Preventing & Treating Foot Injuries in Grappling

Here’s a reader question that turned into quite the 3-way discussion….

Q: Hi Stephan, I twisted my foot badly around 18 months ago. I tore a load of ligaments and was out of action for a bit.

After recovering I was doing great, but then this year I suffered a twisting injury to my midfoot. I broke 2 metatarsals and pretty much smashed it up: I needed surgery followed by 6 weeks of non weightbearing and then 6 weeks of rehab .

My question: is there something I’m doing to that’s going to cause me to suffer a similar injury, and is there anything to do about it? I did striking arts (TKD, Muay Thai, and kickboxing) for years with minimal injuries of this type (but loads of bruises!!) ??

I’m 74 kg, so most of the guys in my MMA club are bigger, and the injuries are happening when attempting a sprawl/scramble against larger guys.

Any advice as to what I should do to not get any more foot injuries?

A:  I feel your pain and know EXACTLY where you’re coming from.

A few years ago I suffered a major foot injury myself. My recovery required a couple of surgeries and a lot of rehab, and I’ll admit that I was pretty worried about my prospects of ever walking without a limp. Fortunately it all healed up fine.

It seems like feet heal very slowly. I’m no doctor but maybe this is because the feet are so far from the heart that the circulation isn’t as strong down there…

Anyway, here are four specific suggestions for you:

1 – Avoid training throws and takedowns.

Takedowns are important, but training them is also inherently dangerous. A failed double leg takedown is how I ripped my foot apart, and it sounds like your second injury happened during takedown training as well.

Yes, throws and takedowns are part of being a well-rounded grappler. And if you want to compete in MMA or BJJ at a high level then you definitely need to have a good takedown game.

But if you’re a recreational player and just enjoy rolling around on the ground with your friends there’s nothing wrong with being an exclusive groundworm. Have fun. Stay on the ground. Roll around, and minimize the chances of reinjuring that foot a third time!

ESPECIALLY given your history of frequent foot injuries I would avoid throws and takedowns.

Sorry to be the bearer of evil tidings, but it’s true.

2 – Don’t train MMA

If your main goal is to avoid injuries, then training with the gi on the ground is definitely safer than training MMA or Submission Grappling.

Sure, in BJJ you might twist your fingers in the cloth, but the gi just slows things down. Wild scrambles are a prime time to get injured, and BJJ sparring tends to be more controlled and less wild than other types of grappling.

3 – Wear wrestling boots

Of course it depends on your instructor, but if it’s OK with him then lightweight wrestling boots really do protect your feet in class.

It’s true that they’ll also cut down on your dexterity and make you a little more vulnerable to footlocks, but if you’re willing to accept those downsides then they’ll greatly protect your feet from further injury.

I’ve know quite a few grapplers who ALWAYS wear wrestling boots during BJJ class to protect.

There’s more information about boots and other protective equipment for grappling in this article here.

4 – Don’t roll with the big guys.

This is pretty self explanatory. But it’ll take some self-discipline for you to stick to this rule, because your ego will get in the way and you won’t want to seem like a ‘wuss.’

Well forget that!

Wrestling the big gorillas means that you’re putting your already-twice-injured foot at additional risk. Bigger guys means more momentum, and more momentum means greater risk of injury.

You know you’re vulnerable in this bodypart, and presumably you like being able to walk, so just say no.

Find the smaller guys (or find a new club with smaller guys) and mostly/only train with them.

Well that was the end of my advice to my reader.  But not the end of the discussion…

Anyhow, after I wrote the above section on preventing foot injuries (and shared it with the entire readership of my free grappling newsletter too) I heard from a guy called Tony Ricci.  Not only is Tony a grappler, but he’s also a full-time fire paramedic with a very strong, credentialed background in Exercise and Rehabilitation Science.

Tony wanted to pass on some additional information to the rest of the readership about foot injuries.  This is good stuff, so I’m going to share it with you now…

Tony Ricci writes:

“Hi Stephan,

I read all your emails and enjoy the majority of them greatly.  I wanted to add a couple of items that MAY help the reader who posed the injury question (re. feet) as I do have medical background, esp. with sports injuries.

1) Wobble Board: You’re right -injuries to the feet take a long time to heal and when ligaments are damaged (including fascia, tendons, etc.) there is much more to the injury than straight tissue damage.

Neurological feedback mechanisms are injured as well and these mechanisms impede the reflexes of the foot and leg.  This is the reason that the number one cause of a sprain is a previous sprain.

So…..if rehab for the writer didn’t include standing barefoot on a wobble board, he should consider it.  A typical protocol is a simple 10 x 5 x 5: that is, 10 minutes of wobbleboard, five days a week for five weeks using a round wobble-board.

2) Prolotherapy: The injuries are slow to heal and often heal incompletely for a number of reasons.  Distance from the heart is probably not the main reason for this, although if the injured person has any other conditions (e.g. high blood pressure, diabetes, etc.) those types of things definitely do put the feet at a disadvantage.

I have found that prolotherapy is a phenomenal tool for healing “nagging” injuries that won’t otherwise go away.  With one or two injections, I’ve personally observed injuries resolve completely.

Examples of those injuries that respond exceptionally well to prolotherapy are: rib injuries, jammed fingers, sprains, acromioclavicular separation (aka separated shoulder), tennis elbow, wrist injuries (esp. the meniscal injury that often eludes diagnosis and a cure for many), medial and lateral ligament injuries to the knees, etc. etc.).

I wouldn’t waste your time or mine writing this answer, but I know well the frustration of injuries.  Most of what I know has been gleaned through years of learning the proverbial hard way.  So taking into account the excellent advice you gave the writer, I hope you can relay the above information to him as well.”

P.S. Talking about this stuff may seem a bit weird and specialized.  But it’ll only seem weird if you’ve never hurt your foot, which is actually a semi-common injury in the grappling arts.

The bottom line is that if you’ve never had a foot injury, then count yourself lucky.  I really, truly hope that you NEVER have to use this information.  But you never know when this stuff might come in handy for you or a training partner.