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Miloš Štefanovský1, Tomáš Mihálik2

1Comenius University in Bratislava, Faculty of physical education and sport, Department of gymnastics, Slovak Republic

2Comenius University in Bratislava, Faculty of physical education and sport, Department of athletics, Slovak Republic

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This vocational article deals with problems of injuries and health troubles, which typically

occur in combat sports during trainings or competitions. Firstly, the simple taxonomy of

injuries is discussed. Authors deal with specific injuries according to anatomic location,

especially in combat sports such as wrestling, judo and karate. Secondly, the article is focused

on acute and chronic lower back pain. Furthermore, authors try to analyze the problem,

discover the common causes of pain. Subsequently, they recommend the possible solutions in

the form of Core training. Finally, practical applications of several Core exercises are

presented.

KK eeyywwoorr ddss:: combat sports, low back pain, core training, prevention

TThhee pprr oobblleemm

Most of the combat sports like judo, wrestling or karate belong to dynamic and power

sports with acyclic motions and continued opponent’s resistance. To defeat their opponents

the fighters use strikes, kicks, throws, strangles, levers and immobilization techniques.

Throwing techniques lead to the falls, which are also part of the fighting actions. Sometimes

fighting actions and expeditious opponent resistance can lead to different kind of injuries.

Combat sports traumatology divide all types of injuries in three groups (Zemková, 2006):

a) Acute injuries, which arise from extrinsic factors (for example an opponent) and

affect negatively the organism,

b) Micro-trauma is a pathological condition which arises from acute small injuries. It

shows up with a small pain and small functional changes.

c) Chronic damages of kinetic system are a result of acute injuries and micro-traumas.

The reasons are following: physiological overloading in the moment of reduced productivity,

constant overloading of organism, repeated injuries and their “quick” healing, repeated micro-

traumas.

To the specific combat sports injuries according to anatomic location belong head injuries,

like concussions by take-downs, punches and kicks. This type of injuries have occurred form

1 % to 8 % of all wrestling injuries (Pasque - Hewett, 2000). Other wrestling and judo head

injuries are nosebleeds, lacerations, dental, eye and ear injuries (cauliflower ear).

Wroble and Albright (1986) reviewed injuries over 8 year period in a college wrestling

team. The neck was the second most frequent anatomical location injured. Most of these 104

injuries were sprains, strain injuries and stingers (Wroble, 1996).

Shoulder injuries account from 3.5 % to 24 % of all wrestling injuries. Similar ratio of

shoulder injuries can be observed in judo (Sterkowicz, 1987). This type of injuries arises from

throwing techniques directly on the shoulder, or when the opponent land on his side and the

other fighter land straight on top of him. The most common problems in those situations are

shoulder dislocations, acromioclavicular sprains, clavicular fractures, rotator cuff tears or

strains (White – Rollitt, 2010).

Wroble (1996) noticed that the most common elbow injury is the hyperextension abduction

sprain affecting the ulnar collateral ligament and the anterior capsule. Elbow injuries result

from throwing, falls on extended arm and levers by practicing ne-waza fight in judo, jiu-jitsu,

or mma.

Knee is the single most commonly injured anatomic area in combat sports. Takedowns

are involved in the majority of knee injuries of all types. Collateral ligament sprains occur

when a varus and valgus force is applied. Another common injury is prepatellar bursitis,

anterior cruciate ligament disruption, meniscus damage (White – Rollit, 2010). The most

common ankle injury is a lateral ligament sprain (Wroble, 1996).

Severe injuries in karate were observed like III grade concussions, III degree sprains,

damage to viscera, facial bone fracture excluding nasal fractures and eye injury. Among

moderate karate injuries belong II grade concussions, clavicular, nasal, digital, metacarpal and

metatarsal fractures, dental injuries with teeth loss, lacerations requiring stitches. Minor karate

injuries are I grade concussions and contusions of solar plexus (Arriaza – Leyes, 2005).

Vertebrogenic disorders especially in the lumbar spine are one of the biggest problems

many fighters face. According to latest researches deep stabilizing spinal system plays an

essential role in protecting the spine against the active forces. Just deep stabilizing spinal

system muscles insufficiency is an important factor involved in the athlete’s vertebrogenic

disorders formation. For these reasons it is especially important for coaches to monitor the

athlete’s locomotor system functional state and ensure the targeted deep stabilizing spinal

system muscles involvement in the training process as unilateral pressure compensation and

vertebrogenic disorders prevention.

Iwai et al. (2002) noticed low back pain in 55 collegiate wrestlers. These wrestlers had

lower extensor strength than controls. Pain may be bilateral or unilateral and can lead to

decreased range of motion in the lumbar spine and negative sciatic tension signs.

Low-back-pain in combat sports arises mostly from overloading by practicing on the mat

or by weight training, bad selected exercises, insufficient compensation of unilateral load

and inadequate training technique. A research from last 30 years shows that muscle factor

plays critical role in low back pain (Kolář, 2001). Long-term overloading of soft tissues

without adequate compensation leads to tension in kinetic structures, which causes acute pain

in static positions and in motion. This type of tension can be observed in tennis, contact sports

or martial arts. Pain arises from damage of coordination between global and local stabilization

system. These two create protective function of spine (Rašev, 1992). In order to prevent

another vertebra, disc and ligaments damage, CNS creates compensatory mechanisms to

protect them. After exhaustion of these mechanisms there approach structural changes, like

degeneration of vertebras, or inter-vertebral disks.

Prevention is the basis in the management of low back pain in combat sports. Stretching

exercises belong to the first part of prevention back injuries and lumbal pain. The second part

of prevention from our point of view should be the CORE training with focus on centre of the

body. One of the biggest problems in training of the centre of body is isolated strengthening

of segments at the expense of integrate muscle activation as a complex – co activation

(example: crunches and consecutively back extension).

In functional stabilization these muscles work as a complex and not separately. In situation

which leads to defect of functional stabilization, the global stabilization system work

excessively and deep placed muscles (for ex. m. transversus abdominis) work inadequately,

then it comes up to excessive activation of paravertebral muscles (for ex. erectores spinae).

Low segments of lumbal spine are not sufficiently protected.

In our article there are few exercise examples. However it is not the “right manual” for

CORE training. The true sense of CORE training is not about quantity and attractiveness, but

it is in the right setting of body segments and correct execution by a professional trainer or a

physiotherapist. The presented exercises are divided into general and specific.

The foundation for our CORE training is: co-activation, right breathing (diaphragm),

caudal position of thorax, holding of neutral position of lumbal spine, specific positions and

movements in combat situation.

Figure 1 shows the wrong hyperlordosis and cranial position of thorax. The correct

stabilization of the lumbal spine must precede every aimed movement we want to execute.

The most common mistake in traditional basic exercises is the wrong position of the thorax

and hyperlordosis (Figure 1). By this incorrect technique we develop the non-functional

stabilization of lumbal spine which results initially in the pain of the given segment and later

on in the degeneration of intervertebral discs. In the correct positioning (Figure 2a) there

should be paid attention to holding the neutral position of pelvis, caudal position of thorax and

diaphragmatic breathing (Figure 2b). The correct positioning should be held by coaches and

athletes not only in the conditioning preparation, but if it is possible also in the movements

specific for combat sports (kicking, throwing, punches)!

Figure 1 Figure 2a

Figure 2b Figure 3

Sit-ups without feet support (Figure 3) and with

neutral pelvis position, caudal position of thorax, feet

apart in hips width are important for co-activation and

for the optimal work of all the muscles which

stabilise torso. Figure 4 shows basic stabilization in

“on all fours” position with knees raise. Working

muscles are: seratus anterior for scapula stabilization,

m. triceps, knees extensors and core. Figure 4

Exercise “side bridge” with a partner (Figure 5a,b). Figure 5a shows an initial position.

Figure 5b shows a final position of the exercise. During the exercise there should be paid

attention to keeping the torso stability (erect posture), correct breathing and positioning of the

body segments. It is possible to make the exercise more difficult by active pulling of one of

the partners by means of hand grasp.

Figure 5a Figure 5b Exercise “front bridge” with one-leg support (Figure 6a,b). Figure 6a shows an initial

position. Figure 6b shows a final position of the exercise. During the exercise there should be

paid attention to keeping the torso stability (erect posture), correct breathing and positioning

of the body segments.

Figure 6a Figure 6b Pushing exercise (Figure 7a) – trainee in a blue gi represent a static “wall”. Trainee in a

white gi carries out active pushing. Puling exercise (Figure 7b) - after the exercise static

“wall” trainee in a white gi follows by active pulling of the opponent.

Figure 7a

Figure 7b

Both trainees try to respect all the above mentioned rules for correct CORE training during

the exercise.

Puling exercise with a belt, figure 8 shows trainees

pulling with a belt. It is possible to carry out the

exercise in an amusing form with set rules and with an

aim to pull an opponent through a marked zone. Also

in this exercise we pay attention to the correct

positioning of the body segments and erect posture.

Figure 8 Push-ups with partner (figure 9). Trainee in a blue

judo-gi with outstretched arms leis on his back and

support her partner in the reverse push-up position.

Both legs are lifted in the “walking” position. Trainee

in a white gi raises her leg and does push-ups. She

can also alternate her legs after each repetition. Keep

attention on erect posture!

Figure 9

Squats with push-ups (figure 10 a, b). This is a difficult core exercise which requires high

level of physical condition and enough experiences with lifting, caring or throwing of partner.

Trainee in a blue gi does push-up position and cross her legs. The other one does squat

position and grasp opponents both legs. Make sure that you have correct squat position! By

bringing your body up make an explosive one-handed shoulder press.

Figure 10a Figure 10b

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Acknowledgements: This study was supported through a Scientific Grant Agency of the Ministry of Education of Slovak Republic VEGA No. 1/0503/11. TToo ccii ttee tthhiiss aarr tt iiccllee:: ŠTEFANOVSKÝ, Miloš a Tomáš MIHÁLIK. Primjena core treninga u prevencii bolova u donjem dijelu leda u borilačkim sportovima. In: Kondicijska priprema sportaša. Zagreb: Kineziološki fakultet Sveučilišta u Zagrebu, 2012, p. 386 - 389.