5 Phase Strategy To Recover From Injury Fast w/ Machiel van Kolck (SSOF Ep 67)

James de Lacey2:33

And then with judo, it's with the Judo Academy. What age of judo players do you have there?

Machiel van Kolck2:33

Yeah, so they roughly come in at 17-ish and they'll stay until they're 22, 23 years. And then they either transition out when they don't really make it, or they transition to a transition group where they stay for another couple years to get used to the actual senior level. And then after that, so they're with my colleague, and then after that they'll have an option.

They'll either go on to the Olympic layer where they'll end up at their sort of Olympic cycle, the highest level in judo. So we're working with three guys and science on top of it. And that's like a transition from layer to layer, building them to Olympic athletes.

James de Lacey3:41

We'll circle back to the academy judo side, but I wanted to touch on today's topic around the title of this podcast, right? Integrating the rehab physio side with the strength and conditioning to essentially help accelerate someone's return to play, return to training on the mats, in the ring, in the cage, whatever it is.

And I think a lot of people, the ones that aren't—they're more recreational in nature doing the sport, maybe they compete a bit—they get injured, but once they get injured, it's, "Okay, I'm injured so I'm going to do nothing." And then they end up slowing their progress or making it worse because they've done nothing, and then just once the pain's gone maybe get back on the mats.

But maybe let's start with your philosophy around this, around—I mean, obviously different injuries have different approaches—but just the general philosophy around integrating these two together and how someone can go about, or why someone shouldn't just sit there and just rest if something does happen.

Machiel van Kolck4:39

Yeah, so one of the things we looked at is, there's a mental side of things and then a physical side of things. So those can be two things we'll come back to that later. But mostly we can have a reductionist approach to any movement, any type of sport, and bring it back to whatever we feel like, and then go from there and then build back up to where we want to be.

So any sport, any movement can be done from that kind of, well, looking at it like that. And then going from there we can build back up and then get them where we want them to be. And that's back on the mat doing full sessions, doing everything.

But that rests on multiple pillars. Like I just said, there's a physical, there's a mental element to it. But there's also a chance when someone's injured to pick up things, or qualities—physical qualities, mental qualities, any quality—that can't be really done in a busy schedule that is judo or any combat sport. Because you're always fatigued, you're always getting punches or bruises or whatever. So whenever someone's injured, it's also a great opportunity to pick up those things you normally can't get to because of that chaotic schedule, that busyness, everything.

James de Lacey6:13

Yeah, that's a good point. Like I think a lot of people listening to this, combat athletes, most of them probably work full-time and then train on top of a full-time schedule, get an injury, okay, maybe don't go to training. But what can they fill that time with? So if someone does—let's just say maybe if there's an example that's recent to you—but maybe just a random lower body, upper body injury, what's the first thing? Obviously see a physio, etc., this is not medical advice. What is something they could do, I guess, in that time while they're off the mats and recovering?

Machiel van Kolck6:43

Yeah, so the most recent example I have is for upper body. So to answer your question, that is what I will focus on for now a little bit. So there's a few things. First and foremost, the physio comes into the picture. So the physio will deal with that injured part until the physio said it's okay to do any extra strength on top of the easier, normal day-to-day tasks that a physio will do to the shoulder.

And then for me, or what I will focus on, is anything that's basically not being treated by the physio. So when you hurt your shoulder, you can still do squats, but not with a back squat, but a leg press or a belt squat or whatever. You still got your other shoulder, you can work on. You got your other arm you can work on. Sometimes you're in the sling, so you easily don't use it anyway.

There's a really good opportunity to work on your conditioning, especially getting that—what a lot of combat athletes don't do is getting that easy conditioning in, that's kind of zone two work. Because later on you'll be off the mat so long, so you lose a bit of that hard conditioning that sometimes athletes try to replace, and they go full-on conditioning. But that's not going to help you getting back on the mat when you need to get back on the mat to build up that load.

Because when you get in that zone two conditioning, it will help you recover from when you need to have those hard sessions again on the mat, instead of, "I'm not doing mat work, so I don't get that zone kind of zone five-plus heart rate up. Let's start supplementing that in because I really need that." Or let's prepare for actually getting back on the mat, doing rehab stuff, being ready for that, and being able to recover from that so that I can do a lot of that kind of work to get quicker back in.

James de Lacey8:46

Would there be an argument around not doing too much hard work because it might impair the recovery of maybe the injury?

Machiel van Kolck9:18

Yeah, that could be an argument as well. It's more as in—how would I go about that? The body's already trying to recover from something that's maybe torn, broken, or needs to focus on that. And then at the same time—what you say, I'm trying to find the words for it, but sorry.

James de Lacey9:18

I know what you mean. Like, kind of like, you know, you have this injury, your body's allocating resources to basically fix, or whatever it is, this injury. And then you're layering on top such hard training that those resources get pulled from the recovery to repair other parts of the body, in quotation marks, because you're doing so much hard work. Would that be something that maybe you take into account within, I guess, your rehab processes with these athletes?

Machiel van Kolck9:58

Yeah, there's then there's two sides to it. That's, there's the recovery side which you just explained, and at the same time...

It also when you have to go really hard, you also for a shoulder perspective, even when you're on the bike you try to, when you're on the bike you try to grab that bike handle with one hand and you'll be trying to do it with your other hand as well. So there's also an incentive to get that shoulder moving or to get that upper body part that's injured moving.

So it's also a bit of a self-preservation method in terms of, well, we try to rest it and we try to recover it and the physio does all the work with it, so please don't stress it too much and just go about things and then we'll go from there.

James de Lacey10:53

Nice. There's also I think what people also avoid, training the other limb. So you mentioned obviously, okay, you injure one shoulder, you have another shoulder limb you can train. Do you want to maybe dive into okay, what are some of the benefits of training the other side of the body when the other one's injured? Because people might be like, okay, I don't want to get, I don't want to create imbalances quote unquote, I don't want my left arm now to be bigger and stronger than my injured right arm. Do you want to dive into your philosophy around that?

Machiel van Kolck11:19

Oh yeah, to start with, I rather want one strong arm than no arms that are strong. Let's start with that. I think we need to do a fair bit of work to get the other one stronger than the other one when in an injured period. So go ahead and challenge me on getting that other arm so much stronger than the other one that's injured, because it's kind of challenge you to go do arm wrestling or something, and then you probably win the challenge.

But either than that, you need to do a lot of, that's, let's call, you need to do a lot of work to get that imbalance going.

Yes, there will be an imbalance, but there's also a strength transfer. And I forgot the exact amount at this point, but you probably have it more prepared than me. But there's a strength transfer even when your arm's injured to when you're not training it, but still training the other limb. So doing that, that's fine.

There's sometimes a problem with, like, you're trying to do like a dumbbell bench press, so you need, and that's like a stability problem sometimes where you still ask some stability from the other, from the whole upper body or the shoulder girdle or whatever, and then you get a little bit of irritation on the other shoulder sometimes. So you try to bring it back to floor presses or seated rows or just open chain versus closed chain kind of exercises where you still train it, but you try to not ask as much from stability or coordination of the whole shoulder girdle in itself.

James de Lacey13:06

Yeah, that cross education effect of that strength transfer, most people aren't aware of that, at least I've talked to. They, as we mentioned, they avoid training the other side because they don't want to create these imbalances, but don't recognize that training that side can potentially speed up the recovery of the injured side, plus building the strength, plus potentially maintaining some of the muscle mass from training your other limb. So it's worth doing regardless.

Machiel van Kolck13:37

And there's also enough, even if you're in a slightly further stage, you can add in a blood flow restriction kind of work where you keep the low load but still ask something from it. And you don't even need that lot of movement. You can have a blood flow and then only move your arm or have two or three kilos and that doesn't hurt the shoulder in itself or hurt the, and you can keep some muscle mass on.

So there's also always a way when you, like I said in the beginning, when you bring it back to the most basic part of it, of a movement, then you can always find a way to still train it.

James de Lacey14:07

That's a good call around blood flow, the blood flow restriction. Do we dive into a little bit that blood flow restriction? Maybe just some of the potential how it works, you know, if you're going to blood flow restriction your shoulder, where you would tie it up, your favorite exercises and set rep schemes when doing it.

Machiel van Kolck14:31

Not been experimenting that much with it though. There's been one occasion where I've tried it with conditioning in the leg, so keep it on for, it's just an easy bike ride for 10 minutes. And then put it on the legs and then have it at a, there's ways you can have the actual pressure and it's personalized, but we'll try to go always with an RPE saying it just needs to feel like it's stuck on a six or a seven.

It's not really strict, but then we do it for 10 minutes on a bike and there's been some protocols about it which has been really good so far, good results.

But then again, it's more as in, okay, let's get that signal to the muscles of, you got to get working, you got to get working, just do something even though the body doesn't want to do something and then at that kind of intensity and level that it's not harmful for the muscles in itself. So I can't really explicitly name set rep schemes. It's more as, okay, so the pressure's got to feel a little bit like a six or seven so it doesn't hurt too much, it doesn't damage anything.

And then you go somewhere between 10, 20 reps, just have that little bit of an old school pump going, feel like a few, luck watching Egger in front of the mirror and have a go with it. And it doesn't hurt anything when you keep it low intensity.

James de Lacey16:02

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Are you taking it off between sets, or you keep it on between sets as well? So if you're doing three sets, you keep it on the whole time?

Machiel van Kolck16:27

We kept it on now for the whole time. I've not, there's been protocols and experiments where they take it off, but there's also been instances where they say, okay, we'll leave it on even after the set for two to four minutes. And there's been, just leave it on and then take it off only after that, just for some extra buildup of everything. And then I've not been really going into that that much because also it's not that big a part of a training modality.

It's just, it's somewhere in between two, three, four weeks, and then you can go on to the next one already. And then you can, so at least that's what you hope with an athlete, it's just that you don't do it for six to eight weeks just keep it in at some point, because that's at that point the best thing to do or the most efficient thing to do, the lowest load in order to not damage other tissues.

James de Lacey17:43

So just for the people listening, this would be you'll do this on the, well, you could do it on non-injured limb, but you'll do this on the injured limb to essentially be able to train that limb without the pain and without having to load it heavy, but still get some of the benefits you would get when you're using heavier loads.

Machiel van Kolck17:43

Yeah, exactly, perfect, that's it.

James de Lacey17:43

And when you mentioned the bike one, I like that, that sounds brutal, even though it's just 10 minutes easy. But so you would basically, you would tie, for people listening, you can use like a long voodoo rubber band, you could use like knee wraps or elbow wraps, whatever, but you would tie these right up the top of your legs, six out of 10, then sit on a bike. And how intense are you having someone go on a bike, a resistance on that bike as well?

Machiel van Kolck18:09

Yeah, almost no. So when you chuck a heart rate monitor on it as well, and they just go maybe 110, 120, so that's like a blue, not even green, it's like upper middle bluish, just getting that, especially when someone has an ankle or lower limb injury. It's, they can't really put that much pressure on the paddle anyway.

And then no, almost no resistance, but just getting that cycle in. Then you need no resistance on the paddles, but there's, your legs feel like there's resistance somewhere. So but it's a non-load bearing thing. So then that signals the body to start working again and do something on those legs.

James de Lacey19:08

Yeah, I had, I was doing some blood flow restriction arms the other week just for a bit of fun and I tied it up top and I did like 30 overhead band triceps and then like 25 band curls. And I was, oh yeah, I'll do three sets. I did one...

The pain was so bad I had to take them off. I couldn't do anymore, man. That holding that blood in there is just like is killer. I don't know how people suffer through it.

Machiel van Kolck19:35

When you're really enthusiastic younger athletes or top sport athletes go "I want to do that" and they put it on so tight and they experience the same thing as you just mentioned, whereas okay it doesn't have to be that tight. It's only a six out of ten. I mean when I ask you to do a six out of ten squat, you don't load it up to 90% plus as well, so why would you do it on a band?

But then they're so enthusiastic about actually using that, doing something with that body part again that you actually have to slow them down.

James de Lacey20:02

So how would you progress, say for a four-week cycle, if someone's listening to this and like hey, they implement some of Blood Flow Restriction? You obviously mentioned 10 to 20 reps, but would you have them do the same thing weeks one to week four or is there some kind of progression you usually put in place?

Machiel van Kolck20:29

No, because it's kind of self-controlling in that way sometimes, because once they get stronger and they feel like they can do more reps, they can usually add a little bit more pressure on it. Sometimes the weight can also go up because the muscles just feel well.

And it's usually just like a finisher kind of thing. It's not the main part of a session. It's more of a finisher or part of that session at the end where they haven't used that limb yet because we try to afford it a little bit, or it's just been to the physio or whatever. So we'll keep it the same and let it self-regulate in terms of reps, and then maybe a little bit of load if I feel like they are underperforming or trying to overperform.

But that's just also the mental side and having to work really close with an athlete in terms of okay, you got to trust each other. So what you're saying is you got to be real with me, otherwise you might be hurting yourself. So we also have to build a bit of a, yeah, a good understanding from each other.

James de Lacey21:52

I think for the listeners as well, I mean they don't have access to full-time strength and conditioning coach, physio, et cetera, and a whole team to help them. So a lot of the times, okay, let's take your shoulder injury for example, they go to the physio, they do their whatever exercises they do, and there's a clear black and white when you go—when I guess it's a private physio and you're training—they'll be okay, you can't do this.

And then they go through their four, eight weeks of physio and then it's going from you can't do anything, now you can do everything. And obviously that presents problems for the practitioner because you go from doing nothing to okay, now you can go back to full training and do everything, which obviously they re-aggravate the injury, re-injure it, injure something else because they weren't prepared, whatever.

So that in-between stage, is there maybe some advice, some tips, some things that you like to do to get people ready to go back onto the mats, on the cage or whatever it is? And we can use your shoulder injury as an example.

Machiel van Kolck22:43

Yeah, that's that has been one of the hardest parts but also the experiment we tried about one and a half years ago to see where, how we can transition from that kind of first phase until let's call it fifth phase, because there's actually a lot of two, three, four, five, maybe even more phases in between.

And so what happens is that as soon as you can start moving your arm again, we say to the general public we say, "Oh, you can brush your teeth again or you can drink your beer or you can cut your steak again." That's actually using your arm, whereas that's great for a really just a general population.

But these really enthusiastic athletes, doesn't really matter if you're an amateur, a professional, if you want to be doing sports, you want to be got back into it. So you don't care about eating that steak, you care about how, what can I do as close to the sport as I can without actually doing the sport, because you're not allowed to do it yet.

So we try doing the most childish—that's where being a PE teacher is actually really good—because we bring movement back to the simplest thing ever. As in, okay, we got balloons out, we got two balloons, you versus me or me versus you. You can just get someone from your dojo or whatever. Can you help me out? Sure. Here's a balloon, here's a balloon. Okay, I'll chuck it in the air, you chuck it in the air, we run up and down, but you're only allowed to use your injured arm.

That's like a non-load bearing thing, but you're actually asking function from that arm or that shoulder without actually injuring it or having some load on it. So we bring it back to the most simple things. It could be balloons, it could be throwing as much cones at them, sitting on the floor throwing 20 cones at them, just catch them, or throw a tennis ball or play one-uppy against the wall with a volleyball, just throw it against the wall, the other one throw it against the wall.

So anything that's asking a function from the arm but doesn't involve impact and doesn't involve a chaotic movement like any combat sport is. I mean even Uchikomi forms from judo are too chaotic in the beginning because they ask a lot of rotation and strength from that. So you can't do that. So we start with just playing games.

James de Lacey25:01

And that would be considered phase two, after—carry on.

Machiel van Kolck25:01

Oh no, so that's playing games like that and then involving some kind of conditioning element to it or even a mental component to it. Could be a part of that phase.

James de Lacey25:43

Gotta—yeah, I really like that too. I talked about this briefly on the podcast with Shawn Sherman a couple of episodes ago, and about how for example like ACL rehab, instead of just balancing on whatever it is that some people do, maybe it's balancing or something, but throwing a ball back and forth or challenging that somehow. Because it takes your mind off the injury.

Otherwise you're standing on and you're focusing so much on the injury. For example, your example with hitting the balloons in the air and then running and making a game out of it. If you're just sitting there maybe hitting the balloon just by yourself, you're focusing the whole time on the injured shoulder while you're doing it, and often that restricts you, you might have some pain. Whereas if you're doing other activities, it seems to remove that.

Machiel van Kolck26:41

Yeah, it's distracting them from what's actually happening, especially—well, it's just a there's a way of thinking about the injury. But sometimes it's also vice versa. You have to deal with athletes that are scared of using it, so you have to distract them or just, yeah, so that's part of it.

But also at the same time, there's also an opportunity to implement mental strength in terms of okay, well I can't be on the mat, so I can't actually go into someone, get stuck into someone and have that feeling of winning and giving a submission to someone. But what are my mental strength weaknesses for my sport, and what can I then work on and try to funnel that into a game or into an element?

We, for example, when the games could go up a little bit in terms of intensity where they could actually get a bit of a heart rate up, we try to play games and then in the rest periods I would rest because I'm old and I need to rest anyway. Those pro athletes just keep going. So I give them a—what we did, we did there was this sheet of 50 numbers on them and she had to go out, she had to find them all on the list from 1 to 50.

And then if she didn't make it, there would been a—if she didn't make it, if she made it, I would do something, if she made it—I forget. But it's about having that stress because she said, "Oh yeah, I'll find them all in three times one minute." But you didn't get to 11 in three times one minute. But that's also a mental challenge in terms of okay, as a rest period you need to rest, so you need to focus on your rest while at the same time you're trying to do a, yeah, it's a fun game but you also want to win it.

So you have to be ready to recover, so you have to focus on your breathing, you have to do all that. Whereas in a game or when someone's on the floor resting and you need that 30 seconds recovery, you're also doing the same thing.

It's about that, "Oh yeah, I think I feel comfortable but I'm actually being uncomfortable, but I need to be feeling comfortable in order to get this done." And that's why we also chucked in a lot of these mental games to prepare them back. One of the weakness because she put it down as one of our wanting to learn things, so we worked on that and then that builds huge confidence going back on the mat again.

James de Lacey29:29

Interesting. So would this be part of phase three, adding this stuff in?

Machiel van Kolck29:29

I could be already at two. It depends, like depends on how hard you run after the balloons. But there's also when there's a little bit of more stability in that shoulder in like a phase two, three kind of situation, you can also start doing kumite or any grip kind of work with one arm and then just hold your arm on, like hold your arm on the shirt or don't or hold it here and just start fighting sideways on one arm.

Or just I'll put a hand on you, you just try to get rid of it with one arm and I just try to hold on for my life, try rid of me. So you do ask some function from that noninjured arm, but at the same time you're asking stability from the injured arm but not at that kind of intensity and bearing low bear weight that it can't get injured again. But you do ask a function from it which you probably don't when you do a single arm delt press in a different way at least.

James de Lacey30:29

Now that's interesting. So what's the difference between the phase two and the phase three? I mean, obviously that everything on a spectrum, not like you just go from two to three, but what's the difference between the two when you're progressing?

Machiel van Kolck30:29

I think there's a lot of games, non-sports specific games in phase two. It's just asking function again. And when we go to three, it's more a combination between games and actually some sport specific work, but in still in game form. So we could go play kumite form where we try to get that grip off, or I'll be attacking or I'll be defending.

We'll be playing games where I'll try to pin someone down on the floor and the other one just has to. Because you want to pin position like this, you can't use your shoulder, so we are just asking them to turn a lot. So there you're on your back, so you don't use your shoulders, but you still have to get a little that shimmy in the upper body, that kind of games.

We try to even turn our belt around, try to get the back of the belt game, show it when you were five or six. Because when I tried to get close to someone or tried to get close to the other person and he's still trying to get away from you and use that arm or not, and then those little instances is where you can't injure someone even more, but you can still ask function from that arm or that shoulder or that upper body.

Whereas they'll, yeah, you're actually training them because you're preparing them for what's coming instead of, "Okay, you're clear to go, go on the mat, but I haven't done anything. I haven't had no feeling whatsoever, and besides that, the other person standing in front of me tries to kill me."

So then we try to, that should be like a phase three, and then there's a lot of things you can do on the floor already, on your back, and then getting that in.

James de Lacey32:25

So for the grip game and for grabbing the bout, you're using the non-injured arm on those, or would you still, would you also incorporate some of the injured arm stuff?

Machiel van Kolck32:50

We later on we did that, but we first started on the non-injured arm and then we played those games to get an understanding for that game. Because then later on we used a rope. So I hold the rope on my on one end, and then the other person holds the rope on the injured arm, but we still play the game.

So yeah, you're holding a rope, but we're not actually using that arm to play that game. We're just using it to hold a rope, which is like a short rad. But because I'm trying to play with it, the other arm gets some movement in, but I'm not putting pressure on that noninjured arm. I'm just holding a rope. I'm not pulling on it or moving it. I'm just it's a bit of an implicit way of using that arm but not actually using it. So we try to trick it, trick the athletes into actually doing something with it but not for real yet.

James de Lacey33:47

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Nice. I like this because I mean, this applies for all grappling athletes, but I mean even strikers can use a lot of these drills anyway, even though that's someone specific to judo. I mean, if you have an injured shoulder, this is going to start to bring back some of that function. But don't we dive into phase four and then and then phase five as well?

Machiel van Kolck34:17

So when we're more into phase four, we actually we can use a bit more uchikomi where you actually get into a bit of, okay, so what's kind of the throws you do or the movements you make. And you can do that because it doesn't have to be finish. We can just be really close to each other and then use that arm to put a little bit of rotation in.

But then some athletes have these really cool overhead throws where they will, they'll be here and then, oh sorry, what's better on the camera here? But it'll be here and then they go all the way here. Let's not do that throw yet. Let's start, let's start with leg sweeps first. So we'll start here first and then later on we'll start here. So we'll start with leg sweeps and then move gradually up instead of. So not no rotation on the arm, slight rotation on the arm, open rotation on the arm, and then. But that's just technical work and then not really finishing.

We've been, there's been these, yeah, you've been probably done it a hundred times in rugby preseason where you do all this no-gi grappling with rugby. Just on the field. So it's always no-gi anyway, but you do all this grappling while holding someone, try to get away. That doesn't ask a lot of rotation from the shoulder, but it does ask a little bit of that quasi isometric strength needed strength. Whereas that's great to prepare for the next step, which is going to be falling and throwing and getting thrown.

So that we actually played rugby. We did tackling. We did where you sit on your knees, you pull someone forward to go for the jackal. So I will pull someone forward, it hits the floor, and that's that impact on the shoulder, which athletes love as well to play while doing the rugby. Oh sorry, while doing the judo or sport, and then adding another sport in which is close by but not as far away. So they love, they love the rugby because it's contact, it's NASA, it's grappling. So that all that kind of adds in.

And then at the same time, we also did a lot of no-gi work, just got rash guards on and do that kind of NASA. Because it doesn't allow, and then no arm bars and all that kind of stuff, but just so we kind of structured it into, okay, no arm bars. We can do any net work, but we can't stretch or rotate arms. So it's just let's go only pin someone down, that's when you win.

So that's when you you just take some of the boundaries of, you make boundaries in terms of, okay, we're not, that's not going to happen to a shoulder, that's not going to happen there. Whereas you still ask a lot of function from that shoulder, and there's a lot of rolling over that shoulder. There's a lot of strength in it.

And then that way kind of you can already build a lot of strength and sports specific qualities, whereas you don't get that dangerous part where you might be injured or you might get into too much rotation where where the injury actually happened, where you can't get yet get to yet. Yeah, that's kind of how phase four looks a little bit.

James de Lacey38:06

And then and then progressing into phase five, you're starting to ramp up to get back to full training.

Machiel van Kolck38:06

That should then be six, but if you if you want to. And that, no, that's first. Five is where in a safe environment, whereas it with a coach or a designated other athlete or someone you trust, you start building up hard kumite work or even...

Harder would you call me where you get thrown. We'll do full NASA, whereas because you don't have to be thrown or you don't have to fall, it's just only floor work. So we'll go build a lot of load and minutes in that and then get them fatigued.

At some point we did even tag, like a shark tank idea, where we got two athletes where we worked for four minutes. The athlete worked for four minutes and then I worked for two and another person worked for two, because that's kind of that specific overload that an athlete on itself can't really create, whereas two athletes can overload those four minutes. But in a safe environment, so all with rules where we with no arm bars or whatever, so all rules.

But yeah, it's we have to start fighting again. That's where we went from there. A typical end stage five training would be, for example, five times two minutes of no gi grappling, and then build it and then get the gi on and have a – I think we started at five times two minutes and we ended up at four times four minutes with a two or three minute rest, whereas as with another athlete though at the end.

That's when we said okay, if you can do three to four times four minutes, I think you're ready for to go back into technical training with other athletes again.

James de Lacey40:21

Nice. I like how you have that kind – you have that, I wouldn't say boundary, but you have that end point where okay, you've done this, you're pretty much ready to go.

Machiel van Kolck40:21

Yeah, and that's just a – that's not just a combination of the minutes I just prescribed. It's also the how does the athlete progress mentally through it, did you feel confident. That's why we brought in trusty athletes, other athletes that the person trusts, because it's still, we're still doing combat sports where you got the other person trying to kill you. So you need to have some trust for that other person that you're going to fight with.

So that's, it's a mental part. There's a physical part to it. And then there's also okay, where can we put you in in the trainings during the week, but also how much strength difference is there still in certain ranges. And is that deficit small enough to be to think that it's, to say it's safe to go from there.

James de Lacey41:18

Regarding that phase four, kind of getting used to hitting the ground – obviously with Judo you're getting thrown, Jiu-Jitsu, most grappling, you're being thrown to the floor. Obviously you mentioned, for example, tackling from the knees and then falling onto the elbows – there is one way of do it. How else are you progressing the athlete to be able to handle impacts now? Because I can imagine phase five is rather scary for a lot of them going into full contact throwing and being thrown onto the floor and, for example, an upper body injury like that.

Machiel van Kolck41:51

Yeah. So I've basically done my whole rugby preseason template from the first four weeks of grappling I put them through. And that could be that the throw, the pulling forward and falling on your arms with a ball, especially using the ball so you don't catch yourself but you actually accept the hit.

We've done, we use crash mats, which we've even put up to three or four mats high where someone just gets thrown over the shoulder. But then as soon as someone's on the shoulder, they'll actually hit the mats already, and we bring the mats down over the week, so even in the training if it's confident enough.

Any form of chaos push-ups on a band, for example. Having depth, little depth push-ups, straight arm depth push-up catches, that kind of work. Getting half kilo balls, throwing them to a person, having them accept them here and then throwing them as hard as they can against the wall. So that's all, all that is a combination of an integrated approach to rehab, whereas okay, yeah, you have that sport-specific on the mat, you have the physio working, and then you have the S&C next to it looking at that chaotic side of things. And that integration, that combination of everything, build you back.

But we also did climbing, like what is it, bouldering is the English word for it or not?

James de Lacey43:32

Yeah, I think so. Yeah, different types.

Machiel van Kolck43:32

So we also did that, and then swimming, because yeah, you actually need to go and then pull back as hard as you can. So all that kind of those other things that are not necessarily sport-specific can be a great asset to it.

James de Lacey44:03

I like that. And someone's listening to this looking to kind of go through some of these phases, how do they know when they're ready to progress through to the next phase?

Machiel van Kolck44:03

Yeah, you can set a few weeks for it. We try to get, okay, so we try to get a lot of similar exercises throughout the weeks, and we just asked them okay, do you feel confident? So out of one to ten, how confident do you feel in this exercise compared to last week or at the moment? Whereas okay, if you feel an eight being confident with doing this, I have a, I know you will go full on with this exercise, so you don't hold back.

And then usually after every set, if I didn't notice say a change in mood with an athlete or a change in pressure which they, which I feel, then I would ask at the end of like a block, I would ask them okay, how are you, are you still confident, how's the pain on RPE, all on RPE scale of one to ten. And then, so confidence, pain, and what was the last one? Oh yeah, and next I would explain the next exercise and seeing how they felt about the next exercise as well.

James de Lacey45:02

Gotcha, gotcha. So it's more, it's more of a confidence and pain thing. As someone's doing this on their own, are they tentative going into whatever the exercise is? And if so, maybe they need more time at the previous one if they're not fully confident in it.

Machiel van Kolck45:32

Well, we also used, which is, we used the micro FET as well, which is that kind of pressure, little pressure thing that a lot of physios have, where in certain positions from the shoulder we try to see how much pressure they could give and then how much that would differ from left to right. So you can also ask your physiotherapist to take those tests from you and see if there's still a lot of difference.

Because that has been a lot of help in me guiding, making S&C, whereas someone was still lagging a little bit above. So a little bit above here, and then okay, I'm still lagging strength here, so might be not smart to do overhead presses yet, whereas it would be in terms of the rehab period or the times, timeline, sorry. That would be okay, but you're still lagging strength down, we might have to look at it different. But it's an easily accessible tool, which from my experience a lot of physiotherapists have at their practice. So you can also ask them that.

James de Lacey46:37

That's just a grip dynometer, right?

Machiel van Kolck46:37

A grip, no, it's, it's like a half a tennis ball and it has like a compression pad on it. And then the physio will hold it like this and then you push into it, and then it will measure amount of force you can put into it. And then it comes back with a number, and that's the difference in force you can apply in those different angles, which can help you guide S&C but also can guide sport-specific mat training.

James de Lacey47:05

Got you. And for anyone who's listening to this without watching the video, Machiel was just kind of showing the different shoulder, essentially adding pressure to this ball in different shoulder positions, and you can kind of compare side to side in different positions and see if, basically see if you're ready.

Machiel van Kolck47:29

Correct, yeah. We don't really have numbers yet to be ready. It's more as in okay, how much difference is there still in strength. And how much, sorry, how much, yeah, how much deficit is there left versus right. I can't 100% say it's about clearance. It's more about the deficit and in terms of how far we are with getting that right.

James de Lacey47:29

Yeah, no, perfect, perfect. Now this has been awesome, Machiel, going through the these five phases, and hopefully the listeners are able to maybe take something out for themselves if they're going through a minor injury themselves. But if people want to follow you and find you, see what you're working on and everything, where can they do that?

Machiel van Kolck48:25

Yeah, so I'll say it, I'll say it my way right now. Say that, but that's just my, just my full. That's my full name is just, if you type it in Instagram, that's also my Instagram. And then further than that, if they have any questions, just shoot me a message there. I'm always happy to chat about what we've done and if I can help out.

Any specific questions to where they at now, I'm happy to help out and chat.

James de Lacey48:56

Sweet. Now I'll link that Instagram down the description as well for anyone listening. But thanks for coming on, Machiel, appreciate it.

Machiel van Kolck48:56

Thanks for having me.