal wall, such as damage to the abdominals (trauma to the body), lifting heavy weight (exertion) and suddenly gaining weight (rehydration + feasting after a weight cut, potentially gaining 20+ lbs in a very short period).
.
Treatment:
Hernias do not heal on their own. Whittaker is scheduled for surgery today to repair the hernia.
.
As a fan I was looking forward to watching Whittaker defend his title. Hoping the champ has a speedy recovery!
@doctor_kickass

Hernia forces Robert Whittaker out of UFC 234 ••••••••••••••••••••••••• The highly anticipated main event for @ufc 234 was @robwhittakermma vs @kgastelum . Unfortunately Whittaker was complaining of abdominal pain last night and was diagnosed with an abdominal hernia. What is a hernia and why did he pull out? . What is a hernia? When an organ, such as the intestines, push through the abdominal wall. . Symptoms Pain, discomfort and tenderness to palpation. In the context of fighting this would significantly impair his ability to absorb a body shot. . Why would he suddenly complain about this now? Wouldn’t he had noticed it during his training camp? [author speculation, no evidence] Certain factors may predispose someone to have a weakened abdominal wall, such as damage to the abdominals (trauma to the body), lifting heavy weight (exertion) and suddenly gaining weight (rehydration + feasting after a weight cut, potentially gaining

Update on Gordon Ryan's Knee
•••••••••••••••••••••
This weekend @gordonlovesjiujitsu had a grappling match with @jgrocha , while trying to elevate the large man he suffered a knee injury. Reports during the match was that Gordon complained of having “no stability on his leg”. Diagnostic imaging have confirmed a grade 3 LCL tear (complete) and “bad” biceps femoris tendon strain (outside hamstring muscle). What does this mean? How long will Gordon Ryan be out for?
.
Function of the LCL:
Primary function of the LCL is to resist a varus force (sideways force moving the knee outwards), hyperextension and tibial external rotation. With a torn LCL there is a common complaint of “instabilty”.
.
Does the LCL heal on its own? Will Ryan need surgery?
The LCL does have access to the vascular system, however compared to the MCL, it does not have the same ability to repair itself. Grade 1 tears typically do well with nonoperative care, however grade 3 typically require surgical intervention. Typically LCL repair rehabilitation can take up to 6 months prior to return to training. This would be the same surgery @tonyfergusonxt has several months ago.
.
Thoughts of orthobiologics?
The use of PRP and stem cells are becoming more common in modern medicine, however they are not magic healing. PRP and stem cells ASSIST in the healing process, but they will be less effective since there was a complete tear. If Ryan had suffered a grade II tear the use of orthobiologics may have been a potential option to avoid surgery but due to the complete tear of the LCL and bad strain of the supporting musculture (hamstring) I do not feel that this will be a realistic option. Many surgeons are using orthobiologics during surgery to reduce failure rates.
.
Speedy recovery to the grappling wizard. I know many of us were looking forward to watch him competing in @combatjjworlds against other legends like @werdum and @joshlbarnett .
@doctor_kickass

Update on Gordon Ryan's Knee ••••••••••••••••••••• This weekend @gordonlovesjiujitsu had a grappling match with @jgrocha , while trying to elevate the large man he suffered a knee injury. Reports during the match was that Gordon complained of having “no stability on his leg”. Diagnostic imaging have confirmed a grade 3 LCL tear (complete) and “bad” biceps femoris tendon strain (outside hamstring muscle). What does this mean? How long will Gordon Ryan be out for? . Function of the LCL: Primary function of the LCL is to resist a varus force (sideways force moving the knee outwards), hyperextension and tibial external rotation. With a torn LCL there is a common complaint of “instabilty”. . Does the LCL heal on its own? Will Ryan need surgery? The LCL does have access to the vascular system, however compared to the MCL, it does not have the same ability to repair itself. Grade 1 tears typically do well with nonoperative care, however

How to reduce muscle soreness
••••••••••••••••••••••
Soreness from one practice may interfere with an athlete‘s ability to perform in future practices or competitions. 
Delayed onset muscle soreness (DOMS) usually occurs 8-10 hours following an exercise and can last for up to 48 hours.
So the ultimate question for athletes: 
How do you maximize the ability to train and minimize soreness?
.
All athletes should first optimize the big 3 categories:
1️⃣Sleep
2️⃣Nutrition
3️⃣Load management
If you aren’t sleeping, aren’t consuming complete quality nutrition and with a sudden increase of training time no other factors will help significantly. Get these in order first.
.
Following that how can one reduce muscle soreness?
“Myofascial release”: this can include massage, foam rolling or the vibration therapy devices. .
“The mechanism by which self myofascial release affects DOMS is unclear. Current beat evidence points towards the inhibition of pain feedback”. However there may also be improved arterial function, improved vascular endothelial function, and increased parasympathetic nervous system activity. (Beardsley 2015).
.
Massage vs Vibration:
“The result of this study indicates that vibration therapy and massage therapy both are equally effective in prevention of DOMS. Massage is more effective in restoration of concentric strength (1 RM), yet vibration therapy shows clinically early reduction of pain and is effective in decrease the level of LDH in 48 hours post exercise periods. (Imtiyaz 2014)”
.
References:
1️⃣Beardsley, C., & Škarabot, J. (2015). Effects of self-myofascial release: a systematic review. Journal of bodywork and movement therapies, 19(4), 747-758.
2️⃣Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS). Journal of clinical and diagnostic research: JCDR, 8(1), 133.
@doctor_kickass

How to reduce muscle soreness •••••••••••••••••••••• Soreness from one practice may interfere with an athlete‘s ability to perform in future practices or competitions. Delayed onset muscle soreness (DOMS) usually occurs 8-10 hours following an exercise and can last for up to 48 hours. So the ultimate question for athletes: How do you maximize the ability to train and minimize soreness? . All athletes should first optimize the big 3 categories: 1️⃣Sleep 2️⃣Nutrition 3️⃣Load management If you aren’t sleeping, aren’t consuming complete quality nutrition and with a sudden increase of training time no other factors will help significantly. Get these in order first. . Following that how can one reduce muscle soreness? “Myofascial release”: this can include massage, foam rolling or the vibration therapy devices. . “The mechanism by which self myofascial release affects DOMS is unclear. Current beat evidence points towards

The most important post you will see on the IG today
.
Repost @drlocrao with @get_repost
・・・
Journey, Not Destination
—
I usually get a few requests per week for online consults.  If you have PAIN, I think that is the line between being able to use an online platform vs. needing to go see someone in real life.
—
My DM conversations have gotten to the point where I have read about what are, IMO, bad practices that are now affecting people in need, as I’ve communicated with at least 4 individuals who tried something they saw on IG for their (X), and it ended up either aggravating their symptoms/injuries or was altogether CONTRAINDICATED.
—
IMHO, I think Instagram and Google are great platforms to share ideas and create a network, but they should be used for information only, and not be your plan of care.
@doctor_kickass

The most important post you will see on the IG today . Repost @drlocrao with @get repost ・・・ Journey, Not Destination — I usually get a few requests per week for online consults. If you have PAIN, I think that is the line between being able to use an online platform vs. needing to go see someone in real life. — My DM conversations have gotten to the point where I have read about what are, IMO, bad practices that are now affecting people in need, as I’ve communicated with at least 4 individuals who tried something they saw on IG for their (X), and it ended up either aggravating their symptoms/injuries or was altogether CONTRAINDICATED. — IMHO, I think Instagram and Google are great platforms to share ideas and create a network, but they should be used for information only, and not be your plan of care.

Risky saddle entry: How Gordon Ryan hurt his knee
••••••••••••••••••••••••••
Last night at @kasaigrappling @gordonlovesjiujitsu took on @jgrocha . In the course of the match Ryan went to elevate his opponent end up in the saddle position, however his opponent sprawled which resulted in a “LCL injury”. Despite the injury Gordon was still able to win the match.
.
What did Gordon do wrong and why is this position potentially dangerous for your knee?
@lachlan_giles , black belt and physiotherapist, points out that this entry may be effective but puts unnecessary strain on the knee.
The lateral collateral ligament (LCL) primarily limits a varus force. The knee does not have sideway motion (movement in the frontal plane) and the LCL protects the knee from this motion. If you attempt to elevate with your hip muscle and your opponent sprawls near your ankle or lower leg there will be tremendous shear forces on the outside of the knee. While lateral muscles may help to support the LCL since the knee doesn’t actively move in that direction the LCL has to endure a majority of that force.
.
What is a safer way to enter the saddle? 
Connecting to your opponent and rocking back like a wheel. This lets you use your weight to get them up in the air. The higher up you elevate them the less ability for them to sprawl. Once the opponent is elevated to a sufficient height you can adjust your legs to enter the saddle. Competition is chaotic and it is hard to control all of the variables, so while Gordon knows how to elevate correctly sometimes details are rushed.
.
While Gordon complained of popping in his knee to confirm a LCL injury would require orthopedic testing and diagnostic imaging.
@doctor_kickass

Risky saddle entry: How Gordon Ryan hurt his knee •••••••••••••••••••••••••• Last night at @kasaigrappling @gordonlovesjiujitsu took on @jgrocha . In the course of the match Ryan went to elevate his opponent end up in the saddle position, however his opponent sprawled which resulted in a “LCL injury”. Despite the injury Gordon was still able to win the match. . What did Gordon do wrong and why is this position potentially dangerous for your knee? @lachlan giles , black belt and physiotherapist, points out that this entry may be effective but puts unnecessary strain on the knee. The lateral collateral ligament (LCL) primarily limits a varus force. The knee does not have sideway motion (movement in the frontal plane) and the LCL protects the knee from this motion. If you attempt to elevate with your hip muscle and your opponent sprawls near your ankle or lower leg there will be tremendous shear forces on the outside of the knee.

Mechanics of the Anaconda Choke
•••••••••••••••••••••
The anaconda choke is a head and arm strangulation variation that functions by using one of your arms and one of your opponent’s arms to occlude their carotid arteries. With sufficient compression you will render your opponent unconscious.
.
How do strangulations work? A study examined the physiology of strangles. The vascular structures targeted by the technique are the internal carotid artery (ICA) and the carotid sinus. The carotid sinus has pressure receptors that maintain blood pressure and when there is an external compression the response of the body is to reduce blood flow. For loss of consciousness to occur the structure need to be compressed enough to decrease cerebral blood flow. 
1️⃣Cerebral hypoxia or 'going to sleep' occurs when the cerebral blood flow velocity dropped below 50% from baseline on both the right and left carotid artery.
2️⃣The compression force required to compress the carotid arteries was at least 100mmHg. An important note is that more than 100mmHg did not cause a faster response in which the subject was rendered unconscious.
3️⃣To render an opponent unconscious BOTH arteries require sufficient compression. If you only compress one side you may not be able to complete the strangle.
4️⃣The average time for unconsciousness following the vascular constraint was held for 9-10 seconds (9.5 +/- 0.4 seconds).
.
@charlesdobronxs is a very skillful submission hunter who used this choke for his 13th submission, record for most submission finishes in the UFC.
.
Reference:
Mitchell JR, Roach DR, et al. Mechanism of loss of consciousness during vascular neck restraint. J Appl Physiol. 2012 Feb;112(3):396-402.
@doctor_kickass

Mechanics of the Anaconda Choke ••••••••••••••••••••• The anaconda choke is a head and arm strangulation variation that functions by using one of your arms and one of your opponent’s arms to occlude their carotid arteries. With sufficient compression you will render your opponent unconscious. . How do strangulations work? A study examined the physiology of strangles. The vascular structures targeted by the technique are the internal carotid artery (ICA) and the carotid sinus. The carotid sinus has pressure receptors that maintain blood pressure and when there is an external compression the response of the body is to reduce blood flow. For loss of consciousness to occur the structure need to be compressed enough to decrease cerebral blood flow. 1️⃣Cerebral hypoxia or 'going to sleep' occurs when the cerebral blood flow velocity dropped below 50% from baseline on both the right and left carotid artery. 2️⃣The compression force

Passive treatments may create a TEMPORARY window to train the injured area. If there is no active component that window will be wasted.
.
Repost @squat_university with @get_repost
・・・
Have you gone to a rehab professional and ALL they do is ultrasound, electrical stimulation, dry needling, or scraping techniques on your body? This is considered a “passive” treatment because it’s something done TO YOU.
.
Regardless of if you think any of these treatments may or may not work, they should NEVER be the sole treatment method for addressing an injury.❌
.
Rehabbing from an injury requires you to take a step back and NOT just focus on the site of pain.📝
.
For example, I’ve had many patients come to me from other rehab professionals who in trying to treat an Achilles tendon injury have only used a scraping tool. While there’s nothing wrong in this case with using this technique to the calf muscles, this treatment is not enough by itself to address the cause of the injury – the problem will only return unless an active approach is taken of strength based exercises and eventually returning to more plyometric loads once the tendon can handle the added stress.✅
.
Don’t think of “passive” treatments as either good or bad, but instead question those who ONLY use these tools as the sole method of their treatment.
@doctor_kickass

Passive treatments may create a TEMPORARY window to train the injured area. If there is no active component that window will be wasted. . Repost @squat university with @get repost ・・・ Have you gone to a rehab professional and ALL they do is ultrasound, electrical stimulation, dry needling, or scraping techniques on your body? This is considered a “passive” treatment because it’s something done TO YOU. . Regardless of if you think any of these treatments may or may not work, they should NEVER be the sole treatment method for addressing an injury.❌ . Rehabbing from an injury requires you to take a step back and NOT just focus on the site of pain.📝 . For example, I’ve had many patients come to me from other rehab professionals who in trying to treat an Achilles tendon injury have only used a scraping tool. While there’s nothing wrong in this case with using this technique to the calf muscles, this treatment is not enough by itself to address the cause of the injury

When you roll with @craigjonesbjj it is a good idea to tap to heel hooks. .
Don’t be like @fiorejosh . 
Your MCL will thank me for this advice.
@doctor_kickass

When you roll with @craigjonesbjj it is a good idea to tap to heel hooks. . Don’t be like @fiorejosh . Your MCL will thank me for this advice.

Neck bridging: Is it safe?
••••••••••••••••••••••
The neck bridge has been a strengthening exercise that grapplers have used for hundreds of years. Grappling is fairly hard on the neck so having a strong neck is key for injury mitigation. Does the neck bridge reduce injury or exacerbate it?
.
The challenge with this exercise is while you are strengthening the cervical muscles you are also axial compressing the spine. The cervical muscles have two main jobs: 
1️⃣resist motion 
2️⃣orient your head for optimal sensory input. 
These muscles are stabilizers, not prime movers and not designed to support the human body.
.
Intervertebral discs are spacers between vertebrae. There is an inner layer (nucleus pulposus) surrounded by the outer layer (anulus fibrosus). The orientation of the structure is designed to absorb compressive forces on the spine.
.
Potential mechanisms of injury regarding discs:
1️⃣Excessive axial compression or shear forces from a single traumatic event. (Ex: landing on your head following a throw or sweep.)
2️⃣Repetitive forces of a lower magnitude over a prolonged period. (Ex: getting choked for several years.)
.
The body is designed to adapt to stress, however there is a fine line regarding appropriate and excessive stress.
.
When to do this exercise:
I cannot recommend any exercise without knowing someone's medical history and goals. If properly dosed this exercise can be used with caution. For an athlete with a previous neck injury I would recommend alternative methods (Isometric holds and open chain strengthening, such as @theironneck ).
.
In the end there are no
@doctor_kickass

Neck bridging: Is it safe? •••••••••••••••••••••• The neck bridge has been a strengthening exercise that grapplers have used for hundreds of years. Grappling is fairly hard on the neck so having a strong neck is key for injury mitigation. Does the neck bridge reduce injury or exacerbate it? . The challenge with this exercise is while you are strengthening the cervical muscles you are also axial compressing the spine. The cervical muscles have two main jobs: 1️⃣resist motion 2️⃣orient your head for optimal sensory input. These muscles are stabilizers, not prime movers and not designed to support the human body. . Intervertebral discs are spacers between vertebrae. There is an inner layer (nucleus pulposus) surrounded by the outer layer (anulus fibrosus). The orientation of the structure is designed to absorb compressive forces on the spine. . Potential mechanisms of injury regarding discs: 1️⃣Excessive axial compression or

Longevity of a Fighter
••••••••••••••••••
There has been a recent trend of veteran MMA fighters returning from retirement hoping to claim former glory. Unfortunately the result generally does not go well for the returning legend. .
So my question how long can a fighter stay competitive? .
What is an accurate indicator for a fighter to know when they are past their prime? 
1️⃣Physiological age
2️⃣Overall time competing in MMA
3️⃣Fighting style
4️⃣Accumulation of physical trauma from fights .
Experience vs Vitality. 
An unfortunate fact of physiology is that at some point an aging fighter will begin to slow down, become weaker, recover slower on top of an increase likelihood of developing chronic injuries.
.
Obviously there are fighters outside the bell curve who were able to stay competitive longer than most feel they should have been. .
Advice for increasing longevity for fighters:
1️⃣Address your injuries.
2️⃣Don’t neglect strength training. Building strength is one of the best ways to reduce injury.
3️⃣Minimize unnecessary abuse. The training room is for learning, you don’t get an award for gym ears.
4️⃣Maintain mobility.
@doctor_kickass

Longevity of a Fighter •••••••••••••••••• There has been a recent trend of veteran MMA fighters returning from retirement hoping to claim former glory. Unfortunately the result generally does not go well for the returning legend. . So my question how long can a fighter stay competitive? . What is an accurate indicator for a fighter to know when they are past their prime? 1️⃣Physiological age 2️⃣Overall time competing in MMA 3️⃣Fighting style 4️⃣Accumulation of physical trauma from fights . Experience vs Vitality. An unfortunate fact of physiology is that at some point an aging fighter will begin to slow down, become weaker, recover slower on top of an increase likelihood of developing chronic injuries. . Obviously there are fighters outside the bell curve who were able to stay competitive longer than most feel they should have been. . Advice for increasing longevity for fighters: 1️⃣Address your injuries. 2️⃣Don’t

Choking identified as potential contributor to cognitive damage in MMA? [Article Review]
••••••••••••••••••
Recently on mixedmartialarts.com there was an article about choking potentially being involved in the development of CTE for fighters. .
The author argues over a course of an athlete’s career there will be multiple episodes of transient asphyxiation from strangles and chokes, which may lead to intermittent hypoxic events to the brain.
.
Do you agree?
My personal view of this argument: 
1️⃣frequency: being rendered unconscious with strangles are rare, both in training and competition.
2️⃣duration: when someone is put to sleep they are often held for only a few seconds until the training partner/referee realize and release the hold.
3️⃣mechanism: being “put to sleep” via a strangle does not require complete artery occlusion. The structure only requires 50% occlusion which signals receptors to induce unconsciousness.
.
Conclusion: While I concede that choking COULD play a role in CTE development with the current evidence I feel it is unlikely significant. I feel more research would need to be done to make a stronger connection. I feel young fighters should worry more
about repetitive subconcussive head strikes which likely play a more significant role.
.
Despite me not being sold on the author’s argument my advice for young fighters would still be to tap and minimize repetitive episodes of going to sleep from strangles.
.
References:
Lim, L. J., Ho, R., & Ho, C. S. (2019). Dangers of mixed martial arts in the development of chronic traumatic encephalopathy. International journal of environmental research and public health, 16(2), 254.
.
Mitchell, J. R., Roach, D. E., Tyberg, J. V., Belenkie, I., & Sheldon, R. S. (2012). Mechanism of loss of consciousness during vascular neck restraint. Journal of Applied Physiology, 112(3), 396-402.
@doctor_kickass

Choking identified as potential contributor to cognitive damage in MMA? [Article Review] •••••••••••••••••• Recently on mixedmartialarts.com there was an article about choking potentially being involved in the development of CTE for fighters. . The author argues over a course of an athlete’s career there will be multiple episodes of transient asphyxiation from strangles and chokes, which may lead to intermittent hypoxic events to the brain. . Do you agree? My personal view of this argument: 1️⃣frequency: being rendered unconscious with strangles are rare, both in training and competition. 2️⃣duration: when someone is put to sleep they are often held for only a few seconds until the training partner/referee realize and release the hold. 3️⃣mechanism: being “put to sleep” via a strangle does not require complete artery occlusion. The structure only requires 50% occlusion which signals receptors to induce unconsciousness. .

Mechanotherapy : The secret behind rehabilitation ••••••••••••••••••••••••••
Everyone has had injuries and in many cases the body can heal itself without problems. Unfortunately there are many cases that natural healing is insufficient. Injury may lead to pain, weakness and/or compensatory movements which can lead to more injuries. .
How can we help the healing process?
✅Mechanotherapy. This term refers to the use of “therapeutic exercise prescribed to promote repair or remodelling of injured tissue.” Tissues involved may be tendon, muscle, cartilage and/or bone. The remodeling occurs  through mechanotransduction. This is the process in which mechanical loading begins cellular responses to create structural change (Khan 2009).
.
Healing essentially is just strengthening damaged tissues so that they can regain their previous state of resilience.
.
Passive treatments may have their place to reduce pain however a good rehab program should load the injured tissue in some capacity. Of all the modalities that a rehabilitation specialist can provide the one with the most consistent evidence supporting it is thereuptic exercise.
.
Reference 
1️⃣Khan, K. M., & Scott, A. (2009). Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. British journal of sports medicine, 43(4), 247-252.
@doctor_kickass

Mechanotherapy : The secret behind rehabilitation •••••••••••••••••••••••••• Everyone has had injuries and in many cases the body can heal itself without problems. Unfortunately there are many cases that natural healing is insufficient. Injury may lead to pain, weakness and/or compensatory movements which can lead to more injuries. . How can we help the healing process? ✅Mechanotherapy. This term refers to the use of “therapeutic exercise prescribed to promote repair or remodelling of injured tissue.” Tissues involved may be tendon, muscle, cartilage and/or bone. The remodeling occurs through mechanotransduction. This is the process in which mechanical loading begins cellular responses to create structural change (Khan 2009). . Healing essentially is just strengthening damaged tissues so that they can regain their previous state of resilience. . Passive treatments may have their place to reduce pain however a good rehab

Next