Punch Em’ With Everything Except Your Fists

With the increasing popularity of MMA (mixed martial arts) due to new organizations such as UFC (ultimate fighting champion), Strikeforce and Bellator (to name a few) more and more everyday folks are taking a second look at this growing sport.  In its simplest definition, MMA is a combination of Muay thai, vale tudo and boxing, combining the power and precision of striking with the flexibility and technique of grappling.  Most MMA schools will teach separate classes for each art as well as a MMA class which combines it all into one.  As with any art, MMA requires strength, endurance and technique, the latter being the MOST important!  The most basic strike (punch) requires years of experience to perfect.  Mechanics behind a punch may differ slightly relative to the art it is learned in however, a common theme is generating power from the floor to the fist.  In a right cross punch for example, the right leg is grounded and pushes off as contralateral trunk rotation is initiated to transmit the force through the shoulder to the hand.  Upon impact, balance is shifted to the left leg, which will generate force to begin retraction of the striking arm with simultaneous scapular retraction and ipsilateral trunk rotation…..WHAT!!!??  Can you imagine the mistakes and compensations your patients will make when learning this complicated series of movements?

In my experience, some common issues and injuries I have seen with martial artists include knee pain, shoulder pain, hand/wrist pain and low back pain.  So how can we as PTs treat these patients to use proper technique without first mastering the technique ourselves? I found it helpful to identify key principles of common movements in whatever sport or art my patient is involved with.  Here are some key things I’ve identified while treating patients with a martial art background:

1. Core, core, core!  With more and more research coming out relating ankle and knee stability to core strengthening, these athletes are one of the first in line to experience problems with their knees due to the transmission of force through the lower extremities.

2. Scapular stability.  Since the final stages of striking involve scapular protraction and shoulder elevation, these athletes are susceptible to impingement due to repetitive use during training.

3. Thoracic extension.  Beginners to the sport will tend to have increased thoracic flexion in a static fighting stance.  This is done as a means to protect themselves, however, it can be detrimental to their shoulders long-term.  Studies show that scapular movement is coupled with thoracic movement in maintaining length tension relationships of the peri-scapular muscles.

4. Single leg balance.  Perhaps something you would not expect to see as an important part of a martial art training regime, single leg stance is indeed an important part of striking.  During the first half of the strike (actually punching) a majority of the weight is transferred to the back leg, whereas during the retraction phase, weight is shifted to the lead leg.  In real-time (sparring or an actual match), fighters will throw a punch outside their BOS (base of support) making them vulnerable to knee and ankle injuries as well as repetitive shoulder injuries. A progression of a single leg stance proprioceptive exercise can greatly reduce the chance of injury and increase confidence during striking.

As a new PT I am quickly realizing the importance of finding biomechanical principles within each sport as a means to treat athletes without actually having first hand experience in the sport.  I hope these four areas of focus will help you all in treatment of patients in the growing art of MMA.