Don’t Fall Prey To The Injury Bug: BJJ Prehab (Part 1)

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In this two-part article about injury prevention in BJJ, I will discuss the physical and psychological factors that contribute to injury, and how to address them. In Part 1, I summarize a conversation with 3rd Degree BJJ Black Belt and Doctor of Physical Therapy and CSCS Mike Pellegrino, who has used his experience rehabbing BJJ-related injuries to create a “prehab” injury prevention program.

If you’ve been doing BJJ for longer than a few months, it’s hard to imagine that you haven’t sustained some sort of injury. Maybe you tapped a bit too late and ended up with an overextended elbow or hurt shoulder. Maybe you rolled your ankle or hit your head when your partner knocked you off balance. Maybe your partner stacked you past your flexibility limit and left you sore from overextension. Most of us have known injury at some point.

Brazilian jiu-jitsu is unusual in that, unlike other sports, our goal when rolling is to injure — or at least to almost injure — our opponent. Because injury is both something we want to avoid, and something that we pursue aggressively, we walk a fine line that creates many opportunities for potential injury. The risk of injury is higher because BJJ practitioners spend so much of their time rolling close to an injury.

As a BJJ practitioner of 18 years, Mike Pellegrino is keenly aware of this fact — and as a physical therapist and authority on rehabbing BJJ-related injuries, he has spent a lot of time thinking about how to help BJJ practitioners to protect their bodies before an injury occurs. Here are his four tips for injury prevention!

Mike Pellegrino
I have had the good fortune of attending some classes at Mike’s gym. AWESOME experience! (Photo by Mike Pellegrino. Used with permission).

Tip 1: It’s All About Balance

Pellegrino observes that almost everything we do in jiu-jitsu — kneeling, curling up into turtle, playing our guard — involves pulling. In other words, BJJ is a flexion-based activity. When we spend all of our time curled up, not extending our bodies; and pulling, not pushing; our bodies can develop in ways that are imbalanced. These imbalances result in an increased probability of an overuse-related injury such as a Rotator Cuff Tendonitis, a common condition among BJJ practitioners. It is also an example of an injury which can easy be prevented with a proper strength- and stretching-based exercise plan.

Pellegrino notes that every individual has different tendencies, and therefore has different injury prevention needs. When advising BJJ practitioners on resolving and preventing these types of chronic injuries, he draws on personalized routines created from quick, simple physical therapy exercises as a proven methodology for countering imbalances.

Tip 2: Every Part Of Your Body Is Relevant to Jiu-Jitsu

People talk about “just wanting to train jiu-jitsu,” but Pellegrino notes that jiu-jitsu is a full-body sport, and every part of your body is relevant. While some new to BJJ may be overwhelmed at the idea, Pellegrino notes that to prevent injuries, it’s important to have a general prehab and fitness program outside of class.

He points specifically to three areas that are the foundation of injury prevention in jiu-jitsu:

1) strength, specifically in the upper body (shoulders/neck/mid-upper back), lower body (hips, knees, ankles), and core (low back, abs, obliques, hip);

2) flexibility (i.e. muscle length); and

3) mobility (i.e. range of motion related to joints)

Pellegrino argues that one need not spend hours a day at the gym to target these three areas. Instead, cycle through different exercises each day, touching on each area a few times a week. “10-15 mins a day is enough if you do it 3-5 times per week,” says Pellegrino.

If you get injured, you’ll have to rehab. Pellegrino argues: skip the injury part and do prehab instead! (Photo by Mike Pellegrino. Used with permission).

Tip 3: Moving Well Is Moving Safely

When it comes to injury prevention, Pellegrino says that your first line of defense is proper form, movement, and posture. Many injuries happen when a person has poor posture and ends up in a bad position as a result — one she should never have been in the first place, had she kept up a solid frame. In a sense, it’s related to the “strength” part of Tip 2 (without a certain foundation of strength, this will not be possible), but at the same time, Pellegrino says, it isn’t about strength so much as structure. If you maintain a posture that can accommodate the strength and size of any size opponent, you are much less likely to end up injured. He also notes that it’s important to practice maintaining your frame while moving — if someone can push you off base any time you are in transition, you’re still vulnerable much of the time.

TIP 4: Consistency Is Key, But Don’t Go Apes**t

Like any physical therapist, Pellegrino is “prescribing” a certain type of exercise to his clients. However, he warns, exercise, like a medication, has to be taken in a certain way for the best results. If you overdose, there are negative side effects (see part 2 for some of them!). If you underdose, it’s not going to have an impact. “Peak athletes degrade 50% in 2 weeks, so being good for a week and not good for a week isn’t going to help you progress,” says Pellegrino. In short, if you want to prevent injuries, you’ve got to spend a few minutes on it nearly every day. “The challenge that most people have,” Pellegrino says,”is that they don’t know which exercises are helpful, and figuring that out can be very time consuming.”

Moving Forward — Realistically, How To Prevent Injuries?

So far, here’s what we’ve learned: to prevent injuries, it’s important to do extension-based exercises that are designed to promote strength, flexibility, and mobility, and it’s important to do them regularly. If you’re like me, you may be wondering… but how do I decide what exercises? What’s extension vs. flexion-based? How many reps do I need to do to improve my strength? How do I know what the right difficulty level is for me? And maybe, if I’m being honest, the most important question — how am I going to remember to do this, because I am super duper forgetful?

I’m a huge technology geek, and not at all savvy about planning fitness routines, so I was very excited to hear that Pellegrino is working on an algorithm-based app called BJJ Prehab, which will implement a lot of what we talked about in this blog post for consumers. Here’s how it works: you tell the app what areas you want to focus on, and it provides you customized weekly progressions of 9-12 minute warm-up exercises. These are designed to be done anytime, such as right before you train or before your morning shower.

That’s it! It knows when you’re going to class and reminds you beforehand to do your Prehab warm-up. You get to watch Mike do the exercises and follow along, and as you get better and better, it adjusts to you, increasing the difficulty so you’re working right where you should be. Once you have achieved the top level, your goal becomes to continue the plan and maintain what you’ve worked hard to progress to (remember that 50% weekly degradation).

I love the idea of preventing injuries, but I’m lazy and not that literate when it comes to body mechanics, so I was signed up to be a beta tester in 30 seconds flat. You could be, too… check it out!

Mike Pellegrino is a 3rd degree black belt in BJJ who trained under Robert Maia in Boston, MA. He is head instructor and owner at Mass BJJ in Arlington, MA and a physical therapist at his own practice, Peak Performance Physical Therapy, where he specializes in rehabilitation from BJJ-related injuries. His forthcoming app, BJJ Prehabwill offer 9-12 minute warm-up routines designed to prevent injuries. The first 1000 signups get a free month, so visit the website and enter your email address to check it out!


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