Doctor Megan Jimenez is a BJJ black belt, Kenpo Karate Black Belt, and an Orthopedic Surgeon.
She joins the podcast to discuss going through Medical School to become an Orthopedic Surgeon, the challenges of working with grapplers, how she recovered from an ACL injury, positions and techniques to avoid in BJJ, learning BJJ while injured, red flags to watch out for when traveling, why rolling is like a conversation, her thoughts on peptides, and when to see a medical provider if you get injured.
Learn more about Megan here: https://meganjimenez.com/
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Summary
Dr. Megan Jimenez, a BJJ black belt and orthopedic surgeon, offers a unique and invaluable perspective on injury prevention and recovery within Brazilian Jiu-Jitsu. Her extensive background in martial arts, combined with her medical expertise, allows her to understand the specific demands and risks of the sport. She emphasizes that while injuries are an inherent part of BJJ, smart training and awareness can significantly reduce their occurrence. For Dr. Jimenez, BJJ provides a "flow state" similar to performing surgery, highlighting the constant challenge, continuous learning, and strong community that keeps her engaged despite personal injuries.
Dr. Jimenez advises caution with several BJJ techniques known for high injury risk. She personally avoids certain positions and encourages students to use techniques like heel hooks, scissor takedowns, and guard jumps with extreme care, or to ban them in training due to the potential for severe knee injuries. She advocates for a "catch and release" philosophy for submissions and stresses the importance of understanding defenses for dangerous positions, even if one doesn't actively use them. Furthermore, she highlights the value of choosing trusted training partners and engaging in "flow rolling" as a "conversation" to develop technique safely, particularly for smaller practitioners or those returning from injury.
A significant focus of the discussion is on injury recovery, particularly the mental aspect. Dr. Jimenez notes that physical recovery is often secondary to the mental challenge of being sidelined, emphasizing the importance of staying connected to the gym community and maintaining an active lifestyle through modified training. She underscores the common issue of BJJ athletes rushing back to training, often neglecting proper rest and physical therapy, which can lead to re-injury. For ACL recovery, she stresses a realistic one-year timeline. Regarding physical preparation, she recommends a routine of lifting, hot yoga for flexibility, and proactive physical therapy. She also shares insights on emerging therapies, noting that while peptides lack sufficient human data for recommendation, biologics like PRP show promise for specific conditions like early knee arthritis and tendonitis by reducing inflammation.
Transcript
Show transcript
Speaker 1: What up, guys? Welcome to The Jiu-Jitsu Podcast. Today, we're going to be speaking with uh, Dr. Megan Jimenez. She is a Jiu-Jitsu black belt. She's also a Kempo Karate black belt. She's, as you'll talk about, she's been doing martial arts for a long time. And she's also an orthopedic surgeon, which, you know, doing a uh, doing a sport like Jiu-Jitsu where you're just tugging on joints aggressively, you know, it's funny because I remember, you know, having orthopedic surgeons and um, I remember when my nose got broken years ago, uh, you know, the surgeons are looking at what we're doing. They're like, what the heck are you doing? So I think it's interesting. She has an interesting perspective and a and a vantage point uh, that's a little different than a lot of us, right? Because she's in there repairing people and she knows exactly um, what can happen. And, you know, she also, she's a surgeon. She has to have her hands and her body functional to do her job. So I think it's, she has an interesting perspective that a lot of people don't necessarily have. And so, um, in during the podcast, we talk about a lot of interesting things, you know, um, one of, we talk about sort of some of the positions that she stays away from or the different types of techniques that she stays away from personally, sort of to avoid, you know, excess injuries. Because, you know, you can't, you can't eliminate injuries, but you can reduce them to some degree. And she talks about some of those ideas. Um, we get into the ideas of warm-ups, um, how to roll and even how to roll with women if you're a guy and like kind of some ideas there. Plus, just anything under the sun that relates kind of back to training, injuries, balancing, even getting older too, because we're all, you know, none of us are exactly in our 20s. So, um, we'll get into that, guys. And hopefully, you guys get something from the podcast that's useful to you that you can implement in your training uh, coming up. Um, we talk a lot, one thing we talk a lot about, which is important, is even sort of coming back from injury and doing it the right way so that you don't get reinjured and you actually get healthy again so you can train. Super important. But anyway, hopefully, you guys enjoy the podcast. Big thanks to our sponsors for helping make this podcast happen. Charlotte's Web. You guys can check them out at CharlottesWeb.com. That's their website. Again, they make a lot of good products. Uh, they're one of the OGs in the CBD space. They've been there for a long time. They also make a lot of other products, uh, like functional mushroom products, balms and rubs for sore muscles, and CBN products, which can be really useful for sleep. And again, if you guys want to check out any of their stuff, you know, we talk a little bit about injury and recovery on this podcast and some of the things that revolve around that. For me, personally, CBD is, CBD and all the CBN products and stuff like that that they make, to me, it falls under the category of recovery, right? You know, as recovery, you're trying to get your rest in, you're trying to eat a good diet, you're trying to manage stress because that's a big deal. Uh, and you're trying to so you can get back to training. And as you get a little bit older, you want every sort of little percentage you can put in your corner, right? And if you're doing all the big stuff like getting enough sleep, eating a decent diet, you know, sort of being smart about your training protocols and stuff like that, then you can get kind of get into those supplements and CBD can be a part of that. And so for me, that's kind of where it falls under uh, the category. Take it before bed. For me, that's what I like doing. And I feel like I get a a positive effect. And again, if you guys want to check out their stuff, see what kind of effect it has on you, see how you feel on it. That's my encouragement, you know, supplements are always one of those things where everybody's a little different. You know, you give one person a cup of coffee and they're freaking on edge and they're jittery and they're anxious. You give one person a cup of coffee and they're they like, I need six more, right? So everybody responds to things differently. But if it's worth a try, if you guys want to check them out, their website is CharlottesWeb.com and the promo code is CHUJITSU30 at checkout, C-H-E-W-J-I-T-S-U for 30% off whatever you buy on the order. Also, thanks to our buddies over at Epic Roll. Epic Roll's been supporting the podcast for a long time. They make all my Nogi gear. Um, I'll be putting some of that Nogi gear into uh, into action this this weekend, hopefully. Um, I'm doing a the Indy tournament and uh, at the time of recording this, and when competing, like, you know, the first day is going to be Gi, second day is going to be Nogi, and uh, uh, hopefully, depending on what time they put me in because my son's birthday is on Sunday. So, if they can get me in there early enough, I can compete and then drive back home and be home for uh, to to be there for his his his birthday. But anyway, I get my my Gis and rashguards and all my Nogi stuff made through them and the Gi stuff for my gym. If you guys want to check them out, they make terrific products, uh, good quality stuff, good designs, good customer service, all around is a cool company that supports the local Jiu-Jitsu community and uh, they do a lot of cool stuff. If you want to check them out, their website is EpicRollBJJ.com and the website, or the, excuse me, the checkout code is CHUJITSU20 for 20% off the order. So if you buy a T-shirt, a rashguard, shorts, whatever, I think they have some of the best, most comfortable Nogi stuff in the business. Uh, CHUJITSU20, 20% off the order is what you get. Also, if you guys want to support the podcast directly, you can check out our Patreon at Patreon.com/TheJiuJitsuPodcast. And when you uh, join up, you'll get a bunch of different perks. If you guys want to check out the different perks that we offer, you can go there. Again, a lot of it is um, centered around some extra content that we have for from the podcast with the guests and with you, Eugene and I, as well as some recordings as like warm-up routines and things like that. We talk about warm-ups and hip circles and all these um, articular rotations on the podcast. Eugene recorded a uh, session of him basically taking a Jiu-Jitsu group through that. That's on there as well. It's 20 minutes. Uh, for any of you guys who would like a good warm-up routine that can loosen up your shoulders and your hips and everything else, it could be very useful to you and give you some ideas to to work with. Again, that's at Jiu-Jitsu, or that's at the um, Patreon.com/TheJiuJitsuPodcast if you want to join up. And if you guys want to get my daily email that I send out and get some exclusive offers that I send out to only that list, because again, I don't I don't I don't advertise a lot of stuff out and I don't uh, give a lot of the discounts that I give out that I give out on that particular email group. And so if you want to be a subscriber, go to Jiu-Jitsu.net/join. And if you join up, you'll get access to the uh, the daily email. You'll also get access to everything else that uh, I share through out my website. And, you know, if you enjoy the the ramblings, the videos, the books and stuff that I'm reading and some different ideas on training, you'll like the emails that I send out. And again, they uh, they come out every day. So, that's at Jiu-Jitsu.net/join. So with that said, guys, let's get into this podcast with Megan.
[Music]
Speaker 2: It took about the same time to get my doctorate or I guess to become a doctor as it did to become a black belt.
Speaker 1: Which one was harder and why?
Speaker 2: Oh, definitely becoming a doctor. Yeah.
Speaker 1: Yeah.
Speaker 2: It's more a lot more mental energy and you have to just force yourself to sit and study and you have to pass all these tests. And some of the tests have nothing to do with what you're even going to do in your future. Like my orthopedic board exam, they're asking stuff about like crazy tumors and pediatrics that I Yeah. will never see or biology stuff, biomechanics stuff. Just silly questions that you have to just study to take a test, not to treat the human. At least in Jiu-Jitsu, I study to do Jiu-Jitsu. You know.
Speaker 1: Oh, that makes sense. Yeah, it's just, do you think it's because um, so it's more applicable for you essentially is what what you kind of took from it?
Speaker 2: Yeah, medical school was just going through, you got to do it, this many years, residency this many years, and then you move along and a lot of the stuff you don't even use until kind of later in residency, fellowship, and then you become a doctor and you really start to learn.
Speaker 1: Yeah, more like on the job training.
Speaker 2: Mhm. Yeah, there's a lot of like wasted space, I think, in medical training.
Speaker 1: Yeah, I was going to ask, like, what do you think like if, you know, obviously, you don't want to rush, you know, the uh, the person through doctor school, right? You want you want them to kind of know their stuff. But I feel like a lot of times when I hear about certain degrees that people have from college, it's like, it's almost like it's just a vetting process. Like we're going to get you through, you're going to learn some stuff, but we're going to vet you, make sure that you can do this at whatever. And then you'll eventually actually get to learn the thing that you actually signed up to learn in the first place. How how short, you think of your your medical school period, right? From like, you know, whatever, beginning to end. How how much do you think you could condense that? Like, how how short do you think that it could have been and still actually gotten the information and the tools you needed to be effective at what you do as a medical professional?
Speaker 2: I wonder about that a lot and changing the system. It's kind of just like it's so set in its ways and I'm not sure it would be very difficult to change. Um, especially because you have older people that are like, well, that's what I did. So this is what people have to go through. And there is an element of that because you don't want people to get through easily because medicine is very difficult. Surgery is hard. And so you don't want people to get through easily. Um, but just to let you know how long it is, a lot of people don't know. It's four years undergrad, four years medical school, five years residency to be a surgeon, and then I did an extra year fellowship to be a sports specialized surgeon. So it's a lot of years. Um, medical school, I think a lot of it was stuff that I couldn't even tell you half the classes what they were, you know. So medical school probably doesn't need to be four with undergrad. Uh, undergrad was fun, right? We had I had a good time and it was a a life experience rather than just school. But medical school was just I had a chair in the library that everybody knew was my chair for four years and that's where I went because you have to study, you got to pass the tests. Yeah. You know.
Speaker 1: It's intense. I've had some I've had several students that were in medical school and they're good for like the first little bit and then it's like, I guess it's like whether it's like second year, third year, whatever it is, it's like, they're just like, sorry, man. I I just can't. I don't have the ability to do really anything anymore. I just, you know, they could maybe train lift weights or something, but they're just getting hammered um, in school.
Speaker 2: I couldn't train during medical school. I did a little bit. That's where I first started dabbling, but then residency I started and I had to go to a school that was I went to school that was awesome. And I said, hey, there might be six months where I'm not here because I'm on trauma and I'm not leaving that hospital like except to maybe go home on a weekend, you know. And I'd go home during the week sometimes, but you don't sleep much, you're on trauma rotation and I would pause my membership and they were awesome. They were like, we're not going to charge you. Just don't worry about it. We'll freeze it completely. Come back when you come back. And my professor was so cool then, Jonathan Webb out in Jersey, who's my first coach. He was like, just come in and train when you can. Don't even worry about it. You know, if you can come in once a week, just come in. So it was really cool.
Speaker 1: Wasn't the residency, and I could be completely wrong about this. I feel like I heard this somewhere that the guy, I guess who like sort of helped create the residency system was like a hopped up on the amphetamines.
Speaker 2: I don't know about that, but it could be true.
Speaker 1: I I just remember like the schedule that the schedule that they place on some of the the people, it's like, dude, it's intense. Like you guys are like it's it's like a long, long shift and you're like doing medical stuff. It's not like you're just like, you know, screwing in like nuts and bolts or something.
Speaker 2: And a lot of the hour things have changed. Like as I progress, they had like duty violations and hours. Then you have again, the older school people are like, well, that's how I trained and you know, you got to do it sometimes tired. You're going to be on trauma and things are going to come in. And now in the military too, it's like, well, you might be tired, right? You might be woken up. There might be an emergency. So part of it is good. Um, but sometimes it is a little bit much and on your on your mind. Like you don't realize how sleep deprived. You kind of go through that five years and at the end you're just like, what happened? Because you just got to keep your head above water for most of residency.
Speaker 1: You take a step back and you're like, whoa.
Speaker 2: Yeah, you're just trying to keep your head above water for most of residency.
Speaker 1: So it's kind of like, what was medical school what you expected? Like is being um, a surgeon what you thought it would be?
Speaker 2: Yeah, being a surgeon's awesome. Um, I love getting people back to sports. That's what I mostly do. So doing a complex surgery and like crushing it and having these guys get back and be so grateful. That's like the best part. Um, when I was a civilian doc, I'd go to their games. I'd go watch like my soccer players. I'd go to their games when they were coming back after an ACL surgery, things like that. And now I can't really see the military guys in action, but um, I can see them at least crushing physical therapy and sometimes some of them train Jiu-Jitsu too with me. So I'll I'll just train with them after I've treated them and they're back, which is awesome. Um, but I don't think I realized how hard it would be to for the complications or the people that don't do well or things not going my way. Like you you take it pretty I take it very much to heart. Yeah. Um, and when I first started, I wouldn't sleep for days if something didn't go the way I wanted or and the patient could do totally fine. Just it wasn't what I had envisioned. And so I took it pretty hard. I still do. Um, because, you know, you want it to be perfect. You want it Right. somebody's limbs in your hands.
Speaker 1: What's something when you say like not perfect, like what's an example of something maybe not working out the way you'd like?
Speaker 2: So maybe I had a a operative plan because before we go into surgery, we do preoperative plans, right? So that's usually Sundays for me. Sundays, I'll work on my brand and do podcast newsletters and then I work on all my surgeries. So a lot of it is on my computer. I've got this big word document or PowerPoint that has all my cases I do. Little details, things that I want to do better each case, I write a little something. And so maybe a little a pin placement was off by a couple millimeters. Something that probably won't make a difference, right? You're like, well, I know where that where I want that to be. And then it's figuring out, I had a mentor that used to say the enemy of good is great or the enemy of good is perfect. Because you could sit in that operating room trying to get a a pin in the perfect location, you know, because I use a lot of hard like tools. Um, so I'll have a drill and I'm putting a pin and you're trying to get in that perfect location and all of a sudden you're you're not anywhere you're where you wanted it to be and the first place was good enough. Right? The patient outcome will be the same. But what you learned in textbook or what you've seen where it's perfect could actually go the opposite on you if you try to get it. Probably like Jiu-Jitsu too. You want this move to look picture perfect like you saw on Instagram. And then when you're trying to get it there, the person passes you or submits you because you were trying to get it perfect. But maybe the slightly less perfect version still worked.
Speaker 1: Right. Well, there's always that textbook and then there's kind of what happens. And, you know, even, you know, every situation's a little different, right? So, um, a lot of us, you know, as you train, you develop certain techniques and stuff like that that you know very well and they may look a little different depending on the person, their body type, the the style of game that they had. It's the same move essentially, but like you, you know, you're saying with the pin, because of the situation that you're in, maybe you have to move this pin, you know, a small distance this way or that way. And, you know, if you're going up against a competitor and you're doing the same move you've done a bazillion times in the gym and you've hit it in competitions, well, they're doing something different, so you have to slightly adjust it a little bit differently, right? There's there's the textbook, there's like the picture perfect, here's what we were aiming for, but then there's the reality of, you know, just life and whatever else happens and you have to make adjustments, right?
Speaker 2: Yeah, and that's the hardest part about once you become a doctor, you have to realize what those limits are. You know, where you are still doing a a great surgery and the patient will do well. And they're not going to know the pin was off a millimeter, right? Only I know that because they're going to have the same outcome. So that's a really tough thing for my brain to to switch off.
Speaker 1: Human body is very, it's is very variable. There's so I mean, not everyone you look at a textbook and it's like the muscle is supposed to run this way, the bone is supposed to run just like this, but everybody's got different bone structure. They have different muscles, some are bigger, some are smaller. And then you have so many other health conditions that can impact, you know, a treatment or even like you have to have compliance. Not just like you're you're screwing, put a screw in like a piece of wood. It's like you're it's like a mobile, active thing that people have different pain responses and they're their compliance levels vary, you know, especially with Jiu-Jitsu. Jiu-Jitsu people are a crazy breed of people because like they will do anything to get back to training. And a a fun example is we had a a guy that had ACL uh, surgery. Just ACL, no meniscus, so he didn't have any weight-bearing restrictions. A month in, it was a month. He was doing like we were doing like takedowns, like um, leg sweeps, like sweeping out the leg and and he was like standing. I was like, didn't you have surgery? He's like, yeah, yeah, I'm feeling pretty good. I was like, I'm not touching you, man. Like I'm not even going to move with you. Like you shouldn't be out here and I just let him know and then sometimes.
Speaker 1: Jiu-Jitsu guys will do anything but like rehab therapy and like take time off or like lighten up the rolls or whatever. They'll do anything but that, like, you know, but they'll just get back out on the mats.
Speaker 2: Yeah, and I think Jiu-Jitsu post-op stuff is so important. Um, I work a lot with a buddy of mine. Do you know Mike Piekarski? He's got all this really cool stuff going on. Um, and we've put out some literature together about Jiu-Jitsu athletes because there's it's so sparse. And um, I love what he's put together because it's specific Jiu-Jitsu specific drills to get people back. And just he's like, they're going to get out there, right? So it's modifying and telling them what they can and can't do and their limits, but more so telling them what they can do. Because if you focus on what they can't do, they're going to go do it. And if you just say go ahead to the mats, that's a big problem with orthopedic surgeons too. Yeah, you can start training. But you don't know what Jiu-Jitsu training means, right? You tell them they can go train and you just think they're going to be doing shoulder rolls or like a light little drill with a with a trusted partner. No. They're going and having death matches because you released them. So it's giving them the limits and that's really hard to enforce if you're not there.
Speaker 1: Yeah, is that what what do you think like the most challenging thing um, or some of the most challenging things of working with Jiu-Jitsu athletes or grapplers or MMA fighters? What's one of the big sticking points for you of whether it's compliance or getting the the best rehab or the best recovery or the best performance out of them after a surgery?
Speaker 2: Well, you guys hit the nail on the head. It's not wanting to take any time off. Like sometimes I'll just ask people, just take the rest of this week off. Go do an ice bath. Go sauna. Go see a physical therapist. And nobody can take even take like a day off, you think I was taking their firstborn child. One day. Just go chill, you know, sleep. Getting people to sleep is hard too. Um, and I think we all try to do more and like, oh, we slept less, we're tougher. But that's not the case. And so I'm teaching a lot of my my friends at at the gym now too, like we have to sleep. You have to eat. You can't just train two day two times a day without any recovery. If you're training twice a day, you got to recover just as much or more. Right? So that's a really tough balance to strike and each person's different. But nobody will take a day off. And for some reason, people don't want to go to see physical therapists, which it can be expensive, right? Copays aren't cheap. So I get that. Um, but even getting a home program. Like go see a physical therapist once. Get them to give you a program and then stick to it. But then the knee pain starts to let up a little bit and they send it. And then the knee pain comes back because they didn't properly load slowly. And I'm a I'm a victim there too, right? I'll have a pain and I want to get back out there. But I try to modify and use trusted partners.
Speaker 1: Yeah, it's uh, I remember coming back from a meniscus surgery. I had two meniscus surgery, one on my left leg, one on my right leg. I tore the one on my right leg when I was 19. I tore the one on my left leg when I was 29. And the one on my right leg, I mean, I did, you know, a 19-year-old's physical therapy rehab, which was not much. And then I went back and competed like four or six weeks later. I lost a few degrees of extension in my right leg because of it. So it never, it's fine. It's okay. Knee feels okay, but it never fully locks out. My left one though, I was like, I'm not going to screw this one up. And I had Eugene like give me a plan and I stuck to that sucker for like, you know, even afterwards, I kept doing the rehab stuff as preventive. But I remember um, for me, I had to put it like a work almost, you know, you think of like a workout plan, you go into the gym and you have the plan, so this way you stay on what you're supposed to do. Hey, these many sets, this many reps, whatever. I had to put a plan in place for myself ahead of time because I was like, I'm only teaching for these weeks. On week four to six, I'm going to do this. On week six to eight, I'm going to do this. On week 12, I'm, you know, whatever. And basically just doubled what the uh, the surgeon's recommendation to return back was and then came back and had no issues out of it whatsoever. And um, you know, you extend the rest a little bit, but on the back side, you don't have to end up under the knife again or, you know, back on the shelf again because the injury keeps coming back.
Speaker 2: Yeah, I think that's beautifully said. You have to incorporate it into your workouts. Like I've my knee was acting up recently. So the other day I said, I'm not going to do my workout, I'm going to do PT. And what's that for me? Like bike and different leg workouts that I've done with my physical therapist. And the bike is so powerful for knee injuries. Uh, people I don't think realize. It's so easy. When people have knee injuries, I'm like, get on the bike 20 minutes a day. You don't have to crush it. You're not doing a marathon. Just get on the bike and move your knee and you'll see how much better you feel. And so it's just simple things and they can be put into your day easily.
Speaker 1: I think the main gap when you're looking at the and you uh, Megan kind of mentioned it, it's like when somebody there's a lot of lack of understanding um, from physicians about what Jiu-Jitsu really is, what the requirements are, um, the mobility requirements, the strength requirements, just the, you know, being put in these situations where your leg has to externally rotate or move in just certain positions. And also, you have somebody pushing forces in different ways, basically testing your knee or your joint, the ligaments and the and the strength of it. So I think the there's such a gap in like being released from physical therapy versus being ready to train Jiu-Jitsu. And that's where kind of Mike and myself, we kind of that's a lot of the clients that I see is like, all right, now we you're been released from traditional PT. You're not quite ready to get back to, you know, Jiu-Jitsu. So you kind of put these guard rails on people and then a little bit at a time you take them off and and you allow them to like you said, there's certain variables you can kind of take away as you go on, like positional training, uh, maybe drilling, trusted partners, maybe avoiding certain positions for a little bit and and things like that. Um, so I think education's a huge piece and just the understanding. Is there anything like as as Jiu-Jitsu athletes or as um, physical therapists you think that we could do better like when we see a physician? Like how can people do a better job of letting them know, hey, this is what we're doing, this is what I need to get back to to to training?
Speaker 2: Well, I actually just went to a course recently, like two weeks ago, uh, Smith and Nephew, it's a company of implants that I use. And they do a big UFC course every year. It's this was the second year that they did it and I speak at the course. And it's tremendous because they bring in docs from all over the country and world, really. We get people from Canada coming down and we talk about UFC and combat sports in like specifically, these athletes in the population and how to deal with these problems, right? And you have docs from like white belts. You have we have a bunch of black belts that are on the faculty as well that speak. And then we have ex-MMA guys, people that still fight. And then you have doctors that don't know anything about the sport or just watch UFC on Saturdays, you know, know very little. And so I think it's really eye-opening for them because a lot of the talks I do are about specifically Jiu-Jitsu culture, Jiu-Jitsu, um, techniques and moves and what it looks like when people return to the mats. So I think that we bring that really nice element. We also talk about, you know, ACLs, shoulder instability, what we're treating in the surgeries, but I think the bigger component of that conference is the athlete and the athlete in particular. How do we get these guys back and how do we hold them back from themselves and protect them from themselves?
Speaker 1: What do you specialize in with your surgeries? Because I know you um, typically, I don't it's what I for my understanding, a lot of times surgeons like orthopedic surgeons have a a specialty of a few things that they do better than others and that's kind of what they stick to.
Speaker 2: Yeah, I mostly do shoulders and knees. Um, mostly arthroscopy, some open procedures, so the camera procedures. And then some open stuff. Um, and then basic trauma, ankle fractures, femur fractures. If you have any long bone fractures, we have to be able to treat those. Hip fractures in the elderly are very common. So lots of we call it kind of cold trauma. Um, as in like you could break your femur and we don't typically have to rush right that second in the middle of the night. We can kind of do it at 6:00 a.m. or 7:30, you know. Sure. Ankle fracture, week or two later because you need the swelling to calm down so that you can close the wounds after you you've fixed it definitively. Um, and then some of my partners are hand specialists or foot and ankle specialists, joint replacement specialists. Um, but I do sports surgery. So anything that you can imagine being sports related, mostly shoulder and knee, some elbow.
Speaker 1: Got it. Is there anything in particular like um, surgery-wise that you find I I'm there's techniques that are always coming out all the time and things change, but are there any particular surgeries or repairs on people's bodies that you find um, more challenging than some of the other ones?
Speaker 2: Uh, ACL is actually a very tough surgery. I had a mentor that said that there's no orthopedic procedure that's more that has more areas you can like mess up or can go wrong than an ACL surgery. And I thought that was a bold statement. I was like, oh, that's pretty bold. Like we have a lot of ACL injuries, but there's so many steps and you're trying to reconstruct and make a new ACL for somebody with little poke holes. So everything you're doing is under a camera and with little instrumentation, like not even your your hands really on the tissue. And there's a lot of areas where things can not go your way and you have to just have plans A through F, you know, because that's the way that ACLs go. And so you do so many ACLs that you're just like, you know where things can be challenging and then you know what you do for the to to help that situation. You try to avoid it, but you know, things happen and it it really is a tough surgery. It's hard. Even just picking what graft type you want, right? Because people are always coming in asking what graft and that's a whole podcast in itself about what graft to use because there's a lot of different ones that you can use. And I mostly do grafts from the patient. So I take tissue from you and make your new ACL. But there's also cadaver, like somebody donated their body to science and you can use that tissue. And I'll use that maybe like a 40 or 50-year-old, not as active, um, and then we won't have to take tissue from them and have issues with their donor site, right? Because if I take a tissue from you, that's another area where you can have pain after surgery and dysfunction. Um, so it's so patient specific uh, ACLs from like the start and then the recovery is so hard. It's so hard. I tell people it takes a year to get back. And that's the truth, you know, nine months is the earliest, but we use all these timelines and and numbers. That doesn't mean you're ready. So people hit nine months and they're like, I'm ready and they're they're still weak. They don't have full motion still sometimes. I'm like, you're not ready. Like, sorry, I know you hit nine months, but do you feel ready? And if they're honest with themselves, a lot of times they don't. So ACLs are hard from start to finish. It's a bad diet, it's a tough diagnosis to take.
Speaker 1: Yeah, what do you think um, as far as like, so for people that maybe are like, what's a graft? What do you like what you're explaining if you just explain that to some people and what do you like to use? What do you prefer to use in grapplers? What type of tissue or graft do you prefer um, that you think does the best job with, you know, keeping their knee secure and and giving them the best outcomes to because there are obviously there's pros and cons to everything. Especially with Jiu-Jitsu, you know, if we're taking something like the patellar tendon, we're kneeling. So it's like there's, you know, secondary injury there. So what do you like to use and kind of what's what's the research that you found that's been helpful?
Speaker 2: Sure. When I talk about ACLs, I always like to say first of all, not all ACLs need surgery. Um, you know, people often hear ACL and and in in my world now too, when when the soldiers come in with an ACL tear, they're like, oh my God, I have an ACL tear, I have to have surgery. And they're on profile, they're shut down from everything. But sometimes their knee's pretty stable. And like, have you had any instability? Have your knee buckled on you? And they're like, no, not really, I feel pretty good. And these might be the guys that we trial for no surgery. Still have to do physical therapy. Like, I think a lot of Jiu-Jitsu athletes have either ACLs with partial tears or no ACLs. I think many do because of the motions that we're constantly in, lots of rotation of the lower leg. Um, maybe we hear a pop or, you know, a heel hook too far. It doesn't swell as much as a traditional big pivot shift that you see like in the NFL. And so you don't notice it as much. You might have a little knee pain, a little swelling, move along. But you still have to do PT. Like that's my theory on non-op because I don't want everybody to think that they have to have it. Now, if the knee's giving way and it's super unstable and it's inhibiting you from living, if your knee's constantly swelling, you're probably not a coper. You're probably not going to do well non-op. Now, grafts are, we have to make the ACL out of a new tissue, out of your tissue. We got to make a new one. And so there's really four options. There's a fifth one that's been kind of coming out. Um, I have not dabbled in and I don't really think I will. Um, at least not yet. Um, there's the quad, which is just above the knee cap. We take a strip of quad of your quad tendon. Uh, there's patellar tendon, which is like the tried and true what is um, kind of like most commonly done if you go to the combine, uh, see pro athletes, they're probably have a patellar tendon, which takes pieces of your bone as well. Then there's hamstring, uh, which I think is still the most commonly done in the world. Like Europe and in the world, people are still hamstring is it. Then you can get tissue from a donor. And those can come from many different areas of a donor. They can come from Achilles, they can come from a patella, they can come from the hamstrings. Lots of different options. They can come from the quad. And I usually go with quad when I pick that allograft because I just think it's a nice thick tendon, it's very strong. Uh, and then when I talk to my patients, they're usually young, usually young soldiers, um, or dependents. So I'll get like the soccer players, Jiu-Jitsu athletes, um, football, 15 to like 45 are my main population. And so I mostly offer people their own tissue. I don't like hamstrings, um, I think that the literature shows a higher failure risk, especially in young females. So I don't and I don't really love it when when you take a hamstring graft. Um, it's it's just it's not very it doesn't make me happy. It's not as thick as if you take a patellar tendon or a quad. So most of the times you come into my office and I talk to you about all of these. Uh, peroneus or peroneal tendons are also starting to be used. Um, but I have not dabbled there. That's just coming from the lower leg. But um, I know that there's some research coming out about it. So anyway, you come to my office, you get quad or patellar tendon most of the time. Unless you're a little bit older and less active, then I go allograft cadaver. Um, patellar tendon, yes, you can fracture the knee cap. That is one downside. You can get kneeling pain because we take a piece of the knee cap. And then with the quad tendon, it's a very good tendon. It's a little bit newer than patella, um, but sometimes people have a little bit of quad weakness early on. Getting that quad to fire back up. So I usually offer both of those and I have my patients go research it on their own, talk to friends, see what they want to do and then we talk about it and I answer questions and then we go one way or the other.
Speaker 1: Now, for you, this is sort of kind of veering off a little bit. We rolled in um, in Costa Rica at the camp. And um, I sort of just commented on you. You just like, I feel like when you're around this stuff long enough, you can kind of move around with someone and get a feel for their body, their movement, uh, the musculature and they're like, oh, this is like an athlete. Versus like, oh, this is like a you train a little bit, you start working out versus like, oh, you you're your body's been moving for a long time. Um, have you always been an athlete? Like, have you always been involved in some sort of athletics?
Speaker 2: Yeah, I started karate when I was five, I want to say. I my mom tried to put me in ballet and I hated it. There's videos of me with my arms crossed, stomping around with my like frilly dress on. And I hated it. So they were like, all right, we're just going to put her in karate. I think it was right below the dance studio. And I loved it. So I did Kempo for a long time. Uh, then I boxed a little amateur. Then I did a little bit of Muay Thai. I never competed, I just kind of trained it. And one day I was um, like I was boxing and I was in medical school and I saw people rolling around in pajamas. It looked like karate Gis. And I was like, are they doing karate? Like what are they doing over there? And that was probably like 2011 or so, 12. Okay. Um, and I so I was in medical school. And I bought like a $40 Fuji Gi online and went and then I just loved it.
Speaker 1: So yeah, so you've been doing martial arts in some capacity since you were a you were a little one.
Speaker 2: Yeah. Yeah. I think it was good for just like karate was great. Um, you know, we make fun of karate sometimes or people are like, oh, you do karate now. It's like, no, I do Jiu-Jitsu. But karate was great as a kid to discipline, just learn like respect. You learn um, how to work with other people of all different ages, right? Because sometimes I'd be I was a like a 15-year-old sometimes teaching the adult class. Um, because I've been doing karate so long. They're like, you're going to teach. So you you definitely I learned a lot.
Speaker 1: Well, and that has to build a little bit of confidence, right? Like if you're I remember having a um, teenager train with me who's, you know, he's like 15, 16 years old and he's a little killer. And he both had the respect of some of the older guys in the gym because of how good he was. And he would teach some of the beginner classes because he was just really, really good. And so he's going to high school. And I remember thinking about how like interesting that must be to experience, right? Like that, you know, I didn't experience that, that you go to high school, you're, you know, taking classes or whatever. And then at nighttime, you have 40 grown men and women that are coming to you, um, and they're learning from you and they're giving you respect and like asking you questions on how to do something, you know, it's it's kind of an interesting dynamic for a uh, for a teenager to experience, you know, that sort of thing.
Speaker 2: I think it it helped a lot. Like I never thought about this before, but I was teaching at a very young age. And now I love teaching. And I have residents at work. I love teaching residents. I teach Jiu-Jitsu a couple nights a week and it's just so tremendous because you you have to learn, you don't know everything too, right? In the beginning, I wanted to be like, oh, I know the answers. I'll tell you and you just start fumbling. Now, I just say, I don't know, but be ready for a full dissertation tomorrow. You know, and then I go home and just study it up for hours. And they're like, I wish I had never asked. Because I go full send on it. Yeah.
Speaker 1: But I I think that also, you know, if you're in a position where you are teaching and you you know, you have that whatever that position is that has some authority to it or some recognition to it. I think it shows a certain level of like honesty and humility when you're willing to say, I don't know what's going, I don't know. Because I've done the same thing for a long time. Like someone would ask me a question and I'm like, you know, I don't know. I don't have a good answer for that. Let me get back to you. And then like I would go research, ask questions to some other people and then come back to them. Hey, like whatever, you know, and I think people appreciate that versus trying to just bullshit your way through it.
Speaker 2: And I love more teaching than taking class most times. Because I have to go look at it and look at all the what ifs, right? Okay, what if it turned that way? What if it turned this way? Because you know they're going to come. Those questions are going to happen in class. And so you have to be almost like an expert on this area. I was going to teach buggy chokes coming up in a couple weeks. I'm like, I don't buggy choke. Like my legs will they are it's almost impossible. I think I'm going to destroy my knees.
Speaker 1: I was going to say, you're not really built for buggy chokes.
Speaker 2: No, and also I know too much. I start feeling pressure on my knee and I'm like, okay, my ACL is going to pop. So I let it go. Um, I've heard the pops, you know, especially like that and um, rubber guard. I've heard the pops across the room. I don't play them, but I want to teach them. And so I I try to become educated in these things so I can at least teach them for people that like them, you know.
Speaker 1: So so that's a great uh, bring up a great point. What are um, besides those, there's certain positions that you try to encourage maybe your students to avoid on the mats or I mean, obviously, inverting is okay once in a while, but if you do it a lot and you get stacked a ton, that can cause problems. So what are maybe some ways that either positional kind of techniques that you're like, hey, maybe stay away from these or use these sparingly or even some training philosophies that you've kind of developed over the years to help um, keep yourself healthy and your students healthy?
Speaker 2: Yeah, the inverting thing is funny because I inverted a lot and I have a bad neck because I am tiny. I'm like 123 pounds right now. And we're getting stacked. So I've learned I don't invert with people I don't trust or really big people. People I trust, then I'll invert, give them my full game or people my size. But the bigger people stacking constantly is is definitely rough. Um, so, you know, going inverting, I try to tell people to do it safely. You do your best. Sometimes people get stacked and it it happens. I think um, heel hooks are a big one. Um, I tore my ACL to a heel hook a couple years back. So I'm super vigilant about the position and I teach it. I love teaching heel hooks. I love reaping. I love teaching it. I teach it very safely. And then I'm like, you know, this is what the top person should be doing. You know, don't leave your foot planted when they go to reap your leg because your leg's going to twist. Start to kind of uh, bring the weight off of it. Work with your partners. And then in the gym, especially, I give a little like brief at the end of class. If you guys are going to do leg locks, talk to your partner about it. Make sure you know it's safe. We catch and release. You're not trying to prove anything to your partners. You catch and release and pretty much any joint lock, um, last night one of my older professors, he's hilarious. He he's does the old man Jiu-Jitsu where he just like chokes you and does crazy arm bars out of nowhere if your arm is extended and tries to like break your arm off. And so I was like, if it's a joint lock, just let it go. Keep the tally in your head, move to the next thing. And the other professor, he's like, yeah, but you could choke people unconscious. Like they'll just get a nap, it's fine. Yeah. Different philosophies, you know. Yeah. I um, I'm very much of when I roll with people, I'll hold things. They don't tap and I know it's pretty tight. We move along. I let it go. Because I'm not trying to hurt my partners and I'm trying to teach that because not everybody will show you that same back.
Speaker 1: Yeah. But I I think, you know, because I I I share that philosophy like with, you know, with heel hooks, it's like with all the submissions, like when our white belts are going through their basics classes, we'll teach like sort of a philosophy of like catch and hold. So you can be very quick to like, you know, get your arms locked around say a Kimura and then once you get the position where it should be, you're going to kind of hold there. We don't really want to, you know, and everybody's a little different flexibility-wise, but when you start to feel, you know, a certain tightness in the the shoulder, you just stop and hold. If you're in the heel hook, you get the catch and you hold. We're not going to start ripping stuff. Um, at the same time, I tell them, you know, if if you got a guy in a fully locked arm bar and that arm is fully extended and you're holding it for like 1 1,000, 2 1,000, don't go past that point. Just come get me because then me and that person have to have a talk and figure out like why aren't they tapping? Are they just crazy flexible or are they just being a bonehead and and try not to tap? And then, you know, that's a different conversation. Because, you know, you you don't want to have someone that's like, it's like you're playing a game of chess. Hey, I just put you in checkmate and they just keep moving pieces. You're like, no, no, no, like like we're we're playing this game here and we don't want to leave mangled if we don't have to be.
Speaker 2: And the big thing is the defense part for heel hook specifically. People come into my class sometimes they're like, well, I don't really want to do heel hooks. I was like, okay, but is nobody going to ever put you in a heel hook? Like you need to know where the dangerous positions are, how to escape, when you need to tap. Because that was one of my downfalls. I thought I kind of knew heel hooks and I didn't tap in time, right? And so it's just kind of teaching that on the defense. Where you should not roll, right? Because we've all had that person we have in that heel hook and they roll the wrong way and you feel that knee tighten up. And if you don't let that leg go, they're exploding at themselves. So I try to teach all those safety items when I'm doing heel hooks in particular and any leg entanglements. And we've been pretty safe so far.
Speaker 1: That's so important.
Speaker 2: Oh, the other position that I don't really love is like scissor takedowns. Um, because people blast into the side of the knee. I think there's a way to do it, right? There's a way to like Connie Basami safely. There's a way to do all these things safely, scissor takedowns. But people blast into the side of the knee and then they create the the big stress and MCL ACL go. Um, I've seen it so many times. I always forget the name of the takedown where you have the person not on their back, but you're on their side and then you go to sit and sweep them over your back leg.
Speaker 1: Oh, that that one I've seen that go like south so many times.
Speaker 2: Because you're supposed to sit your butt to the floor from what I.
Speaker 1: And they like sit it right on the side of the knee. Oh.
Speaker 2: They jump into the side of the knee. So anything that goes into the side of the knee like that, I really I just tell my students like, we're not doing that. You know, if you get around to somebody and then I also teach J I learned this from uh, J-Flo out in uh, down in San Diego. When somebody has me behind me and they have their hands locked, I have my hands right down and I'm blocking my hips so that their knees can't come around the sides and they can't jump into the side of my knee. He he taught that as like a good defense. And I was like, it's okay, take my back, but don't blow my knees out.
Speaker 1: That's right. He's like, I'll I'll I'll give you the takedown, but don't just don't blow me out, right? Like.
Speaker 2: So it's just kind of blocking and protecting and being aware of that. Um, but yeah, I've seen so many people just jump into the side of his knees and blow out people's knees. Like ACLs, meniscus, MCL, the whole thing.
Speaker 1: Yeah, and that's like, you know, that's one of the some of the worst injuries will come from like like following body weight. You know, you I've seen just over the years from MMA training, Jiu-Jitsu and everything else, you know, someone post an arm the wrong way. They they're trying to fight the takedown all the way through instead of just, you know, sort of conceding and their their foot gets stuck just at the last minute and it twists and their ACL blows out. And um, you know, this is why we typically sort of ban things like scissor takedowns and guard jumps even in the gym because it's like it's not worth it. If you want to pull guard, you can pull guard just fine and, you know, there's plenty of other takedowns you can do than a scissor leg takedown. And I I it can be done safely, but even then, it's just, you know, if the person moves one wrong way and it even if even if you're executing it safely, if they move the wrong way, like, boom, they're they're went someone's knee. No good.
Speaker 2: Yeah, the the jumping guard thing kills me too because I've seen so many people's knees hyperextend the other way. Right? For sure. And it's so uncontrolled and you'll see it in like these masters divisions sometimes like white belts jumping into each other's knees and, you know, it's okay. I've seen people do it very elegantly, jump into the hip or jump up on the hips, right? But the problem is people jump right above the knee.
Speaker 1: Oh, run into them. Yeah.
Speaker 2: Run into the knee, right above the knee. And the foot's planted. And I've had friends with some pretty nasty. Now you're talking about not even like ACL, MCL, posterolateral corner injuries, which are like a whole other beast, right? That's a bad injury. That's a tough injury to come back from. ACL is hard enough. But now you have PLC, which is a whole other area of the knee that you can affect with that hyperextension. So through a lot of things I would ban. Um, you know, just kind of those that we talked about. And down at Legion, I actually talked to them and they have a couple of these band techniques. Even I was out in Japan and I went to Minari's gym. I loved it. He had a full paper of like band techniques and it was all these ones that we're talking about. And I was like, very well, very well done because you have people coming from all over the world. You don't need people just coming in blowing each other's knees out in training.
Speaker 1: What's been um, for your ACL injury and your recovery, what was one of the more challenging things of you for you to get back on the mats and maybe what's like a piece of advice that you have for others coming back from injury? I mean, there's a lot, you know, physical, mental components, there's so many different things there, right? And it's all got to be online, it's all got to be together.
Speaker 2: Yeah, when my athletes tear their ACL and I see them, I actually just saw an ACL post-op um, a couple days ago. Young girl, 16, uh, I just did her surgery two weeks ago. So her knee's still swollen. Uh, you know, she's going to school. So you can always tell the kids going to school, their knee's still swollen two weeks in because they're they're not elevating it as much.
Speaker 1: Still walking around everywhere.
Speaker 2: Right. And, you know, I'm telling them go to school, go do things you want to do. Um, but I looked at her and I said, you're going to get through this physically if you do the rehab and you do the right stuff. This is a mental injury now. And she just looked at me and she just went like this. It's like, cuz you lost all your well, not lost, but you feel disconnected from all your friends, from the sport that made you was your personality, was your identity.
Speaker 1: It's your identity.
Speaker 2: It's all of it, right? And now you had an this injury and you can't go hang out with your friend group or you feel that you can't. And so I talked to her, I said, you still need to go to practice. Like I she's a a soccer player. I said, go to practice. Be on the sideline. Cheer your friends on. Go out with them after. Go to dinner. Do the like pasta if you do pasta nights like track or whatever. Go do the things with them. Go to the weight room. Who says you can't go to the weight room with them? Go do upper body, get on the bike. So that's what I tell my athletes. I'm like, this is all mental. You'll be fine physically as long as you do the right stuff. But it is it was a big mental one for me. Also regret of like, man, you should have tapped. How could you be so stupid? Like, how could you do that? So it was a lot of watching the video over and over just torturing myself. And then with crutches and I I had to get over that. And um, the day after my surgery, I was at Jiu-Jitsu, probably not smart. I didn't do anything, but I went and my knee swelled up. Well, it was already swollen, right? But I felt that I needed to be with Yeah. my crew. Like be there and just start my recovery path like day one. Um, and so now I tell people, maybe wait a couple days. Like let the swelling go down. Because I was in pain from not being able to ice and elevate when I went to class and I got in an Uber because I couldn't drive because it was my right leg. Um, but I was paying one of my physical therapist kids to drive me to the gym. It was my right leg. So for the first couple weeks, I couldn't drive. And I'd pay him like 100 bucks. He'd take me to Jiu-Jitsu on Sunday and then we'd go lift. You know, so he was like my little chauffeur, but he loved it because he got to lift and go train and he just drove me around. Uh, so the biggest thing is mental and staying with the people that you want to be with and still staying on the mats. You can't do anything, right? You're sitting on the sideline, but you're there. You're in the culture and you're still hanging out with everybody. I was I was coaching at a tournament on crutches like four weeks out. You there's pictures of me and my brace and my crutches. So you have to just keep doing it. And I taught as soon as I was kind of allowed more range of motion on my knee, I was teaching. You know, I couldn't knee cut that way to show the the technique, but I would like kind of slowly get into my knee cut on the other side and then be like, and then I would do this. And so I'd have people demonstrate for me, but I was trying to teach right away.
Speaker 1: Yeah. I think that's uh, that's such a I you know, I've never thought about it, but doing I've done some of the same things that you're talking about, but it's such a an important thing to consider that yeah, it's a physical thing, but man, like where it really takes a toll is on the mental side because you have this whole routine and this whole lifestyle built around this thing a lot of times because, you know, like once you're training, your diet's usually in better shape because you have the you have the feedback if you eat crappy food all day and then you go train, you feel terrible. So your diet's usually where it needs to be and everything else. And then all of a sudden, if you lose that sort of anchor to your routine, I've seen so many people where they stop training, they stop coming to the gym and they just sort of their whole lifestyle sort of spirals into a not so great place. And then when they come back, they've been off the mats, they've been away completely. They've gained, you know, X amount of pounds and everything else. And then they're in this deep hole, both physically and mentally that they got to dig out of. Um, and some of the guys have even had them where they said that they were depressed and like you said, you're like, you can still come in, you can still be a part of the gym, you can still do whatever it is that you can do. Um, I remember at one point, I had an injury and I was like going in there just to sit on the mat and like I was we didn't have a nice clock at the time. This is like 20 years ago. I'm just sitting there like running the timer, you know, just to kind of be around and then just like help out where I could.
Speaker 2: I would take notes. I would sit with my computer and take notes on whatever they were doing, take pictures, do videos. I learned more and whenever I'm injured, I learn so much more. Because just because I'm not training on the mats, it doesn't mean I'm not learning. And so I watch more tape and I just study, study, study. So when I come back, I have a plan and I'm keeping it fresh.
Speaker 1: That's smart. Yeah.
Speaker 2: Yeah.
Speaker 1: What's Jiu-Jitsu meant to you through all these years? Like why have you felt this need, this desire to stick with it even through the injuries and seeing all these injuries, you know, obviously being a a physician. Um, what does it mean to you to be on the mats and what how's it kind of enriched your life?
Speaker 2: I think like after every injury I've had, because I had my first shoulder surgery pretty quickly after I started Jiu-Jitsu, just rolled two white belts. I didn't tap. Didn't even know what it was happening and my arm just um, I think it was an Americana. And so I had a shoulder surgery. And I was only six months in or so. And I remember my surgeon cleared me at like three or four months out. I didn't feel ready, you know, and so I kept doing my rehab and then a couple months later, I came back and my parents were like, you can't go back. Like you're going to be a surgeon, you're in residency, you got things to do. And thinking of not going back was devastating. It was like worse than going back to get injured again. You know. I think the community is the biggest thing. Um, like anywhere I go in the world, there's somewhere to train, you know. First thing I pack anywhere I go is a belt, my mouth guard, like Nogi stuff. Rent a Gi, borrow a Gi. And there's always um, especially the female group is a little bit smaller and I think tighter knit because there's fewer of us. So I can go almost anywhere and just like see females and it's almost like an instant sisterhood. Um, and you go to the gym and everybody just wants to train and have a good time. Um, so I think it's more the community, but also it's so challenging. It's like surgery. Um, you never have it figured out all the way, right? And so there's always little things to learn. You can always get better. There's always new challenges. And so it's that like, I don't know if you've ever heard flow state. Um, I can't say the guy's name that created flow state.
Speaker 1: Oh yeah, Eugene can say we we read that book. What was it uh,
Speaker 2: Mihaly something.
Speaker 1: Csikszentmihalyi, is that the guy for flow?
Speaker 2: Yeah, his last name is crazy, yeah. So I I read up a lot about him and I was like, okay, when am I in flow in my life? And it's literally Jiu-Jitsu, surgery, right? Um, and then spending time like with my fiance, we're if you think about the times where you're not thinking about anything else, you know, it's very rare. Like right now, I'm not thinking about anything else. We have a a great conversation going. But most things that I'm doing every day, Jiu-Jitsu, surgery. My mind doesn't wander because if it starts to wander, surgery's not going to go the way I had planned. My roll is not going to go the way I planned, right? So those are the two areas where I feel like the most everything could be crashing down and around me in my world and I show up and it's like, okay, these are my spaces, right? I could go into a surgery and drop it all and focus and get the get it done. Get it done well and and then I come out and I'm like, okay, there it is again, right? Same thing in Jiu-Jitsu. You slap hands and it's gone. And then even this morning, I was training and my professor he showed me something little and he's like, I wonder if I even know Jiu-Jitsu because this is so stupid and I just found it on Instagram. And it was like a little hook pulling a leg just to get a sweep. Just a little adjustment. And I was like, well, that's the beauty of Jiu-Jitsu, right? We don't ever know everything and that's why we all stay.
Speaker 1: Yeah. Constantly learning. Yeah. I mean, like that's it like medicine's constantly evolving, right? Jiu-Jitsu's constantly evolving. It's like that you have to be a a lifelong learner. I think you have to. You have to continue continue to evolve. For some people that don't know, like like hip replacements, for example. The past, you know, 15, 20 years, like the evolution of hip replacements. They used to everybody used to go through the back of the hip. Now they go through the front. And it's like, now people can train Jiu-Jitsu with hip replacements. Before it's like, well, you're probably going to dislocate your hip. So it's just just everything evolves, right? Everything just you got to be a a consummate learner and um, I think that's why and it's weird too because I had that same situation as you. I hurt my hand uh, like a year into Jiu-Jitsu. I think I fractured my thumb and I was in PT school and my parents are like, you're not going to keep doing this, are you? You have to work with your hands. And my hands are kind of mangled now a little bit, but it's just one of those things. It's like you just have a drive or desire. Someone just have it and you just you're willing to kind of put yourself at some risk for some odd reason, right?
Speaker 2: I don't know what you think about this, but as knowing what I know about the body, I am definitely.
Speaker 1: I was going to ask this by the way because both you guys know you know exactly what's going on with the body where like knuckle draggers like me are going in there and we're kind of just we don't really know all the different ins and outs. We kind of know something might hurt or whatever, but you guys have a very intimate knowledge of the body. Like I wanted to hear this. Sorry, I sorry to interrupt you. I was kind of excited to hear this because that was my next question to you.
Speaker 2: I think it can be a hindrance sometimes because I'll be training and I'm so I get so nervous about different things. I'm like, oh, my knee could really go the wrong way there. Like and then I'm and then if I do get injured, it could be something so small. Like my I I forget what I did. I just I think I posted or was gripping training pretty hard last Friday and my forearm lit up. Like I had a lot of pain over my tendons and I was like, I I ruptured something. I tore my tendon off the bone. Yeah. I go like the worst case scenario and like do those exist? Sure. Like a case report. Like one per, right? And it's not even bad. But my brain is going to what it could be, which can be detrimental. I don't know if you have that too, Eugene.
Speaker 1: Um, I used to, not so much as of like, you know, I've hurt myself, I've had some fractures in my arm and I've done some dumb stuff as a younger like earlier grappler, but I I don't know like I feel like I I've been at the gym with Chewy for 12 years. I don't even know how long the the vast vast. I just I know my training partners. I know um, who who has tendencies to do what and how to train. And I think having that community and understanding and also just I kind of almost have like a tab on everyone at the gym because if there's an injury, they're always letting me know. So I kind of have so we just kind of try to keep each other safe. And yeah, shit happens, of course. You you know, and and I think probably when there's more scrambles, that's when the things kind of go wrong. I mean, yes, positionally, like if you're getting a heel hook or something, yes, if it's somebody's trying to crank on it, but usually everybody if you have a good understanding, good gym culture, it's you keep each other safe for the most part. Um, not so much anymore. Knock on wood, but yeah, I mean, I it was definitely a concern in my head and and when I go to tournaments, like I have to literally my parents are like, oh, you're doing another tournament. I was like, look, I got this. If I if I get in a bad spot, I'll tap. That's it. I'll just tap. And and you have to go into you have to go to work the next day or or like that Monday, right? So it's just knowing that this is something that I do and, you know, if I if I get caught in something, you just have to tap and and be mindful of it. So try to keep yourself safe. I mean, that's it. It's not do or die again.
Speaker 1: Well, I also wonder if that's too if it's if it's a, you know, both the knowledge that you guys have or even to the fact that as you get older, you really appreciate like as you get older and you have more experience, you have a couple of injuries, um, you start to appreciate the bucket of bones you've been given to to go on the ride with versus when you're younger, uh, you don't have any experience with it, right? Like so, you know, if you've never had a surgery before, you've never had a um, a serious injury, you you go into it and you're kind of ignorant towards it and you've never experienced it. Then you experience it and you're like, I don't want to have that happen again. And then as you get older, you got more stuff going on. Like you guys, you know, you have careers, you got to work with people's bodies, you got to have surgery, you got kids, you got things you want to do besides, you know, let your arm or leg break for a $5 medal at a tournament, right?
Speaker 2: Yeah, it's tough. It's the ego, right? And sometimes I've competed where I tore my ACL. I'm like, I could win this. Like, let's go. I feel great. I trained. And then you go in and you don't even think to tap, right? And your adrenaline's going, you don't feel it. So you have to be more aware. And that was a big learning experience for me. So like now, I don't go in that way. I go in, yeah, I'm I can win this. I'm confident and if I'm in a bad position and can't escape quickly, we're tapping. So I had to change that mindset a bit going in.
Speaker 1: Here's a question to you as far as training. Um, are there because obviously if you try like you mentioned traveling and going to different gyms and things like that and are there any and there may be none, maybe you've never experienced it or anything like that, but are there any sort of red flags or things that you look at related to training practices, right? Are there any things that you have been that you've seen at gyms or been at gyms where you're like, ooh, I don't I don't feel comfortable necessarily with this or that because like we said, we had good ones where we have a a list of like banned moves. And so it kind of gives you guys some, hey, we're going to stay away from these to protect our training partners. Have you seen kind of the opposite where are there any red flags or anything related to gym practices or people training that you kind of notice yourself?
Speaker 2: I honestly haven't seen it much. I think I do a good job of scoping out the gyms that I'm going to go to. Like I I kind of understand looking at their Instagram, looking at their website. Do they have females that train there? Um, what what's going on with the professors? I can kind of scope it out and get the feel of the gym almost before I get there and that's how I pick where I'm going to go. Okay. Um, otherwise, it's mostly there might be some big dudes that are just tossing people around and they ask me to roll. I'm like, no, thank you. Yeah. You know, so I have no problem doing that. When I was younger, like if you had asked me eight years ago, 10 years ago, I'd go with anyone. I was like, I'd mighty. Like I can beat up. I'm this little girl that can just beat up all the dudes. And I think my body took a big toll from that mindset.
Speaker 1: Yeah, is that like um, so advice for being a smaller grappler or women or whomever, like what's like some some key ideas that you really like, obviously, you know, choosing your training partners wisely, things like that. What are some things that you try to encourage, you know, other people to keep themselves safe on the mats?
Speaker 2: We talked about it too at the retreat when we were at the retreat this year. Some of the guys were asking how to train better with women. I thought that was a brilliant question. Like I was I got goosebumps because I was like, that's a really nice question to ask. And then one of the big dudes who had the two knee replacements, who is um, I forget his name. It might have been like Mike or Peter. Okay. And he he was so sweet. He was like, can you teach me how to roll with women? Can you do some rolls with me? I was like, I'd love to. And so I I go to start passing his guard and it's just immediate tensing, right? Like really tight. And we did a round like that. And I and he was trying and then afterwards he goes, okay, what can I do? I was like, just accept passes. Like if I do a technique right, just let it go. And then transition to something else. And then as we kept rolling, he he was getting better and and accepting passes was like mind-blowing, right? Because he was doing everything in his power. I was like, if you do everything in your power, I'm not going to pass you, right? Like you're double my size. And you're you're enormous. Like, there's no way that you're going to that I'm going to be able to pass your guard with your strength. You'll just pick me up and put me down next to you. And so he had to kind of get that through and and that's a whole life of learning, right? To train that way or however however long he's going to train. To change it. But I was so appreciative and so like honored that he asked that question and was trying. Um, but I think also I'll roll with a lot of guys who have like wives in the gym because they really know how to roll with females. I think that they're seeing it in others. They've probably gone through the ringer with them. It's like, thank you for putting yourself at risk for the rest of us later on with your significant other.
Speaker 1: I was uh, I remember talking to Peter, we were we were on this uh, the van or whatever coming into the the city and he had talked about, you know, he's he's an older guy, he's had two knee replacements and knee replacements, they took great. He's able to do stuff, but he was even talking about just generally in rolling period, right? He uh, he has a lot of trouble just relaxing and letting go and sometimes giving up stuff. He like he just is super tense. You felt it. And uh, I think that that's just that's something that all of us, you know, it's a good idea with with women or smaller grapplers just in general. Um, but even as you get older, you're going to have to like every round can't be the hardest round, right? Like sometimes like it's it's it's you can get a lot more from like allowing movement to happen. Um, like even you and I rolled and we had a great roll and like, you know, you're taking my back, we're falling, we're flowing through positions and it's a lot of fun and there's a lot of stuff to a lot of movement and skill to be gained from it. Um, even if it's not the scrappy, we're both, you know, snarling and sweating and grunting and then afterwards we're spent after six minutes. Um, you know, I think as you're older, you eventually have to learn that one way or the other.
Speaker 2: And the guys, they'll ask to roll with me a lot because of how much learning they can get if they don't use their strength. Like you will get so much technique from these small little females. Um, I also think it's something about detail. Like when I teach, I'm so detail-oriented. Sometimes my the main coach, he's like, I think they just want to roll today, Meg. Like they don't want a whole uh, education about reverse De La Hiva. They don't want.
Speaker 1: Are you do you talk about how the body moves and the mechanics of the joints or anything?
Speaker 2: Sometimes, uh, more for like injury prevention. I'm like, hey guys, look at this position here. You're in danger here. You may not notice it. But if like, uh, like 50/50 is a good one. Um, I actually sprained my good ACL because I was in 50/50 and a buddy of mine tried to like knee cut through it, right? And so my foot's up on his hip. The bell was about to run out. I kind of got lax and he just my foot was on his waist. And it's almost like a heel hook, right? The rotation as they're so with these kinds of things, I'm like, we don't knee cut through this. We back out of it, right? And so I try to really promote safety in those areas that we can potentially avoid it. And just for people to be more aware of where their body is. Because injuries sucks. Like it sucks to be out because you're injured. It's devastating mentally. And so I anything I can do to avoid that is for myself and students is really important.
Speaker 1: Yeah. And with the injury, like coming back from rolling, like I had a um, a very minor tweak on my shoulder. Nothing crazy, just, you know, it's an aggravated shoulder thing. And uh, this was a few weeks ago. I have a competition this weekend. And the last thing you want is to like have to take off time, serious time from training when you have a competition just a few weeks away. And um, I, you know, I get a couple of the guys that I know can move. And, you know, we'll we'll do um, we call it play rolling. People have different flow rolling, play rolling, whatever. You're still moving and you're actually executing like movement and technique and everything else. You just don't put that next level of like squeeze or a resistance towards things and you give and take. You allow people to, you know, you you you pass the guard and then you give them a little space and they escape and they sweep you and you just you can flow through it. And you're able to get some decent movement and at the same time, my my heart rate monitor was on and I was maintaining in like the 130s, which is great. It's a good workout. But at no point was I ever in risk of any serious injuries. It was it was able to do that for a week. Uh, or so and then was able to come back and my shoulder was fine afterwards and was able to get some blood flow going in the area with no um, issues opposed to just taking off completely because I didn't because if I couldn't roll really hard then I didn't want to roll kind of thing.
Speaker 2: Right. Yeah, and I learned more in those situations. PJ Barch actually did a seminar here and he calls it a conversation. And I thought that was so brilliantly stated. He's like, when you're flow rolling like that, and you're most of your training, really, should be like a conversation, right? You say something, I say something, they you say something, I and we're going back and forth. Sometimes you say a little more. Sometimes I say a little more, right? That's me passing the guard, taking your back. Okay, I was talking. Now you're going to be escaping it and then maybe I counter with something and then you escape it and then you counter, right? So that's how most of my rolls are at the gym or how I like them to be. Like we have some people that can't flow to save their lives. We've got some like 20-year-olds that are just savages and the teenagers that just come for my head. Like cuz they're my size. And they just come after me. Like they must love me. Uh, so there's really no flowing with most of these people. Um, but when you can get somebody that flows well like this, the learning is crazy. I'll just pause and be like, whoa, what did we just do, right? And then Yeah. notes, yeah.
Speaker 1: That's awesome. Yeah, it's just you kind of get in that that state where it's just a they're fluid. It's smooth. It's kind of controlled. Um, that's a nice thing. Yeah, it's it's a great way to warm up too. It's a great way to kind of start to get your your brain and your body online. And I think sometimes, you know, we'll do certain warm-ups and there's a lot of people that love warm-ups and and some people hate warm-ups and and things like that. But if you're one of the people that doesn't really like to warm up and you want to get your blood flowing a little bit instead of just like, you know, doing some jumping jacks or just getting to like a a nice flowy controlled roll where you kind of give and and let up stuff and just move. And I think, you know, do you do that for three to four minutes, you start to get a little sweat going. I think it's a great way to also move your body, but get your brain and your body online.
Speaker 2: Yeah. Yeah. I do it all the time for open mat. Open mat, I'll do one or two flows and see who can flow. One of my friends, she just got into town last week and I tried to flow with her and as soon as we slapped hands, it was like instant tensing, knee cutting and I said, okay, let me teach you how we're going to do this, you know.
Speaker 1: You've been training for a while. Strength conditioning, what do you like to do? What do you what do you prefer? Um, what do you what's kind of part of your strength conditioning routine now to to keep yourself healthy?
Speaker 2: I try to lift three times a week and then I do hot yoga once a week. And I started hot yoga in like 2021 when I was uh, training up for my first competition like seven years. I decided to do Master Worlds back then. And I was like, let's do it. Let's send it. And I was noticing I was so stiff. My hands were hurting, my neck. I'd get out of bed stiff and I started hot yoga and it was a huge game changer because you're you're moving in the opposite positions of what Jiu-Jitsu is, right? Like downward dog and all these things where you have to press your chest up, which is the opposite of what we're usually curled up in Jiu-Jitsu. So I really loved hot yoga. Um, I also have several physical therapists and I have pretty much standing appointments because it's I've always got aches and pains. Um, that I need help with. And so I have a couple of therapists that I go to and and I I try to at least once or twice a week do physical therapy either with them or on my own at the gym for whatever's bothering me.
Speaker 1: Yeah. Yeah, that's a great idea. Just addressing things early and even like kind of on a maintenance basis going every couple months if you need to just to see if there's anything that needs to be addressed. Um, because I think a lot of traditional weightlifting is very linear. It's pushing, pulling. We're not doing a lot of rotate. Usually rehab is more rotational work. So if you can incorporate rehab, you know, with with the stuff that I do, you know, you're doing cars or joint circles, doing end range conditioning, we're doing end range lift-offs and end range control, which is really important, especially for Jiu-Jitsu with, you know, the amount of rotation that we need in in the in the hips and um, and in the spine essentially. So I mean, I think those are all that stuff's really great. Um, I incorporate a lot of band work too. So I'll be say it's leg day. I go leg press and then in between, I might put a band around my legs and do uh, like stuff for my glutes, you know, like the walking forward and back kind of stuff in between sets or rotational band work if I'm doing upper body. Like I'll just have it and I'll be doing rotations in between my heavier sets. I don't lift super, super heavy. Like I'll try to deadlift kind of heavy here and there. Um, but I'm not trying to max. I'm going 10 to 15 reps when I do lift, like three to four sets, 10 to 15. Whatever I can do at that weight pretty comfortably. Uh, and then in between is a lot more of the rotational or single leg balance type stuff. Uh, I do use BFR. I think people think I'm a lunatic when I have the the blood pressure cuffs on like all four of my extremities and I'll get on the assault bike and I'm dead. Like my limbs are, you know, like purple. They're starting to turn colors and I'm just crushing the assault bike. But you could do that in 10 minutes and I can go like back to work. I could be on lunch break and just do some BFR real quick. So I really use BFR a lot. Um, if I if I have an injury too, put the blood flow restriction cuffs on and go lighter. Right? I don't have to deadlift a million pounds. Um, I can just go and deadlift like 50 pounds. 20 in each hand, whatever, do single legs with a BFR, you'll be burning.
Speaker 1: Yeah. And and BFR is for people that don't, it's like blood flow, it includes blood flow. Um, it allows blood flow into the muscle, but it doesn't allow blood flow out. So it basically gives you a you fatigue significantly faster. You don't have to use as much weight. Um, so it's a little bit better on your joints. You're not stressing your joints as much, which I think people I think for cardio as well. People don't use it for cardio as much too. You can, you know, you put it at less occlusion and you can get really just a such a pump and and such a fatigue in there a little faster. Um, so it's it's definitely useful. It's not just for recovery, but even just or just for rehab, but it's for recovery as well. If you want to still get some work in and not stress your body as much.
Speaker 2: It's great for after surgery. I love I let my PTs put BFR in like right away. They'll they'll text me or call me and say, hey, can we do BFR? Like one week out? I'm like, you could have done it already. You know, you put it on the leg and just have them do straight leg raises. I think it's really good for the athletes too because they feel like they can't do anything. They're like, I can't do anything right now. I'm like, well, you probably should not go deadlift 120 right now, you know. You know, but you can put I bet you that you won't do 20 straight leg raises with that BFR on. And then they try to do it and they're like, that was really hard. Like good. There's a challenge and a safe challenge.
Speaker 1: Yeah. And it probably gives them as an athlete, right? Like you you almost become, you know, what you become sort of sort of used to that sort of discomfort that you get from a hard workout. And when you're not able to train, you kind of miss it. So when you can get something that's challenging that's also kind of along the lines of okay with uh, your physical therapy and your rehab, that's probably a nice win where you're like, I can do something that's challenging that makes me feel a little uncomfortable where I feel like I'm doing something or getting something from it, but at the same time, I'm not risking reinjury.
Speaker 2: Yeah. And you get a sweat too. BFR is hard. It's hard. Because I would do PT a lot early on after my ACL and I was like, I'm not really sweating. I feel like I'm not doing anything, right? To your point. And they they'd be like, all right, BFR time. And then I was like, oh, shit. Yes. Yeah. And I went and did it.
Speaker 1: What do you um, all right, so this is a hot topic. This is a hot topic right here. And you it is. It really is. I don't you know, I've got clients I work with and literally they've all either asked me, all of them have probably at least asked me and a good amount of them do use peptides. Yeah. So, and I've talked to some surgeons about this and they're like, well, they're very like, uh, I can't say anything about this. So, there's a lot of, you know, it's not a lot of research. There's a lot what what are your thoughts? I mean, it doesn't have to be a like an official statement, but what do you think? What do you see as like the potential? Is it, you know, all placebo? Like what do you think with peptides?
Speaker 2: I don't know. I I have um, I have hope for it. Like it seems really great, right? It's it peptides are at least the marketing's really great. And it seems like it could help in the future. I just don't have enough literature yet on humans to be like recommending it to my patients and say, hey, take it and this will give you a better recovery. No, we don't have that yet. Could it? Hopefully, I would love for it to. That's great. But it's also we can talk about I put biologics into the same category, right? We hear about PRP, we hear about stem cells. Um, and then like all these other crazy things they're doing in other countries, uh, that I caution people because we've seen lots of gnarly infections and things when they go to other countries and get them and come back. Um, I've had friends who have had to take care of some pretty messy situations of things that haven't been tested. It's like trials. But, you know, PRP, very safe. It comes from your own body. We take the blood out, we spin it down. Stem cells, pretty safe. You can get donor site issues, right? Actually, you have to take the stem cells from bone somewhere and then people often complain of like their hip. Uh, it hurts where you took the stem cells. And again, depends on what it is. What injury are we treating? There's some pretty good literature behind these things. Like I've used PRP in areas that there's great literature. But trying to throw PRP at everything, not going to work. Could work, but there's not the literature. Same thing with peptides. And peptides is a little bit behind all these other these other things, these other therapies and that we don't have human data yet. Will it come out? I think so. I think people are probably doing it because there's a lot of money in it as well. Um, it's not FDA approved. So you don't know what you're getting. So when my athletes and my soldiers say they want to take it, say you have to do the right research. You have to make sure you're getting it from a good source. There's also different there's oral, there's you could take pills, there's injectables. We don't know what the best route is. At least I don't. Um, if it's out there, I'd love to hear about it and I'd love for somebody to shoot me some new data because I'm always looking for it. But it's not there yet. Um, to the point where like I would take it.
Speaker 1: With the PRP, you said that for certain areas, um, being that it's safe and it's pretty easy to have it done, you know, it's not like you have to go to it's expensive, but like, you know, you can get it done. It's not like you have to like, you know, haul over to Colombia or something to do it. Uh, what is a good area of the body or some areas like or types of injuries that PRP can be useful for uh, assisting with?
Speaker 2: Some of the best research we have is early arthritis in the knees. So early, early arthritis before you start having a lot of changes or deformities of the knees, um, you can do PRP there and it does pretty well because what is PRP doing? It's just decreasing inflammation, which is creating pain. Like the inflammation creates the pain from the arthritis. And so we're just decreasing inflammation. We're not regrowing cartilage. We're not giving you your cartilage back and getting your knee back, right? So I think there's some misinformation there or maybe the marketing sometimes tries to sell that we're going to create new tissues with stem cells in particular because it has the power to do that, but it hasn't been shown clinically to do that. Um, again, I would love for these things to do that because it would help people so tremendously. Um, but it's not there yet. PRP, also, I had mine on my elbows. So if you ever had tendonitis in your uh, elbows, like on the inside, you guys probably have because of our grips. So when I'm gripping a lot, um, my tendonitis was acting up like crazy for years. I tried everything under the sun. I went to dry needling, PT, everything straps and would try to cut down, but it was killing me. So I did PRP in both. Um, and it took a couple months, but it it got better. It hasn't come back. So certain areas, there's pretty good literature to support.
Speaker 1: Interesting. Yeah, and it's something that's been used for quite a while. I think I feel like people use a lot for Achilles tendonitis and things like that. Those kind of like tendon issues.
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Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. It's just a lot of things that I would ban. Um, you know, just kind of those that we talked about. And down at Legion, I actually talked to them and they have a couple of these band techniques. Even I was out in Japan and I went to Minari's gym. I loved it. He had a full paper of like banned techniques and it was all these ones that we're talking about. And I was like, very well, very well done because you have people coming from all over the world. You don't need people just coming in blowing each other's knees out in training.
Speaker 1: What's been um, for your ACL injury and your recovery, what was one of the more challenging things of you for you to get back on the mats and maybe what's like a piece of advice that you have for others coming back from injury? I mean, there's a lot, you know, physical, mental components, there's so many different things there, right? And it's all got to be online, it's all got to be together.
Speaker 2: Yeah, when my athletes tear their ACL and I see them, I actually just saw an ACL post-op um, a couple days ago. Young girl, 16, uh, I just did her surgery two weeks ago. So her knee's still swollen. Uh, you know, she's going to school. So you can always tell the kids going to school, their knee's still swollen two weeks in because they're they're not elevating it as much.
Speaker 1: Still walking around everywhere.
Speaker 2: Right. And, you know, I'm telling them go to school, go do things you want to do. Um, but I looked at her and I said, you're going to get through this physically if you do the rehab and you do the right stuff. This is a mental injury now. And she just looked at me and she just went like this. It's like, cuz you lost all your well, not lost, but you feel disconnected from all your friends, from the sport that made you was your personality, was your identity.
Speaker 1: It's your identity.
Speaker 2: It's all of it, right? And now you had an this injury and you can't go hang out with your friend group or you feel that you can't. And so I talked to her, I said, you still need to go to practice. Like I she's a a soccer player. I said, go to practice. Be on the sideline. Cheer your friends on. Go out with them after. Go to dinner. Do the like pasta if you do pasta nights like track or whatever. Go do the things with them. Go to the weight room. Who says you can't go to the weight room with them? Go do upper body, get on the bike. So that's what I tell my athletes. I'm like, this is all mental. You'll be fine physically as long as you do the right stuff. But it is it was a big mental one for me. Also regret of like, man, you should have tapped. How could you be so stupid? Like, how could you do that? So it was a lot of watching the video over and over just torturing myself. And then with crutches and I I had to get over that. And um, the day after my surgery, I was at Jiu-Jitsu, probably not smart. I didn't do anything, but I went and my knee swelled up. Well, it was already swollen, right? But I felt that I needed to be with Yeah. my crew. Like be there and just start my recovery path like day one. Um, and so now I tell people, maybe wait a couple days. Like let the swelling go down. Because I was in pain from not being able to ice and elevate when I went to class and I got in an Uber because I couldn't drive because it was my right leg. Um, but I was paying one of my physical therapist kids to drive me to the gym. It was my right leg. So for the first couple weeks, I couldn't drive. And I'd pay him like 100 bucks. He'd take me to Jiu-Jitsu on Sunday and then we'd go lift. You know, so he was like my little chauffeur, but he loved it because he got to lift and go train and he just drove me around. Uh, so the biggest thing is mental and staying with the people that you want to be with and still staying on the mats. You can't do anything, right? You're sitting on the sideline, but you're there. You're in the culture and you're still hanging out with everybody. I was I was coaching at a tournament on crutches like four weeks out. You there's pictures of me and my brace and my crutches. So you have to just keep doing it. And I taught as soon as I was kind of allowed more range of motion on my knee, I was teaching. You know, I couldn't knee cut that way to show the the technique, but I would like kind of slowly get into my knee cut on the other side and then be like, and then I would do this. And so I'd have people demonstrate for me, but I was trying to teach right away.
Speaker 1: Yeah. I think that's uh, that's such a I you know, I've never thought about it, but doing I've done some of the same things that you're talking about, but it's such a an important thing to consider that yeah, it's a physical thing, but man, like where it really takes a toll is on the mental side because you have this whole routine and this whole lifestyle built around this thing a lot of times because, you know, like once you're training, your diet's usually in better shape because you have the you have the feedback if you eat crappy food all day and then you go train, you feel terrible. So your diet's usually where it needs to be and everything else. And then all of a sudden, if you lose that sort of anchor to your routine, I've seen so many people where they stop training, they stop coming to the gym and they just sort of their whole lifestyle sort of spirals into a not so great place. And then when they come back, they've been off the mats, they've been away completely. They've gained, you know, X amount of pounds and everything else. And then they're in this deep hole, both physically and mentally that they got to dig out of. Um, and some of the guys have even had them where they said that they were depressed and like you said, you're like, you can still come in, you can still be a part of the gym, you can still do whatever it is that you can do. Um, I remember at one point, I had an injury and I was like going in there just to sit on the mat and like I was we didn't have a nice clock at the time. This is like 20 years ago. I'm just sitting there like running the timer, you know, just to kind of be around and then just like help out where I could.
Speaker 2: I would take notes. I would sit with my computer and take notes on whatever they were doing, take pictures, do videos. I learned more and whenever I'm injured, I learn so much more. Because just because I'm not training on the mats, it doesn't mean I'm not learning. And so I watch more tape and I just study, study, study. So when I come back, I have a plan and I'm keeping it fresh.
Speaker 1: That's smart. Yeah.
Speaker 2: Yeah.
Speaker 1: What's Jiu-Jitsu meant to you through all these years? Like why have you felt this need, this desire to stick with it even through the injuries and seeing all these injuries, you know, obviously being a a physician. Um, what does it mean to you to be on the mats and what how's it kind of enriched your life?
Speaker 2: I think like after every injury I've had, because I had my first shoulder surgery pretty quickly after I started Jiu-Jitsu, just rolled two white belts. I didn't tap. Didn't even know what it was happening and my arm just um, I think it was an Americana. And so I had a shoulder surgery. And I was only six months in or so. And I remember my surgeon cleared me at like three or four months out. I didn't feel ready, you know, and so I kept doing my rehab and then a couple months later, I came back and my parents were like, you can't go back. Like you're going to be a surgeon, you're in residency, you got things to do. And thinking of not going back was devastating. It was like worse than going back to get injured again. You know. I think the community is the biggest thing. Um, like anywhere I go in the world, there's somewhere to train, you know. First thing I pack anywhere I go is a belt, my mouth guard, like Nogi stuff. Rent a Gi, borrow a Gi. And there's always um, especially the female group is a little bit smaller and I think tighter knit because there's fewer of us. So I can go almost anywhere and just like see females and it's almost like an instant sisterhood. Um, and you go to the gym and everybody just wants to train and have a good time. Um, so I think it's more the community, but also it's so challenging. It's like surgery. Um, you never have it figured out all the way, right? And so there's always little things to learn. You can always get better. There's always new challenges. And so it's that like, I don't know if you've ever heard flow state. Um, I can't say the guy's name that created flow state.
Speaker 1: Oh yeah, Eugene can say we we read that book. What was it uh,
Speaker 2: Mihaly something.
Speaker 1: Csikszentmihalyi, is that the guy for flow?
Speaker 2: Yeah, his last name is crazy, yeah. So I I read up a lot about him and I was like, okay, when am I in flow in my life? And it's literally Jiu-Jitsu, surgery, right? Um, and then spending time like with my fiance, we're if you think about the times where you're not thinking about anything else, you know, it's very rare. Like right now, I'm not thinking about anything else. We have a a great conversation going. But most things that I'm doing every day, Jiu-Jitsu, surgery. My mind doesn't wander because if it starts to wander, surgery's not going to go the way I had planned. My roll is not going to go the way I planned, right? So those are the two areas where I feel like the most everything could be crashing down and around me in my world and I show up and it's like, okay, these are my spaces, right? I could go into a surgery and drop it all and focus and get the get it done. Get it done well and and then I come out and I'm like, okay, there it is again, right? Same thing in Jiu-Jitsu. You slap hands and it's gone. And then even this morning, I was training and my professor he showed me something little and he's like, I wonder if I even know Jiu-Jitsu because this is so stupid and I just found it on Instagram. And it was like a little hook pulling a leg just to get a sweep. Just a little adjustment. And I was like, well, that's the beauty of Jiu-Jitsu, right? We don't ever know everything and that's why we all stay.
Speaker 1: Yeah. Constantly learning. Yeah. I mean, like that's it like medicine's constantly evolving, right? Jiu-Jitsu's constantly evolving. It's like that you have to be a a lifelong learner. I think you have to. You have to continue continue to evolve. For some people that don't know, like like hip replacements, for example. The past, you know, 15, 20 years, like the evolution of hip replacements. They used to everybody used to go through the back of the hip. Now they go through the front. And it's like, now people can train Jiu-Jitsu with hip replacements. Before it's like, well, you're probably going to dislocate your hip. So it's just just everything evolves, right? Everything just you got to be a a consummate learner and um, I think that's why and it's weird too because I had that same situation as you. I hurt my hand uh, like a year into Jiu-Jitsu. I think I fractured my thumb and I was in PT school and my parents are like, you're not going to keep doing this, are you? You have to work with your hands. And my hands are kind of mangled now a little bit, but it's just one of those things. It's like you just have a drive or desire. Someone just have it and you just you're willing to kind of put yourself at some risk for some odd reason, right?
Speaker 2: I don't know what you think about this, but as knowing what I know about the body, I am definitely.
Speaker 1: I was going to ask this by the way because both you guys know you know exactly what's going on with the body where like knuckle draggers like me are going in there and we're kind of just we don't really know all the different ins and outs. We kind of know something might hurt or whatever, but you guys have a very intimate knowledge of the body. Like I wanted to hear this. Sorry, I sorry to interrupt you. I was kind of excited to hear this because that was my next question to you.
Speaker 2: I think it can be a hindrance sometimes because I'll be training and I'm so I get so nervous about different things. I'm like, oh, my knee could really go the wrong way there. Like and then I'm and then if I do get injured, it could be something so small. Like my I I forget what I did. I just I think I posted or was gripping training pretty hard last Friday and my forearm lit up. Like I had a lot of pain over my tendons and I was like, I I ruptured something. I tore my tendon off the bone. Yeah. I go like the worst case scenario and like do those exist? Sure. Like a case report. Like one per, right? And it's not even bad. But my brain is going to what it could be, which can be detrimental. I don't know if you have that too, Eugene.
Speaker 1: Um, I used to, not so much as of like, you know, I've hurt myself, I've had some fractures in my arm and I've done some dumb stuff as a younger like earlier grappler, but I I don't know like I feel like I I've been at the gym with Chewy for 12 years. I don't even know how long the the vast vast. I just I know my training partners. I know um, who who has tendencies to do what and how to train. And I think having that community and understanding and also just I kind of almost have like a tab on everyone at the gym because if there's an injury, they're always letting me know. So I kind of have so we just kind of try to keep each other safe. And yeah, shit happens, of course. You you know, and and I think probably when there's more scrambles, that's when the things kind of go wrong. I mean, yes, positionally, like if you're getting a heel hook or something, yes, if it's somebody's trying to crank on it, but usually everybody if you have a good understanding, good gym culture, it's you keep each other safe for the most part. Um, not so much anymore. Knock on wood, but yeah, I mean, I it was definitely a concern in my head and and when I go to tournaments, like I have to literally my parents are like, oh, you're doing another tournament. I was like, look, I got this. If I if I get in a bad spot, I'll tap. That's it. I'll just tap. And and you have to go into you have to go to work the next day or or like that Monday, right? So it's just knowing that this is something that I do and, you know, if I if I get caught in something, you just have to tap and and be mindful of it. So try to keep yourself safe. I mean, that's it. It's not do or die again.
Speaker 1: Well, I also wonder if that's too if it's if it's a, you know, both the knowledge that you guys have or even to the fact that as you get older, you really appreciate like as you get older and you have more experience, you have a couple of injuries, um, you start to appreciate the bucket of bones you've been given to to go on the ride with versus when you're younger, uh, you don't have any experience with it, right? Like so, you know, if you've never had a surgery before, you've never had a um, a serious injury, you you go into it and you're kind of ignorant towards it and you've never experienced it. Then you experience it and you're like, I don't want to have that happen again. And then as you get older, you got more stuff going on. Like you guys, you know, you have careers, you got to work with people's bodies, you got to have surgery, you got kids, you got things you want to do besides, you know, let your arm or leg break for a $5 medal at a tournament, right?
Speaker 2: Yeah, it's tough. It's the ego, right? And sometimes I've competed where I tore my ACL. I'm like, I could win this. Like, let's go. I feel great. I trained. And then you go in and you don't even think to tap, right? And your adrenaline's going, you don't feel it. So you have to be more aware. And that was a big learning experience for me. So like now, I don't go in that way. I go in, yeah, I'm I can win this. I'm confident and if I'm in a bad position and can't escape quickly, we're tapping. So I had to change that mindset a bit going in.
Speaker 1: Here's a question to you as far as training. Um, are there because obviously if you try like you mentioned traveling and going to different gyms and things like that and are there any and there may be none, maybe you've never experienced it or anything like that, but are there any sort of red flags or things that you look at related to training practices, right? Are there any things that you have been that you've seen at gyms or been at gyms where you're like, ooh, I don't I don't feel comfortable necessarily with this or that because like we said, we had good ones where we have a a list of like banned moves. And so it kind of gives you guys some, hey, we're going to stay away from these to protect our training partners. Have you seen kind of the opposite where are there any red flags or anything related to gym practices or people training that you kind of notice yourself?
Speaker 2: I honestly haven't seen it much. I think I do a good job of scoping out the gyms that I'm going to go to. Like I I kind of understand looking at their Instagram, looking at their website. Do they have females that train there? Um, what what's going on with the professors? I can kind of scope it out and get the feel of the gym almost before I get there and that's how I pick where I'm going to go. Okay. Um, otherwise, it's mostly there might be some big dudes that are just tossing people around and they ask me to roll. I'm like, no, thank you. Yeah. You know, so I have no problem doing that. When I was younger, like if you had asked me eight years ago, 10 years ago, I'd go with anyone. I was like, I'd mighty. Like I can beat up. I'm this little girl that can just beat up all the dudes. And I think my body took a big toll from that mindset.
Speaker 1: Yeah, is that like um, so advice for being a smaller grappler or women or whomever, like what's like some some key ideas that you really like, obviously, you know, choosing your training partners wisely, things like that. What are some things that you try to encourage, you know, other people to keep themselves safe on the mats?
Speaker 2: We talked about it too at the retreat when we were at the retreat this year. Some of the guys were asking how to train better with women. I thought that was a brilliant question. Like I was I got goosebumps because I was like, that's a really nice question to ask. And then one of the big dudes who had the two knee replacements, who is um, I forget his name. It might have been like Mike or Peter. Okay. And he he was so sweet. He was like, can you teach me how to roll with women? Can you do some rolls with me? I was like, I'd love to. And so I I go to start passing his guard and it's just immediate tensing, right? Like really tight. And we did a round like that. And I and he was trying and then afterwards he goes, okay, what can I do? I was like, just accept passes. Like if I do a technique right, just let it go. And then transition to something else. And then as we kept rolling, he he was getting better and and accepting passes was like mind-blowing, right? Because he was doing everything in his power. I was like, if you do everything in your power, I'm not going to pass you, right? Like you're double my size. And you're you're enormous. Like, there's no way that you're going to that I'm going to be able to pass your guard with your strength. You'll just pick me up and put me down next to you. And so he had to kind of get that through and and that's a whole life of learning, right? To train that way or however however long he's going to train. To change it. But I was so appreciative and so like honored that he asked that question and was trying. Um, but I think also I'll roll with a lot of guys who have like wives in the gym because they really know how to roll with females. I think that they're seeing it in others. They've probably gone through the ringer with them. It's like, thank you for putting yourself at risk for the rest of us later on with your significant other.
Speaker 1: I was uh, I remember talking to Peter, we were we were on this uh, the van or whatever coming into the the city and he had talked about, you know, he's he's an older guy, he's had two knee replacements and knee replacements, they took great. He's able to do stuff, but he was even talking about just generally in rolling period, right? He uh, he has a lot of trouble just relaxing and letting go and sometimes giving up stuff. He like he just is super tense. You felt it. And uh, I think that that's just that's something that all of us, you know, it's a good idea with with women or smaller grapplers just in general. Um, but even as you get older, you're going to have to like every round can't be the hardest round, right? Like sometimes like it's it's it's you can get a lot more from like allowing movement to happen. Um, like even you and I rolled and we had a great roll and like, you know, you're taking my back, we're falling, we're flowing through positions and it's a lot of fun and there's a lot of stuff to a lot of movement and skill to be gained from it. Um, even if it's not the scrappy, we're both, you know, snarling and sweating and grunting and then afterwards we're spent after six minutes. Um, you know, I think as you're older, you eventually have to learn that one way or the other.
Speaker 2: And the guys, they'll ask to roll with me a lot because of how much learning they can get if they don't use their strength. Like you will get so much technique from these small little females. Um, I also think it's something about detail. Like when I teach, I'm so detail-oriented. Sometimes my the main coach, he's like, I think they just want to roll today, Meg. Like they don't want a whole uh, education about reverse De La Hiva. They don't want.
Speaker 1: Are you do you talk about how the body moves and the mechanics of the joints or anything?
Speaker 2: Sometimes, uh, more for like injury prevention. I'm like, hey guys, look at this position here. You're in danger here. You may not notice it. But if like, uh, like 50/50 is a good one. Um, I actually sprained my good ACL because I was in 50/50 and a buddy of mine tried to like knee cut through it, right? And so my foot's up on his hip. The bell was about to run out. I kind of got lax and he just my foot was on his waist. And it's almost like a heel hook, right? The rotation as they're so with these kinds of things, I'm like, we don't knee cut through this. We back out of it, right? And so I try to really promote safety in those areas that we can potentially avoid it. And just for people to be more aware of where their body is. Because injuries sucks. Like it sucks to be out because you're injured. It's devastating mentally. And so I anything I can do to avoid that is for myself and students is really important.
Speaker 1: Yeah. And with the injury, like coming back from rolling, like I had a um, a very minor tweak on my shoulder. Nothing crazy, just, you know, it's an aggravated shoulder thing. And uh, this was a few weeks ago. I have a competition this weekend. And the last thing you want is to like have to take off time, serious time from training when you have a competition just a few weeks away. And um, I, you know, I get a couple of the guys that I know can move. And, you know, we'll we'll do um, we call it play rolling. People have different flow rolling, play rolling, whatever. You're still moving and you're actually executing like movement and technique and everything else. You just don't put that next level of like squeeze or a resistance towards things and you give and take. You allow people to, you know, you you you pass the guard and then you give them a little space and they escape and they sweep you and you just you can flow through it. And you're able to get some decent movement and at the same time, my my heart rate monitor was on and I was maintaining in like the 130s, which is great. It's a good workout. But at no point was I ever in risk of any serious injuries. It was it was able to do that for a week. Uh, or so and then was able to come back and my shoulder was fine afterwards and was able to get some blood flow going in the area with no um, issues opposed to just taking off completely because I didn't because if I couldn't roll really hard then I didn't want to roll kind of thing.
Speaker 2: Right. Yeah, and I learned more in those situations. PJ Barch actually did a seminar here and he calls it a conversation. And I thought that was so brilliantly stated. He's like, when you're flow rolling like that, and you're most of your training, really, should be like a conversation, right? You say something, I say something, they you say something, I and we're going back and forth. Sometimes you say a little more. Sometimes I say a little more, right? That's me passing the guard, taking your back. Okay, I was talking. Now you're going to be escaping it and then maybe I counter with something and then you escape it and then you counter, right? So that's how most of my rolls are at the gym or how I like them to be. Like we have some people that can't flow to save their lives. We've got some like 20-year-olds that are just savages and the teenagers that just come for my head. Like cuz they're my size. And they just come after me. Like they must love me. Uh, so there's really no flowing with most of these people. Um, but when you can get somebody that flows well like this, the learning is crazy. I'll just pause and be like, whoa, what did we just do, right? And then Yeah. notes, yeah.
Speaker 1: That's awesome. Yeah, it's just you kind of get in that that state where it's just a they're fluid. It's smooth. It's kind of controlled. Um, that's a nice thing. Yeah, it's it's a great way to warm up too. It's a great way to kind of start to get your your brain and your body online. And I think sometimes, you know, we'll do certain warm-ups and there's a lot of people that love warm-ups and and some people hate warm-ups and and things like that. But if you're one of the people that doesn't really like to warm up and you want to get your blood flowing a little bit instead of just like, you know, doing some jumping jacks or just getting to like a a nice flowy controlled roll where you kind of give and and let up stuff and just move. And I think, you know, do you do that for three to four minutes, you start to get a little sweat going. I think it's a great way to also move your body, but get your brain and your body online.
Speaker 2: Yeah. Yeah. I do it all the time for open mat. Open mat, I'll do one or two flows and see who can flow. One of my friends, she just got into town last week and I tried to flow with her and as soon as we slapped hands, it was like instant tensing, knee cutting and I said, okay, let me teach you how we're going to do this, you know.
Speaker 1: You've been training for a while. Strength conditioning, what do you like to do? What do you what do you prefer? Um, what do you what's kind of part of your strength conditioning routine now to to keep yourself healthy?
Speaker 2: I try to lift three times a week and then I do hot yoga once a week. And I started hot yoga in like 2021 when I was uh, training up for my first competition like seven years. I decided to do Master Worlds back then. And I was like, let's do it. Let's send it. And I was noticing I was so stiff. My hands were hurting, my neck. I'd get out of bed stiff and I started hot yoga and it was a huge game changer because you're you're moving in the opposite positions of what Jiu-Jitsu is, right? Like downward dog and all these things where you have to press your chest up, which is the opposite of what we're usually curled up in Jiu-Jitsu. So I really loved hot yoga. Um, I also have several physical therapists and I have pretty much standing appointments because it's I've always got aches and pains. Um, that I need help with. And so I have a couple of therapists that I go to and and I I try to at least once or twice a week do physical therapy either with them or on my own at the gym for whatever's bothering me.
Speaker 1: Yeah. Yeah, that's a great idea. Just addressing things early and even like kind of on a maintenance basis going every couple months if you need to just to see if there's anything that needs to be addressed. Um, because I think a lot of traditional weightlifting is very linear. It's pushing, pulling. We're not doing a lot of rotate. Usually rehab is more rotational work. So if you can incorporate rehab, you know, with with the stuff that I do, you know, you're doing cars or joint circles, doing end range conditioning, we're doing end range lift-offs and end range control, which is really important, especially for Jiu-Jitsu with, you know, the amount of rotation that we need in in the in the hips and um, and in the spine essentially. So I mean, I think those are all that stuff's really great. Um, I incorporate a lot of band work too. So I'll be say it's leg day. I go leg press and then in between, I might put a band around my legs and do uh, like stuff for my glutes, you know, like the walking forward and back kind of stuff in between sets or rotational band work if I'm doing upper body. Like I'll just have it and I'll be doing rotations in between my heavier sets. I don't lift super, super heavy. Like I'll try to deadlift kind of heavy here and there. Um, but I'm not trying to max. I'm going 10 to 15 reps when I do lift, like three to four sets, 10 to 15. Whatever I can do at that weight pretty comfortably. Uh, and then in between is a lot more of the rotational or single leg balance type stuff. Uh, I do use BFR. I think people think I'm a lunatic when I have the the blood pressure cuffs on like all four of my extremities and I'll get on the assault bike and I'm dead. Like my limbs are, you know, like purple. They're starting to turn colors and I'm just crushing the assault bike. But you could do that in 10 minutes and I can go like back to work. I could be on lunch break and just do some BFR real quick. So I really use BFR a lot. Um, if I if I have an injury too, put the blood flow restriction cuffs on and go lighter. Right? I don't have to deadlift a million pounds. Um, I can just go and deadlift like 50 pounds. 20 in each hand, whatever, do single legs with a BFR, you'll be burning.
Speaker 1: Yeah. And and BFR is for people that don't, it's like blood flow, it includes blood flow. Um, it allows blood flow into the muscle, but it doesn't allow blood flow out. So it basically gives you a you fatigue significantly faster. You don't have to use as much weight. Um, so it's a little bit better on your joints. You're not stressing your joints as much, which I think people I think for cardio as well. People don't use it for cardio as much too. You can, you know, you put it at less occlusion and you can get really just a such a pump and and such a fatigue in there a little faster. Um, so it's it's definitely useful. It's not just for recovery, but even just or just for rehab, but it's for recovery as well. If you want to still get some work in and not stress your body as much.
Speaker 2: It's great for after surgery. I love I let my PTs put BFR in like right away. They'll they'll text me or call me and say, hey, can we do BFR? Like one week out? I'm like, you could have done it already. You know, you put it on the leg and just have them do straight leg raises. I think it's really good for the athletes too because they feel like they can't do anything. They're like, I can't do anything right now. I'm like, well, you probably should not go deadlift 120 right now, you know. You know, but you can put I bet you that you won't do 20 straight leg raises with that BFR on. And then they try to do it and they're like, that was really hard. Like good. There's a challenge and a safe challenge.
Speaker 1: Yeah. And it probably gives them as an athlete, right? Like you you almost become, you know, what you become sort of sort of used to that sort of discomfort that you get from a hard workout. And when you're not able to train, you kind of miss it. So when you can get something that's challenging that's also kind of along the lines of okay with uh, your physical therapy and your rehab, that's probably a nice win where you're like, I can do something that's challenging that makes me feel a little uncomfortable where I feel like I'm doing something or getting something from it, but at the same time, I'm not risking reinjury.
Speaker 2: Yeah. And you get a sweat too. BFR is hard. It's hard. Because I would do PT a lot early on after my ACL and I was like, I'm not really sweating. I feel like I'm not doing anything, right? To your point. And they they'd be like, all right, BFR time. And then I was like, oh, shit. Yes. Yeah. And I went and did it.
Speaker 1: What do you um, all right, so this is a hot topic. This is a hot topic right here. And you it is. It really is. I don't you know, I've got clients I work with and literally they've all either asked me, all of them have probably at least asked me and a good amount of them do use peptides. Yeah. So, and I've talked to some surgeons about this and they're like, well, they're very like, uh, I can't say anything about this. So, there's a lot of, you know, it's not a lot of research. There's a lot what what are your thoughts? I mean, it doesn't have to be a like an official statement, but what do you think? What do you see as like the potential? Is it, you know, all placebo? Like what do you think with peptides?
Speaker 2: I don't know. I I have um, I have hope for it. Like it seems really great, right? It's it peptides are at least the marketing's really great. And it seems like it could help in the future. I just don't have enough literature yet on humans to be like recommending it to my patients and say, hey, take it and this will give you a better recovery. No, we don't have that yet. Could it? Hopefully, I would love for it to. That's great. But it's also we can talk about I put biologics into the same category, right? We hear about PRP, we hear about stem cells. Um, and then like all these other crazy things they're doing in other countries, uh, that I caution people because we've seen lots of gnarly infections and things when they go to other countries and get them and come back. Um, I've had friends who have had to take care of some pretty messy situations of things that haven't been tested. It's like trials. But, you know, PRP, very safe. It comes from your own body. We take the blood out, we spin it down. Stem cells, pretty safe. You can get donor site issues, right? Actually, you have to take the stem cells from bone somewhere and then people often complain of like their hip. Uh, it hurts where you took the stem cells. And again, depends on what it is. What injury are we treating? There's some pretty good literature behind these things. Like I've used PRP in areas that there's great literature. But trying to throw PRP at everything, not going to work. Could work, but there's not the literature. Same thing with peptides. And peptides is a little bit behind all these other these other things, these other therapies and that we don't have human data yet. Will it come out? I think so. I think people are probably doing it because there's a lot of money in it as well. Um, it's not FDA approved. So you don't know what you're getting. So when my athletes and my soldiers say they want to take it, say you have to do the right research. You have to make sure you're getting it from a good source. There's also different there's oral, there's you could take pills, there's injectables. We don't know what the best route is. At least I don't. Um, if it's out there, I'd love to hear about it and I'd love for somebody to shoot me some new data because I'm always looking for it. But it's not there yet. Um, to the point where like I would take it.
Speaker 1: With the PRP, you said that for certain areas, um, being that it's safe and it's pretty easy to have it done, you know, it's not like you have to go to it's expensive, but like, you know, you can get it done. It's not like you have to like, you know, haul over to Colombia or something to do it. Uh, what is a good area of the body or some areas like or types of injuries that PRP can be useful for uh, assisting with?
Speaker 2: Some of the best research we have is early arthritis in the knees. So early, early arthritis before you start having a lot of changes or deformities of the knees, um, you can do PRP there and it does pretty well because what is PRP doing? It's just decreasing inflammation, which is creating pain. Like the inflammation creates the pain from the arthritis. And so we're just decreasing inflammation. We're not regrowing cartilage. We're not giving you your cartilage back and getting your knee back, right? So I think there's some misinformation there or maybe the marketing sometimes tries to sell that we're going to create new tissues with stem cells in particular because it has the power to do that, but it hasn't been shown clinically to do that. Um, again, I would love for these things to do that because it would help people so tremendously. Um, but it's not there yet. PRP, also, I had mine on my elbows. So if you ever had tendonitis in your uh, elbows, like on the inside, you guys probably have because of our grips. So when I'm gripping a lot, um, my tendonitis was acting up like crazy for years. I tried everything under the sun. I went to dry needling, PT, everything straps and would try to cut down, but it was killing me. So I did PRP in both. Um, and it took a couple months, but it it got better. It hasn't come back. So certain areas, there's pretty good literature to support.
Speaker 1: Interesting. Yeah, and it's something that's been used for quite a while. I think I feel like people use a lot for Achilles tendonitis and things like that. Those kind of like tendon issues.
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Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah: It took about the same time to get my doctorate or I guess to become a doctor as it did to become a black belt.
Speaker 1: Which one was harder and why?
Speaker 2: Oh, definitely becoming a doctor. Yeah.
Speaker 1: Yeah.
Speaker 2: It's more a lot more mental energy and you have to just force yourself to sit and study and you have to pass all these tests. And some of the tests have nothing to do with what you're even going to do in your future. Like my orthopedic board exam, they're asking stuff about like crazy tumors and pediatrics that I Yeah. will never see or biology stuff, biomechanics stuff. Just silly questions that you have to just study to take a test, not to treat the human. At least in Jiu-Jitsu, I study to do Jiu-Jitsu. You know.
Speaker 1: Oh, that makes sense. Yeah, it's just, do you think it's because um, so it's more applicable for you essentially is what what you kind of took from it?
Speaker 2: Yeah, medical school was just going through, you got to do it, this many years, residency this many years, and then you move along and a lot of the stuff you don't even use until kind of later in residency, fellowship, and then you become a doctor and you really start to learn.
Speaker 1: Yeah, more like on the job training.
Speaker 2: Mhm. Yeah, there's a lot of like wasted space, I think, in medical training.
Speaker 1: Yeah, I was going to ask, like, what do you think like if, you know, obviously, you don't want to rush, you know, the uh, the person through doctor school, right? You want you want them to kind of know their stuff. But I feel like a lot of times when I hear about certain degrees that people have from college, it's like, it's almost like it's just a vetting process. Like we're going to get you through, you're going to learn some stuff, but we're going to vet you, make sure that you can do this at whatever. And then you'll eventually actually get to learn the thing that you actually signed up to learn in the first place. How how short, you think of your your medical school period, right? From like, you know, whatever, beginning to end. How how much do you think you could condense that? Like, how how short do you think that it could have been and still actually gotten the information and the tools you needed to be effective at what you do as a medical professional?
Speaker 2: I wonder about that a lot and changing the system. It's kind of just like it's so set in its ways and I'm not sure it would be very difficult to change. Um, especially because you have older people that are like, well, that's what I did. So this is what people have to go through. And there is an element of that because you don't want people to get through easily because medicine is very difficult. Surgery is hard. And so you don't want people to get through easily. Um, but just to let you know how long it is, a lot of people don't know. It's four years undergrad, four years medical school, five years residency to be a surgeon, and then I did an extra year fellowship to be a sports specialized surgeon. So it's a lot of years. Um, medical school, I think a lot of it was stuff that I couldn't even tell you half the classes what they were, you know. So medical school probably doesn't need to be four with undergrad. Uh, undergrad was fun, right? We had I had a good time and it was a a life experience rather than just school. But medical school was just I had a chair in the library that everybody knew was my chair for four years and that's where I went because you have to study, you got to pass the tests. Yeah. You know.
Speaker 1: It's intense. I've had some I've had several students that were in medical school and they're good for like the first little bit and then it's like, I guess it's like whether it's like second year, third year, whatever it is, it's like, they're just like, sorry, man. I I just can't. I don't have the ability to do really anything anymore. I just, you know, they could maybe train lift weights or something, but they're just getting hammered um, in school.
Speaker 2: I couldn't train during medical school. I did a little bit. That's where I first started dabbling, but then residency I started and I had to go to a school that was I went to school that was awesome. And I said, hey, there might be six months where I'm not here because I'm on trauma and I'm not leaving that hospital like except to maybe go home on a weekend, you know. And I'd go home during the week sometimes, but you don't sleep much, you're on trauma rotation and I would pause my membership and they were awesome. They were like, we're not going to charge you. Just don't worry about it. We'll freeze it completely. Come back when you come back. And my professor was so cool then, Jonathan Webb out in Jersey, who's my first coach. He was like, just come in and train when you can. Don't even worry about it. You know, if you can come in once a week, just come in. So it was really cool.
Speaker 1: Wasn't the residency, and I could be completely wrong about this. I feel like I heard this somewhere that the guy, I guess who like sort of helped create the residency system was like a hopped up on the amphetamines.
Speaker 2: I don't know about that, but it could be true.
Speaker 1: I I just remember like the schedule that the schedule that they place on some of the the people, it's like, dude, it's intense. Like you guys are like it's it's like a long, long shift and you're like doing medical stuff. It's not like you're just like, you know, screwing in like nuts and bolts or something.
Speaker 2: And a lot of the hour things have changed. Like as I progress, they had like duty violations and hours. Then you have again, the older school people are like, well, that's how I trained and you know, you got to do it sometimes tired. You're going to be on trauma and things are going to come in. And now in the military too, it's like, well, you might be tired, right? You might be woken up. There might be an emergency. So part of it is good. Um, but sometimes it is a little bit much and on your on your mind. Like you don't realize how sleep deprived. You kind of go through that five years and at the end you're just like, what happened? Because you just got to keep your head above water for most of residency.
Speaker 1: You take a step back and you're like, whoa.
Speaker 2: Yeah, you're just trying to keep your head above water for most of residency.
Speaker 1: So it's kind of like, what was medical school what you expected? Like is being um, a surgeon what you thought it would be?
Speaker 2: Yeah, being a surgeon's awesome. Um, I love getting people back to sports. That's what I mostly do. So doing a complex surgery and like crushing it and having these guys get back and be so grateful. That's like the best part. Um, when I was a civilian doc, I'd go to their games. I'd go watch like my soccer players. I'd go to their games when they were coming back after an ACL surgery, things like that. And now I can't really see the military guys in action, but um, I can see them at least crushing physical therapy and sometimes some of them train Jiu-Jitsu too with me. So I'll I'll just train with them after I've treated them and they're back, which is awesome. Um, but I don't think I realized how hard it would be to for the complications or the people that don't do well or things not going my way. Like you you take it pretty I take it very much to heart. Yeah. Um, and when I first started, I wouldn't sleep for days if something didn't go the way I wanted or and the patient could do totally fine. Just it wasn't what I had envisioned. And so I took it pretty hard. I still do. Um, because, you know, you want it to be perfect. You want it Right. somebody's limbs in your hands.
Speaker 1: What's something when you say like not perfect, like what's an example of something maybe not working out the way you'd like?
Speaker 2: So maybe I had a a operative plan because before we go into surgery, we do preoperative plans, right? So that's usually Sundays for me. Sundays, I'll work on my brand and do podcast newsletters and then I work on all my surgeries. So a lot of it is on my computer. I've got this big word document or PowerPoint that has all my cases I do. Little details, things that I want to do better each case, I write a little something. And so maybe a little a pin placement was off by a couple millimeters. Something that probably won't make a difference, right? You're like, well, I know where that where I want that to be. And then it's figuring out, I had a mentor that used to say the enemy of good is great or the enemy of good is perfect. Because you could sit in that operating room trying to get a a pin in the perfect location, you know, because I use a lot of hard like tools. Um, so I'll have a drill and I'm putting a pin and you're trying to get in that perfect location and all of a sudden you're you're not anywhere you're where you wanted it to be and the first place was good enough. Right? The patient outcome will be the same. But what you learned in textbook or what you've seen where it's perfect could actually go the opposite on you if you try to get it. Probably like Jiu-Jitsu too. You want this move to look picture perfect like you saw on Instagram. And then when you're trying to get it there, the person passes you or submits you because you were trying to get it perfect. But maybe the slightly less perfect version still worked.
Speaker 1: Right. Well, there's always that textbook and then there's kind of what happens. And, you know, even, you know, every situation's a little different, right? So, um, a lot of us, you know, as you train, you develop certain techniques and stuff like that that you know very well and they may look a little different depending on the person, their body type, the the style of game that they had. It's the same move essentially, but like you, you know, you're saying with the pin, because of the situation that you're in, maybe you have to move this pin, you know, a small distance this way or that way. And, you know, if you're going up against a competitor and you're doing the same move you've done a bazillion times in the gym and you've hit it in competitions, well, they're doing something different, so you have to slightly adjust it a little bit differently, right? There's there's the textbook, there's like the picture perfect, here's what we were aiming for, but then there's the reality of, you know, just life and whatever else happens and you have to make adjustments, right?
Speaker 2: Yeah, and that's the hardest part about once you become a doctor, you have to realize what those limits are. You know, where you are still doing a a great surgery and the patient will do well. And they're not going to know the pin was off a millimeter, right? Only I know that because they're going to have the same outcome. So that's a really tough thing for my brain to to switch off.
Speaker 1: Human body is very, it's is very variable. There's so I mean, not everyone you look at a textbook and it's like the muscle is supposed to run this way, the bone is supposed to run just like this, but everybody's got different bone structure. They have different muscles, some are bigger, some are smaller. And then you have so many other health conditions that can impact, you know, a treatment or even like you have to have compliance. Not just like you're your screwing, put a screw in like a piece of wood. It's like you're it's like a mobile, active thing that people have different pain responses and they're their compliance levels vary, you know, especially with Jiu-Jitsu. Jiu-Jitsu people are a crazy breed of people because like they will do anything to get back to training. And a a fun example is we had a a guy that had ACL uh, surgery. Just ACL, no meniscus, so he didn't have any weight-bearing restrictions. A month in, it was a month. He was doing like we were doing like takedowns, like um, leg sweeps, like sweeping out the leg and and he was like standing. I was like, didn't you have surgery? He's like, yeah, yeah, I'm feeling pretty good. I was like, I'm not touching you, man. Like I'm not even going to move with you. Like you shouldn't be out here and I just let him know and then sometimes.
Speaker 1: Jiu-Jitsu guys will do anything but like rehab therapy and like take time off or like lighten up the rolls or whatever. They'll do anything but that, like, you know, but they'll just get back out on the mats.
Speaker 2: Yeah, and I think Jiu-Jitsu post-op stuff is so important. Um, I work a lot with a buddy of mine. Do you know Mike Piekarski? He's got all this really cool stuff going on. Um, and we've put out some literature together about Jiu-Jitsu athletes because there's it's so sparse. And um, I love what he's put together because it's specific Jiu-Jitsu specific drills to get people back. And just he's like, they're going to get out there, right? So it's modifying and telling them what they can and can't do and their limits, but more so telling them what they can do. Because if you focus on what they can't do, they're going to go do it. And if you just say go ahead to the mats, that's a big problem with orthopedic surgeons too. Yeah, you can start training. But you don't know what Jiu-Jitsu training means, right? You tell them they can go train and you just think they're going to be doing shoulder rolls or like a light little drill with a with a trusted partner. No. They're going and having death matches because you released them. So it's giving them the limits and that's really hard to enforce if you're not there.
Speaker 1: Yeah, is that what what do you think like the most challenging thing um, or some of the most challenging things of working with Jiu-Jitsu athletes or grapplers or MMA fighters? What's one of the big sticking points for you of whether it's compliance or getting the the best rehab or the best recovery or the best performance out of them after a surgery?
Speaker 2: Well, you guys hit the nail on the head. It's not wanting to take any time off. Like sometimes I'll just ask people, just take the rest of this week off. Go do an ice bath. Go sauna. Go see a physical therapist. And nobody can take even take like a day off, you think I was taking their firstborn child. One day. Just go chill, you know, sleep. Getting people to sleep is hard too. Um, and I think we all try to do more and like, oh, we slept less, we're tougher. But that's not the case. And so I'm teaching a lot of my my friends at at the gym now too, like we have to sleep. You have to eat. You can't just train two day two times a day without any recovery. If you're training twice a day, you got to recover just as much or more. Right? So that's a really tough balance to strike and each person's different. But nobody will take a day off. And for some reason, people don't want to go to see physical therapists, which it can be expensive, right? Copays aren't cheap. So I get that. Um, but even getting a home program. Like go see a physical therapist once. Get them to give you a program and then stick to it. But then the knee pain starts to let up a little bit and they send it. And then the knee pain comes back because they didn't properly load slowly. And I'm a I'm a victim there too, right? I'll have a pain and I want to get back out there. But I try to modify and use trusted partners.
Speaker 1: Yeah, it's uh, I remember coming back from a meniscus surgery. I had two meniscus surgery, one on my left leg, one on my right leg. I tore the one on my right leg when I was 19. I tore the one on my left leg when I was 29. And the one on my right leg, I mean, I did, you know, a 19-year-old's physical therapy rehab, which was not much. And then I went back and competed like four or six weeks later. I lost a few degrees of extension in my right leg because of it. So it never, it's fine. It's okay. Knee feels okay, but it never fully locks out. My left one though, I was like, I'm not going to screw this one up. And I had Eugene like give me a plan and I stuck to that sucker for like, you know, even afterwards, I kept doing the rehab stuff as preventive. But I remember um, for me, I had to put it like a work almost, you know, you think of like a workout plan, you go into the gym and you have the plan, so this way you stay on what you're supposed to do. Hey, these many sets, this many reps, whatever. I had to put a plan in place for myself ahead of time because I was like, I'm only teaching for these weeks. On week four to six, I'm going to do this. On week six to eight, I'm going to do this. On week 12, I'm, you know, whatever. And basically just doubled what the uh, the surgeon's recommendation to return back was and then came back and had no issues out of it whatsoever. And um, you know, you extend the rest a little bit, but on the back side, you don't have to end up under the knife again or, you know, back on the shelf again because the injury keeps coming back.
Speaker 2: Yeah, I think that's beautifully said. You have to incorporate it into your workouts. Like I've my knee was acting up recently. So the other day I said, I'm not going to do my workout, I'm going to do PT. And what's that for me? Like bike and different leg workouts that I've done with my physical therapist. And the bike is so powerful for knee injuries. Uh, people I don't think realize. It's so easy. When people have knee injuries, I'm like, get on the bike 20 minutes a day. You don't have to crush it. You're not doing a marathon. Just get on the bike and move your knee and you'll see how much better you feel. And so it's just simple things and they can be put into your day easily.
Speaker 1: I think the main gap when you're looking at the and you uh, Megan kind of mentioned it, it's like when somebody there's a lot of lack of understanding um, from physicians about what Jiu-Jitsu really is, what the requirements are, um, the mobility requirements, the strength requirements, just the, you know, being put in these situations where your leg has to externally rotate or move in just certain positions. And also, you have somebody pushing forces in different ways, basically testing your knee or your joint, the ligaments and the and the strength of it. So I think the there's such a gap in like being released from physical therapy versus being ready to train Jiu-Jitsu. And that's where kind of Mike and myself, we kind of that's a lot of the clients that I see is like, all right, now we you're been released from traditional PT. You're not quite ready to get back to, you know, Jiu-Jitsu. So you kind of put these guard rails on people and then a little bit at a time you take them off and and you allow them to like you said, there's certain variables you can kind of take away as you go on, like positional training, uh, maybe drilling, trusted partners, maybe avoiding certain positions for a little bit and and things like that. Um, so I think education's a huge piece and just the understanding. Is there anything like as as Jiu-Jitsu athletes or as um, physical therapists you think that we could do better like when we see a physician? Like how can people do a better job of letting them know, hey, this is what we're doing, this is what I need to get back to to to training?
Speaker 2: Well, I actually just went to a course recently, like two weeks ago, uh, Smith and Nephew, it's a company of implants that I use. And they do a big UFC course every year. It's this was the second year that they did it and I speak at the course. And it's tremendous because they bring in docs from all over the country and world, really. We get people from Canada coming down and we talk about UFC and combat sports in like specifically, these athletes in the population and how to deal with these problems, right? And you have docs from like white belts. You have we have a bunch of black belts that are on the faculty as well that speak. And then we have ex-MMA guys, people that still fight. And then you have doctors that don't know anything about the sport or just watch UFC on Saturdays, you know, know very little. And so I think it's really eye-opening for them because a lot of the talks I do are about specifically Jiu-Jitsu culture, Jiu-Jitsu, um, techniques and moves and what it looks like when people return to the mats. So I think that we bring that really nice element. We also talk about, you know, ACLs, shoulder instability, what we're treating in the surgeries, but I think the bigger component of that conference is the athlete and the athlete in particular. How do we get these guys back and how do we hold them back from themselves and protect them from themselves?
Speaker 1: What do you specialize in with your surgeries? Because I know you um, typically, I don't it's what I for my understanding, a lot of times surgeons like orthopedic surgeons have a a specialty of a few things that they do better than others and that's kind of what they stick to.
Speaker 2: Yeah, I mostly do shoulders and knees. Um, mostly arthroscopy, some open procedures, so the camera procedures. And then some open stuff. Um, and then basic trauma, ankle fractures, femur fractures. If you have any long bone fractures, we have to be able to treat those. Hip fractures in the elderly are very common. So lots of we call it kind of cold trauma. Um, as in like you could break your femur and we don't typically have to rush right that second in the middle of the night. We can kind of do it at 6:00 a.m. or 7:30, you know. Sure. Ankle fracture, week or two later because you need the swelling to calm down so that you can close the wounds after you you've fixed it definitively. Um, and then some of my partners are hand specialists or foot and ankle specialists, joint replacement specialists. Um, but I do sports surgery. So anything that you can imagine being sports related, mostly shoulder and knee, some elbow.
Speaker 1: Got it. Is there anything in particular like um, surgery-wise that you find I I'm there's techniques that are always coming out all the time and things change, but are there any particular surgeries or repairs on people's bodies that you find um, more challenging than some of the other ones?
Speaker 2: Uh, ACL is actually a very tough surgery. I had a mentor that said that there's no orthopedic procedure that's more that has more areas you can like mess up or can go wrong than an ACL surgery. And I thought that was a bold statement. I was like, oh, that's pretty bold. Like we have a lot of ACL injuries, but there's so many steps and you're trying to reconstruct and make a new ACL for somebody with little poke holes. So everything you're doing is under a camera and with little instrumentation, like not even your your hands really on the tissue. And there's a lot of areas where things can not go your way and you have to just have plans A through F, you know, because that's the way that ACLs go. And so you do so many ACLs that you're just like, you know where things can be challenging and then you know what you do for the to to help that situation. You try to avoid it, but you know, things happen and it it really is a tough surgery. It's hard. Even just picking what graft type you want, right? Because people are always coming in asking what graft and that's a whole podcast in itself about what graft to use because there's a lot of different ones that you can use. And I mostly do grafts from the patient. So I take tissue from you and make your new ACL. But there's also cadaver, like somebody donated their body to science and you can use that tissue. And I'll use that maybe like a 40 or 50-year-old, not as active, um, and then we won't have to take tissue from them and have issues with their donor site, right? Because if I take a tissue from you, that's another area where you can have pain after surgery and dysfunction. Um, so it's so patient specific uh, ACLs from like the start and then the recovery is so hard. It's so hard. I tell people it takes a year to get back. And that's the truth, you know, nine months is the earliest, but we use all these timelines and and numbers. That doesn't mean you're ready. So people hit nine months and they're like, I'm ready and they're they're still weak. They don't have full motion still sometimes. I'm like, you're not ready. Like, sorry, I know you hit nine months, but do you feel ready? And if they're honest with themselves, a lot of times they don't. So ACLs are hard from start to finish. It's a bad diet, it's a tough diagnosis to take.
Speaker 1: Yeah, what do you think um, as far as like, so for people that maybe are like, what's a graft? What do you like what you're explaining if you just explain that to some people and what do you like to use? What do you prefer to use in grapplers? What type of tissue or graft do you prefer um, that you think does the best job with, you know, keeping their knee secure and and giving them the best outcomes to because there are obviously there's pros and cons to everything. Especially with Jiu-Jitsu, you know, if we're taking something like the patellar tendon, we're kneeling. So it's like there's, you know, secondary injury there. So what do you like to use and kind of what's what's the research that you found that's been helpful?
Speaker 2: Sure. When I talk about ACLs, I always like to say first of all, not all ACLs need surgery. Um, you know, people often hear ACL and and in in my world now too, when when the soldiers come in with an ACL tear, they're like, oh my God, I have an ACL tear, I have to have surgery. And they're on profile, they're shut down from everything. But sometimes their knee's pretty stable. And like, have you had any instability? Have your knee buckled on you? And they're like, no, not really, I feel pretty good. And these might be the guys that we trial for no surgery. Still have to do physical therapy. Like, I think a lot of Jiu-Jitsu athletes have either ACLs with partial tears or no ACLs. I think many do because of the motions that we're constantly in, lots of rotation of the lower leg. Um, maybe we hear a pop or, you know, a heel hook too far. It doesn't swell as much as a traditional big pivot shift that you see like in the NFL. And so you don't notice it as much. You might have a little knee pain, a little swelling, move along. But you still have to do PT. Like that's my theory on non-op because I don't want everybody to think that they have to have it. Now, if the knee's giving way and it's super unstable and it's inhibiting you from living, if your knee's constantly swelling, you're probably not a coper. You're probably not going to do well non-op. Now, grafts are, we have to make the ACL out of a new tissue, out of your tissue. We got to make a new one. And so there's really four options. There's a fifth one that's been kind of coming out. Um, I have not dabbled in and I don't really think I will. Um, at least not yet. Um, there's the quad, which is just above the knee cap. We take a strip of quad of your quad tendon. Uh, there's patellar tendon, which is like the tried and true what is um, kind of like most commonly done if you go to the combine, uh, see pro athletes, they're probably have a patellar tendon, which takes pieces of your bone as well. Then there's hamstring, uh, which I think is still the most commonly done in the world. Like Europe and in the world, people are still hamstring is it. Then you can get tissue from a donor. And those can come from many different areas of a donor. They can come from Achilles, they can come from a patella, they can come from the hamstrings. Lots of different options. They can come from the quad. And I usually go with quad when I pick that allograft because I just think it's a nice thick tendon, it's very strong. Uh, and then when I talk to my patients, they're usually young, usually young soldiers, um, or dependents. So I'll get like the soccer players, Jiu-Jitsu athletes, um, football, 15 to like 45 are my main population. And so I mostly offer people their own tissue. I don't like hamstrings, um, I think that the literature shows a higher failure risk, especially in young females. So I don't and I don't really love it when when you take a hamstring graft. Um, it's it's just it's not very it doesn't make me happy. It's not as thick as if you take a patellar tendon or a quad. So most of the times you come into my office and I talk to you about all of these. Uh, peroneus or peroneal tendons are also starting to be used. Um, but I have not dabbled there. That's just coming from the lower leg. But um, I know that there's some research coming out about it. So anyway, you come to my office, you get quad or patellar tendon most of the time. Unless you're a little bit older and less active, then I go allograft cadaver. Um, patellar tendon, yes, you can fracture the knee cap. That is one downside. You can get kneeling pain because we take a piece of the knee cap. And then with the quad tendon, it's a very good tendon. It's a little bit newer than patella, um, but sometimes people have a little bit of quad weakness early on. Getting that quad to fire back up. So I usually offer both of those and I have my patients go research it on their own, talk to friends, see what they want to do and then we talk about it and I answer questions and then we go one way or the other.
Speaker 1: Now, for you, this is sort of kind of veering off a little bit. We rolled in um, in Costa Rica at the camp. And um, I sort of just commented on you. You just like, I feel like when you're around this stuff long enough, you can kind of move around with someone and get a feel for their body, their movement, uh, the musculature and they're like, oh, this is like an athlete. Versus like, oh, this is like a you train a little bit, you start working out versus like, oh, you you're your body's been moving for a long time. Um, have you always been an athlete? Like, have you always been involved in some sort of athletics?
Speaker 2: Yeah, I started karate when I was five, I want to say. I my mom tried to put me in ballet and I hated it. There's videos of me with my arms crossed, stomping around with my like frilly dress on. And I hated it. So they were like, all right, we're just going to put her in karate. I think it was right below the dance studio. And I loved it. So I did Kempo for a long time. Uh, then I boxed a little amateur. Then I did a little bit of Muay Thai. I never competed, I just kind of trained it. And one day I was um, like I was boxing and I was in medical school and I saw people rolling around in pajamas. It looked like karate Gis. And I was like, are they doing karate? Like what are they doing over there? And that was probably like 2011 or so, 12. Okay. Um, and I so I was in medical school. And I bought like a $40 Fuji Gi online and went and then I just loved it.
Speaker 1: So yeah, so you've been doing martial arts in some capacity since you were a you were a little one.
Speaker 2: Yeah. Yeah. I think it was good for just like karate was great. Um, you know, we make fun of karate sometimes or people are like, oh, you do karate now. It's like, no, I do Jiu-Jitsu. But karate was great as a kid to discipline, just learn like respect. You learn um, how to work with other people of all different ages, right? Because sometimes I'd be I was a like a 15-year-old sometimes teaching the adult class. Um, because I've been doing karate so long. They're like, you're going to teach. So you you definitely I learned a lot.
Speaker 1: Well, and that has to build a little bit of confidence, right? Like if you're I remember having a um, teenager train with me who's, you know, he's like 15, 16 years old and he's a little killer. And he both had the respect of some of the older guys in the gym because of how good he was. And he would teach some of the beginner classes because he was just really, really good. And so he's going to high school. And I remember thinking about how like interesting that must be to experience, right? Like that, you know, I didn't experience that, that you go to high school, you're, you know, taking classes or whatever. And then at nighttime, you have 40 grown men and women that are coming to you, um, and they're learning from you and they're giving you respect and like asking you questions on how to do something, you know, it's it's kind of an interesting dynamic for a uh, for a teenager to experience, you know, that sort of thing.
Speaker 2: I think it it helped a lot. Like I never thought about this before, but I was teaching at a very young age. And now I love teaching. And I have residents at work. I love teaching residents. I teach Jiu-Jitsu a couple nights a week and it's just so tremendous because you you have to learn, you don't know everything too, right? In the beginning, I wanted to be like, oh, I know the answers. I'll tell you and you just start fumbling. Now, I just say, I don't know, but be ready for a full dissertation tomorrow. You know, and then I go home and just study it up for hours. And they're like, I wish I had never asked. Because I go full send on it. Yeah.
Speaker 1: But I I think that also, you know, if you're in a position where you are teaching and you you know, you have that whatever that position is that has some authority to it or some recognition to it. I think it shows a certain level of like honesty and humility when you're willing to say, I don't know what's going, I don't know. Because I've done the same thing for a long time. Like someone would ask me a question and I'm like, you know, I don't know. I don't have a good answer for that. Let me get back to you. And then like I would go research, ask questions to some other people and then come back to them. Hey, like whatever, you know, and I think people appreciate that versus trying to just bullshit your way through it.
Speaker 2: And I love more teaching than taking class most times. Because I have to go look at it and look at all the what ifs, right? Okay, what if it turned that way? What if it turned this way? Because you know they're going to come. Those questions are going to happen in class. And so you have to be almost like an expert on this area. I was going to teach buggy chokes coming up in a couple weeks. I'm like, I don't buggy choke. Like my legs will they are it's almost impossible. I think I'm going to destroy my knees.
Speaker 1: I was going to say, you're not really built for buggy chokes.
Speaker 2: No, and also I know too much. I start feeling pressure on my knee and I'm like, okay, my ACL is going to pop. So I let it go. Um, I've heard the pops, you know, especially like that and um, rubber guard. I've heard the pops across the room. I've heard the pops across the room. I don't play them, but I want to teach them. And so I I try to become educated in these things so I can at least teach them for people that like them, you know.
Speaker 1: So so that's a great uh, bring up a great point. What are um, besides those, there's certain positions that you try to encourage maybe your students to avoid on the mats or I mean, obviously, inverting is okay once in a while, but if you do it a lot and you get stacked a ton, that can cause problems. So what are maybe some ways that either positional kind of techniques that you're like, hey, maybe stay away from these or use these sparingly or even some training philosophies that you've kind of developed over the years to help um, keep yourself healthy and your students healthy?
Speaker 2: Yeah, the inverting thing is funny because I inverted a lot and I have a bad neck because I am tiny. I'm like 123 pounds right now. And we're getting stacked. So I've learned I don't invert with people I don't trust or really big people. People I trust, then I'll invert, give them my full game or people my size. But the bigger people stacking constantly is is definitely rough. Um, so, you know, going inverting, I try to tell people to do it safely. You do your best. Sometimes people get stacked and it it happens. I think um, heel hooks are a big one. Um, I tore my ACL to a heel hook a couple years back. So I'm super vigilant about the position and I teach it. I love teaching heel hooks. I love reaping. I love teaching it. I teach it very safely. And then I'm like, you know, this is what the top person should be doing. You know, don't leave your foot planted when they go to reap your leg because your leg's going to twist. Start to kind of uh, bring the weight off of it. Work with your partners. And then in the gym, especially, I give a little like brief at the end of class. If you guys are going to do leg locks, talk to your partner about it. Make sure you know it's safe. We catch and release. You're not trying to prove anything to your partners. You catch and release and pretty much any joint lock, um, last night one of my older professors, he's hilarious. He he's does the old man Jiu-Jitsu where he just like chokes you and does crazy arm bars out of nowhere if your arm is extended and tries to like break your arm off. And so I was like, if it's a joint lock, just let it go. Keep the tally in your head, move to the next thing. And the other professor, he's like, yeah, but you could choke people unconscious. Like they'll just get a nap, it's fine. Yeah. Different philosophies, you know. Yeah. I um, I'm very much of when I roll with people, I'll hold things. They don't tap and I know it's pretty tight. We move along. I let it go. Because I'm not trying to hurt my partners and I'm trying to teach that because not everybody will show you that same back.
Speaker 1: Yeah. But I I think, you know, because I I I share that philosophy like with, you know, with heel hooks, it's like with all the submissions, like when our white belts are going through their basics classes, we'll teach like sort of a philosophy of like catch and hold. So you can be very quick to like, you know, get your arms locked around say a Kimura and then once you get the position where it should be, you're going to kind of hold there. We don't really want to, you know, and everybody's a little different flexibility-wise, but when you start to feel, you know, a certain tightness in the the shoulder, you just stop and hold. If you're in the heel hook, you get the catch and you hold. We're not going to start ripping stuff. Um, at the same time, I tell them, you know, if if you got a guy in a fully locked arm bar and that arm is fully extended and you're holding it for like 1 1,000, 2 1,000, don't go past that point. Just come get me because then me and that person have to have a talk and figure out like why aren't they tapping? Are they just crazy flexible or are they just being a bonehead and and try not to tap? And then, you know, that's a different conversation. Because, you know, you you don't want to have someone that's like, it's like you're playing a game of chess. Hey, I just put you in checkmate and they just keep moving pieces. You're like, no, no, no, like like we're we're playing this game here and we don't want to leave mangled if we don't have to be.
Speaker 2: And the big thing is the defense part for heel hook specifically. People come into my class sometimes they're like, well, I don't really want to do heel hooks. I was like, okay, but is nobody going to ever put you in a heel hook? Like you need to know where the dangerous positions are, how to escape, when you need to tap. Because that was one of my downfalls. I thought I kind of knew heel hooks and I didn't tap in time, right? And so it's just kind of teaching that on the defense. Where you should not roll, right? Because we've all had that person we have in that heel hook and they roll the wrong way and you feel that knee tighten up. And if you don't let that leg go, they're exploding at themselves. So I try to teach all those safety items when I'm doing heel hooks in particular and any leg entanglements. And we've been pretty safe so far.
Speaker 1: That's so important.
Speaker 2: Oh, the other position that I don't really love is like scissor takedowns. Um, because people blast into the side of the knee. I think there's a way to do it, right? There's a way to like Connie Basami safely. There's a way to do all these things safely, scissor takedowns. But people blast into the side of the knee and then they create the the big stress and MCL ACL go. Um, I've seen it so many times. I always forget the name of the takedown where you have the person not on their back, but you're on their side and then you go to sit and sweep them over your back leg.
Speaker 1: Oh, that that one I've seen that go like south so many times.
Speaker 2: Because you're supposed to sit your butt to the floor from what I.
Speaker 1: And they like sit it right on the side of the knee. Oh.
Speaker 2: They jump into the side of the knee. So anything that goes into the side of the knee like that, I really I just tell my students like, we're not doing that. You know, if you get around to somebody and then I also teach J I learned this from uh, J-Flo out in uh, down in San Diego. When somebody has me behind me and they have their hands locked, I have my hands right down and I'm blocking my hips so that their knees can't come around the sides and they can't jump into the side of my knee. He he taught that as like a good defense. And I was like, it's okay, take my back, but don't blow my knees out.
Speaker 1: That's right. He's like, I'll I'll I'll give you the takedown, but don't just don't blow me out, right? Like.
Speaker 2: So it's just kind of blocking and protecting and being aware of that. Um, but yeah, I've seen so many people just jump into the side of his knees and blow out people's knees. Like ACLs, meniscus, MCL, the whole thing.
Speaker 1: Yeah, and that's like, you know, that's one of the some of the worst injuries will come from like like following body weight. You know, you I've seen just over the years from MMA training, Jiu-Jitsu and everything else, you know, someone post an arm the wrong way. They they're trying to fight the takedown all the way through instead of just, you know, sort of conceding and their their foot gets stuck just at the last minute and it twists and their ACL blows out. And um, you know, this is why we typically sort of ban things like scissor takedowns and guard jumps even in the gym because it's like it's not worth it. If you want to pull guard, you can pull guard just fine and, you know, there's plenty of other takedowns you can do than a scissor leg takedown. And I I it can be done safely, but even then, it's just, you know, if the person moves one wrong way and it even if even if you're executing it safely, if they move the wrong way, like, boom, they're they're went someone's knee. No good.
Speaker 2: Yeah, the the jumping guard thing kills me too because I've seen so many people's knees hyperextend the other way. Right? For sure. And it's so uncontrolled and you'll see it in like these masters divisions sometimes like white belts jumping into each other's knees and, you know, it's okay. I've seen people do it very elegantly, jump into the hip or jump up on the hips, right? But the problem is people jump right above the knee.
Speaker 1: Oh, run into them. Yeah.
Speaker 2: Run into the knee, right above the knee. And the foot's planted. And I've had friends with some pretty nasty. Now you're talking about not even like ACL, MCL, posterolateral corner injuries, which are like a whole other beast, right? That's a bad injury. That's a tough injury to come back from. ACL is hard enough. But now you have PLC, which is a whole other area of the knee that you can affect with that hyperextension. So through a lot of things I would ban. Um, you know, just kind of those that we talked about. And down at Legion, I actually talked to them and they have a couple of these band techniques. Even I was out in Japan and I went to Minari's gym. I loved it. He had a full paper of like banned techniques and it was all these ones that we're talking about. And I was like, very well, very well done because you have people coming from all over the world. You don't need people just coming in blowing each other's knees out in training.
Speaker 1: What's been um, for your ACL injury and your recovery, what was one of the more challenging things of you for you to get back on the mats and maybe what's like a piece of advice that you have for others coming back from injury? I mean, there's a lot, you know, physical, mental components, there's so many different things there, right? And it's all got to be online, it's all got to be together.
Speaker 2: Yeah, when my athletes tear their ACL and I see them, I actually just saw an ACL post-op um, a couple days ago. Young girl, 16, uh, I just did her surgery two weeks ago. So her knee's still swollen. Uh, you know, she's going to school. So you can always tell the kids going to school, their knee's still swollen two weeks in because they're they're not elevating it as much.
Speaker 1: Still walking around everywhere.
Speaker 2: Right. And, you know, I'm telling them go to school, go do things you want to do. Um, but I looked at her and I said, you're going to get through this physically if you do the rehab and you do the right stuff. This is a mental injury now. And she just looked at me and she just went like this. It's like, cuz you lost all your well, not lost, but you feel disconnected from all your friends, from the sport that made you was your personality, was your identity.
Speaker 1: It's your identity.
Speaker 2: It's all of it, right? And now you had an this injury and you can't go hang out with your friend group or you feel that you can't. And so I talked to her, I said, you still need to go to practice. Like I she's a a soccer player. I said, go to practice. Be on the sideline. Cheer your friends on. Go out with them after. Go to dinner. Do the like pasta if you do pasta nights like track or whatever. Go do the things with them. Go to the weight room. Who says you can't go to the weight room with them? Go do upper body, get on the bike. So that's what I tell my athletes. I'm like, this is all mental. You'll be fine physically as long as you do the right stuff. But it is it was a big mental one for me. Also regret of like, man, you should have tapped. How could you be so stupid? Like, how could you do that? So it was a lot of watching the video over and over just torturing myself. And then with crutches and I I had to get over that. And um, the day after my surgery, I was at Jiu-Jitsu, probably not smart. I didn't do anything, but I went and my knee swelled up. Well, it was already swollen, right? But I felt that I needed to be with Yeah. my crew. Like be there and just start my recovery path like day one. Um, and so now I tell people, maybe wait a couple days. Like let the swelling go down. Because I was in pain from not being able to ice and elevate when I went to class and I got in an Uber because I couldn't drive because it was my right leg. Um, but I was paying one of my physical therapist kids to drive me to the gym. It was my right leg. So for the first couple weeks, I couldn't drive. And I'd pay him like 100 bucks. He'd take me to Jiu-Jitsu on Sunday and then we'd go lift. You know, so he was like my little chauffeur, but he loved it because he got to lift and go train and he just drove me around. Uh, so the biggest thing is mental and staying with the people that you want to be with and still staying on the mats. You can't do anything, right? You're sitting on the sideline, but you're there. You're in the culture and you're still hanging out with everybody. I was I was coaching at a tournament on crutches like four weeks out. You there's pictures of me and my brace and my crutches. So you have to just keep doing it. And I taught as soon as I was kind of allowed more range of motion on my knee, I was teaching. You know, I couldn't knee cut that way to show the the technique, but I would like kind of slowly get into my knee cut on the other side and then be like, and then I would do this. And so I'd have people demonstrate for me, but I was trying to teach right away.
Speaker 1: Yeah. I think that's uh, that's such a I you know, I've never thought about it, but doing I've done some of the same things that you're talking about, but it's such a an important thing to consider that yeah, it's a physical thing, but man, like where it really takes a toll is on the mental side because you have this whole routine and this whole lifestyle built around this thing a lot of times because, you know, like once you're training, your diet's usually in better shape because you have the you have the feedback if you eat crappy food all day and then you go train, you feel terrible. So your diet's usually where it needs to be and everything else. And then all of a sudden, if you lose that sort of anchor to your routine, I've seen so many people where they stop training, they stop coming to the gym and they just sort of their whole lifestyle sort of spirals into a not so great place. And then when they come back, they've been off the mats, they've been away completely. They've gained, you know, X amount of pounds and everything else. And then they're in this deep hole, both physically and mentally that they got to dig out of. Um, and some of the guys have even had them where they said that they were depressed and like you said, you're like, you can still come in, you can still be a part of the gym, you can still do whatever it is that you can do. Um, I remember at one point, I had an injury and I was like going in there just to sit on the mat and like I was we didn't have a nice clock at the time. This is like 20 years ago. I'm just sitting there like running the timer, you know, just to kind of be around and then just like help out where I could.
Speaker 2: I would take notes. I would sit with my computer and take notes on whatever they were doing, take pictures, do videos. I learned more and whenever I'm injured, I learn so much more. Because just because I'm not training on the mats, it doesn't mean I'm not learning. And so I watch more tape and I just study, study, study. So when I come back, I have a plan and I'm keeping it fresh.
Speaker 1: That's smart. Yeah.
Speaker 2: Yeah.
Speaker 1: What's Jiu-Jitsu meant to you through all these years? Like why have you felt this need, this desire to stick with it even through the injuries and seeing all these injuries, you know, obviously being a a physician. Um, what does it mean to you to be on the mats and what how's it kind of enriched your life?
Speaker 2: I think like after every injury I've had, because I had my first shoulder surgery pretty quickly after I started Jiu-Jitsu, just rolled two white belts. I didn't tap. Didn't even know what it was happening and my arm just um, I think it was an Americana. And so I had a shoulder surgery. And I was only six months in or so. And I remember my surgeon cleared me at like three or four months out. I didn't feel ready, you know, and so I kept doing my rehab and then a couple months later, I came back and my parents were like, you can't go back. Like you're going to be a surgeon, you're in residency, you got things to do. And thinking of not going back was devastating. It was like worse than going back to get injured again. You know. I think the community is the biggest thing. Um, like anywhere I go in the world, there's somewhere to train, you know. First thing I pack anywhere I go is a belt, my mouth guard, like Nogi stuff. Rent a Gi, borrow a Gi. And there's always um, especially the female group is a little bit smaller and I think tighter knit because there's fewer of us. So I can go almost anywhere and just like see females and it's almost like an instant sisterhood. Um, and you go to the gym and everybody just wants to train and have a good time. Um, so I think it's more the community, but also it's so challenging. It's like surgery. Um, you never have it figured out all the way, right? And so there's always little things to learn. You can always get better. There's always new challenges. And so it's that like, I don't know if you've ever heard flow state. Um, I can't say the guy's name that created flow state.
Speaker 1: Oh yeah, Eugene can say we we read that book. What was it uh,
Speaker 2: Mihaly something.
Speaker 1: Csikszentmihalyi, is that the guy for flow?
Speaker 2: Yeah, his last name is crazy, yeah. So I I read up a lot about him and I was like, okay, when am I in flow in my life? And it's literally Jiu-Jitsu, surgery, right? Um, and then spending time like with my fiance, we're if you think about the times where you're not thinking about anything else, you know, it's very rare. Like right now, I'm not thinking about anything else. We have a a great conversation going. But most things that I'm doing every day, Jiu-Jitsu, surgery. My mind doesn't wander because if it starts to wander, surgery's not going to go the way I had planned. My roll is not going to go the way I planned, right? So those are the two areas where I feel like the most everything could be crashing down and around me in my world and I show up and it's like, okay, these are my spaces, right? I could go into a surgery and drop it all and focus and get the get it done. Get it done well and and then I come out and I'm like, okay, there it is again, right? Same thing in Jiu-Jitsu. You slap hands and it's gone. And then even this morning, I was training and my professor he showed me something little and he's like, I wonder if I even know Jiu-Jitsu because this is so stupid and I just found it on Instagram. And it was like a little hook pulling a leg just to get a sweep. Just a little adjustment. And I was like, well, that's the beauty of Jiu-Jitsu, right? We don't ever know everything and that's why we all stay.
Speaker 1: Yeah. Constantly learning. Yeah. I mean, like that's it like medicine's constantly evolving, right? Jiu-Jitsu's constantly evolving. It's like that you have to be a a lifelong learner. I think you have to. You have to continue continue to evolve. For some people that don't know, like like hip replacements, for example. The past, you know, 15, 20 years, like the evolution of hip replacements. They used to everybody used to go through the back of the hip. Now they go through the front. And it's like, now people can train Jiu-Jitsu with hip replacements. Before it's like, well, you're probably going to dislocate your hip. So it's just just everything evolves, right? Everything just you got to be a a consummate learner and um, I think that's why and it's weird too because I had that same situation as you. I hurt my hand uh, like a year into Jiu-Jitsu. I think I fractured my thumb and I was in PT school and my parents are like, you're not going to keep doing this, are you? You have to work with your hands. And my hands are kind of mangled now a little bit, but it's just one of those things. It's like you just have a drive or desire. Someone just have it and you just you're willing to kind of put yourself at some risk for some odd reason, right?
Speaker 2: I don't know what you think about this, but as knowing what I know about the body, I am definitely.
Speaker 1: I was going to ask this by the way because both you guys know you know exactly what's going on with the body where like knuckle draggers like me are going in there and we're kind of just we don't really know all the different ins and outs. We kind of know something might hurt or whatever, but you guys have a very intimate knowledge of the body. Like I wanted to hear this. Sorry, I sorry to interrupt you. I was kind of excited to hear this because that was my next question to you.
Speaker 2: I think it can be a hindrance sometimes because I'll be training and I'm so I get so nervous about different things. I'm like, oh, my knee could really go the wrong way there. Like and then I'm and then if I do get injured, it could be something so small. Like my I I forget what I did. I just I think I posted or was gripping training pretty hard last Friday and my forearm lit up. Like I had a lot of pain over my tendons and I was like, I I ruptured something. I tore my tendon off the bone. Yeah. I go like the worst case scenario and like do those exist? Sure. Like a case report. Like one per, right? And it's not even bad. But my brain is going to what it could be, which can be detrimental. I don't know if you have that too, Eugene.
Speaker 1: Um, I used to, not so much as of like, you know, I've hurt myself, I've had some fractures in my arm and I've done some dumb stuff as a younger like earlier grappler, but I I don't know like I feel like I I've been at the gym with Chewy for 12 years. I don't even know how long the the vast vast. I just I know my training partners. I know um, who who has tendencies to do what and how to train. And I think having that community and understanding and also just I kind of almost have like a tab on everyone at the gym because if there's an injury, they're always letting me know. So I kind of have so we just kind of try to keep each other safe. And yeah, shit happens, of course. You you know, and and I think probably when there's more scrambles, that's when the things kind of go wrong. I mean, yes, positionally, like if you're getting a heel hook or something, yes, if it's somebody's trying to crank on it, but usually everybody if you have a good understanding, good gym culture, it's you keep each other safe for the most part. Um, not so much anymore. Knock on wood, but yeah, I mean, I it was definitely a concern in my head and and when I go to tournaments, like I have to literally my parents are like, oh, you're doing another tournament. I was like, look, I got this. If I if I get in a bad spot, I'll tap. That's it. I'll just tap. And and you have to go into you have to go to work the next day or or like that Monday, right? So it's just knowing that this is something that I do and, you know, if I if I get caught in something, you just have to tap and and be mindful of it. So try to keep yourself safe. I mean, that's it. It's not do or die again.
Speaker 1: Well, I also wonder if that's too if it's if it's a, you know, both the knowledge that you guys have or even to the fact that as you get older, you really appreciate like as you get older and you have more experience, you have a couple of injuries, um, you start to appreciate the bucket of bones you've been given to to go on the ride with versus when you're younger, uh, you don't have any experience with it, right? Like so, you know, if you've never had a surgery before, you've never had a um, a serious injury, you you go into it and you're kind of ignorant towards it and you've never experienced it. Then you experience it and you're like, I don't want to have that happen again. And then as you get older, you got more stuff going on. Like you guys, you know, you have careers, you got to work with people's bodies, you got to have surgery, you got kids, you got things you want to do besides, you know, let your arm or leg break for a $5 medal at a tournament, right?
Speaker 2: Yeah, it's tough. It's the ego, right? And sometimes I've competed where I tore my ACL. I'm like, I could win this. Like, let's go. I feel great. I trained. And then you go in and you don't even think to tap, right? And your adrenaline's going, you don't feel it. So you have to be more aware. And that was a big learning experience for me. So like now, I don't go in that way. I go in, yeah, I'm I can win this. I'm confident and if I'm in a bad position and can't escape quickly, we're tapping. So I had to change that mindset a bit going in.
Speaker 1: Here's a question to you as far as training. Um, are there because obviously if you try like you mentioned traveling and going to different gyms and things like that and are there any and there may be none, maybe you've never experienced it or anything like that, but are there any sort of red flags or things that you look at related to training practices, right? Are there any things that you have been that you've seen at gyms or been at gyms where you're like, ooh, I don't I don't feel comfortable necessarily with this or that because like we said, we had good ones where we have a a list of like banned moves. And so it kind of gives you guys some, hey, we're going to stay away from these to protect our training partners. Have you seen kind of the opposite where are there any red flags or anything related to gym practices or people training that you kind of notice yourself?
Speaker 2: I honestly haven't seen it much. I think I do a good job of scoping out the gyms that I'm going to go to. Like I I kind of understand looking at their Instagram, looking at their website. Do they have females that train there? Um, what what's going on with the professors? I can kind of scope it out and get the feel of the gym almost before I get there and that's how I pick where I'm going to go. Okay. Um, otherwise, it's mostly there might be some big dudes that are just tossing people around and they ask me to roll. I'm like, no, thank you. Yeah. You know, so I have no problem doing that. When I was younger, like if you had asked me eight years ago, 10 years ago, I'd go with anyone. I was like, I'd mighty. Like I can beat up. I'm this little girl that can just beat up all the dudes. And I think my body took a big toll from that mindset.
Speaker 1: Yeah, is that like um, so advice for being a smaller grappler or women or whomever, like what's like some some key ideas that you really like, obviously, you know, choosing your training partners wisely, things like that. What are some things that you try to encourage, you know, other people to keep themselves safe on the mats?
Speaker 2: We talked about it too at the retreat when we were at the retreat this year. Some of the guys were asking how to train better with women. I thought that was a brilliant question. Like I was I got goosebumps because I was like, that's a really nice question to ask. And then one of the big dudes who had the two knee replacements, who is um, I forget his name. It might have been like Mike or Peter. Okay. And he he was so sweet. He was like, can you teach me how to roll with women? Can you do some rolls with me? I was like, I'd love to. And so I I go to start passing his guard and it's just immediate tensing, right? Like really tight. And we did a round like that. And I and he was trying and then afterwards he goes, okay, what can I do? I was like, just accept passes. Like if I do a technique right, just let it go. And then transition to something else. And then as we kept rolling, he he was getting better and and accepting passes was like mind-blowing, right? Because he was doing everything in his power. I was like, if you do everything in your power, I'm not going to pass you, right? Like you're double my size. And you're you're enormous. Like, there's no way that you're going to that I'm going to be able to pass your guard with your strength. You'll just pick me up and put me down next to you. And so he had to kind of get that through and and that's a whole life of learning, right? To train that way or however however long he's going to train. To change it. But I was so appreciative and so like honored that he asked that question and was trying. Um, but I think also I'll roll with a lot of guys who have like wives in the gym because they really know how to roll with females. I think that they're seeing it in others. They've probably gone through the ringer with them. It's like, thank you for putting yourself at risk for the rest of us later on with your significant other.
Speaker 1: I was uh, I remember talking to Peter, we were we were on this uh, the van or whatever coming into the the city and he had talked about, you know, he's he's an older guy, he's had two knee replacements and knee replacements, they took great. He's able to do stuff, but he was even talking about just generally in rolling period, right? He uh, he has a lot of trouble just relaxing and letting go and sometimes giving up stuff. He like he just is super tense. You felt it. And uh, I think that that's just that's something that all of us, you know, it's a good idea with with women or smaller grapplers just in general. Um, but even as you get older, you're going to have to like every round can't be the hardest round, right? Like sometimes like it's it's it's you can get a lot more from like allowing movement to happen. Um, like even you and I rolled and we had a great roll and like, you know, you're taking my back, we're falling, we're flowing through positions and it's a lot of fun and there's a lot of stuff to a lot of movement and skill to be gained from it. Um, even if it's not the scrappy, we're both, you know, snarling and sweating and grunting and then afterwards we're spent after six minutes. Um, you know, I think as you're older, you eventually have to learn that one way or the other.
Speaker 2: And the guys, they'll ask to roll with me a lot because of how much learning they can get if they don't use their strength. Like you will get so much technique from these small little females. Um, I also think it's something about detail. Like when I teach, I'm so detail-oriented. Sometimes my the main coach, he's like, I think they just want to roll today, Meg. Like they don't want a whole uh, education about reverse De La Hiva. They don't want.
Speaker 1: Are you do you talk about how the body moves and the mechanics of the joints or anything?
Speaker 2: Sometimes, uh, more for like injury prevention. I'm like, hey guys, look at this position here. You're in danger here. You may not notice it. But if like, uh, like 50/50 is a good one. Um, I actually sprained my good ACL because I was in 50/50 and a buddy of mine tried to like knee cut through it, right? And so my foot's up on his hip. The bell was about to run out. I kind of got lax and he just my foot was on his waist. And it's almost like a heel hook, right? The rotation as they're so with these kinds of things, I'm like, we don't knee cut through this. We back out of it, right? And so I try to really promote safety in those areas that we can potentially avoid it. And just for people to be more aware of where their body is. Because injuries sucks. Like it sucks to be out because you're injured. It's devastating mentally. And so I anything I can do to avoid that is for myself and students is really important.
Speaker 1: Yeah. And with the injury, like coming back from rolling, like I had a um, a very minor tweak on my shoulder. Nothing crazy, just, you know, it's an aggravated shoulder thing. And uh, this was a few weeks ago. I have a competition this weekend. And the last thing you want is to like have to take off time, serious time from training when you have a competition just a few weeks away. And um, I, you know, I get a couple of the guys that I know can move. And, you know, we'll we'll do um, we call it play rolling. People have different flow rolling, play rolling, whatever. You're still moving and you're actually executing like movement and technique and everything else. You just don't put that next level of like squeeze or a resistance towards things and you give and take. You allow people to, you know, you you you pass the guard and then you give them a little space and they escape and they sweep you and you just you can flow through it. And you're able to get some decent movement and at the same time, my my heart rate monitor was on and I was maintaining in like the 130s, which is great. It's a good workout. But at no point was I ever in risk of any serious injuries. It was it was able to do that for a week. Uh, or so and then was able to come back and my shoulder was fine afterwards and was able to get some blood flow going in the area with no um, issues opposed to just taking off completely because I didn't because if I couldn't roll really hard then I didn't want to roll kind of thing.
Speaker 2: Right. Yeah, and I learned more in those situations. PJ Barch actually did a seminar here and he calls it a conversation. And I thought that was so brilliantly stated. He's like, when you're flow rolling like that, and you're most of your training, really, should be like a conversation, right? You say something, I say something, they you say something, I and we're going back and forth. Sometimes you say a little more. Sometimes I say a little more, right? That's me passing the guard, taking your back. Okay, I was talking. Now you're going to be escaping it and then maybe I counter with something and then you escape it and then you counter, right? So that's how most of my rolls are at the gym or how I like them to be. Like we have some people that can't flow to save their lives. We've got some like 20-year-olds that are just savages and the teenagers that just come for my head. Like cuz they're my size. And they just come after me. Like they must love me. Uh, so there's really no flowing with most of these people. Um, but when you can get somebody that flows well like this, the learning is crazy. I'll just pause and be like, whoa, what did we just do, right? And then Yeah. notes, yeah.
Speaker 1: That's awesome. Yeah, it's just you kind of get in that that state where it's just a they're fluid. It's smooth. It's kind of controlled. Um, that's a nice thing. Yeah, it's it's a great way to warm up too. It's a great way to kind of start to get your your brain and your body online. And I think sometimes, you know, we'll do certain warm-ups and there's a lot of people that love warm-ups and and some people hate warm-ups and and things like that. But if you're one of the people that doesn't really like to warm up and you want to get your blood flowing a little bit instead of just like, you know, doing some jumping jacks or just getting to like a a nice flowy controlled roll where you kind of give and and let up stuff and just move. And I think, you know, do you do that for three to four minutes, you start to get a little sweat going. I think it's a great way to also move your body, but get your brain and your body online.
Speaker 2: Yeah. Yeah. I do it all the time for open mat. Open mat, I'll do one or two flows and see who can flow. One of my friends, she just got into town last week and I tried to flow with her and as soon as we slapped hands, it was like instant tensing, knee cutting and I said, okay, let me teach you how we're going to do this, you know.
Speaker 1: You've been training for a while. Strength conditioning, what do you like to do? What do you what do you prefer? Um, what do you what's kind of part of your strength conditioning routine now to to keep yourself healthy?
Speaker 2: I try to lift three times a week and then I do hot yoga once a week. And I started hot yoga in like 2021 when I was uh, training up for my first competition like seven years. I decided to do Master Worlds back then. And I was like, let's do it. Let's send it. And I was noticing I was so stiff. My hands were hurting, my neck. I'd get out of bed stiff and I started hot yoga and it was a huge game changer because you're you're moving in the opposite positions of what Jiu-Jitsu is, right? Like downward dog and all these things where you have to press your chest up, which is the opposite of what we're usually curled up in Jiu-Jitsu. So I really loved hot yoga. Um, I also have several physical therapists and I have pretty much standing appointments because it's I've always got aches and pains. Um, that I need help with. And so I have a couple of therapists that I go to and and I I try to at least once or twice a week do physical therapy either with them or on my own at the gym for whatever's bothering me.
Speaker 1: Yeah. Yeah, that's a great idea. Just addressing things early and even like kind of on a maintenance basis going every couple months if you need to just to see if there's anything that needs to be addressed. Um, because I think a lot of traditional weightlifting is very linear. It's pushing, pulling. We're not doing a lot of rotate. Usually rehab is more rotational work. So if you can incorporate rehab, you know, with with the stuff that I do, you know, you're doing cars or joint circles, doing end range conditioning, we're doing end range lift-offs and end range control, which is really important, especially for Jiu-Jitsu with, you know, the amount of rotation that we need in in the in the hips and um, and in the spine essentially. So I mean, I think those are all that stuff's really great. Um, I incorporate a lot of band work too. So I'll be say it's leg day. I go leg press and then in between, I might put a band around my legs and do uh, like stuff for my glutes, you know, like the walking forward and back kind of stuff in between sets or rotational band work if I'm doing upper body. Like I'll just have it and I'll be doing rotations in between my heavier sets. I don't lift super, super heavy. Like I'll try to deadlift kind of heavy here and there. Um, but I'm not trying to max. I'm going 10 to 15 reps when I do lift, like three to four sets, 10 to 15. Whatever I can do at that weight pretty comfortably. Uh, and then in between is a lot more of the rotational or single leg balance type stuff. Uh, I do use BFR. I think people think I'm a lunatic when I have the the blood pressure cuffs on like all four of my extremities and I'll get on the assault bike and I'm dead. Like my limbs are, you know, like purple. They're starting to turn colors and I'm just crushing the assault bike. But you could do that in 10 minutes and I can go like back to work. I could be on lunch break and just do some BFR real quick. So I really use BFR a lot. Um, if I if I have an injury too, put the blood flow restriction cuffs on and go lighter. Right? I don't have to deadlift a million pounds. Um, I can just go and deadlift like 50 pounds. 20 in each hand, whatever, do single legs with a BFR, you'll be burning.
Speaker 1: Yeah. And and BFR is for people that don't, it's like blood flow, it includes blood flow. Um, it allows blood flow into the muscle, but it doesn't allow blood flow out. So it basically gives you a you fatigue significantly faster. You don't have to use as much weight. Um, so it's a little bit better on your joints. You're not stressing your joints as much, which I think people I think for cardio as well. People don't use it for cardio as much too. You can, you know, you put it at less occlusion and you can get really just a such a pump and and such a fatigue in there a little faster. Um, so it's it's definitely useful. It's not just for recovery, but even just or just for rehab, but it's for recovery as well. If you want to still get some work in and not stress your body as much.
Speaker 2: It's great for after surgery. I love I let my PTs put BFR in like right away. They'll they'll text me or call me and say, hey, can we do BFR? Like one week out? I'm like, you could have done it already. You know, you put it on the leg and just have them do straight leg raises. I think it's really good for the athletes too because they feel like they can't do anything. They're like, I can't do anything right now. I'm like, well, you probably should not go deadlift 120 right now, you know. You know, but you can put I bet you that you won't do 20 straight leg raises with that BFR on. And then they try to do it and they're like, that was really hard. Like good. There's a challenge and a safe challenge.
Speaker 1: Yeah. And it probably gives them as an athlete, right? Like you you almost become, you know, what you become sort of sort of used to that sort of discomfort that you get from a hard workout. And when you're not able to train, you kind of miss it. So when you can get something that's challenging that's also kind of along the lines of okay with uh, your physical therapy and your rehab, that's probably a nice win where you're like, I can do something that's challenging that makes me feel a little uncomfortable where I feel like I'm doing something or getting something from it, but at the same time, I'm not risking reinjury.
Speaker 2: Yeah. And you get a sweat too. BFR is hard. It's hard. Because I would do PT a lot early on after my ACL and I was like, I'm not really sweating. I feel like I'm not doing anything, right? To your point. And they they'd be like, all right, BFR time. And then I was like, oh, shit. Yes. Yeah. And I went and did it.
Speaker 1: What do you um, all right, so this is a hot topic. This is a hot topic right here. And you it is. It really is. I don't you know, I've got clients I work with and literally they've all either asked me, all of them have probably at least asked me and a good amount of them do use peptides. Yeah. So, and I've talked to some surgeons about this and they're like, well, they're very like, uh, I can't say anything about this. So, there's a lot of, you know, it's not a lot of research. There's a lot what what are your thoughts? I mean, it doesn't have to be a like an official statement, but what do you think? What do you see as like the potential? Is it, you know, all placebo? Like what do you think with peptides?
Speaker 2: I don't know. I I have um, I have hope for it. Like it seems really great, right? It's it peptides are at least the marketing's really great. And it seems like it could help in the future. I just don't have enough literature yet on humans to be like recommending it to my patients and say, hey, take it and this will give you a better recovery. No, we don't have that yet. Could it? Hopefully, I would love for it to. That's great. But it's also we can talk about I put biologics into the same category, right? We hear about PRP, we hear about stem cells. Um, and then like all these other crazy things they're doing in other countries, uh, that I caution people because we've seen lots of gnarly infections and things when they go to other countries and get them and come back. Um, I've had friends who have had to take care of some pretty messy situations of things that haven't been tested. It's like trials. But, you know, PRP, very safe. It comes from your own body. We take the blood out, we spin it down. Stem cells, pretty safe. You can get donor site issues, right? Actually, you have to take the stem cells from bone somewhere and then people often complain of like their hip. Uh, it hurts where you took the stem cells. And again, depends on what it is. What injury are we treating? There's some pretty good literature behind these things. Like I've used PRP in areas that there's great literature. But trying to throw PRP at everything, not going to work. Could work, but there's not the literature. Same thing with peptides. And peptides is a little bit behind all these other these other things, these other therapies and that we don't have human data yet. Will it come out? I think so. I think people are probably doing it because there's a lot of money in it as well. Um, it's not FDA approved. So you don't know what you're getting. So when my athletes and my soldiers say they want to take it, say you have to do the right research. You have to make sure you're getting it from a good source. There's also different there's oral, there's you could take pills, there's injectables. We don't know what the best route is. At least I don't. Um, if it's out there, I'd love to hear about it and I'd love for somebody to shoot me some new data because I'm always looking for it. But it's not there yet. Um, to the point where like I would take it.
Speaker 1: With the PRP, you said that for certain areas, um, being that it's safe and it's pretty easy to have it done, you know, it's not like you have to go to it's expensive, but like, you know, you can get it done. It's not like you have to like, you know, haul over to Colombia or something to do it. Uh, what is a good area of the body or some areas like or types of injuries that PRP can be useful for uh, assisting with?
Speaker 2: Some of the best research we have is early arthritis in the knees. So early, early arthritis before you start having a lot of changes or deformities of the knees, um, you can do PRP there and it does pretty well because what is PRP doing? It's just decreasing inflammation, which is creating pain. Like the inflammation creates the pain from the arthritis. And so we're just decreasing inflammation. We're not regrowing cartilage. We're not giving you your cartilage back and getting your knee back, right? So I think there's some misinformation there or maybe the marketing sometimes tries to sell that we're going to create new tissues with stem cells in particular because it has the power to do that, but it hasn't been shown clinically to do that. Um, again, I would love for these things to do that because it would help people so tremendously. Um, but it's not there yet. PRP, also, I had mine on my elbows. So if you ever had tendonitis in your uh, elbows, like on the inside, you guys probably have because of our grips. So when I'm gripping a lot, um, my tendonitis was acting up like crazy for years. I tried everything under the sun. I went to dry needling, PT, everything straps and would try to cut down, but it was killing me. So I did PRP in both. Um, and it took a couple months, but it it got better. It hasn't come back. So certain areas, there's pretty good literature to support.
Speaker 1: Interesting. Yeah, and it's something that's been used for quite a while. I think I feel like people use a lot for Achilles tendonitis and things like that. Those kind of like tendon issues.
Speaker 2: Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah
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