@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/

#Repost @scientificwrestling with @get_repost
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Numbers don’t lie, so your training probably needs to change
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Wrestling with 28, BJJ with 17, boxing with 12. Still, nationwide, wrestling classes remain the most overlooked in almost every fight gym. I know this because I see it but also hear it from friends around the world
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Wrestling is a glue that helps blend all styles together and a lack of it makes you very choppy in your transitions; it’s not about takedowns as much as it’s about feel and body awareness. There’s always exceptions but numbers don’t lie.
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Bottom line - it’s mainly the easier of learning curve, top control,  and ability to dictate where the fight takes place battle that helps wrestlers . It’s also way easier to teach a wrestler basic boxing and BJJ defense than it is to teach any of the other arts how to wrestle.
@doctor_kickass

#Repost @scientificwrestling with @get repost ・・・ . Numbers don’t lie, so your training probably needs to change . Wrestling with 28, BJJ with 17, boxing with 12. Still, nationwide, wrestling classes remain the most overlooked in almost every fight gym. I know this because I see it but also hear it from friends around the world . Wrestling is a glue that helps blend all styles together and a lack of it makes you very choppy in your transitions; it’s not about takedowns as much as it’s about feel and body awareness. There’s always exceptions but numbers don’t lie. . Bottom line - it’s mainly the easier of learning curve, top control, and ability to dictate where the fight takes place battle that helps wrestlers . It’s also way easier to teach a wrestler basic boxing and BJJ defense than it is to teach any of the other arts how to wrestle.

Understanding the Ezekiel Choke
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The Ezekiel choke or Sode Guruma Jime (Japanese for “Sleeve wheel constriction”) is a widely verstaile choke due to the ability to hit the technique from a variety of different positions. This is one of the few submission attacks that a grappler can use while being in someone's guard or even when in bottom mount. This attack's effectiveness is enhanced by the use of the gi grip however it can be performed without the gi.
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Physiology of the choke:
Like all chokes for this to be a true strangle the attacker must occlude both sides of the carotid to induce unconsciousness. Typically the attacker will use the side of their biceps on one side of the carotid artery and either fist or blade of the hand on the other. This can be used as a choke as well if the attacker uses the fist / blade to compress the trachea instead.
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@ufc fighter @alexeyoleynik1 has had great success with this submission as he has 11 wins by ezekiel choke in MMA! Oleynik has been able to use this attack to submit his opponents even from inferior positions such as bottom mount.
@doctor_kickass

Understanding the Ezekiel Choke ••••••••••••••••• The Ezekiel choke or Sode Guruma Jime (Japanese for “Sleeve wheel constriction”) is a widely verstaile choke due to the ability to hit the technique from a variety of different positions. This is one of the few submission attacks that a grappler can use while being in someone's guard or even when in bottom mount. This attack's effectiveness is enhanced by the use of the gi grip however it can be performed without the gi. . Physiology of the choke: Like all chokes for this to be a true strangle the attacker must occlude both sides of the carotid to induce unconsciousness. Typically the attacker will use the side of their biceps on one side of the carotid artery and either fist or blade of the hand on the other. This can be used as a choke as well if the attacker uses the fist / blade to compress the trachea instead. . @ufc fighter @alexeyoleynik1 has had great success with this submission as he

Mobility Deficits of UFC fighters: Part 5 - Abnormal foot posture
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The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility.
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@ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes.
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Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes
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Navicular drop: 5.1 mm (1-17) vs <6
While the average was in an “optimal range” the range was fairly large.
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What is navicular drop? Flat feet.
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This occurs due to inadequate stability of the medial longitudinal arch. This negatively affects the ability to absorb impact, generate power (striking, takedowns and change in directions) and the sense of balance can be altered. Abnormal foot position may predispose an athlete to other leg injuries (ACL tears, patellofemoral pain or medial tibial stress)
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How to address:
1️⃣Joint dysfunction: Often this occurs because of inadequate ankle mobility. Regular and capsule focused ankle controlled articular rotations help to ensure proper mobility in the ankle complex (talocrural, subtalar, midtarsal).
2️⃣Motor control: Foot intrinsic strengthening can be achieved with active toe exercises (specifically the great toe) and the “short foot exercise”.
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Reference:
1️⃣A Cross-Sectional Performance Analysis and Projection of the UFC Athlete: UFC Performance Institute.
2️⃣Kim, E. K., & Kim, J. S. (2016). The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients. Journal of physical therapy science, 28(11), 3136-3139.
@doctor_kickass

Mobility Deficits of UFC fighters: Part 5 - Abnormal foot posture ••••••••••••••• The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility. . @ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes. . Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes . Navicular drop: 5.1 mm (1-17) vs

Mobility Deficits of UFC fighters: Part 4 - Hip
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The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility.
.
@ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes.
.
Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes
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Hip
Extension: 11.2 (7-24) vs. >15
Pelvic position: Anterior pelvic tilt more prevalent in UFC fighters.
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Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support):
Many fighting positions require a lot of hip flexion: Slightly crouched fighting/wrestling stance, body/head kicks and various guard positions. These fighters do not to put their hips into extension as much as other athletes. A compensation for lacking sufficient hip extension is an anterior pelvic tilt.
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How to address:
1️⃣Joint dysfunction: With restricted hip joint capsule you want to use rotational inputs to influence the joint capsule.
🅰️Hip 90/90: Do not stretch if there is pain or a pinch! 🅱️Hip Sleeper (regressed variation) this may work better if you have inadequate hip internal rotation.
2️⃣Tissue dysfunction: With restricted anterior thigh tissue (iliopsoas, TFL or rectus femoris) you use linear inputs.
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How do you know which one to use? Get assessed by a qualified healthcare professional.
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3️⃣Progressive isometric angular loading: Following a 2 minute hold you can add isometric inputs of 10-15” with gradually increasing tension. Mechanical tension to attempt to create plastic changes to the capsule followed up with isometrics for improved neural drive.
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❇️NOTE: There is nothing pathological about an anterior pelvic tilt! The problem is when people loses hip extension ROM so that they develop the resting pelvic position compensation. Inadequate hip mobility is a problem.
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Reference:
A Cross-Sectional Performance Analysis and Projection of the UFC Athlete: UFC Performance Institute
@doctor_kickass

Mobility Deficits of UFC fighters: Part 4 - Hip ••••••••••••••• The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility. . @ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes. . Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes . Hip Extension: 11.2 (7-24) vs. >15 Pelvic position: Anterior pelvic tilt more prevalent in UFC fighters. . Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support): Many fighting positions require a lot of hip flexion: Slightly crouched fighting/wrestling stance, body/head kicks and various guard positions. These fighters do not to put their hips into

Cardio explained for MMA
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Cardiovascular endurance is arguably the most important physical attribute necessary for success in mixed martial arts. Despite its importance this attribute is not properly understood. Which one is right? MMA is a mixture of striking and grappling that have differing energy requirements. Old school coaches emphasize 'road work' while newer coaches often promote high intensity intervals to match competition-like speeds. .
There are 3 energy pathways that define cardiovascular endurance
1️⃣Phosphagen system (anaerobic) 
2️⃣Glycolysis (anaerobic) 
3️⃣Oxidative phosphorylation (aerobic) ✳️
@doctor_kickass

Cardio explained for MMA •••••••••••••••••••••••• Cardiovascular endurance is arguably the most important physical attribute necessary for success in mixed martial arts. Despite its importance this attribute is not properly understood. Which one is right? MMA is a mixture of striking and grappling that have differing energy requirements. Old school coaches emphasize 'road work' while newer coaches often promote high intensity intervals to match competition-like speeds. . There are 3 energy pathways that define cardiovascular endurance 1️⃣Phosphagen system (anaerobic) 2️⃣Glycolysis (anaerobic) 3️⃣Oxidative phosphorylation (aerobic) ✳️"Each energy system works in concert, [while] one energy system may dominate (Galvan 2011).” . A prominent MMA Strength & Conditioning Coach, @coachjoeljamieson , notes that while each energy pathway works in concert the aerobic pathway is responsible for a majority of the energy required

Fantastic insight on how to approach grappling from jiu jitsu master, John Danaher. @danaherjohn .
Jiu jitsu is one of the few fighting arts that actively encourages you to not be effective by being athletic but by using proper body mechanics.
@doctor_kickass

Fantastic insight on how to approach grappling from jiu jitsu master, John Danaher. @danaherjohn . Jiu jitsu is one of the few fighting arts that actively encourages you to not be effective by being athletic but by using proper body mechanics.

Will Felipe Pena be able to compete at ADCC 2019?
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@felipepenabjj was on the wrong side of a brutal inside heel hook while match up against @texjohnsonbjj during their match at @kasaigrappling . As 2017 ADCC absolute champion he was scheduled for a super fight against previous champion, Andre Galvao, at the next ADCC, September 28-29th. Will he be cleared to compete or will a potential knee injury prevent him from the super fight? .
Potential injuries:
1️⃣Anterior Cruciate Ligament (ACL): Grade 3 (complete tears) require reconstruction and extensive rehabilitation, which will keep him out of competition for at least 9-12 months.
2️⃣Posterior Cruciate Ligament (PCL): Rarely the PCL requires surgical intervention if it was an isolated injury. PCL tears often do well with conservative care (physical therapy).
3️⃣Medial Collateral Ligament (MCL): The MCL is the one ligament with the best blood supply and has the highest likelihood of healing. MCL tears, even grade 3, may respond to conservative care.
4️⃣Lateral Collateral Ligament (LCL): Grade 3 LCL tears will require surgery, however severe LCL tears are less likely based on the mechanism of injury (inside heel hook).
5️⃣Medial meniscus: Based on the mechanism of injury if a meniscus tear occurred it would be the medial meniscus. Meniscus tears often can be treated conservatively unless there was mechanical locking or catching. Potential surgery involving a meniscus would either be menisectomy (trimming the tear) or repair (stitching the tear). Rehabilitation following a menisectomy is fairly easy and he would easily be able to have surgery, rehab and be ready to compete. If he was a candidate for a repair (based on the location of the tear) he would unlikely be cleared to compete as he would need 6+ months of rehabilitation.
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What about PRP / Stemcells? Orthobiologics may be an option for mild / moderate sprains (grade 2) tears or mensicus tears without locking and catching. They will not be able to repair a complete tear.
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I wish Pena a speedy recovery. Hopefully the injury to his knee is less severe than it appeared and he is able to compete at @adccsubmission
@doctor_kickass

Will Felipe Pena be able to compete at ADCC 2019? •••••••••••••••••••••••••••• @felipepenabjj was on the wrong side of a brutal inside heel hook while match up against @texjohnsonbjj during their match at @kasaigrappling . As 2017 ADCC absolute champion he was scheduled for a super fight against previous champion, Andre Galvao, at the next ADCC, September 28-29th. Will he be cleared to compete or will a potential knee injury prevent him from the super fight? . Potential injuries: 1️⃣Anterior Cruciate Ligament (ACL): Grade 3 (complete tears) require reconstruction and extensive rehabilitation, which will keep him out of competition for at least 9-12 months. 2️⃣Posterior Cruciate Ligament (PCL): Rarely the PCL requires surgical intervention if it was an isolated injury. PCL tears often do well with conservative care (physical therapy). 3️⃣Medial Collateral Ligament (MCL): The MCL is the one ligament with the best blood

Injury prevention for jiu jitsu workshop
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Objectives:
•Educate students on injury prevention / mitigation practices relating specific to jiu jitsu
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Topics to be covered:
•Movement baseline assessment and home tests (Lab portion)
•Educate on strengthening vs. stretching. Importance of a warm up. Dynamic warm up vs. static stretching. (Lecture / Lab portion)
•Educate on exercises for joint health and self mobility assessments (Lab portion)
•Educate on when you should get seen by a healthcare professional.
•Difference between acute vs. chronic. (Lecture)
•Recovery strategies. Key points to focus on. When to heat and when to ice. (Lecture)
•Injury prevention strategies specific to jiu jitsu (Lecture / Lab)
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DM me if you are interested in hosting me at your gym.
@doctor_kickass

Injury prevention for jiu jitsu workshop •••••••••••••••••• Objectives: •Educate students on injury prevention / mitigation practices relating specific to jiu jitsu . Topics to be covered: •Movement baseline assessment and home tests (Lab portion) •Educate on strengthening vs. stretching. Importance of a warm up. Dynamic warm up vs. static stretching. (Lecture / Lab portion) •Educate on exercises for joint health and self mobility assessments (Lab portion) •Educate on when you should get seen by a healthcare professional. •Difference between acute vs. chronic. (Lecture) •Recovery strategies. Key points to focus on. When to heat and when to ice. (Lecture) •Injury prevention strategies specific to jiu jitsu (Lecture / Lab) . DM me if you are interested in hosting me at your gym.

Mobility Deficits of UFC fighters: Part 3 - Shoulder
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The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility.
.
@ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes.
.
Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes
.
Shoulder
Flexion: 173.8 (155-181) vs. >180
Abduction: 176.8 (146.5-189) vs. >180
Internal rotation: 60 (40-89.5) vs. >70
External rotation: 110.85 (73.150) vs. >90
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Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support).
1️⃣Chronic injuries
2️⃣Joint Microtrauma
3️⃣Insufficient use of the range of motion.
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Shoulder: Strikers have to generate tremendous force for their punches. The repetitive impact from hitting pads, the heavy bag and sparring, it is not surprising that shoulder health might suffer. Grapplers will have significant accumulation of micro trauma from repetitive shoulder and elbow locks stressing the joint.
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What can you do to improve glenohumeral motion and shoulder joint health?
1️⃣Sleeper stretch: Using rotational inputs to improve linear motion. The use of internal rotation is to create more space in the joint capsule. 
2️⃣Progressive isometric angular loading: Following a 2 minute hold you can add isometric inputs of 10-15” with gradually increasing tension. Mechanical tension to attempt to create plastic changes to the capsule followed up with isometrics for improved neural drive.
3️⃣Controlled articular rotations: full pain-free movements in all directions: flexion, rotation and extension. ❌Do not rotate through pain. Move in pain-free motions and see a healthcare professional/ @functionalrangerelease practitioner to assess and treat your shoulder.

In my next post I will discuss movements to improve hip movement and health.
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Reference:
A Cross-Sectional Performance Analysis and Projection of the UFC Athlete: UFC Performance Institute
@doctor_kickass

Mobility Deficits of UFC fighters: Part 3 - Shoulder ••••••••••••••• The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility. . @ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes. . Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes . Shoulder Flexion: 173.8 (155-181) vs. >180 Abduction: 176.8 (146.5-189) vs. >180 Internal rotation: 60 (40-89.5) vs. >70 External rotation: 110.85 (73.150) vs. >90 . Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support). 1️⃣Chronic injuries 2️⃣Joint Microtrauma 3️⃣Insufficient use of the range of motion. . Shoulder: Strikers have to

Mobility Deficits of UFC fighters: Part 2 - Cervical Spine
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The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility.
.
@ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes.
.
Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes
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Cervical spine:
Flexion: 43.6 (15-68) vs. >45
Extension: 54 (20-86) vs. >55
Rotation: 68.3 (40.5-99) vs. >70
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Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support).
1️⃣Chronic injuries
2️⃣Joint Microtrauma
3️⃣Insufficient use of the range of motion.
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Cervical spine: Grapplers have an extreme amount of microtrauma to their neck from takedowns and chokeholds. It is not surprising that the accumulation of stress would eventually take its toil on the overall health of the cervical spine.
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What can you do to improve cervical motion and neck joint health?
1️⃣Controlled articular rotations: full pain-free movements in all directions: flexion, rotation, lateral flexion and extension.
2️⃣Capsular controlled articular rotations: When you find one specific segment does not move you can do more focused motion. Laterally flex away at that segment. Combine flexion/ rotation at that segment. Ultimate goal is for each of the lower cervical segments (C3-7) to have symmetrical movement.
❌Do not rotate through pain. Move in pain-free motions and see a healthcare professional / @functionalrangerelease practitioner to assess and treat your neck.

In my next post I will discuss movements to improve shoulder movement and health.
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Reference:
A Cross-Sectional Performance Analysis and Projection of the UFC Athlete: UFC Performance Institute. Volume One
@doctor_kickass

Mobility Deficits of UFC fighters: Part 2 - Cervical Spine ••••••••••••••• The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility. . @ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes. . Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes . Cervical spine: Flexion: 43.6 (15-68) vs. >45 Extension: 54 (20-86) vs. >55 Rotation: 68.3 (40.5-99) vs. >70 . Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support). 1️⃣Chronic injuries 2️⃣Joint Microtrauma 3️⃣Insufficient use of the range of motion. . Cervical spine: Grapplers have an extreme amount of microtrauma to their neck

Mobility Deficits of UFC fighters: Part 1
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The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility.
.
@ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes.
.
Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes
.
Cervical spine:
Flexion: 43.6 (15-68) vs. >45
Extension: 54 (20-86) vs. >55
Rotation: 68.3 (40.5-99) vs. >70
.
Shoulder
Flexion: 173.8 (155-181) vs. >180
Abduction: 176.8 (146.5-189) vs. >180
Internal rotation: 60 (40-89.5) vs. >70
External rotation: 110.85 (73.150) vs. >90

Hip
Extension: 11.2 (7-24) vs. >15
Pelvic position: Anterior pelvic tilt more prevalent in UFC fighters.
.
Possible explanations for suboptimal mobility and joint health (Personal opinion, no research to support).
1️⃣Chronic injuries
2️⃣Joint Microtrauma
3️⃣Insufficient use of the range of motion.
.
Cervical spine: Grapplers have an extreme amount of microtrauma to their neck from takedowns and chokeholds. It is not surprising that the accumulation of stress would eventually take its toil on the overall health of the cervical spine.
.
Shoulder: Strikers have to generate tremendous force for their punches. The repetitive impact from hitting pads, the heavy bag and sparring, it is not surprising that shoulder health might suffer.
.
Hip: Many fighting positions require a lot of hip flexion: Slightly crouched fighting/wrestling stance, body/head kicks and various guard positions. These fighters do not to put their hips into extension as much as other athletes. A compensation for lacking sufficient hip extension is an anterior pelvic tilt. While an anterior pelvic tilt is not necessarily pathological it may be suboptimal.
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In this series I will specifically address some of these mobility deficits and how to address them.
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Reference:
A Cross-Sectional Performance Analysis and Projection of the UFC Athlete: UFC Performance Institute. Volume One
@doctor_kickass

Mobility Deficits of UFC fighters: Part 1 ••••••••••••••• The violent nature of MMA it is not surprising that @ufc fighters would have multiple chronic injuries, inadequate joint health and suboptimal mobility. . @ufcpi started to perform orthopedic assessments on fighters and discovered a few areas of common mobility deficits among UFC athletes when compared to non-combat elite athletes. . Key areas to address: Average range of motion in degrees for UFC fighters (ROM range) compared to average range of motion in degrees for other elite athletes . Cervical spine: Flexion: 43.6 (15-68) vs. >45 Extension: 54 (20-86) vs. >55 Rotation: 68.3 (40.5-99) vs. >70 . Shoulder Flexion: 173.8 (155-181) vs. >180 Abduction: 176.8 (146.5-189) vs. >180 Internal rotation: 60 (40-89.5) vs. >70 External rotation: 110.85 (73.150) vs. >90 Hip Extension: 11.2 (7-24) vs. >15 Pelvic position: Anterior pelvic tilt more prevalent in UFC fighters. . Possible explanations for

New Mobility class in Sacramento
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Mobility: the ability to move or be moved freely and easily. Active control.
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Do you feel your joints are stiff or lack mobility to play your sport?
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I’ll be teaching a class specifically designed to improve your mobility. USABLE motion that you will not get from stretching alone. .
This class will be twice a month at @capitalstrengthperformance . Saturday April 6th and April 20th 10am. .
DM me if you are interested in attending.
@doctor_kickass

New Mobility class in Sacramento ••••••••••••••••••••••• Mobility: the ability to move or be moved freely and easily. Active control. . Do you feel your joints are stiff or lack mobility to play your sport? . I’ll be teaching a class specifically designed to improve your mobility. USABLE motion that you will not get from stretching alone. . This class will be twice a month at @capitalstrengthperformance . Saturday April 6th and April 20th 10am. . DM me if you are interested in attending.

#Repost @combatphysiodocs with @get_repost
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🔥WRIST HEALTH IN BJJ🔥
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In collaboration w/ @doctor_kickass in time for the 2019 IBJJF Pan Championships this weekend in Irvine, CA✌🏼
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‼️Grappling is a sport that requires dexterity & control of your entire body during unconventional positional changes while trying to manipulate your opponent - so maintaining healthy joints is extremely important🙏🏼 In this collab series, we go over ways to improve wrist & elbow health‼️
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❓So how do you maintain joint health and longevity❓
➡️Joint cartilage does not have their own blood supply so it gets oxygen and other nutrition from the surrounding joint fluid. When joints are moved, waste products are released from the cartilage and is replaced by fluid with oxygen and nutrients. Joint health = movement🔥(@functionalrangeconditioning)
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❓What are CARs❓
➡️Active, rotational movements at the outer limits of articular motion - so basically, rotations at the end ranges of a joint
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✅Here we are showing the wrist CARs in 2 positions:
➡️In BJJ, the wrist is either extended when posting the arm out, or the wrist is flexed like in a wrist lock
➡️Because of this sport demand, we are focusing on moving the body over the wrist (close chained)
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‼️Having control in these specific positions can build tolerance to the load specific to these particular positions that have the potential of causing an injury‼️ .
🔑Key Points🔑
➡️Maintain tension throughout the body
Make sure to keep the palm/back of the hand completely in contact with the ground at all times
➡️Keep the intention of making the circle bigger with every revolution
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Move Smart. Fight Smart.
@combatphysiodocs
@doctor_kickass
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Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
@doctor_kickass

#Repost @combatphysiodocs with @get repost ・・・ 🔥WRIST HEALTH IN BJJ🔥 . In collaboration w/ @doctor kickass in time for the 2019 IBJJF Pan Championships this weekend in Irvine, CA✌🏼 . ‼️Grappling is a sport that requires dexterity & control of your entire body during unconventional positional changes while trying to manipulate your opponent - so maintaining healthy joints is extremely important🙏🏼 In this collab series, we go over ways to improve wrist & elbow health‼️ . ❓So how do you maintain joint health and longevity❓ ➡️Joint cartilage does not have their own blood supply so it gets oxygen and other nutrition from the surrounding joint fluid. When joints are moved, waste products are released from the cartilage and is replaced by fluid with oxygen and nutrients. Joint health = movement🔥(@functionalrangeconditioning) . ❓What are CARs❓ ➡️Active, rotational movements at the outer limits of articular motion - so basically, rotations at

The Science to maximize knock outs
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In combat sports a fighter's goal is to render their opponent unconscious while minimizing damage to themselves. .
Physiology of KO: Rotational acceleration of the brain. Shearing forces on the brain that strain the pathways in the upper brainstem. Additional impact can occur when the brain strikes the skull following impact.
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Factors that influence KOs:
1️⃣Force generated by the attacker. This typically is generated by ground reaction force (pushing off the floor) to create force to to distributed by punch, kick, elbow or knee.
2️⃣The type of strike used: Rotational acceleration tends to cause more disruption to the brain compared to linear acceleration (Barth 1989). This may be a hook punch or straight punch if the attacker has the proper angle
3️⃣Neck Strength: A fighter aware of a strike can brace for impact and roll with the strike. However this only helps when the defender is aware of the strike (Neumann).
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A very common saying in combat sports is that the most devastating strike is the one that you don't see coming.
4️⃣History of concussions: The brain can only absorb so much punishment. With a history of concussions and repetitive submaximal strikes a fighter's brain loses the resiliency it may have once had.
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A great example was last night at @ufc Tennessee where a smaller man, @showtimepettis , used a beautiful off the cage Superman punch to knock out @wonderboymma . Thompson had never been knocked out in 60 fights. Thompson said “It was so ninja I never saw it coming”. The combination of Pettis using the cage to propel him into the strike and using an unorthodox attack is how he managed to knock out Thompson.
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References:
Barth, J. T., Alves, W. M., Ryan, T. V., Macciocchi, S. N., Rimel, R. W., Jane, J. A., & Nelson, W. E. (1989). Mild head injury in sports: neuropsychological sequelae and recovery of function. Mild head injury, 257-275.
Neumann, D. A. Neumann, Kinesiology of the musculoskeletal system: Foundations for Rehabilitation
@doctor_kickass

The Science to maximize knock outs •••••••••••••••••••••••• In combat sports a fighter's goal is to render their opponent unconscious while minimizing damage to themselves. . Physiology of KO: Rotational acceleration of the brain. Shearing forces on the brain that strain the pathways in the upper brainstem. Additional impact can occur when the brain strikes the skull following impact. . Factors that influence KOs: 1️⃣Force generated by the attacker. This typically is generated by ground reaction force (pushing off the floor) to create force to to distributed by punch, kick, elbow or knee. 2️⃣The type of strike used: Rotational acceleration tends to cause more disruption to the brain compared to linear acceleration (Barth 1989). This may be a hook punch or straight punch if the attacker has the proper angle 3️⃣Neck Strength: A fighter aware of a strike can brace for impact and roll with the strike. However this only helps

Elbow health and rehab for jiu jitsu
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The armbar, arguably the most iconic technique in grappling, is a submission that involves hyperextension of the elbow joint (humeroulnar joint). Due to the prevalence of armbars the elbow is a commonly injured joint in Jiu jitsu. Maintaining adequate elbow joint health is essential for grapplers.
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After years of grappling many martial artists may lose a bit of range from chronic exposure to hyperextension, but the average person should have about 5 degrees of hyperextension.
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Almeida et al did a study to investigate the type injury following an armbar. All of the subjects complained had diffuse elbow pain at rest and on palpation, specifically in the medial (inside) area of the elbow.
MRI results revealed: 
1️⃣Total or partial rupture of the common flexor tendon
2️⃣Rupture of the ulnar collataral ligament
3️⃣Bone contusion of the distal humerus/olecranon
4️⃣Joint effusion.
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Prehab Strategy (How to minimize a breakdown of the elbow joint):
Controlled articular rotations: •Full pain-free ranges of motion
•This movement aids joint health by releasing synovial fluid and triggers tissue adaption of the joint
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Rehab Strategy (How to speed up the healing process from an armbar injury):
•Isometric loading: isometric contractions prior to painful ranges of motion to trigger tissue adaption to rebuild tissue capacity
•Gradually work up to 100% tension prior to moving into a new range
•Work up to 10-15 second holds
•Isometrics can be performed both in elbow flexion or wrist flexion to properly rehab the joint
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The picture below is of @matheusgabrieljj applying a vicious  armbar on his opponent @kennedy_jiujitsu .
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This post is a collaboration with @combatphysiodocs .
Reference:
Almeida, T. B. C. D., Dobashi, E. T., Nishimi, A. Y., ALMEIDA JUNIOR, E. B. D., Pascarelli, L., & Rodrigues, L. M. R. (2017). Analysis of the pattern and mechanism of elbow injuries related to armbar-type armlocks in jiu-jitsu fighters. Acta ortopedica brasileira, 25(5), 209-211.
@doctor_kickass

Elbow health and rehab for jiu jitsu ••••••••••••••••••••••••• The armbar, arguably the most iconic technique in grappling, is a submission that involves hyperextension of the elbow joint (humeroulnar joint). Due to the prevalence of armbars the elbow is a commonly injured joint in Jiu jitsu. Maintaining adequate elbow joint health is essential for grapplers.
.
After years of grappling many martial artists may lose a bit of range from chronic exposure to hyperextension, but the average person should have about 5 degrees of hyperextension.
. Almeida et al did a study to investigate the type injury following an armbar. All of the subjects complained had diffuse elbow pain at rest and on palpation, specifically in the medial (inside) area of the elbow.
MRI results revealed: 
1️⃣Total or partial rupture of the common flexor tendon
2️⃣Rupture of the ulnar collataral ligament
3️⃣Bone contusion of the distal

Understanding ACL injuries: Part 1
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@thebeastufc is reported to be scheduled for ACL reconstruction surgery. According to ESPN (@arielhelwani ) Lewis consulted with his doctors 2 weeks prior to his fight against Junior dos Santos who concluded even though he had a torn ACL he would still be able to fight. The source also confirmed that this was a chronic ACL tear from 2015 when he fought out of a kneebar attempt against Ruan Potts. Additional damage to the knee included a torn meniscus and torn MCL.
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Lewis ultimately decided to have surgery because he felt his knee “give out” during the second round against dos Santos.
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If he had his ACL torn for 4 years how could he have made a successful run for the title? ACL rupture requires reconstruction for return to high level competition, right? New evidence shows that is depends.
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Copers vs. noncopers: 42% of people are copers : meaning they have enough leg strength and dynamic balance to function despite not having an ACL.
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IDing a coper:
• No other injuries
•Minimal swelling • Full ROM
•Able to walk without a limp
•70% quadriceps strength on bilateral comparison
•Hop on leg without pain
•1 or less incidents of knee giving out.
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ACL reconstruction is still the gold standard for ACL injuries, which is a decision up to the athlete, surgeon and other medical staff. However there are many high level athletes who return to activity without a functional ACL. Consequences of nonop include further meniscus damage and early onset of arthritis. .
In this video orthopedic surgeon,. @drnimamehran demonstrates a lachman and pivot shift, orthopedic tests to demonstrate the laxity in the knee with a compromised ACL. These tests work better while performed under anesthesia due to the patient being unable to guard. .
Next post I’ll discuss the surgery, rehab and return to fighting.
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Reference:
Logerstedt, D. S., Snyder-Mackler, L., Ritter, R. C., Axe, M. J., & Godges, J. J. (2010). Knee stability and movement coordination impairments: knee ligament sprain: clinical practice guidelines Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 40(4), A1-A3
@doctor_kickass

Understanding ACL injuries: Part 1 •••••••••••••••• @thebeastufc is reported to be scheduled for ACL reconstruction surgery. According to ESPN (@arielhelwani ) Lewis consulted with his doctors 2 weeks prior to his fight against Junior dos Santos who concluded even though he had a torn ACL he would still be able to fight. The source also confirmed that this was a chronic ACL tear from 2015 when he fought out of a kneebar attempt against Ruan Potts. Additional damage to the knee included a torn meniscus and torn MCL. . Lewis ultimately decided to have surgery because he felt his knee “give out” during the second round against dos Santos. . If he had his ACL torn for 4 years how could he have made a successful run for the title? ACL rupture requires reconstruction for return to high level competition, right? New evidence shows that is depends.
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Copers vs. noncopers: 42% of people are copers : meaning they have enough leg strength and dynamic

Mobility vs. Flexibility ••••••••••••••••••••••
Mobility and flexibility are poorly understood nowadays with many differing thoughts on the subject. What's most important and how to achieve it?
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Some rely completely on static stretching, while others say that
@doctor_kickass

Mobility vs. Flexibility •••••••••••••••••••••• Mobility and flexibility are poorly understood nowadays with many differing thoughts on the subject. What's most important and how to achieve it? . Some rely completely on static stretching, while others say that "stretching doesn't work" and to focus entirely on active movements. 🅰️Flexibility: The ability to passively move a joint or limb. Often this is improved with stretching. This ultimately is your movement POTENTIAL. 🅱️Mobility: The ability to actively move a joint or limb. Often this is improved with dynamic mobility exercises. This ultimately is your current movement AVAILABILITY. . Which one is necessary? Technically the answer is BOTH. . The ability to have a range of motion that you cannot control is a problem. The ability to have control of only a small range is also not ideal. "You cannot have active motion without passive motion first" - @drmchivers . . Anecdotally who

Can you kneel? Knee mobility prerequisite for grappling
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Being able to sit on ones heels is a fundamental mobility requirement for most humans. This position is particular important for movement arts, such as jiu jitsu and yoga. There are many factors that may limit you: joint hypomobility, muscle length deficits, swelling, neural tension etc. Here is mobility drill that you can do to improve your kneeling mobility.
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1️⃣End-range squat holds: squat as deep as you can and spend time at the bottom. If one knee feels tighter you can lean towards that side. Start with 20 second holds and build up to 2 minutes.
2️⃣Kneeling PAIL/RAIL: kneel to your end range and hold for up to 2 minutes. 🅰️Progressive angular isometric load: gradually contract your quad in a lengthened position. Start using lower intensities and progress as your quad builds resiliency. Hold for up to 15 seconds. Perform 3-5 repetitions.
🅱️Regressive angular isometric load : once have gradually increased to a maximum PAIL contraction you can perform a RAIL contraction. Engage your hamstrings and actively pull your butt to your heels. Hold up to 15 seconds. Perform 3-5 repetitions.
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Professionally I would recommend someone who is coming back from a knee injury be able to perform this movement prior to returning to Jiu jitsu.
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Nothing should be painful. 
Interested in improving your mobility? I run a mobility class bimonthly in Sacramento. DM me for details.
@doctor_kickass

Can you kneel? Knee mobility prerequisite for grappling •••••••••••••••••••••••• Being able to sit on ones heels is a fundamental mobility requirement for most humans. This position is particular important for movement arts, such as jiu jitsu and yoga. There are many factors that may limit you: joint hypomobility, muscle length deficits, swelling, neural tension etc. Here is mobility drill that you can do to improve your kneeling mobility. . 1️⃣End-range squat holds: squat as deep as you can and spend time at the bottom. If one knee feels tighter you can lean towards that side. Start with 20 second holds and build up to 2 minutes. 2️⃣Kneeling PAIL/RAIL: kneel to your end range and hold for up to 2 minutes. 🅰️Progressive angular isometric load: gradually contract your quad in a lengthened position. Start using lower intensities and progress as your quad builds resiliency. Hold for up to 15 seconds. Perform 3-5 repetitions.


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