PREHAB for MMA Athletes Part 1

By Mark Zuber, D.C.

This is the first of a series of articles contributed by Mark Zuber D.C. Mark is a practicing chiropractor in Plano, TX. He actively treats athletes in many sports, including mixed martial arts. He has been training in the martial arts for over 10 years and has focused on Brazilian Jiu Jitsu for the past 5 years. His office combines chiropractic, myofascial release techniques, occupational therapy, massage therapy and kinesiotaping. The office website is

Stay on the Mat! Prevent Injuries!

Recovery in athletics, particularly in MMA/BJJ, is an often-ignored component to training. There are many theories, forums and books on every aspect of MMA, save for recovery. By utilizing the techniques and strategies outlined in these articles, a martial artist will be able to train more often, get injured less and just feel better in general. As an athlete ages, it becomes of even more importance. Randy Couture has stated this time and time again. Plus, a martial artist can not evolve if he or she can not stay on the mat! By monitoring recovery, athletes will be better able to train more often, more regularly, and with more intensity. The injury prevention techniques shown in this book will also lead to increased muscle flexibility, core strength and balance. BJJ induced injuries are numerous and can involve nearly every body part. Sometimes, these injuries are caused by impact or a body part caught improperly. Other times, an injury occurs because someone didn’t tap! This is not our focus. A larger percentage of BJJ injuries are actually caused from overuse, and are largely preventable. How does BJJ cause overuse?! Almost all sports create imbalances due to their repetitive nature. This leads to overall tightness in muscles and across joints. Just watch an over-30 BJJer get out of a car after a tournament to get an idea of what I am talking about. Some sports like tennis cause lateral imbalances where one side is stronger than the other, while some like swimming cause imbalances from front to back. Ours just so happens to do both! Preventing or eliminating these imbalances leads to fewer injuries and increased well-being. Learning to detect and monitor your body for signs of impending imbalances is just as critical to a martial artist as awareness of your environment and sensitivity to MMA moves. The techniques shown in this book will help you not only identify these weaknesses, but help you stop them before they turn into an injury that keeps you out of training.

The Over-30 Crowd

As an athlete ages, his body starts changing. His or her hormone levels drop, he gets more sore from exercise and it lasts longer than when he was younger. Some athletes compensate by working out less. Other athletes stop all together as work, family, etc. get involved. BJJ is one sport that does not force an athlete to stop. In fact, it can be done well into the later years, just ask Helio Gracie! Realizing that a large percentage of BJJers aren’t interested in taking more days off, this articles’s focus is to allow the over 30 crowd to continue training at that high level, only smarter! By paying better attention to recovery, an older (and wiser) athlete can compensate for these age-related changes and compete with the young guns. For the younger crowd reading this, it is never too early to start learning how to care for yourself, and it will be all the easier for you to continue these principles as you move into the “wiser crowd”. FOR THE RECORD, THE NUTRITION TECHNIQUES YOU LEARN FROM RUDOG ARE CRITICAL TO IMPROVING YOUR RECOVERY!

My background……

This text is written based on my experience as a chiropractor who treats athletes of all kinds, and my experiences as a BJJ practitioner. In my office, we have utilized these techniques for over 10 years to improve sports performance and help our patients achieve their potential. By applying common protocols we use in my practice, I have seen a great number of BJJers not only lower injury rates, but roll more frequently and with more intensity. A large percentage of guys who come see me present with the same set of issues, leading me to conclude that BJJ causes certain repetitive motion injuries in most people. The routines I have showed them are very effective at correcting a good many of these issues, preventing injury. Other common issues I address with my athletes include improper advice regarding nutrition (no issues with RUDOG), hydration, lifting techniques, etc. Results After spending several years treating BJJers, I would say the group utilizing the materials in this book are much better overall. They have fewer aches and pains, they recover from injuries much faster, and they don’t seem to get the accumulated repetitive motion injuries that athletes who ignore this advice do. A simple way to verify this is to check out the number of training partners “out due to injury” at any particular school. The percentages are high! By lowering these numbers, the entire school benefits.

Do Men in MMA have Body Issues?

Do men actually have body image issues, too? You’ve probably never thought about it, but keep thinking about it. With the rise in popularity of MMA, energy drinks, supplements, and muscular fitness, we are seeing an increase in the amount of media targeting men and depicting “hypermuscular” physiques. Male models are now leaner and more muscular than in years past. Could this be having an impact on men and their satisfaction with their own bodies? Look at A&F advertising, just to pick an easy one. What is the message that is being sent to guys? (Besides the whole sex thing…)

Women have been dealing with it since fashion has been in print. There are programs, hospitals, groups, blogs, prescriptions, and more to help women deal with body image issues. What about men? Interestingly, you guys are not immune.

There is a condition or “disorder” called Muscular Dysmorphia. Fancy term for, “I don’t think my body is muscular or big enough”. More directly, a disorder where individuals are preoccupied with the concern that their bodies are not muscular or big enough.

Now, I know what you are thinking. Something along the lines of, “That could be every guy at my gym!”

And you are right. I think it starts really simply. Probably most guys don’t get obsessed with it. I think a few really do. The problem is, how do you determine when a healthy interest in bettering your physical shape crosses a line and becomes unhealthy?

The basic definition of an eating disorder is “any eating behavior that puts a person’s long term physical or emotional health at risk”. So if we apply a similar approach to dysmorphia, we would be looking for behavior that puts physical or emotional health at risk. Can you be too lean? Can you work out too much? Can you take too many supplements? These are fair questions. I think that even beyond that, we should be asking who is holding guys at the gym accountable and not letting them go too far? That is tough. I don’t know that it has ever been done!

Which guy wants to be the one who says to someone, “Hey dude, I think you are muscular enough. Why don’t you lay off training a bit?” (crickets chirping)

As Americans, it is in our blood to be the best we can be! Your coach tells you all the time that you can do one more! You’re asked all the time, “Is that the BEST you can do?” More is better. Don’t be a wimp. One more rep. One more mile. One more plate on the rack.

Where is the voice that says, “That’s enough. Good work.”??

When I look at the MMA athletes and what the sport out right demands from them, I think there is the potential for this type of thing to develop if left unaddressed. Good coaches, knowledgeable staff, and educated athletes are essential to keeping the sport healthy for pros, amateurs, and novices…like me!

Cutting Weight is Dangerous

I have to admit, I am very impressed with Frankie “The Answer” Edgar’s strategy of training at his fight weight. For a title fighter to openly state that he does not cut weight for his fights is such a great example for other fighters. For a fighter to NOT cut weight goes against YEARS of tradition and entrenched thinking, but it has to stop. The practice of cutting weight makes no sense at all. Maybe no one is questioning it. Is it “forbidden” to question it? I am questioning it. MMA is perfectly poised to really set an example in the world of athletics. MMA athletes are perhaps the most well conditioned athletes in the world. A successful MMA fighter is cardiovascularly fit, is strong, has explosive strength, is flexible, quick, mentally focused, is disciplined in all areas of training, I could keep going!! Why would an athlete of that caliber do anything that compromises any one element of his game plan? Think about it. In terms of taking care of your body, and putting yourself in the best possible position to challenge an opponent, why would you starve and stress yourself days leading up to a fight? Let’s look at what happens when you do that:

You lose water weight, yes. BUT, some water that is lost is actually from the inside of the cells. When there is a sudden shift of fluid from the inside to the outside of the cells, you can put yourself at risk for cardiac arrest. That means your heart can stop. Translation: YOU CAN DROP DEAD. Doing this over and over again, fight after fight, takes a toll on you emotionally, hormonally, and physically. It provides the perfect breeding ground for eating disorders, chronic disease (kidney, heart, osteoporosis) as well as chronic injuries that just never seem to completely heal.

Even though there is stress on the body when cutting weight, there is also stress when you carbo load AFTER starving. Then there is the stress of healing and recovery after the fight. When it is all over, the body ends up spending a lot of time in a VERY stressful state. For fighters that take fights close together, the body never really gets a chance to fully recover.

There is a great commentary on this very issue at the following link.

In a world where discipline, pain, and suffering are applauded and aspired to, I can certainly see where “cutting weight” is also a part of getting tough. Unfortunately, it’s dangerous and potentially puts your life at risk. Get smart, guys. Train at your fight weight.

Pre-Exercise: What to Eat and Drink

This is absolutely one of the top 10 topics in sport nutrition.  It is so important to have a strategy in place as to how you will fuel and hydrate to prepare for training and exercise. What and when to eat and drink is highly variable and has to be individualized. As an athlete, you have to do a little experimenting to determine what foods and beverages you tolerate, as well as which ones enhance performance. Keeping a journal is a really good idea. It’s important to remember that what works for one athlete may or may not work for another.


Pre-exercise meals should have some carbohydrate, moderate protein, and some fat. The meal needs to be eaten 3-4 hours prior to exercise. Of course, this will be different for early morning workouts. In those instances, the “meal” will be much smaller (like only 100-200 kcals) and consumed 30-45 min prior to workout.  Think in along the lines of part of an energy bar or a small bowl of oatmeal. If you aren’t doing an exhaustive workout, the pre-exercise calories aren’t as critical.


At least 2-3 hours before a workout, start hydrating. This can be water, a sport drink, or a fitness water. This will not only keep you hydrated, but allow ample time for emptying from the stomach so that you don’t get cramps. If you are wondering, “Which is better? Water or a sports drink?” Then answer is, “They BOTH hydrate equally well.” Choose the one that works best for YOU. There is a lot of science behind the formulas of the sports drinks, so definitely take some time to educate yourself and to try some of them. They will taste very different when they are consumed during/after exercise, as opposed to just drinking them as a beverage.

The sport drinks, like Powerade and Gatorade, are designed in way that reduces the incidence of cramping, promotes absorption and stimulates the thirst mechanism. They are generally around 6-8% Carbohydrate and use a combination of fructose, sucrose and glucose to promote emptying and speed fluid absorption. Gatorade is 6% and this helps stimulate carbohydrate absorption. Powerade is also 6%. They are both low sodium, with just enough to keep the thirst mechanism going!

Always pay attention to how well hydrated you are. Sweat production can vary depending on intensity, duration, temperature, and humidity. Fluid weight that is lost during exercise is fluid that must be replaced.

The Gatorade website has a tremendous amount of information if you want to check it out.

Testing the Tank

If you watched the BJ Penn vs. Kenny Florian bout from a couple years back, you heard the phrase “testing the gas tank” mentioned more than once by the commentator. The question being raised was about Penn’s conditioning. He had undertaken a new cardiovascular conditioning program prior to that fight and he didn’t look as energetic in the second round as he usually does. The commentator’s point was that Penn’s gas tank was being tested…..he looked a little sluggish…..did the new training leave him with enough gas in his tank? Had he overtrained? Penn went on to win that fight, but I thought the commentator raised a great question. It’s a question that all fighters should ask themselves constantly: Is my conditioning program putting gas in my tank or am I overtraining and actually running on empty when it’s fight time?

Doing your cardio (whatever that may be) harder and faster for longer does not necessarily produce BETTER conditioning. The conditioning training is not just about training muscles to do work at a certain intensity or duration, but also training muscles to store FUEL at an optimum rate. This involves:

  • Eating enough carbs, protein, and fat DAILY to fuel all  components of your training
  • Proper timing of your eating: Before, During, and After exercise
  • Proper hydration

Total daily intake MUST be adequate if you are going to preserve muscle and stay lean. If you aren’t eating enough carbs, then you are potentially making up the shortage by breaking down some muscle to use as fuel. You will also be limiting the body’s ability to burn fat, making it more difficult to get and stay lean.

Let me say it again. You HAVE to eat carbs, protein, and fat for everything to work correctly. If you are short changing yourself on the carbs so you can eat more protein, then you are short changing your muscles’ ability to store fuel. There are no short cuts here. Eating lots of protein DOES NOT get stored in the muscle as fuel. It also doesn’t magically create big, beautiful biceps. Carbs are stored as fuel in muscle. Carbs fuel exercise that builds big, beautiful muscles.  Protein repairs and synthesizes new muscle. Careful here. Listen to what I said. Muscle is made of protein and needs protein to repair, not enlarge, it.  If you are eating more protein than you need, it is important you understand that the extra protein is a source of extra calories. Extra calories only have a couple of fates. They can be broken down and excreted to some degree or they can be stored as fat. Some of the extra protein is broken down into amino acids and then excreted through the urine. (bummer!) The rest of it is actually stored as fat—–a bigger bummer. A lot of times this is the very reason why a guy can be working out like a dog, taking the protein supplements, and can’t seem to get really lean.

Some of you are thinking, “Yeah, but don’t you know that carbs cause water gain? You actually look leaner when you don’t eat them.”

My reply? Yep, carbs attract water. We all know that’s why you don’t eat them before weigh in. That’s a short term strategy for a short term goal.  So what? Training is LONG TERM. It’s a terrible long term strategy. Guys that hold to that theory are the ones that don’t go 3 rounds. They definitely don’t go 5 rounds. Their only prayer is to submit in round 1. Longer than that is a crap shoot. So, the take home message? You gotta have carbs.

Let all of that digest, and next week I will talk about timing of food.

Using a Heart Rate Monitor

Using a Heart Rate Monitor

Heart Rate MonitorIn my opinion, the heart rate monitor may perhaps be the most under-utilized training tool in all of MMA training. The heart rate monitor can provide extremely valuable information and feedback about your training, as well as your level of conditioning. I have yet to see anyone use one where I train, and there are “experts” there! However, kudos must be given to Rich Franklin, who in the July 2010 issue of Fighters Only, is shown wearing his heart rate monitor while he trains. I was very impressed. There’s a fighter who clearly has great coaches and trainers. I suspect that most guys are a little unsure as to how or why to use one. Hopefully, this article will help explain some of that and motivate you to get one and use it!

Why get one?

As a fighter you are constantly working to improve strength, conditioning, recovery, and performance. The only way you can evaluate your progress is to measure what you do. For example, you know if you are improving strength by keeping track of how much weight you lift. You know if your performance is better by your actions and results in the cage. How are you able to evaluate progress of conditioning and recovery? What is it that you are measuring? If you are simply evaluating based on how you “feel” during or after a workout, that is NOT good enough. You need real data that shows exactly how well (or not well) you are doing. Using heart rate monitors during training can help do the following:

1. Improve aerobic conditioning and aerobic threshold
2. Simulate intensity levels that are more reflective of an actual fight
3. Identify any unsafe stress response to a given exercise or activity
Let’s go through each of these briefly, to give you a better understanding of how these can be accomplished.

Improving aerobic conditioning and threshold

When you are able to measure your heart rate, you are able to identify how long it takes you to reach your target heart rate, as well as how long it takes you to return to your resting heart rate. This is also known as recovery. The less time it takes for your heart rate to return to a normal rate(or near normal rate) is a measure of how conditioned you are. Heart rate feedback also allows you to measure how long it takes you to reach your maximum heart rate. As you are more conditioned, it should take you longer to get there. You can also adjust the intensity of your workout to keep you in a desired heart rate zone. Suppose you are 28 years old and you want to work out at a low intensity so that you are staying in your fat burning zone. You know that your desired heart rate for this is 115. (220 – Your Age) x 60% The heart rate monitor allows you to track whether or not you are exercising appropriately. You can increase or decrease your intensity accordingly. This is how you make a workout work FOR you.

Reproducing the Fight

You have to be able to simulate the same level of intensity in your training that you will experience in your fight. Knowing your heart rate during 5 minute, all out sparring sessions is critical. You also need to know how well you recover in those 30 second rest periods. If your recovery is poor (heart rate is not back to normal, or near normal levels, at start of next round) then you have identified an area you need to work on. You have seen fighters who seem to have trouble recovering between rounds. It doesn’t have to be that way. Proper training can correct it.

Identifying unsafe responses to exercise

This is perhaps the most important use of the heart rate monitor. If you already know your max heart rate, your recovery rate and your aerobic threshold, then you are much better able to determine if an exercise has pushed you to an unsafe limit or triggered an irregular response. For example, if it is 110 degrees outside and you are pushing tractor tires for the first time ever, your heart rate is going to spike. It is important to monitor how high it goes and how quickly it is able to recover. Going too high or taking too long can be dangerous. You need to know your body, and your coach needs to know it, too.

How do I know which monitor to buy?

There are literally hundreds of monitors out there. Choosing one can be as complicated or as simple as you care to make it. I am all about what works. I have listed some criteria that I think are “top 5” when considering a monitor, but there are lots of other things to consider. These are in no particular order.

Cost Duh! Of course this is a consideration. Do you want to spend $50 or $500? The complexity of the monitor will drive the price. A basic monitor that will calculate average overall HR (heart rate), highest and lowest HR, total calories spent, and have a pause function is a pretty good one. This should cost $100 or less. If you want to track your diet intake and customize 12 different workouts you are going to spend a lot more.
Strap or no strap? The monitors that have chest straps are going to be more accurate and probably a little less expensive. What is nice about the ones that have a strap is your coach or trainer can actually wear the “watch” while you wear the strap. They can keep track of all of the data while you just focus on exercising.
Face Size The size of the face should not be overlooked. You want it big enough to be able to see it, but not so big that it is heavy and in the way. Women especially may want to consider a man’s version as the women’s versions can sometimes be too small to read easily.
Button Size A lot of you guys have large hands and fingers, which can make it difficult to manipulate the buttons. Choose wisely here!
Battery Replacement This may be the MOST important one! I did not even know to consider this when I purchased mine years ago. Apparently, some of the monitors require you to ship your monitor back to the manufacturer to replace the dead battery. Mine sure does. It is still sitting in my gym bag, dead. A major pain in the butt. Others have batteries you can replace yourself. It will say on the package somewhere, so be sure to
know what you are getting.

After doing a little research, the following monitors have repeatedly shown up as being highly recommended and user friendly. On a personal note, I own a lower end model made by Polar and I loved it, until the battery died.

Polar FS1
Simple, and easy to use. Recommended for those not needing all the bells and whistles.
Easily and accurately measures your heart rate to help you get to just the right intensity or your exertion level. This basic HRM features added exercise timer and time-of-day watch features, extra-large digits for easy readability, and one-button functionality. It provides a visual and audible alarm when you reach your target heart rate zone. It provides information on total exercise time and average heart rate during total exercise time.

Omron HR 100C
The Omron is another basic heart rate monitor that is inexpensive, easy to use and doesn’t require hours of time spent reading a manual to figure it out. You get a continuous reading of your heart rate, an alarm that tells you when you’re in your heart rate zone, time of day display and a daily reminder alarm. At around $30-$50, this is a great price for what you get and users will be pleased with how easy this is to use.

Timex T5G941
The Timex T5G941 is another basic model that’s easy to use, offers basic heart rate and workout information and is a favorite among exercisers. The display is large, so you can easily see the numbers and it includes an activity timer to rack exercise time as well as information about minimum, average and maximum heart rate for each workout. Most exercisers like the fact that you can change the battery yourself (something you can’t do with all HRMs) and that you can figure out how to set it up without spending hours reading the manual. At around $30-$60, this HRM is perfect for people who want the basics for a great price.

Eat smart, train hard.

You can schedule your PRE SURGERY TELEHEALTH Bariatric Nutrition Education Class by clicking HERE  

Classes are offered at 2:00 every Monday, 12:00 every Thursday, and 10:00 a.m. every Saturday. Looking for some post-surgery support? Check out our Stay on Track TEXT Program!

We can't wait for you to join us!