The Biggest Mistake After ACL Surgery: Returning to Leg Locks Too Early

Podcast intro and guest introductions 0:00

Do you train combat sports? Have you ever been injured? Dr. Megan Jimenez is an army orthopedic sports surgeon and jujitsu black belt. This is Dr Jujitsu, your go-to podcast for combat, sports, military performance, injury prevention, and treatment. New episodes drop the first Friday of each month. Hi, I'm Dr. Jimenez. I am an orthopedic surgeon and black belt in jujitsu. Am sitting here with my good friend, Mike Pekarski. He is also a blackbelt, he's been a Black Belt since 2018 and a physical therapist since 2015. You guys might know him as DrKickass on Instagram.

It's an honor to be here. We've been talking and chatting and doing research for what, two years? Maybe three years. Yeah, it's And we're finally meeting this time for a course that you did yesterday. If you want to do a little plug on that real quick. Sure. So, you know, I did my first Treating the Jitsu Athlete course, which was just a full day course where I get a whole bunch of physical therapists, athletic trainers to come down and we talked about how the rehab process might be different for jujitsu athlete versus like a traditional field athlete or just general population.

And for me, it was super cool having an orthopedic surgeon there because, you know, as a PT, I get to learn so much from orthopaedic surgeons in general. So to kind of like hear something on the other side, It made the course for just a little bit, just added that little depth and I could definitely tell that there were a lot of the people who attended appreciated your insights. Well, yeah, and it was awesome because a lot of orthopedic surgeons, I think, aren't super keen on what goes into physical therapy.

And it's not by our fault. We're not trained in it. Sure, sure. Or not taught it, we do a surgery. It's like onto the next surgery, all right, go see a PT. But not all PT is equal. Correct. I thank your flair for it treating Jiu-Jitsu athletes, which is where I'm going as well in orthopaedics. Treating Jui-jitsu athlete is very different than the regular athlete. What are the big differences that you see when you treat? Because you're treating clinics still. You also have your online Jiu Jitsu focus, which is probably your bigger focus.

What do you see is the big difference between other athletes and Jujitsu athletes when you're treating? Well, so I would say a big thing with certain things is you look at the demand of the sport. So field athlete, they need to run, and they jump, then they cut. And that's not necessarily the focus of Jiu-Jitsu, like obviously these are things that you can do, you still want to develop their athleticism, but it doesn't have to be the major focus. One of the big things I look at is, we look what I call my movement milestones, and these movements or positions that are somewhat unique to Jui-jitsu.

And from there, you can kind of boil down what does the injured joint need to be able to do. And then from, there you make sure that the joint can do everything that it's supposed to, and then you could then build in the sports specific movement, like kneeling, framing, posting, et cetera. Then we kind build from that. So in my opinion, that is where sports-specific PT or rehab should be, is understanding the demand of the sport.

Jiu-jitsu rehab course and sport-specific PT 2:56

Those are some of things that I typically see. Is your rehab pretty similar in the early stages after a surgery? And when do you switch a focus to, hey, Jiu-Jitsu is where we need to return to? Around what, I guess, time frame or, you know, do an ACL surgery. At what point are you switching from that more athletes focused early recovery to sports specific? So I would say the way that I look at is is acute subacute phase is pretty similar. It's when we get to that strength and conditioning can start thinking about return to sport phase where it gets a little bit different.

So specifically for ACL, it would be between month four or five. A lot of times because I do work with people online for return-to-coaching, so it's kind of like when their insurance ends, which usually is around month four or five, but we know that, you know, return to sport is month nine. That's usually kind of when I take over that role, so I can do that last 20% to ensure that the athlete's actually ready to get back to sports and they don't re-tear their ACL. So if an athlete tears their ACL, for example, heel hook, right?

How I tore mine, how many people tear ACLs, when are you putting them back into that position to start mentally getting ready for that postion again and stressing the leg for the position again? So I do, you know, I remember at the course I talking about doing like long range rotational isometrics and I think where I'm going to go with my course is I am going take one of those lectures and put it online and then I will spend like more in person time where like I get someone on the mat and do it.

But literally what I would be doing is like I get someone on the mat and I'd be like, or the table. So they're not even on them. And I'm doing Isometrics. It'll look like i'm heel hooking somebody, but I am just doing low level Isometric so they are resisting. They are doing that yielding Isometry that I discussed. I mean I could be do that month two, three, because it's all low. Like so I doing a low-level Isymmetric. so there getting exposed to rotational stress fairly early on. If I am working with an athlete at that month five mark where they'd already done PT, most PTs aren't doing those rotational stresses.

So it might be month 5. But for me, like I could do it fairly early for something like meniscus repair where you want to specifically, if it's like a complex tear, you wanna avoid those rotation movements. I might wait until month 4, but I think meniskus repair is probably like, a more conservative in that sense. So like literally it would look like I'm heel hooking someone on the table. And just a low velocity, a very low amount of stress. Do you think that's more for the mind or for body? I do it more for the body, but there is the mind component as well.

Because a lot of times, I mean, notice like, you know, when you were going through ACL rehab, where like you're like okay, now I'm in a heel hook. Is this person going to try to break my leg? You know? So now, like one of the things that I like doing from a psychological confidence standpoint is like we do all the, kind of ran you through the course where we have my moving milestones and then you know, the great, great exposure to sport. So they're going through jujitsu, but they are not getting the leg attack.

And then at some point I would want to get their leg attacked in a controlled way. been heel hooked by my PT, not really heel-hooked, you know what I mean? I've been putting these positions in a safe manner. Yes, yeah. And even when I was returning back after the clear from my doctor, which I did behave and wait for, at that point I went back and I with small people, my size, and just said don't go after my heel, just put me in an Achilles grip. put me in outside actually where I got injured and just let me work, but don't try to put anything on.

Don't force anything. Let me just figure it out and get my mind. Cause I get put in that position and my heart rate would go through the roof because I was just nervous. I had seen it so many times on tape, my ACL tearing, right? And so- You got a tape of it? Oh yeah. Oh no. Yeah. So then you can watch it and watch, cause I didn't know what happened when it happened. That was the interesting piece I kept going. And then afterwards it was like, okay, let's do another match.

ACL rehab, heel hooks, and psychological return 7:00

So it wasn't until I watched that, I was actually getting a tattoo the next day. And I showing my tattoo artist, he's like, wow, it's a miracle you didn't break, tear anything. I definitely did. I didn't even realize. It was a little swollen, I wasn't unstable. And so different ways, different ACL patterns, how you experience it. Okay, so kind of going back, let's go to your origin story a bit. Black Belt, physical therapist, we joke around because yesterday we rolled for the first time, finally, and we're both going after each other's legs, but in a very controlled way.

Right? I did not feel in danger. We were safe. You grip something, you let go, then we move along. That's how I wish more people could train. Do you think, or how does being a physical therapist and a black belt tie into each other? And then how did your brand get started? So I'll start with my origin and then I kind of go from there. So, I had started Jiu Jitsu 2006. I was in college. Actually, what happened was I started, where I went to college, there was a club and I'm surprised we didn't all get destroyed because there The guy running the club was a white belt.

So it was like the Wild West. We were doing heel hooks on each other day one. You know, we had no idea that they were bad. And then I found a guy local when I'd be on break. My first coach at the time was the purple belt, which is kind of interesting now that people start with black belts and they don't realize back in the day what it's like. Like you don' really have access to black belt's. We have access to tape. We don't have to Instagram, social media really. And you just, people would black out their windows, right?

Cause it was like our gym gets this in your gym. It wasn't this like interaction cross training. Exactly. Yeah. So I, you know, I started Jiu Jitsu. Um, um, and then, uh, like this is cool. Then my coach was fighting and in one time he approached me, he's like, are you interested in fighting? And I'd like I'm like a nerdy, unathletic guy. I was. Like, And then I started preparing for it cause I was helping him and I start having fights and then, you know, I had my pro fight and got my nose broken.

And I, was, think I already thinking this way at the time, because I'd been in like pro MMA gyms where I could see those people. There was a few guys that I used to train with, like they were in the UFC, but they, were like the best of the, they're were natural athletes and they super dedicated. Then you'd see people who weren't quite at that level and there were kind of in these local shows making peanuts for money. They're like hoping to get that one win so they get to the U of C. And like, I realized like I don't have the athleticism to be a UFC fighter.

Um, you know, as much as like... I could train as I want, but you, know that athletic system, it just wasn't there. So I was like okay, well I need a more realistic long-term career path. Originally I think about being a personal trainer and then I, was thinking about physical therapy assistant, and I realize I didn't like listening to rules. I'm like well, just be PT so I can do my own thing. And then it wasn't until like I graduated that I realized that it could emerge the two because, you know, I wasn' thinking doing PT for Jiu Jitsu because at that time like Jui Jutsu was so, so small, there's no money.

And then, you know, I'd be in the clinic and I'll be training with people. And so my training partners would come see me. Like, like I want to work with you because at the time I was a brown belt and then I keep my black belt. They're like, oh, yeah, guess I do. But then this is why I made the course is even though I I did understand jiu-jitsu. It wasn't as, you know, systematized as like my course was. Like it was just more haphazard. So then what I do is I kind of took my rehab process, I put it on paper, and then I allowed myself to streamline the process so then i could teach others kind what i do.

Yeah, and I love your courses online, too. I go through them. And even when my partners at work, other orthopedic surgeons, they're like, hey, I've got this guy that likes jiu-jitsu. He just did this ankle reconstruction. What the hell do I do? Because nobody knows the terms. They don't know how to tell him to go back. So I always go to your stuff. All right, what would Mike recommend at this stage? And then we try to help the local physical therapist. Because most people don' t know what a delhiva is.

they don t what these positions are. and they dont know the injuries occurred when you tell them the lingo. People do come to us because we understand the Lingo Yeah, and one of the things too for my jiu-jitsu rehab course, I reach out to you and a few other surgeons because I didn't want to say, hey, you can get back to jitsu at this time. And a surgeon looks at it and like, what are you talking about? And then they hate me as the, so I kind of wanted to see like what would a sergeant be okay with?

Because I mean, doing jui-jiitsu, obviously you're probably less conservative than other, but there's a lot of surgeons out there that are like very, very conservative. So, you know, I kind of wanted a good balance, getting a, good idea. So like I didn't get someone on the mat too slow as well, but I also didn' want to make it too fast where they're going to be re-injured. Yeah. And that's why I appreciate the collaboration. Um, when, we worked together, sure. Getting those athletes back. It's so much more helpful.

We talked about that too yesterday with a lot of the PT's because it's tough to find the PTs when there's hundreds of PTS and then you're just sending your patient out with little protocol. You know? It' hard. Okay. What is the biggest mistake you see Jiu-Jitsu athletes make when they get injured? I think it's just that they ignore the injury. They just think, oh, my elbow popped. It's fine. I'll be back the way it was. And that's not always the case, especially as we get older. We don't heal as well.

These minor injuries start becoming these chronic disabilities. This is why you look at all these black belts. You know, they only can play a very limited game because they have so many injuries that like they can't do the game they did when they were in their 20s and 30s. Yeah. And ignoring it early. So I mean, you probably get these texts a lot. I get this text all the time. Hey, my elbow popped again. Sure. Okay. What did you do the last time it popped? Sure, I just put a sleeve on it and kept going.

It's like, okay, keep popping. When are we going to make do something different? Definition of insanity.

Origin story and building a jiu-jitsu rehab brand 12:40

You did the same thing. How do you talk to these athletes? Because I feel like I can never get through, and sometimes I am that athlete, right? Like, oh, my neck is a little sore, but I'm not stopping. And the game modification, I think, is big deal. We can go into that, too. But how do you talk to these athletes and help them make better decisions for longevity, for them in 10 years, in 20 years? Sure. I mean, so, you know, there's some good and I'm very guilty of this too. Like if there is a minor injury, like I am still training, but it's kind of, and this is kind difficult.

What's a mild injury and what's something where you actually have to do something about it. So, if you have like a tweak and like within a few days you're back to normal, it might not be something you can't be on the mat. Or it is not a bad idea to just go straight to activity modification. Someone tweaks your neck. maybe you're gonna just do more focused on ghee because there's gonna be less of those guillotines front headlocks. Not that they're not there, I still do them in the ghee, but you know, you have other options and ghee chokes tend to be cleaner and they are nicer on the neck.

So that's a super easy one. So I'll use those objective testing that I ran someone through. You know, like when we look at ACL reconstruction or like whether someone needs a reconstruction, or they can go non-operative, being a coper, a lot of those tests that do to clear someone, I could just clear to see if they're a copper. Like, you know to identify a cooper is I think like there's like those one criteria is like, can you hop on one foot before we even see, if like if can do that and their knee doesn't buckle, they could potentially be a cober.

Yeah. Can you explain that Coper a little bit more? What that means? So a Copers someone, and you know, I don't know if there's any science on why someone's a coper, but there are some people that have no ACL and they don t need surgery. They can do sport. they have know instability. I would be fascinated to know why, you like, is it based on with the injury? Does it just like the ACL scar in a way that you have that stability? Is it a neuromuscular control issue? That's what I think it is, more neuromuscular and age is a big one, right?

Because the older patients, I tend to offer non-operative more for them. But people are under the misconception that they have to get an ACL surgery. And I get soldiers all the time that come in to me and they're like, my ACL is torn, and I have get a surgery? Well, not necessarily. Let's talk about that. So the copper thing, there is a copper classification and there's criteria that people meet to see if they will be a coper. The problem with Jiu-Jitsu is, and probably a lot of sports, I think I see it more in Jui-jitsu, lack of insurance, maybe lack trust in the medical field, but they'll tear their ACL, hear a pop, not know, just keep going.

Because especially with leg locks, not even getting to a heel hook, just the entanglements and the rolls, there's little pops that happen. And could be ACLs, but people keep going. They don't even know. Then sometimes I'll go visit a gym and see some friends and they're like, hey, can you check my knee out? I had a pop two years ago. I think I know ACL. Like, oh, you haven't had an ACL for two year, how does it feel? And sometimes they are lucky and then they okay. You still have to do the PT. So even if you're going to non-op, got to go to physical therapy.

That's kind of the trade off. People don' want to that. Yeah. And you know, they do a lot of, there's a lotta researchers in Australia, cause it's socialized medicine. Like you might, if you tear your cell, you may not be getting surgery for like two, three years. So they really push rehab over there. There's lot a times that if somebody is not a coper, If you go through like a full course of rehab, You actually can become a copper. And then jujitsu specific, it's also very style based. Like if you're a guard player, like you probably could get away, even if have a little bit of instability, you could probably get with it versus if your like a speed loose passer.

Take downs wrestling. Yeah, those type of athletes, maybe you want an ACL. I want to talk about modifications when you're training. So people have injuries. We don't want be out. I think you quoted a paper yesterday that if they're out more than a week the mental satisfaction goes down and you become sad. And so after a weak of not training in martial arts. For example, I have a neck injury right now. And so yesterday I was rolling with your wife, who was like, unamazing. I had such a good time rolling because it's very difficult to find 120 pound female high level that are technical and safe.

Like I felt safe doing my whole game with her. But at one point, you know, she was very savvy with leg locks and defending. Yeah. and I, and had to invert to continue getting the leg lock, but I bailed. That's not worth my neck. It looked probably ridiculous because I just like flat my legs out and bail to a turtle. That's hard to do. And I really had to think about it. When you're not with safe partners, you might not think that because you are so busy protecting yourself that you aren't thinking that way.

How do you recommend people train while protecting injuries? Big thing, if you can control your training partners, we all know those people that you say go light and then they roll like it's ADCC finals. So avoid those. If you're going to stick with people your size. I mean, not everybody has this option. Like with women, there's just not a lot of people of your. But finding the smaller people, usually I would say a higher belt knows how to flow, right? Um, you know, let them know. And then, if you can't, like one of the things, which is hard for me to give like global advice, but you take something like a neck injury.

If you kind of see how these neck injuries occurs, so anytime someone's going to grab my neck, it's takedowns or I'm doing a lot of like smash passing, half guard, these are things where all you can do if you're the opponent is grab the neck or the arm, right? So if do something like loose passing, standing passing like the next is nowhere nearby, you know. So that would be obviously something you could do. A lot of guards, assuming you have the awareness to not invert is obviously can be safe. You know, and sometimes people, some people don't necessarily want to modify for the most part if I can get them back to doing something.

Your like, I could have you do this, it's not inverting, its not what you but its jujitsu. And then, you know, because like, I'm also an instructor, so I always push my students, like you don't always have to play your A game.

Common injuries, copers, and training modifications 18:30

Like you should be developing. You should never be the same grappler that you were six months before. So even though it's not your game, Like, You just start working on stuff and then that becomes your thing. That's why I use the example of Gordo, the creator of Half Guard. He had a knee injury. couldn't play normal guard, so just played half guard so he could still do jiu-jitsu, and then he revolutionized it and now we have modern half guards. So it was like something where, you know, the injury pushed his technical innovation.

And that's every injury I've had? Yeah. I have developed a different part of my game. Before my neck, my neck has been bad for years. Sure. But before it got bad, I was inverting and doing these things with big people, not knowing any better, getting stacked, then it And so all of a sudden I was forced to play top game. So every time that my neck eggs up my passing gets phenomenally Substantially better sure because then I just do that but you have talked to your partners, right? Like my fiance is 215 pounds and I'm like, hey, babe, my my Neck is hurting so I am just gonna be passing right now and he loves to wrestle So it's very hard for him.

He has to work on his bottom game, too. All right, so that's a great tactic I think Let's talk about rest even without injuries, we all overdo it. We're trying to do twice a day, trying train every day. How do you talk to your athletes about rest? What do recovery days look like? what do deload weeks look and how do recommend that? So in a perfect world, what we would do is you would, cause for the most part, you should kind of know what your training schedule looks like between jujitsu, strength and conditioning, and then like life stress, because these are all things that play in, like you'd be an orthopedic surgeon.

Like you have a lot more stress than I do. At least I feel like when I go in the OR, I get stressed just observing. But that affects how you're recovering. So what you can do is load management is super key. You can't just be like I'm going to train hard every day, every session, twice a day. Just your body won't be able to handle that. And it's a gradual accumulation, so people see these high level grapplers that could be on performance enhancers, what allows them to train more. But if they're not, you know, like they didn't just do that in one day, they built their way up.

So it should be great exposure to adding new stressors. One of the things that I'll do is I might have, if I do two training sessions in a day. or I do like a skill training and a physical capacity training, I kind of say, hey, you know, this is a, a skilled day, but I'm also going to do, like, heavy leg day. Maybe, um, not doing, maybe I am doing like moderate intensity training. So one of the ways that I can do it like I like doing a lot of takedowns, or at least, because it's something that, that want to be better at takedawns.

so if, if I know that i'm going be tired from strength conditioning, i might just be like i am going pull guard today. You know, but then if like, if I'm not doing a double, be like okay, now I am going to do takedowns, you know. And I've done that where I would try to, I do two jiu-jitsu sessions a day and I get older, so those I don't recover as well. So I can't do too hard days. It might be a hard session and the next session is a little bit lighter. And a lot of light sessions, like when I roll with my wife, I just put myself in really deep submissions and try to work my way out because she's not going to hurt me and it's something I have to do anyway.

So it is a way that I can still get something out of it even if I'm going light. And then when it comes to like ways you can know when you need to, I like using a lot of objective data. So I'll use resting heart rate. I got a Fitbit, which kind of tells me so I can kind see how my body is recovering. Also use a heartrate variability. so all use the Morpheus, Which is, you know, in the morning, You know I check it and kind gives me a recovery and an HRV. It kind let's me know how I feel. Is that a chest strap or is that something you stand on?

So there's two versions. So I have one of the older ones, I think, to get rid of it. It's like a form strap that I use in the morning. And then I used the chest strap when I actually, if I'm actually going to do cardio training, um, think they've switched and they'd gotten rid off the form. But like, because I had that, can still use it and I've, sometimes the data will give me different if use a chest wrap for the mornings. I heard the check strap is a little more accurate from some of podcasts I listen to.

Yeah. When I do conditioning programming for my athletes, they have to have a check-strap on it I won't let them like I work once with a guy who had like an Apple watch and the data was so horrible It was useless like like the I wasn't like he might not have even done any objective data because it wasn' helpful And when your HRV is off like probably too high also goes it goes both ways So if it's too, high then you're more likely in a parasympathetic nervous state So maybe you were maybe your recovering from something.

Maybe you are getting sick So high isn't always good And then if you're low, that usually means you more sympathetic, like you overtaxing yourself. And, you know, I've listened to some coaches where they feel like it's just noise. It doesn't tell you anything. I mean, i can see because like, let's say like my recovery day is poor and it says you are in the red zone. Like I can still train if I want. But then what I notice is then like the next two or three days I'm still in red. So it is kind of like I could train hard.

Because, you know, like, let's say, so like this weekend, I was expecting to do a lot of training. So it's like I'm going to roll, even if my recovery is bad, because I wanted to train with a load of the people here. Thankfully, it wasn't bad. But you don't always get to control the situation, but then there's that repercussion of now I feel like digging myself a hole and now I have to take a few days off to kind of bounce back. So for me, subjectively and objectively, I think they're fairly close.

For some people, they just go by how they feel, which is fine. As long as you're listening. Yeah, exactly. I had multiple clients slash old training partners that stopped using the Morpheus because they are like classic overtrainers. They're like, well, it tells me not to train. I'm not going to listen to this. They just stop using it. And I am guilty of that too. Yeah, I think as we get older too, 30s is not old, but for Jujitsu we were talking, that is kind of a little bit on the older side. Things change.

Yes. Right? I don't go as hard in the paint as I used to. and I look for partners that are safer. Sure. Okay, let's go on to some injuries, specific injuries. Sure. You post a lot on Instagram about different positions and knowing when you're in a dangerous position. I think that was part of what happened with my ACL. Yeah. And I didn't realize how much danger I was in. Especially in competition, your brain kind of just goes blank. So I'm here to win. What are some of the most injuries that you've seen occur where somebody might not know that they're I would say just a lot of leg entanglements.

I'd say, you know, thinking about one of the big ones, lockdown's a big one. You hear a LOT of people getting injured with lockdown. And it could be a variety of things where if you don't train with anyone who's done the 10th Planet style, like they don t even know what this is. or don't think it's that dangerous. I've seen a lot of ACLs pop. Yeah. And I see a lots of injuries that happen from leg entanglements are people that just like disregard the entanglement and they just try to bust through.

You know, there's a good example of T.J. Delashaw when he fought Corey Sandhagen. So Corey gets him an inside heel hook. And like TJ Dillashaw just completely ignored the leg lock. He just kind of like shrugged his leg, popped his knee and got out. But he ended up tearing his meniscus and his LCL. Like he end up winning the fight, but he was out for a year. And then, you know, I think he had one other fight which might've been, maybe one comeback fight after that, Maybe two, But like that was when his shoulder was so unstable.

So it's kind like, I mean, he lost a year of his career just because he blatantly just ignored the leg lock. You know, a good example, if we look at UFC fights, there was also Corey Sanhagan versus Figueredo where Corey Sandhagen had him in a 50-50 and he went for the sweep. And we just talked about 50, 50. A lot of people, they think, I mean, yeah, the point of 50 50 is to get to a leg entanglement, but if you resist, and I've worked with a training partner where I swept him from 50, 50 and he was fighting it and popped his LCL.

Um, thankfully it was only grade two and you didn't need surgery, But you know, it is one of those things. I think that's a big one that people don't realize that, you. Know, if, like, If you fight it in your knees, a somewhat of provocative position, It can be damaged. Yeah, I think that happened to me last year, a 50-50 position where the clock was running out, trusted training partner,

Load management, recovery metrics, and HRV 26:40

but I didn't have my leg reinforced and my foot was on the hip. But you're almost locking your own knee in place, right, if you take your toes around the hips, and then my partner kind of tried to blast through my knee, It was just a sprain, everything was clean, it was a spring to the ACL, but I was very grateful because I didn't want to do an ACL again. But it took me out of Worlds last year, out a Worlds Nogi, and I learned a lot. It's like, hey, I need to be better about protecting myself. And maybe reinforcing that leg, or realizing another friend, she had her ankle popped because of a delahiva.

I think she had a very tight delahiiva hook and then the opponent tried to blast through or tried like to rip the delahaiva aggressively and her whole ankle popped. She's recovering from surgery now from that. Reversed delhiiva too. Anything where you have a hook in like that and people just blasts through. Just being more cognizant of not doing these blasting or super spinny motions, anything really quick like when your knees compromise. But it's hard to do because your instinct takes over. Okay, maintenance physical therapy.

People laugh at me because I have standing appointments with physical therapists and just to take care of various injuries that I've had for a long time. Is there something that you recommend people do every day, every other day? Should everybody be doing some kind of maintenance? So my maintenance, I know, you know I didn't get to show it tomorrow but there's videos, but I use something called a car controller to give rotation, which essentially is an end range rotational movement and I can do it through every joint of my body.

And the reason why I do that is because one, you don't lose range of motion because of age. I mean, it can get worse, but I think it's more from disuse and injury and the injury could make cause the disused. So I kind of think cars have a few different roles. One, I can use them as a joint maintenance. It's kind like joint flossing. With flushing your teeth, You're just kind getting rid of all the, bad stuff, same sort of thing. Like, you know, when people go to jujitsu, like even if somebody, if someone's torquing on your shoulder with a kimura, not bad enough where you're damaged, but you just putting that little bit of stress.

I mean, there might be just this micro trauma that overall, If someone does that day in day out for years and years, now you'll notice your shoulders getting more limited. So I like doing control articular rotations. I think they're very beneficial. I also think there are good, very self-assessment, because as you're going through something, if you start feeling like, oh, when I'm taking my shoulder in this range, I feel pain. And comparing to the other side. Other side, yeah. Yeah, OK. That's tight.

What would be an example of like a car for a shoulder? Shoulder. OK, so normally I would have more room. So what I am going to do is I will start with this. Don't tip your coffee. I'm going to go across midline, I'll go as high as I can to this max elevation, keep my chest nice and tall, start to externally rotate my shoulder, or internally rotate, and I'd go all the way back. I shouldn't be moving my shoulders or my chests, this is just so I don't hit this thing. doing a rotational, so not only am I doing big rotational movement, but I'm kind of taking that glen or euma joint and I am spinning in the socket as I go.

So typically what you're going to see when you run through someone, if someone has like a closing angle pain or classically for people who aren't in a medical field, that's like an impingement, right? So what should happen in healthy shoulders, you should have more of a stretch in that lat. But if I get a pinch in front, what that is telling me is that shoulder There's aberrance joint movement. Like it could just be like it's sore, but it might be that there's like something going on. And especially if there is very like, I get a very sharp focal pain when I'm going into internal rotation that gives you information.

Then usually what I can do is then I could get them on the table and I check their rotation. Be like oh, now your internal rotations really poor. Maybe this is something I need to address. Do you do these for yourself every day? You try to make sure certain joints are where you're kind of sore. Sure. I do. So what I, do is I. Do them daily. Uh, I probably realistically do them five days a week because, you know, everything. But, but I'd do the daily and I then I will do, is also do then before I did a workout.

so if I'm doing Jiu Jitsu or I am doing a strength conditioning program. If I do strength kissing, it might be like related to what I'm doing that day. So if I am doing like a upper body day, I might doing elbow, wrist, shoulder, whatever. I'd do curves for my hip every time I run. Oh, yeah. Before I ran. Yeah, because tight hip flexors and tight IT band. And I think that's helped tremendously with running. Yeah. So, uh, that's one, um, you know, if I'm doing jujitsu, like if anything's sore or it's like, okay, well, what I, would I like to do?

So like this week we're doing leg entanglement. And so it'd be like all right, I'll do hip because I do a lot of leg dexterity. I will do knee because of the rotational movements and then I'd do some ankle stuff. Your knee car, would that just be like internal, external rotation of the tibia or the shin bone? So what I do is like, you can start from 90 degrees. I could just rotate back and forth and that's the rotational component. And then what it can do, is I can add a linear component where I start to externally or internally rotate, I straighten as much as I, can and then I internally, rotate from there.

So essentially it becomes a rotational movement. Usually when I teach people, because if I said to the average person I want you to rotate your leg, You're going to look at living like I'm a psycho. So usually what I'll do is I will just start with just in place. This would be called a Capsular Control Articular Rotation because I'm just working on that rotation. Then initially in the initial phase I usually will do the transition at that 90 degrees because it's easiest. So I have them bend and straighten, rotate, bend, and straight and then as they get better then I can have it like being circular.

And I think most people don't understand how much motion there is to the knee. Correct. We just think it's kind of bending and straightening. But there's so many extra various valgus in and out. And then there that rotation that people didn't appreciate. Yeah. That's a lot of how ACL tears happen. Exactly. Is that a rotation. So what are the big things? As an instructor, like I have run some of my students through cars, but then there's always the big thing for class. It's like, how much time do I want to devote to this?

Because it's, the more that I do, it like learning a jujitsu technique. And I'm big on like training time should be for training. So like if I've 90 minutes, my warmups are those games.

Leg entanglements, maintenance PT, and CARs 33:00

I am not having people run in place. We're just doing low level grappling activities. Everything should benefit. but it'll be very fascinating is, you know, because a lot of my students are also current or former patients. You can see people doing their exercises while they're waiting, which is hilarious. That's good. Yeah. Okay. So for warmups, right? Everybody is so warm up averse. And I'll tell you, I even trended towards warmup aversion myself when I teach because I was like, we only have an hour, so you really only had 40 minutes of instruction, for example, and then maybe 30 minutes and the other for training if people want to roll.

And a lot of people it's their workout, right? People come in after work and they just they don't want hear you talk for an hour. What warm-up would you recommend it for like five minutes that might be helpful for a class that's only an our just to get everybody's joints moving a little bit better and ready for the class? What I would do in a perfect world, if I could teach my people to do it before class, because everyone's waiting, so I'd have them do, where do we know that you're gonna get hurt?

It's gonna be shoulder, knee, and your spine, maybe neck, whatever, elbow. So I might have then do a few of those before. And then my warm up, like I said, is low intensity grappling. A lot of times I'll warm people up. We're starting with pummeling because that's an important skill. I may be doing hand fighting because you are competitively moving, it's really important. Yesterday I did, So just like these like CLA games, I just pick specific low intensity ones. So like a guard retention game where it's like, you know, i'm just trying to get inside control or iIm tryingto touch you with my feet.

Passers just try to clear the the feet line. so it is a way that they're getting to do jiu-jitsu but it s low-intensity. And then one of the things that I don't know if you're supposed to do in CLA traditionally, but I will still do is I explain why. Because I think a lot of times a a of a motor learner people will say that if explain to them that you might be somewhat controlling their ability to learn because you are molding it. But I've also been in stuff where like we've done these games and I didn't understand the point where it like so didn' actually click.

But if I'm like this, I tell everyone very very simple like, this silly game when I am passing. I do that with every single person I pass. It's like check in the box, clear the feet net. clear the feet line, clear knee line clear frame, I'm passed. So like I might even be like, or I like roll with like a lighter blue belt and I am doing with them and then I said like you know that game that we did in the beginning? I just did that for 30 seconds and you didn't know. You know, so then they realized like oh here's a black belt, and he's doing it.

What I would like to think is that what gets by in where the students are like this actually does make sense. And then because now they're warming up, they are getting warm, Now they're ready for that harder training. Cause the big problem with warmups is people will do, you know, and we've all been in those classes. I don't want to say that they are necessarily run by Brazilians, but they like 30, 45 minutes of like conditioning and you're exhausted. Which the problem of that is if you do that now, it's going to affect your motor learning.

So you are not going be as good at processing. And then it's like, why did I spend 40 minutes doing conditioning when I could have done that on my own? And this coach probably isn't a strength and conditioning coach. So it was like what are we doing here? You know what I mean? Yeah. Sometimes for comp classes, I love that. And it has its role, but probably not every class. For comp class, you do all that and you're exhausted. You have to know how to also compete when you are exhausted, it doesn't have every classes.

Yeah, yeah. Moving on to some other coaching things, if you could change one thing about how gyms manage injury prevention, or not even change it, but what could you recommend to gym owners that might be seeing a lot of injuries? Because they happen in Jiu Jitsu, frequently. And so how could recommend people? So I think a lot of injuries is based on the culture. So, I really, really push in the gym a culture of learning versus winning. Like, like I'll tap to colored belts. I don't care. And I tell people, see this blue or purple belt?

I tap it to them. So if I'm a black belt and I tap to a color belt, and you're a blue belt. You tap two blue belts. Why do you care? Like, why are you upset? You know, so I kind of focus on that. And it's like, cause look, if you were always just playing your A game and be like cool, I, the best in, you know like right now we're in the middle of nowhere Eastern Washington. Like so it was like I am the guy in this little town. Who cares? Nobody cares, right? So you'll never get, one you will never be able to actually add technical skill because anytime you add a new skill you are not as good.

So if you're like, well, if I go to this, I'm like I want to do this but then they might tap me and I am scared so I just not going to it. You just never get progress. We've seen all those people and this is something that I got plateaued at Purple Belt because I would just try to win every role and then I was at purple belt for five years and like why am I not getting better? probably because I had the wrong mentality, right? Using the same couple moves that you're good at. Yeah. Which when you go in for competition, sure, you know, sharpen that stuff.

But regular days, I'm always trying to learn new things and teach new thing to my students. So one of the things I tell people, like you don't have a competition on the books. You should be focused on motor development. If you have competition in the book, then you switch from motor to competition prep. That's when can start to refine. I think that's a big one. And like I said, because i focus on that, i think students get there. focus on control. Like we were doing leg locks, we're very controlled.

It was never like I'm trying to destroy your leg. And like, you know, I've been with people and I'll catch their leg and just hold and then I kind of see. I am not a big fan of catch and release because if I catch I release that doesn't, so now then you don't have the awareness like you were caught. But then also like do think understanding breaking mechanics is important. So what I mean is once I have control I can apply it slow. so I giving someone plenty of time to tap. And, you know, if you watch some of those videos that I showed yesterday, how many times did something happen where they could have tapped, but they didn't.

They had plenty of time to cap. You know. So I think as long as you give somebody time. To tap, like I said, I've never heard anyone help with leg locks. I have been here and I heel hook white belts and kids, and i don't care. But you Yeah, I teach all levels, because I think it's important just to understand how to apply them, how do you defend them. And so I'd teach that in my class.

Warmups, gym culture, breakfalls, and longevity advice 39:20

But I do teach more of a catch and release, Because I'm more nervous that the other person's going to roll the wrong way. Inside versus outside, heel hooks, inside heelhooks, are more dangerous, more catastrophic. You can get a much tighter bite on it, and the rotation isn't as easy to get out of. Just the mechanics of it. The way that your leg is rotating to the outside. you can do more damage to the knee. And if somebody rolls the wrong way, they're going to hurt. They're gonna, you know, destroy their knee so I, um, I do have my, my people will catch them.

I'm like, sure. If they aren't going tap, we move along. Well, what I mean is, well, uh, will release. Yeah. What I meant is I don't just catch it and then let go. Cause there's some people that just to catch and they let it go too much where I catch because I've been in it. Um, but yeah, no, that's a good point. Just understanding. Look, this is a checkmate. Yep. Yep, you know, another thing I would say is teaching break falls, like watching people break fall yesterday. I was like, kind of, obviously there's a lot of different skill levels.

And I know so many jujitsu gyms that just kind breeze through breakfalls. Just a super easy skill that everyone should know. Everyone, even if they don't do grappling, should learn how to fall. I was running once and I tripped and i just did a roll without thinking about him like oh that was kind of cool you know but i didn't think about it i Just did it especially aging populations and here where it snows yeah and the ice we see so many older people breaking hips and wrists and backs and things because they just fall on ice Yeah.

There was a super interesting study. I think it was somewhere in Britain. It was at least it with the British Journal of Sports Medicine that released it. But it it like doing a community practice of break falls. And specifically like a judo practitioner was teaching older people how to fall. When I was in PT school, I did a clinical in-service. And this is 12 years ago at this point now. But I remember, this would be a cool idea. So then, and I just talked, it was a skilled nursing facility because you have to do your rotations.

I'm like, This would a be cool and then seeing how someone actually did paper to show. shown a seven-year-old woman had a breakfall. Again, I'm not hiraya-goshing her into a mat, but there's the ways you can regress it. And I think those are super important, because if you fall correctly, you could minimize injury. Now you're not scared of takedowns. There's so many people like, eh, don't want to do take-downs because they don' want get injured. But it's like now you are a novice if do do them. Right.

Learning how to fall is huge. We definitely don't focus enough on that. And I think that's something I took away from yesterday. Go try and teach some better break falls because my breakfalls aren't great. Like I've fallen on my head more times than I can count. I'm just not doing it appropriately or not wanting to concede. Yeah. That's super important. OK. So kind of finishing up here a little bit. If you could give one piece of advice to white blue belts, maybe even younger, because I probably could have used the advice when I was in my 20s starting out.

What would you recommend? for longevity in the sport. I mean, tapping and training doesn't mean you're losing. Who cares? I think, like I said, I tapped a lot at Black Bull. I just stopped caring. You just get to avoid a lots of unnecessary injuries. Just have more of a skill development mindset than a winning mindset. Competition is different. Obviously, you are at a world championship. you know, i've been there. i got my joints popped in a competition. Whether it's good or bad, it happened and I get that.

But like in training, who cares? You losing in a training doesn't mean you're bad at jiu-jitsu, it's just you got caught, right? So I think those are two super easy ways where you can minimize unnecessary injuries and then if you take that mindset, you'll probably get better at Jiu Jitsu quicker in addition to having less injuries, which we know is probably the biggest limitation for mat time. Cool. All right. Well, thanks for being here. I know we said we're going to keep it short, but we ended up talking a little bit.

Yeah. And where can people find you? So find me on Instagram. It is the word doctor underscore kick ass. That's probably the easiest way. Then Facebook, YouTube is there. You know, I have links to all my rehab courses on my Instagram, yeah. Yeah, really great stuff for physical therapists, athletic trainers, even myself. I enjoy it to help with recovery from surgeries and making sure that people are doing the right things and not going back too soon. All right, well thanks Mike. Yeah thanks for having me.