A few weeks ago I wrote about getting an inguinal hernia on New Year’s Day and my subsequent surgery.

(For those of you who don’t know, this type of hernia is when your intestines start protruding through a weakness or tear in your abdominal wall and show up as a bulge on the outside of your belly. These hernias may become strangulated, painful and infected, and if untreated might even kill you!)

First of all, thank you very much to all those who got in touch with wishes of a speedy and complete recovery. I’m happy to say that I’m doing great – I’ve even had a couple of light sparring sessions which was a ton of fun after 6 weeks away from the mats!

I’ve also received some emails with questions about hernias. To my knowledge this subject has never been addressed in the context of BJJ or submission grappling. So long as everybody understands that I AM NOT A DOCTOR I’ll take a stab at answering some of these questions:

————————————————–

Q: How long does it take to recover from hernia surgery and get back to BJJ and grappling?

A: Well, predictably the answer is “it depends.” As far as I can figure out, it depends on a number of factors, including

• what type of hernia you have (inguinal, femoral, umbilical, etc.) and how bad it is,
• what type of surgery you had to repair it (synthetic mesh, internal stitches, etc.),
• what your fitness level was prior to the injury,
• whether there were any complications during or after surgery (hemorrhage, infection, etc.)
• etc.

And sometimes you get conflicting information. For example, when I checked out of the hospital a nurse handed me a pamphlet with instructions not to lift more than 10 pounds for 4 to 6 weeks!

I was very surprised, therefore, when I visited the surgeon for a followup visit and told me that I could get back to FULL activity even though only 2 weeks had gone by since the surgery. He said that the 4 to 6 week rest period recommended by the pamphet was based on old surgical techniques.

So the bottom line is that recovery times seem to be getting a lot shorter (especially for mesh-based surgeries), but YOU REALLY NEED TO TALK TO YOUR DOCTOR OR SURGEON before getting back to training of any kind!

————————————————–

Q: What was your post-surgery workout and rehab schedule like?

A: Here’s my rough schedule so far:

1. For the first two weeks after surgery I did absolutely NOTHING.
2. After two weeks I got the OK to ‘get back to everything’ from my surgeon. Frankly this sounded a bit over-optimistic, and I decided on a gradual back-to-grappling program.
3. For the next week I only did light bodyweight exercises and light BJJ technique drilling with a considerate partner.
4. Then I did a week of light circuit training with weights (i.e. no heavy squats or deadlifts) and continued with the light partner drilling
5. A month post-surgery I’m in a phase of doing slightly heavier weight training (still no squatting with more than 245 lbs though), a bit of running, and some easy sparring with people at least 10 lbs lighter than me

As I’ve said before, I’m determined NOT to get re-injured (or get a different injury) during this post-surgery comeback, so I’m actually being pretty disciplined about not doing too much, too soon.

————————————————–

Q: If a fit guy like you can get a hernia, what about the rest of us? How can we prevent hernias?

A: Well there are a lot of different types of hernias. As I understand it, prevention depends on the exact type of hernia that you’re talking about.

I had what is known as a direct inguinal hernia, which has a strong genetic component. A family history of this condition means that you’re more likely to get it too (and, in fact, my Dad had a hernia surgery a couple of years ago).

It’s clear that picking the right parents is probably the best way to avoid these types of hernias.

On the other hand, some other types of hernias are more related to excessive body weight and/or lack of muscle tone. Staying fit, avoiding obesity and keeping your abdominal wall strong through exercise is probably your best bet to avoid these types of ‘lifestyle’ hernias.

I’m just so very very glad that I had the mostly-genetic type of hernia, because of the saving face factor. I know I’d never live it down if I’d come down with an optional lifestyle hernia….

Tapping out is sending a message to your opponent. The most common message is “OK, you got me with that submission. Now let me go”

Many grapplers don’t realize that tapping out can also be used to send a different message, namely: “I don’t know what’s going on here – I might be in danger of getting injured, so let’s stop for a second”

Recently I was sparring and had my opponent pinned in side mount. He wrapped my head at an awkward angle and bridged. To relieve pressure on my neck I decided to go with the it and roll to the bottom. Halfway during that roll we collided with some punching bags at the edge of the mat – I was now wedged into a corner, my neck at a strange angle, and my partner perched precariously on top of me.

It wasn’t a submission per se – my neck didn’t actually hurt – but I sure as hell didn’t want to find out what would happen if either he or I tried to scramble from that position. I tapped out, he let go, and -for once – nothing went snap or pop.

As you become more experienced your knowledge of technique grows – that is a no-brainer. A less appreciated aspect of the grappling learning process is that your mental library of awkward positions also grows as you spend more time on the mats. You’ll figure out when certain positions are merely uncomfortable, vs. actually being damaging. You might be willing to accept the discomfort of a guillotine choke for longer, because you’ll know if it is going to damage your neck or your windpipe.

Even when you get to black belt level, however, you’re still going to periodically end up in weird, contorted positions that might be uncomfortable but not be submissions per se. My advice is, that if you are unsure about the safety of a position, then swallow your pride, tap out and live to fight another day. The worst that will happen is that you will make the day of some junior guy at the club who just tapped out one of the big guns. Not such a big price to pay really, when you compare it to the alternative of not being able to train for many months due to some stupid, preventable injury!

Remember that the tap can be used to send two different messages.

Happy Tapping!

Additional Resources: an article about two things that will put a halt to your training.

The stiff arm as used in football…
Originally uploaded by kevooooo

The stiff arm on the Heisman Trophy is an iconic posture in football, and it is used by players in every single game. In Brazilian jiu-jitsu, however, the stiff arm has a bit of a bad rap. One of the first lessons a grappler learns is to NOT push the chest with straight arms when trapped in the mount. This piece of wisdom is reinforced by training partners endlessly applying effortless armbars until the lesson is learned.

But there are many times and places to use the stiff arm correctly…

One good example is in guard pass prevention. I’ve written before about the importance of pushing the head to prevent the guard pass. If you manage to lock your arm straight when you do this it is much more efficient than using a bent arm: you can push your opponent further away AND it leaves you with more energy to think about what to do next.

Another example comes from offensive guard work. If you’ve seen my Butterfly and X Guard DVD then you know that transitioning from butterfly guard to X guard is one of my favorite techniques. This technique requires a stiff arm push to the ribs in order to keep your opponent’s weight off of you. The most common error I observe when people try to do this technique is that they try to push with a bent arm, which usually just isn’t strong enough to do the trick.

A final example is the backwards somersault mount escape. In this technique you bridge to get your opponent’s weight forward, put your hands in his armpits, keep your arms straight and do a backwards somersault to escape the mount. If your arms are bent you just won’t be able to pull off this escape.

A straight arm can hold much more weight than a bent arm, because the bones, not the muscles, are doing the work. Consider weightlifting: a person can usually hold (or ‘lock out’) at least a hundred pounds more than they can actually bench press. If the arm is bent then the triceps muscle has to actively work to push the weight away, and gets tired much more quickly.

Keep in mind that when you stiff arm your opponent in the middle of his chest you might be giving him the positioning and energy he needs to apply a quick armbar on you. On those occasions when I do stiff arm someone in the chest I am on ultra-high alert for the armbar. If you want to avoid the armbar danger, restrict your stiff arming to the head, hips or side of the ribcage.

Finally I need to say a few things about injury prevention. Intentionally stiff arming an opponent is very different from just sitting around on the mat with your arm locked out. It’s also very different from putting your arm out straight to stop being thrown, which is a recipe for breaking your arm and/or dislocating your elbow. The general rule in jiu-jitsu is that you DON”T fully straighten your arms, and what I discussed today is an exception to that (very good) rule. Go ahead and stiff arm people, just be conscious about what you are doing and use it judiciously.

We’ve added a lot of information on the care and feeding of cauliflower ears, a relatively common grappling injury. Read the whole article, Cauliflower Ears in Brazilian Jiu-jitsu, here.

We’ve been discussing injuries a lot recently, and it seems to have hit a chord with the Grapplearts readership. I don’t want to beat a dead horse, but I wanted to discuss one more thing before we leave this topic.

One of the most dangerous times in a martial artist’s career is AFTER a serious injury, especially if it involves a lengthy break from training. Far too often I’ve seen a hard-training competitor get injured and start to gain weight, sometimes a lot of weight. I’ve known fighters who originally fought at 185 shoot up to almost 250 pounds. Some of them eventually get back to pre-injury bodyweight, but it’s always a long and tough road. Others never competed again: they blamed the injury of course, but I think that the specter of getting back in shape had more to do with their decision than they would like to admit.

Of course not all hard-training martial artists are going to react to injury in this way, but it is fairly common. In some ways, the more serious the martial artist is about his training, the more likely it is that this weight gain is going to happen.

Maybe this weight gain is because hard training requires a lot of calories, and injury stops the training but not the daily caloric intake. Maybe it’s because fighters have to stay within 10 to 20 pounds of fighting weight and react to their injury layoff by saying “screw it, KFC and cold beer here I come” . Or maybe it is that many martial artists rely on regular hard training to stay on an even keel emotionally, and when they suddenly can’t train they become depressed and thus prone to weight gain or loss.

If you do have a major injury, keeping an eye on your bodyweight and doing whatever you can to maintain some level of physical conditioning is definitely a good idea. Doing something, anything, will help keep you in shape and make your return to the mats a lot easier.

In addition your physical well-being, keep an eye on your state of mind post injury. I am NOT a psychologist, and I DON’T know what all the answers are, but just because you used to win all the local tournaments doesn’t mean that you’re invulnerable psychologically. Do whatever it takes to keep your mindset as positive as possible while you heal from your injury. A more full discussion of fighters and depression was published by Fighter’s Only Magazine.

Machado27
Originally uploaded by bravestrong

Several years ago I found myself waiting for a Jean Jacques Machado seminar to start: I was sitting on the mat, watching people train, and chatting with a friend . Jean Jacques, the jiu-jitsu superstar, strolled over to us and told me something that I think about almost every time I train. What was this nugget of wisdom? He corrected my sitting technique!

You see, I’d been sitting and propping my weight up with my arm which was posted on the mat behind me. My arm was straight and my elbow locked out. Jean Jacques told me never to sit like that on the jiu-jitsu mat. He pointed out that if someone behind me, absorbed in their sparring, rolled onto my arm then my elbow would be shattered. BJJ is such a casual martial art that sitting sprawled out on the mat seems like a ‘normal’ thing to do, but it’s not the right thing to do and it’s not the safe thing to do. Keep your arms where you can see them, and not locked out

This may seem like a minor detail to get hung up on, but the readership of this newsletter is huge. If I share this tip here then someone, somewhere in the world, will avoid a severely damaging arm injury. One less injury is a good thing, justifying the inclusion of this story in my newsletter.