Injury Management for MMA Fighters
For MMA fighters, injuries are common. This is no surprise, given that the aim of a fight is to achieve victory through physical (and mental) force over your opponent. Because of this high level of physical intensity when competing in, and also training for, combat sports, getting injured is more a matter of when than if.
The almost certainty of getting injured as an MMA fighter makes learning the skill of managing injuries a vital part of success and longevity.
Common areas of injury in MMA include:
Knee Injuries - This is often in the form of a ligament injury, meaning an injury to the soft tissue structures running from the femur to the tibia to support the knee joint. It can also be an injury to either of the joints that are at the knee, the tibiofemoral or patellofemoral joints, the meniscus or to the tendons that are attaching the quadriceps muscles to the knee.
Shoulder Injuries - Shoulder injuries can occur during submissions or as a result of the repetitive movements when training boxing or grappling movements. An injury to the shoulder region most commonly involves the rotator cuff muscles, the deep stabilizing muscles that are supporting the primary joint of the shoulder, the glenohumeral joint.
Ankle Injuries - The ankle injuries that occur as a result of MMA are almost always ligament injuries to the ligaments helping to stabilize the outside of the ankle. These can occur again through a submission or by rolling your ankle in the course of training.
Neck Injuries - Between throws on the ground, bridging movements when grappling and punches to the head, the neck muscles work hard when training and competing in MMA. They are also a common area of injury. This is generally in the form of a whiplash injury, meaning the neck muscles injured themselves while working to support and control impacts and forces to the head.
A Four Component Process to Injury Management in MMA
Across the wide spectrum of injuries that can occur as an MMA athlete, this four-part process allows for a calm and strategic ramp up and return to full training.
#1 - Accepting your injury status
I think most athletes would agree that getting injured sucks! When you are a combat athlete, especially a competitive athlete, the thought of being injured is a frustrating one. Often every day revolves around your training and your social network is tied to your MMA gym.
These factors can make accepting that you are injured challenging to do. Accepting your injury is important enough to be a pillar in the rehabilitation process because acknowledging and allowing for your current injury status allows you to make realistic and optimal decisions about how to train with your injury and get you back to your full training routine as quickly as possible.
If you are an athlete who is in denial and has not accepted that you are injured, often you will push through with your training and either aggravate and worsen your injured body part or alter your fighting and training mechanics in a way that has you at risk of injuring another area of your body. This can then lead to a further reaction of completely stopping all of your training in an effort to allow your injury and pain to go away. When the pain has lessened you then again fully return to training, ignoring the injury, and often again experiencing increased pain.
This yo-yo pattern, while common in injured athletes, is unhelpful as it delays the injury rebuilding process and your full and healthy return to training.
Breaking this pattern involves accepting your injury status. This acceptance allows you to then progress to the next pillars that involves adjusting your training to allow for and rehabilitate your injury.
#2 - Adopting progressive loading rehabilitation exercises
Now that you have accepted that you have an injury that is affecting your ability to train as a combat athlete, you can take action!
The first action you can take is to incorporate an exercise or exercises that load the area of your body that you have injured. The aim is to load the tissue enough to cue your body to rebuild the injured tissue. The amount of load to the injured tissue varies depending on the area and degree of injury. The exercises role is to cue and support the rebuilding and repairing process and will be increasing gradually over your rehabilitation timeline.
There are two common errors that you may experience when selecting a rehabilitation exercise or exercises. The first of these is to select exercises that are not challenging enough to support and encourage the rebuilding process. This can look like including only exercises without resistance or avoiding any sensation of soreness or discomfort.
Combat sports are challenging on the body and as you are recovering from injury, rehabilitation exercises will initially often look very different from your sport specific training, but should progress to more and more challenging movements in preparation for your future full return to training.
The second common error is the polar opposite of the first and is regularly trying exercises that re-irritate the injury and create the yo-yo pattern of the first component #1.
In this pillar, having a trusted coach or physiotherapist can be useful to provide guidance in what exercise to include to begin to rebuild your injured tissue and to have a plan for progressing the difficulty of the exercise.
#3 - Continuing with modified versions of your combat sport
To be able to return to full MMA training as quickly and successfully as possible, from the very start of your injury rehabilitation it is important to incorporate aspects of MMA training. While, often frustratingly, you won’t be able to train in the same way, with the same volume and intensity as before you got injured, often you can train specific aspects of your sport.
This can look like doing aspects of grappling or kick-boxing, or practicing a new technique or area of weakness. Having modified MMA training, progressing in volume and difficulty as your injury recovers, lessens the loss of skill and fitness during the rehabilitation process.
Having an injury can be a lonely time. Being able to do aspects of training, at your MMA gym, with your MMA community can also be useful in maintaining your outlook and sense of identity as an athlete. You will likely also be able to see that you are not alone as other friends and athletes are completing their own modified and progressive training to match their own injuries.
#4 - Identifying and incorporating training that is completing unrelated to and unaffected by your injury
This is important for two main reasons. Reason number one is because having ways of training that are unaffected by your injury allows you to make progress in aspects of your sport despite your injury. This may be in building strength, increasing your muscle mass, improving your conditioning or learning specific techniques and will be guided by your specific injury.
Having forms of physical training is also important because it allows for periods of relief from thinking about your injury. With the majority of the rebuilding from injury involving thinking about how to modify and adjust your standard training, having at least one thing to train without having to take into account your injury is helpful.
This can take many forms, including working on lower body cardio or strength movements if you have an upper body injury or upper body strength movements if you have a lower body injury.
Summary
With injuries being common in MMA fighters, applying this 4-part injury management process can be useful in building a path back to full and healthy training.
The 4 components are:
#1 - Accepting that you now have an injury
#2 - Adopting an exercise or exercises to progressively load and rebuild the area of injury
#3 - Modify your MMA training to allow you to continue with adjustments rather than a full pause
#4 - Including a form of training that is unaffected by your injury
A physiotherapist (like myself!) familiar with MMA training is a great resource for diagnosing your injury and helping you make a rehabilitation plan with each of these 4 parts.