Episode #89 Dr. MIchael Piekarski, aka Doctor Kickass, Discusses Injuries, Therapy and Improving Recovery for Fighters

September 08, 2021

With the experience of competing in the cage and the discipline to earn his bjj black belt, Michael Piekarski has a unique perspective when it comes to understanding the demands and stressors that fighters endure. He’s a practicing physical therapist and does a great job explaining things that occur in the cage and on the mat. In today’s podcast, we get a better understanding for what happens in practice, during competition and how we should approach recovery and healing.

In this episode we discuss:

Michael’s education
Earning his BJJ Blackbelt
Competing in MMA and Muay Thai
Overuse vs Traumatic Injuries
3 Keys to Recovery
Working around injuries and ailments
Finding the RIGHT therapist to help you
and more!

Originally from the Northeast, Mike earned his Bachelor’s degree from Binghamton University in upstate New York, where he first discovered Brazilian Jiu-jitsu. After graduating, Mike began competing in Mixed Martial Arts, Muay Thai, and submission grappling. After turning professional as a Mixed Martial Artist, he decided to change his focus and return to school. Mike attended Stony Brook University in Long Island, where he earned his Doctorate in Physical Therapy. After graduate school Mike moved to Los Angeles. During this time he earned the rank of black belt in Brazilian Jiu-jitsu and became recognized as a Board Certified Orthopedic Clinical Specialist by the American Physical Therapy Association. Mike currently lives in Sacramento and works with a variety of athletes as a Sports Physical Therapist.

Follow –> @doctor_kickass

Full Transcription of Our Podcast with Dr. Michael Piekarski, aka Doctor Kickass

Interviewer: Corey Beasley

Interviewee/Guest: Mike Piekarski aka Dr. Kickass

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COREY: Hey guys this is Corey Beasleywith Fight Camp Conditioning. I’m excited to have Mike Piekarskion the line aka Dr. Kickass. Mike, how’re you doing?

MIKE: I’m doing pretty good today. How are you?

COREY: I’m doing good man. Thanks for taking the time to join us and talk with us a little bit. But for everybody that’s listening Mike, give everybody a little two cents of who you are and what you’re doing.

MIKE: Cool. So my name is Mike Piekarski. I’m a Doctor of Physical Therapy. I’m a board certified orthopedic clinical specialist. I also have a background in martial arts. I used to compete as professional mixed martial arts, and I’m a black belt in Brazilian Jiu-jitsu.

COREY: Nice, very cool, man. So Mike, you have a physical therapy background as well as just competing not only in jiu-jitsu, but in MMA. So, well, I’ve noticed at least following you on Instagram and stuff like that, is that you have a really cool unique perspective on some of the things that are happening to our body when people are rolling or fighting or whatever and you do a really great job of correlating that back to a lot of the recent events, whether it’s in UFC or [incomprehensible] or jiu-jitsu. So how did you kind of start out I guess, did you start more on the martial arts side or on the physical side?

01:27

MIKE: I started on the martial arts side. So originally, I was just in school. I was in college and I found jiu-jitsu and I started going that route, I started doing jiu-jitsu. When I finished college, I came home and then I started training a lot with my instructor at the time he was just starting getting into MMA, so helping him get ready for his fights. And one time he goes to me and says; would you want to fight?Something I’d never considered.

So I’m from the northeast. So in that time, the amateur scene was starting to open up so I started having some amateur fights. And then I had a professional fight. And then after thinking about it long term and being with some people who were professional fighters, I decided that, for me as a career, long term fighting might not be the best route. So I started looking into some other things, and then eventually I decided to go into physical therapy and then the rest was history.

02:27

COREY: Nice. Well, cool. So you started out with the BJJ, you had a handful of like, how many MMA fights have you had?

MIKE: I think I had five amateur fights. I had five Muay Thaifights and I had one professional fightand then I was supposed to have a second but the venue fell apart five days before, so that kind of killed my motivation.

02:54

COREY: Right on, cool. So you’ve made that transition, you had a lot of experience in the [incomprehensible] and also in variety martial arts and Muay Thai and MMA, what kind of pointed you towards physical therapy?

MIKE: So like I said, originally when I was fighting, I was going all in because I feel like if you’re going to do mixed martial arts, you really can’t go in if you’re not going to be 100%. So then I was like; okay, what else could I do and what’s sort of related so I could still make sure I could train if I wanted to do both at the same time, which I didn’t think I was going to, but I wanted to look into it. So I was looking into personal training but then I didn’t think that I had the personality to really be successful as a personal trainer at that time. So I started looking into physical therapy and the thing that I found about physical therapy is essentially physical therapy is the study of human movement, how it relates to some kind of injury which is very, very similar to jiu-jitsu, it’s like almost in reverse. Jiu-jitsu is you learn how to use the human body and how to manipulate it and how to disable it, when in physical therapy, you understand how the human body works and how you can improve it.

COREY: Right on Cool, cool, valuable assets when yo’re efficient at breaking people, right?

MIKE: Yeah.

04:23

COREY: Well, cool. Very good. So where did you study your physical therapy?

MIKE: So like I said, I’m from the east coast. So I studied physical therapy in Stony Brook University, it’s in Long Island. And then while I was there, I was training with a black belt Alex Thomas, he’s famous for — he had a video on YouTube that went viral because he was a black belt that put on a white belt, have a chance and check it out. It’s really funny video.

04:54

COREY: Right on. Cool, cool. So you started out there and then now you’re out in California, am I right?

MIKE: Yep, I’m out in California.

COREY: What made you come from the East Coast out here?

05:08

MIKE: There’s a lot of things, but my fiancé is from LA. So once I finished school, we moved out here and then considering the weather, and then the jiu-jitsu scene, and just the opportunities in physical therapy just seemed like a much better fit. So I was in LA for about four years and then I’m following up her so now we’re in Northern California in Sacramento.

COREY: Right on, cool. Now you’ve been out of school for what, five, six years, something like that?

MIKE: About four years.

COREY: About four years, and now on a weekly basis, are you implementing physical therapy? Are you practicing? Are you helping some guys out, you’re still training?

MIKE: All of the above. So I work as a physical therapist, I do work with some fighters on the side and I still train very regularly.

06:10

COREY: Cool. Now, from your perspective, I mean, you had a lot of experience rolling and fighting. You went through physical therapy school, you moved out to California, you continuing your training, how have things changed for you, after going through that education, have you altered your training at all? Have you adjusted your schedule, anything like that?

MIKE: I think I just look at more thing as a whole. So, usually what happens is when people want to get in martial arts, they just kind of like throw themselves in haphazardly, and they’re like, I need to learn jujitsu, I need to learn wrestling, kickboxing and they’re doing all the same things and then they’re doing strength and conditioning and it’s generally very unorganized, probably unless you’re at the extreme highest levels where people are making hundreds of thousand dollars. Because if a coach is with a fighter and then they also have a bunch of other fighters, are they’re going to have the time to really break out the time to help people develop?

So I think for me, I kind of look at that and I was like; okay, if I need to improve, whether it’s my skill set or my physical capacity, what do I need to improve to get better at whatever I want to do?So I kind of like took a step back, I could develop my own program, and then I can go back in and actually try to implement it.

07:33

COREY: Right on. So you’ve kind of a — this a little bit different perspective on things and a little bit more, I guess, detail oriented maybe when it comes to your own training, I mean, versus just kind of going into whatever it everybody else is doing.

MIKE: Absolutely.

07:51

COREY: Cool. Now the guys that you’ve worked with, now and in the past, what are some common things that you’re seeing when guys are coming in that fight or roll. Are there any common things that are happening pretty consistently that are showing up?

MIKE: Are you talking about like injury wise?

COREY: Injuries, ailment, mistakes maybe that they’re making, things that you’re helping them out with?

MIKE: I would say that it’s more of a common theme of there’s a lot of overuse injuriesbecause when it comes to like a traumatic injury, like let’s say you’re rolling and someone like wrestling and someone hits your knee, again, that’s a traumatic injury. That is kind of hard to avoid.

COREY: Right.

MIKE: But overuse is pretty easy because if you have to think if you’re a fighter, you’re training, you’re stand up grappling, you’re ground grappling, you’re doing striking, you’re doing your strength and conditioning, plus probably working full time unless they’re in the UFC. So they are very very over-trained. Very over-trained, and they’re not really taking the recovery side as seriously as they need to. Because that they developed a lot of overuse injuries. And then if you think about this way, when you never really let something heal or you don’t rehab it properly, it doesn’t get better and then becomes a chronic issue and then something else starts getting affected because that one area isn’t working the way it’s supposed to, even though you’re forcing it to. So I think that’s probably the most common theme that I see among fighters.

09:24

COREY: Yeah, so it’s just a matter of the overuse type injuries versus the traumatic, it’s what you’re seeing a lot.

MIKE: Correct, absolutely.

COREY: From your perspective that, is that like tendinitis? Is it aches and pains that just won’t go away or what kind of stuff kind of falls into that category?

MIKE: I would say it’s, I mean, there’s tendinitis, there is aches and pains. Usually, I would say it’s more of like aches and pains of something’s bothering him as opposed to tendinitis, because tendinitis is usually a little bit more involved. And if you catch that one early enough it’s not that hard to deal with, it’s when tendinitis becomes chronic, it becomes really challenging to deal with. But usually I haven’t had too many fighters that had chronic tendinitis that we had to battle through.

10:15

COREY: That’s something you could pretty knock out pretty quick.

MIKE: Yeah, yeah, if they listen.

COREY: If, there’s a big “IF”. Alright, cool. So for the guys that are listening, whether they’re coaches or whether they’re athletes, if overuse is a big issue, do you have any kind of take home points or anything like that, that you’re telling your guys to kind of help them kind of not only just maybe plan but then actually digest and implement that stuff into their schedule?

MIKE: I would say if you think of all of the skills or attributes involved in MMA, like again, the physical side, your maximum strength and muscular endurance, your power, your mobility, and on the skill side, you’re grappling, you’re striking, there’s so much stuff to do. So if you are, especially if you’re at a camp, that’s a good like — let’s say you’re dealing with an injury, work on something else, like maybe you can’t lift weights, maybe you can work on your mobility. Maybe you can’t do jiu-jitsu but you can do footwork or striking drills. There’s always something that you can do that you’ll probably benefit from. This way it’s not like you can’t train and you’re like, oh, I guess this is a waste of time, just work on something else. Because when you’re in fight camp, you won’t be able to do that. That’s more of trying to get you ready to actually fight.

So I would say, if you’re dealing with something, don’t try to be a tough guy. And that’s I think one of the things that gives me an advantage is because I fought, I understand that the fighter themselves, they don’t want to think that they’re weak. So they’re not going to tell anybody, they’re not going to tell the coach and then the coaches, they’re managing a whole bunch of other fighters. They don’t have the time like, how serious of an injury is it. Because it’s probably something small and the coaches would be like, just ignore it.

COREY: Right.

MIKE: Again, it’s hard to tell the coach when to know when something’s more serious when it’s not. But I would say, if you’re dealing with an injury, address it, work on something else as opposed to just ignore it, then it gets worse and worse and worse and worse.

12:23

COREY: Yeah, just plowing through versus working around it. Right?

MIKE: Absolutely.

COREY: I mean, pretty common sense seems like, but it’s just a matter of just having the awareness, maybe being conscious of the fact that you can still be productive when you’re working around certain things, especially when you’re at a camp, right?

MIKE: Absolutely.

COREY: I mean, if you’re not having to compete in six weeks or whatever it is, then hell yeah, you ought to be taking a step back and kind of working on some things so you can actually improve and grow.

MIKE: Yeah.

12:55

COREY: Cool. So aside from — we got a lot of overuse, when guys do actually have traumatic type injuries, so shoulders, elbows, backs, knees, I’m imagining that those are pretty common when it comes to that type of stuff. I mean, let’s say somebody does have something happened, right? Like, somebody’s knee need pops or something like that when they’re rolling or wrestling. What should they do? I mean, what are the steps? I mean, how do you know if it’s real serious? How do you know if it’s not and what do you do from there? What are some good steps that guys can have moving forward if something like that does happen?

MIKE: So this is a tricky one, because I’d be careful about giving medical advice because I don’t know who’s listening. But what I would say is when something happens, it’s good idea to get checked to know how serious it is. Now, I again, this is back to when I was a fighter with no experience, I did have a time where my knee popped and I had no health insurance and I couldn’t afford anything and I panicked and thankfully, it wasn’t that serious and it did get better. But I was also 24 at the time so obviously I was feeling a lot better.

COREY: Yeah.

MIKE: The best thing I’d say is get it checked because the thing is, a lot of the injuries, especially if it’s like a knee pop or an ankle pop or something like that, there’s still trauma to the ligaments. So what happens is, if it stays this way, the ligament gets stretched out. Eventually, it’s not gonna hurt anymore. Like it’s why a lot of people when they roll their ankles, they’ve this history of rolling their ankles because the ligament never returned to its full strength because it kept getting old doesn’t hurt anymore. But it’s still stretched out and weak. Same thing with knees and shoulders and that sort of thing. So it’s a good idea to go get it checked, just to make sure you’re dealing with so opposed to, oh you think you’re okay and you’re not and now you’re going to hurt yourself more because let’s say the ligament in your knee is compromised. So now you’re moving funny. And now when you do get hit again, the ligament will get completely torn or something like that.

15:07

COREY: Right on. So if guys do go get checked, I guess what I’m trying to get to is there’s a variety of just like anything, there’s great physical therapist and then there’s guys that maybe aren’t as attuned or attention to details is not there or whatever it may be, they’re maybe not as good. So when guys are looking for a physical therapist [distortion] checked out, how do they know good from bad, quality versus not. I mean there’s a lot of variable out there, right?

MIKE: Yeah. So this is a tough one. But like most things you pay, like, depending on how much money you pay, the better you get. So a lot of times, if you go to a clinic and they’re seeing a high volume of people, that’s usually not a good sign because then they don’t have the time to really check you out. And those type of clinics, they might not necessarily want to give you what you need, they might just want to kind of bring in. So you have to go through this whole thing of PT which might be necessary. But there’s some things — so physical therapy doesn’t have to be, you go in for twice a week for six to eight weeks all the time. Like sometimes it could be just proper education. Like when it comes to some kind of tendinitis or tendinopathy, for me, that’s more of like, I give you education. You come in once a week, once every other week, if you do what you’re supposed to, or good if you don’t do what you’re supposed to, I can’t help you. But it doesn’t always have to be this thing. And that’s what I think a lot of people are worried about is if they go to CPT, they’re gonna get stuck and they’re not going to leave for two months.

COREY: Right.

MIKE: So you want to look at the volume. You want to see what the PT, what their interests are. If they aren’t athletic, they aren’t the person you should really be going to because they don’t understand the demands. So my specialty is mixed martial arts and combat arts and stuff like that. But this works for any athlete. If you’re a runner, and you want to get back to running, you should see a physical therapist who understands running because they’re going to understand the demand.

17:18

COREY: Right.

MIKE: But do you have to have to have a martial arts background for a fighter? Maybe not, but at least if you’re an athlete who understands competition, they’ll get it because a lot of times people might want to rush back too soon. And if you’re an athletic PT, who’s competed, you will be hopefully trained in a lot of return to sport criteria then go likeno, your knee is good,you’re good. You’re clear. If you can’t do this, it’s not a good sign for you to go back to training.

COREY: Yeah.

17:46

MIKE: Certain certifications that I like and these are ones that I have just because they’re a little bit more involved. So I’m a board certified orthopedic specialist. There’s also a sport one, which is there’s like very slight differences, but there is a difference, both of them would be pretty good because that means they went back to school to get more education.

Then we also have some courses I like is I’m a big fan of functional range conditioning. I think that’s really good, especially for finding out if let’s say there’s parts of the body that aren’t working well. I like the selective the SFMA, because that’s a good way to see if people have faulty movement patterns. And one of the things I’ve noticed is that a lot of fighters do have faulty movement patterns because they’re not necessarily great athletes, not all of them. So that’s a good way to kind of catch things early on. So another recommendation — [Interviewer interrupts]

COREY: And what was that SFMA, I’m sorry?

MIKE: The SFMA, it’s theselective functional movement assessment.

COREY: Right on.

MIKE: It’s the next step to the FMS, but on the clinician side, It’s really good about screening out of you watching people move. And then you really break down and see what part of the body is causing them to move faulty.

19:12

COREY: Gotcha. You’re finding the root cause of what’s making a move wrong, or incorrect, or inefficient?

MIKE: Correct, yeah. And a lot of times, when there’s a traumatic injury, some kinds of knee pain, it’s probably because there’s a knee pain. But when there’s an overuse injury, what if they’re coming in for knee pain and because their ankle doesn’t [inaudible]? Right?

COREY: Yeah.

MIKE: So that’s a useful tool for people to look forward just to see if there — again, those are just some education courses that I’ve taken that I found really helpful that I’d recommend. You don’t have to have those to be a good PT, it’s just something that I look for.

19:51

COREY: Right on. That’s great information because the movie hosted Andrea Spina and his whole crew a handful of times at our gym down here and it’s super, it’s very unique number one, I mean, they really did come out with something that the marketplace did not have and did a really good job of making progressions and regressions and stuff like that to really make it I guess the average coach or person that’s wanting to learn or implement those into their program. But it’s a lot different. I remember when going to PT myself and going to a place initially that it’s just a general physical therapy clinic. So their goal was to get me back so I could perform the tasks of regular life. Hey, Cory, go back to work. You can get in and out of your car and you can go up and down the stairs. And I’m like, that’s not good enough. I need to get it back where I can explode and fight and run around and do my stuff athletically versus just being a regular joe going to work.

20:58

MIKE: And something with that that hinders PTs is, it’s not them as a PTs insurance company. So again, if you document the way that you’re supposed to, you write that the insurance would be like, well, they’re good. But if you’re an athlete, that’s not good enough. So for somebody who wants to get back, it’s not a bad idea to find — because there are a lot of physical therapists out there that do cash based PT or consider out of network PT, where it is a little bit more expensive. But again, what they will do is they’re going to spend more time with you. They’re going to figure out what’s going on. And they can educate you and it’s not like you’re going in twice a week for six weeks. Maybe it’s less, but again, some people might need that twice a week, some people don’t. It just depends on the issue.

21:48

COREY: Yeah, of course. Now, Mike, I know that there’s a lot of things, mobility and recovery, especially from an Equipment standpoint has become a pretty big market from massage balls rollers, trigger point guns scam and I like all these different modalities and methods to speed recovery have become very very popular. Is there anything that you’re seeing out there right now that’s just a complete quack or not very beneficial? I mean because this stuff happens a lot right so people don’t know what to believe or where and they might be doing something that’s good and a lot of their time doing things that aren’t beneficial and it’s not really to rag on anyone in particular individually. But I want to make sure that if there are things out there that just really aren’t as efficient and getting people to heal as others. Is there anything that catches your eye that’s I guess one good but on the other side, just kind of like not really beneficial, maybe we’re wasting our time.

22:56

MIKE: This question is kind of tricky because there’s a lot of things that go into it.

COREY: Sure.

MIKE: When it comes to recovery, as a fighter, I would say the most important things you should focus on for recovery would be nutrition, sleep and load management. Load management is how much you’re doing. So there’s extra stuff, which is important and a lot of the super high level athletes like that’s where they can benefit a little bit more from that. You should be getting the first three, if they aren’t dialed in, you’re not going to get better because nutrition was helping to rebuild your body, sleep is where you rebuild your body. And then load management is if you go from not training to training three days in a row for five days, your body’s not going to tolerate that well. So you want to gradually load. Okay, so then there’s the extra stuff.

COREY: Yeah.

MIKE: So then this becomes tricky because they all have purposes but they’re not always the purpose that a lot of people say that they do, it’s not always correct. So when it comes to soft tissue work, whether it’s through a gun, through a lacrosse ball, through someone’s hands, there’s two mechanisms of really how it works to be able to get it physiologically of what we understand right now. So the science community, we don’t have an accurate understanding of what’s really happening but this is what we think is happening. So when we do any kind of massage, there’s a neuro modulation effect, which essentially what we’re doing is we’re not actually breaking up scar tissue. What we’re doing is we’re convincing the nervous system by stimulating it, that it gives it something else to think about and then things will feel better. So when people say do this to break up scar tissue, that physiologically impossible. If that happened, a surgeon wouldn’t take a scalpel and have to go into do surgery in many cases, but that doesn’t mean it’s not effective, but it doesn’t do what people think it does.

COREY: Okay.

25:10

MIKE: So when it comes to a foam roll, like when I do any kind of foam roll work I have a massage gun, which I do because it makes me temporarily feel better. So if let’s say, I’m feeling tighter, restricted, I might do something just to make me feel a little bit better. But that’s really just given me a small window of, I guess, alleviating some tightness, so then I can do whatever tasks I’m about to do, if that makes sense.

COREY: Sure.

MIKE: Then if you want to look at something — I would say the one modality that I’m not normally a fan of, would be ice stim for athletes. And that’s because East him is the benefits are very local to your getting ice stim and then it’s over and then there’s no more pain relief. Really all it is, it’s like someone gets a bee sting, and then they just rub the bee sting it like feels better temporarily, just because you’re kind of confusing the brain.

COREY: It distracts it, right?

MIKE: Yeah. So if you’re going to a place — now, is there a purpose for it? I mean, what I like for ice stim is it feels good. And then someone comes in and they get treatment and then after they get ice stim, it almost gives them that oh, this is good. I should come back I feel good or it gives them a like a reward. Or if someone if let’s say like you have a really bad injury, and you’ve resting things, resting things like inflammation and you’re laying on the couch and your leg is aching. I’d rather use ice stim and calm things down, then just sit there in pain. But for an athlete who’s kind of recovered between sessions, I don’t know if that really makes a difference.

COREY: Gotcha. Now something that’s also real popular now is ice baths or cryo stuff like that? Do you have any input on either one of those?

MIKE: I don’t have enough research on that, I read some stuff that they’re supposedly if you look at it, there isn’t really a benefit. But I know I’ve used cold bath and physiologically you feel really good after so even if it’s more psychological, that itself is great. I don’t know if it’s doing what they say it’s doing. Again, I think there’s to be more research.

So for some of the cryo stuff we used to pay like $30 a pop like I don’t know if that’s necessarily worth it. Don’t know if it’s really helping.

27:43

Ice bath is probably going to be easier because you don’t need as much stuff. You just need big garbage can and bunch of ice and you’re good to go.

COREY: Yeah, yeah, but then more low tech is sometimes the best.

MIKE: Yeah.

COREY: Well, cool. The last thing I had a question about because I see it popping up all over the place is CBD oils. Do you have any feedback on any of that type of stuff?

28:10

MIKE: I haven’t. I’ve actually talked to a few people who’ve had to try to get their opinion. I don’t have any research or a lot of experience with it. The few people who I’ve asked, who I’ve been working with say it didn’t really help but again, I have to do more research and get more experience to really comment on that.

COREY: Cool, easy, man. But I mean, like I said, it’s just a matter of there’s so much information that’s out there and just trying to get to the bottom of it. And figure out what you’re using with your guys is cool, it’s beneficial. It gives some people some direction at least as far as like we talked about with the overuse versus traumatic, the three main pillars of recovery, nutrition, sleep and load management, just making sure you got that foundational stuff right, working around those overuse injuries and ailments when you can and then some of the things that you’re — the directions you’re given as far as just dealing with traumatic injury and going and getting it checked and then creating a plan moving forward with an athletic type therapist that understands the situation and that’s powerful stuff and just good information. Hopefully a lot of the people that are listening, they’ll be able to gain some insight and have a little bit better experience when they do have these things pop up.

No, I think that’s cool, Mike. For people that are wanting to learn more about what you’re doing and stay in touch with you, Mike, what’s the best way for them to reach out and find you?

MIKE: You can reach me on Instagram. I do have a website that’s almost complete but I mean, essentially what I’m doing is I’m taking some information from Instagram and I put it on the website so it’s easier to sift through because Instagram really isn’t made for what I use it for. But I think Instagram and my website were probably the best.

COREY: Okay cool. And guys, I’ll make sure to put those links down below. Mike, thanks again man, I appreciate you sharing with us and taking the time here to give us some insight and help educate some of these people that are out there [inaudible]. I appreciate it.

MIKE: No problem. Glad to be here.

Episode Transcript

Full Transcription of Our Podcast with Dr. Michael Piekarski, aka Doctor Kickass

Interviewer: Corey Beasley

Interviewee/Guest: Mike Piekarski aka Dr. Kickass

———————————————————————————————————————

COREY: Hey guys this is Corey Beasleywith Fight Camp Conditioning. I’m excited to have Mike Piekarskion the line aka Dr. Kickass. Mike, how’re you doing?

MIKE: I’m doing pretty good today. How are you?

COREY: I’m doing good man. Thanks for taking the time to join us and talk with us a little bit. But for everybody that’s listening Mike, give everybody a little two cents of who you are and what you’re doing.

MIKE: Cool. So my name is Mike Piekarski. I’m a Doctor of Physical Therapy. I’m a board certified orthopedic clinical specialist. I also have a background in martial arts. I used to compete as professional mixed martial arts, and I’m a black belt in Brazilian Jiu-jitsu.

COREY: Nice, very cool, man. So Mike, you have a physical therapy background as well as just competing not only in jiu-jitsu, but in MMA. So, well, I’ve noticed at least following you on Instagram and stuff like that, is that you have a really cool unique perspective on some of the things that are happening to our body when people are rolling or fighting or whatever and you do a really great job of correlating that back to a lot of the recent events, whether it’s in UFC or [incomprehensible] or jiu-jitsu. So how did you kind of start out I guess, did you start more on the martial arts side or on the physical side?

01:27

MIKE: I started on the martial arts side. So originally, I was just in school. I was in college and I found jiu-jitsu and I started going that route, I started doing jiu-jitsu. When I finished college, I came home and then I started training a lot with my instructor at the time he was just starting getting into MMA, so helping him get ready for his fights. And one time he goes to me and says; would you want to fight?Something I’d never considered.

02:27

COREY: Nice. Well, cool. So you started out with the BJJ, you had a handful of like, how many MMA fights have you had?

MIKE: I think I had five amateur fights. I had five Muay Thaifights and I had one professional fightand then I was supposed to have a second but the venue fell apart five days before, so that kind of killed my motivation.

02:54

COREY: Right on, cool. So you’ve made that transition, you had a lot of experience in the [incomprehensible] and also in variety martial arts and Muay Thai and MMA, what kind of pointed you towards physical therapy?

MIKE: So like I said, originally when I was fighting, I was going all in because I feel like if you’re going to do mixed martial arts, you really can’t go in if you’re not going to be 100%. So then I was like; okay, what else could I do and what’s sort of related so I could still make sure I could train if I wanted to do both at the same time, which I didn’t think I was going to, but I wanted to look into it. So I was looking into personal training but then I didn’t think that I had the personality to really be successful as a personal trainer at that time. So I started looking into physical therapy and the thing that I found about physical therapy is essentially physical therapy is the study of human movement, how it relates to some kind of injury which is very, very similar to jiu-jitsu, it’s like almost in reverse. Jiu-jitsu is you learn how to use the human body and how to manipulate it and how to disable it, when in physical therapy, you understand how the human body works and how you can improve it.

COREY: Right on Cool, cool, valuable assets when yo’re efficient at breaking people, right?

MIKE: Yeah.

04:23

COREY: Well, cool. Very good. So where did you study your physical therapy?

MIKE: So like I said, I’m from the east coast. So I studied physical therapy in Stony Brook University, it’s in Long Island. And then while I was there, I was training with a black belt Alex Thomas, he’s famous for — he had a video on YouTube that went viral because he was a black belt that put on a white belt, have a chance and check it out. It’s really funny video.

04:54

COREY: Right on. Cool, cool. So you started out there and then now you’re out in California, am I right?

MIKE: Yep, I’m out in California.

COREY: What made you come from the East Coast out here?

05:08

MIKE: There’s a lot of things, but my fiancé is from LA. So once I finished school, we moved out here and then considering the weather, and then the jiu-jitsu scene, and just the opportunities in physical therapy just seemed like a much better fit. So I was in LA for about four years and then I’m following up her so now we’re in Northern California in Sacramento.

COREY: Right on, cool. Now you’ve been out of school for what, five, six years, something like that?

MIKE: About four years.

COREY: About four years, and now on a weekly basis, are you implementing physical therapy? Are you practicing? Are you helping some guys out, you’re still training?

MIKE: All of the above. So I work as a physical therapist, I do work with some fighters on the side and I still train very regularly.

06:10

COREY: Cool. Now, from your perspective, I mean, you had a lot of experience rolling and fighting. You went through physical therapy school, you moved out to California, you continuing your training, how have things changed for you, after going through that education, have you altered your training at all? Have you adjusted your schedule, anything like that?

MIKE: I think I just look at more thing as a whole. So, usually what happens is when people want to get in martial arts, they just kind of like throw themselves in haphazardly, and they’re like, I need to learn jujitsu, I need to learn wrestling, kickboxing and they’re doing all the same things and then they’re doing strength and conditioning and it’s generally very unorganized, probably unless you’re at the extreme highest levels where people are making hundreds of thousand dollars. Because if a coach is with a fighter and then they also have a bunch of other fighters, are they’re going to have the time to really break out the time to help people develop?

So I think for me, I kind of look at that and I was like; okay, if I need to improve, whether it’s my skill set or my physical capacity, what do I need to improve to get better at whatever I want to do?So I kind of like took a step back, I could develop my own program, and then I can go back in and actually try to implement it.

07:33

COREY: Right on. So you’ve kind of a — this a little bit different perspective on things and a little bit more, I guess, detail oriented maybe when it comes to your own training, I mean, versus just kind of going into whatever it everybody else is doing.

MIKE: Absolutely.

07:51

COREY: Cool. Now the guys that you’ve worked with, now and in the past, what are some common things that you’re seeing when guys are coming in that fight or roll. Are there any common things that are happening pretty consistently that are showing up?

MIKE: Are you talking about like injury wise?

COREY: Injuries, ailment, mistakes maybe that they’re making, things that you’re helping them out with?

MIKE: I would say that it’s more of a common theme of there’s a lot of overuse injuriesbecause when it comes to like a traumatic injury, like let’s say you’re rolling and someone like wrestling and someone hits your knee, again, that’s a traumatic injury. That is kind of hard to avoid.

COREY: Right.

MIKE: But overuse is pretty easy because if you have to think if you’re a fighter, you’re training, you’re stand up grappling, you’re ground grappling, you’re doing striking, you’re doing your strength and conditioning, plus probably working full time unless they’re in the UFC. So they are very very over-trained. Very over-trained, and they’re not really taking the recovery side as seriously as they need to. Because that they developed a lot of overuse injuries. And then if you think about this way, when you never really let something heal or you don’t rehab it properly, it doesn’t get better and then becomes a chronic issue and then something else starts getting affected because that one area isn’t working the way it’s supposed to, even though you’re forcing it to. So I think that’s probably the most common theme that I see among fighters.

09:24

COREY: Yeah, so it’s just a matter of the overuse type injuries versus the traumatic, it’s what you’re seeing a lot.

MIKE: Correct, absolutely.

COREY: From your perspective that, is that like tendinitis? Is it aches and pains that just won’t go away or what kind of stuff kind of falls into that category?

MIKE: I would say it’s, I mean, there’s tendinitis, there is aches and pains. Usually, I would say it’s more of like aches and pains of something’s bothering him as opposed to tendinitis, because tendinitis is usually a little bit more involved. And if you catch that one early enough it’s not that hard to deal with, it’s when tendinitis becomes chronic, it becomes really challenging to deal with. But usually I haven’t had too many fighters that had chronic tendinitis that we had to battle through.

10:15

COREY: That’s something you could pretty knock out pretty quick.

MIKE: Yeah, yeah, if they listen.

COREY: If, there’s a big “IF”. Alright, cool. So for the guys that are listening, whether they’re coaches or whether they’re athletes, if overuse is a big issue, do you have any kind of take home points or anything like that, that you’re telling your guys to kind of help them kind of not only just maybe plan but then actually digest and implement that stuff into their schedule?

MIKE: I would say if you think of all of the skills or attributes involved in MMA, like again, the physical side, your maximum strength and muscular endurance, your power, your mobility, and on the skill side, you’re grappling, you’re striking, there’s so much stuff to do. So if you are, especially if you’re at a camp, that’s a good like — let’s say you’re dealing with an injury, work on something else, like maybe you can’t lift weights, maybe you can work on your mobility. Maybe you can’t do jiu-jitsu but you can do footwork or striking drills. There’s always something that you can do that you’ll probably benefit from. This way it’s not like you can’t train and you’re like, oh, I guess this is a waste of time, just work on something else. Because when you’re in fight camp, you won’t be able to do that. That’s more of trying to get you ready to actually fight.

COREY: Right.

MIKE: Again, it’s hard to tell the coach when to know when something’s more serious when it’s not. But I would say, if you’re dealing with an injury, address it, work on something else as opposed to just ignore it, then it gets worse and worse and worse and worse.

12:23

COREY: Yeah, just plowing through versus working around it. Right?

MIKE: Absolutely.

COREY: I mean, pretty common sense seems like, but it’s just a matter of just having the awareness, maybe being conscious of the fact that you can still be productive when you’re working around certain things, especially when you’re at a camp, right?

MIKE: Absolutely.

COREY: I mean, if you’re not having to compete in six weeks or whatever it is, then hell yeah, you ought to be taking a step back and kind of working on some things so you can actually improve and grow.

MIKE: Yeah.

12:55

COREY: Cool. So aside from — we got a lot of overuse, when guys do actually have traumatic type injuries, so shoulders, elbows, backs, knees, I’m imagining that those are pretty common when it comes to that type of stuff. I mean, let’s say somebody does have something happened, right? Like, somebody’s knee need pops or something like that when they’re rolling or wrestling. What should they do? I mean, what are the steps? I mean, how do you know if it’s real serious? How do you know if it’s not and what do you do from there? What are some good steps that guys can have moving forward if something like that does happen?

MIKE: So this is a tricky one, because I’d be careful about giving medical advice because I don’t know who’s listening. But what I would say is when something happens, it’s good idea to get checked to know how serious it is. Now, I again, this is back to when I was a fighter with no experience, I did have a time where my knee popped and I had no health insurance and I couldn’t afford anything and I panicked and thankfully, it wasn’t that serious and it did get better. But I was also 24 at the time so obviously I was feeling a lot better.

COREY: Yeah.

MIKE The best thing I’d say is get it checked because the thing is, a lot of the injuries, especially if it’s like a knee pop or an ankle pop or something like that, there’s still trauma to the ligaments. So what happens is, if it stays this way, the ligament gets stretched out. Eventually, it’s not gonna hurt anymore. Like it’s why a lot of people when they roll their ankles, they’ve this history of rolling their ankles because the ligament never returned to its full strength because it kept getting old doesn’t hurt anymore. But it’s still stretched out and weak. Same thing with knees and shoulders and that sort of thing. So it’s a good idea to go get it checked, just to make sure you’re dealing with so opposed to, oh you think you’re okay and you’re not and now you’re going to hurt yourself more because let’s say the ligament in your knee is compromised. So now you’re moving funny. And now when you do get hit again, the ligament will get completely torn or something like that.

15:07

COREY: Right on. So if guys do go get checked, I guess what I’m trying to get to is there’s a variety of just like anything, there’s great physical therapist and then there’s guys that maybe aren’t as attuned or attention to details is not there or whatever it may be, they’re maybe not as good. So when guys are looking for a physical therapist [distortion] checked out, how do they know good from bad, quality versus not. I mean there’s a lot of variable out there, right?

MIKE: Yeah. So this is a tough one. But like most things you pay, like, depending on how much money you pay, the better you get. So a lot of times, if you go to a clinic and they’re seeing a high volume of people, that’s usually not a good sign because then they don’t have the time to really check you out. And those type of clinics, they might not necessarily want to give you what you need, they might just want to kind of bring in. So you have to go through this whole thing of PT which might be necessary. But there’s some things — so physical therapy doesn’t have to be, you go in for twice a week for six to eight weeks all the time. Like sometimes it could be just proper education. Like when it comes to some kind of tendinitis or tendinopathy, for me, that’s more of like, I give you education. You come in once a week, once every other week, if you do what you’re supposed to, or good if you don’t do what you’re supposed to, I can’t help you. But it doesn’t always have to be this thing. And that’s what I think a lot of people are worried about is if they go to CPT, they’re gonna get stuck and they’re not going to leave for two months.

COREY: Right.

MIKE: So you want to look at the volume. You want to see what the PT, what their interests are. If they aren’t athletic, they aren’t the person you should really be going to because they don’t understand the demands. So my specialty is mixed martial arts and combat arts and stuff like that. But this works for any athlete. If you’re a runner, and you want to get back to running, you should see a physical therapist who understands running because they’re going to understand the demand.

17:18

COREY: Right.

MIKE: But do you have to have to have a martial arts background for a fighter? Maybe not, but at least if you’re an athlete who understands competition, they’ll get it because a lot of times people might want to rush back too soon. And if you’re an athletic PT, who’s competed, you will be hopefully trained in a lot of return to sport criteria then go likeno, your knee is good,you’re good. You’re clear. If you can’t do this, it’s not a good sign for you to go back to training.

COREY: Yeah.

17:46

MIKE: Certain certifications that I like and these are ones that I have just because they’re a little bit more involved. So I’m a board certified orthopedic specialist. There’s also a sport one, which is there’s like very slight differences, but there is a difference, both of them would be pretty good because that means they went back to school to get more education.

Then we also have some courses I like is I’m a big fan of functional range conditioning. I think that’s really good, especially for finding out if let’s say there’s parts of the body that aren’t working well. I like the selective the SFMA, because that’s a good way to see if people have faulty movement patterns. And one of the things I’ve noticed is that a lot of fighters do have faulty movement patterns because they’re not necessarily great athletes, not all of them. So that’s a good way to kind of catch things early on. So another recommendation — [Interviewer interrupts]

COREY: And what was that SFMA, I’m sorry?

MIKE: The SFMA, it’s theselective functional movement assessment.

COREY: Right on.

MIKE: It’s the next step to the FMS, but on the clinician side, It’s really good about screening out of you watching people move. And then you really break down and see what part of the body is causing them to move faulty.

19:12

COREY: Gotcha. You’re finding the root cause of what’s making a move wrong, or incorrect, or inefficient?

MIKE: Correct, yeah. And a lot of times, when there’s a traumatic injury, some kinds of knee pain, it’s probably because there’s a knee pain. But when there’s an overuse injury, what if they’re coming in for knee pain and because their ankle doesn’t [inaudible]? Right?

COREY: Yeah.

MIKE: So that’s a useful tool for people to look forward just to see if there — again, those are just some education courses that I’ve taken that I found really helpful that I’d recommend. You don’t have to have those to be a good PT, it’s just something that I look for.

19:51

COREY: Right on. That’s great information because the movie hosted Andrea Spina and his whole crew a handful of times at our gym down here and it’s super, it’s very unique number one, I mean, they really did come out with something that the marketplace did not have and did a really good job of making progressions and regressions and stuff like that to really make it I guess the average coach or person that’s wanting to learn or implement those into their program. But it’s a lot different. I remember when going to PT myself and going to a place initially that it’s just a general physical therapy clinic. So their goal was to get me back so I could perform the tasks of regular life. Hey, Cory, go back to work. You can get in and out of your car and you can go up and down the stairs. And I’m like, that’s not good enough. I need to get it back where I can explode and fight and run around and do my stuff athletically versus just being a regular joe going to work.

20:58

MIKE: And something with that that hinders PTs is, it’s not them as a PTs insurance company. So again, if you document the way that you’re supposed to, you write that the insurance would be like, well, they’re good. But if you’re an athlete, that’s not good enough. So for somebody who wants to get back, it’s not a bad idea to find — because there are a lot of physical therapists out there that do cash based PT or consider out of network PT, where it is a little bit more expensive. But again, what they will do is they’re going to spend more time with you. They’re going to figure out what’s going on. And they can educate you and it’s not like you’re going in twice a week for six weeks. Maybe it’s less, but again, some people might need that twice a week, some people don’t. It just depends on the issue.

21:48

COREY: Yeah, of course. Now, Mike, I know that there’s a lot of things, mobility and recovery, especially from an Equipment standpoint has become a pretty big market from massage balls rollers, trigger point guns scam and I like all these different modalities and methods to speed recovery have become very very popular. Is there anything that you’re seeing out there right now that’s just a complete quack or not very beneficial? I mean because this stuff happens a lot right so people don’t know what to believe or where and they might be doing something that’s good and a lot of their time doing things that aren’t beneficial and it’s not really to rag on anyone in particular individually. But I want to make sure that if there are things out there that just really aren’t as efficient and getting people to heal as others. Is there anything that catches your eye that’s I guess one good but on the other side, just kind of like not really beneficial, maybe we’re wasting our time.

22:56

MIKE: This question is kind of tricky because there’s a lot of things that go into it.

COREY: Sure.

COREY: Yeah.

MIKE: So then this becomes tricky because they all have purposes but they’re not always the purpose that a lot of people say that they do, it’s not always correct. So when it comes to soft tissue work, whether it’s through a gun, through a lacrosse ball, through someone’s hands, there’s two mechanisms of really how it works to be able to get it physiologically of what we understand right now. So the science community, we don’t have an accurate understanding of what’s really happening but this is what we think is happening. So when we do any kind of massage, there’s a neuro modulation effect, which essentially what we’re doing is we’re not actually breaking up scar tissue. What we’re doing is we’re convincing the nervous system by stimulating it, that it gives it something else to think about and then things will feel better. So when people say do this to break up scar tissue, that physiologically impossible. If that happened, a surgeon wouldn’t take a scalpel and have to go into do surgery in many cases, but that doesn’t mean it’s not effective, but it doesn’t do what people think it does.

COREY: Okay.

25:10

MIKE: So when it comes to a foam roll, like when I do any kind of foam roll work I have a massage gun, which I do because it makes me temporarily feel better. So if let’s say, I’m feeling tighter, restricted, I might do something just to make me feel a little bit better. But that’s really just given me a small window of, I guess, alleviating some tightness, so then I can do whatever tasks I’m about to do, if that makes sense.

COREY: Sure.

MIKE: Then if you want to look at something — I would say the one modality that I’m not normally a fan of, would be ice stim for athletes. And that’s because East him is the benefits are very local to your getting ice stim and then it’s over and then there’s no more pain relief. Really all it is, it’s like someone gets a bee sting, and then they just rub the bee sting it like feels better temporarily, just because you’re kind of confusing the brain.

COREY: It distracts it, right?

MIKE: Yeah. So if you’re going to a place — now, is there a purpose for it? I mean, what I like for ice stim is it feels good. And then someone comes in and they get treatment and then after they get ice stim, it almost gives them that oh, this is good. I should come back I feel good or it gives them a like a reward. Or if someone if let’s say like you have a really bad injury, and you’ve resting things, resting things like inflammation and you’re laying on the couch and your leg is aching. I’d rather use ice stim and calm things down, then just sit there in pain. But for an athlete who’s kind of recovered between sessions, I don’t know if that really makes a difference.

COREY: Gotcha. Now something that’s also real popular now is ice baths or cryo stuff like that? Do you have any input on either one of those?

MIKE: I don’t have enough research on that, I read some stuff that they’re supposedly if you look at it, there isn’t really a benefit. But I know I’ve used cold bath and physiologically you feel really good after so even if it’s more psychological, that itself is great. I don’t know if it’s doing what they say it’s doing. Again, I think there’s to be more research.

So for some of the cryo stuff we used to pay like $30 a pop like I don’t know if that’s necessarily worth it. Don’t know if it’s really helping.

27:43

Ice bath is probably going to be easier because you don’t need as much stuff. You just need big garbage can and bunch of ice and you’re good to go.

COREY: Yeah, yeah, but then more low tech is sometimes the best.

MIKE: Yeah.

COREY: Well, cool. The last thing I had a question about because I see it popping up all over the place is CBD oils. Do you have any feedback on any of that type of stuff?

28:10

MIKE: I haven’t. I’ve actually talked to a few people who’ve had to try to get their opinion. I don’t have any research or a lot of experience with it. The few people who I’ve asked, who I’ve been working with say it didn’t really help but again, I have to do more research and get more experience to really comment on that.

COREY: Cool, easy, man. But I mean, like I said, it’s just a matter of there’s so much information that’s out there and just trying to get to the bottom of it. And figure out what you’re using with your guys is cool, it’s beneficial. It gives some people some direction at least as far as like we talked about with the overuse versus traumatic, the three main pillars of recovery, nutrition, sleep and load management, just making sure you got that foundational stuff right, working around those overuse injuries and ailments when you can and then some of the things that you’re — the directions you’re given as far as just dealing with traumatic injury and going and getting it checked and then creating a plan moving forward with an athletic type therapist that understands the situation and that’s powerful stuff and just good information. Hopefully a lot of the people that are listening, they’ll be able to gain some insight and have a little bit better experience when they do have these things pop up.

No, I think that’s cool, Mike. For people that are wanting to learn more about what you’re doing and stay in touch with you, Mike, what’s the best way for them to reach out and find you?

MIKE: You can reach me on Instagram. I do have a website that’s almost complete but I mean, essentially what I’m doing is I’m taking some information from Instagram and I put it on the website so it’s easier to sift through because Instagram really isn’t made for what I use it for. But I think Instagram and my website were probably the best.

COREY: Okay cool. And guys, I’ll make sure to put those links down below. Mike, thanks again man, I appreciate you sharing with us and taking the time here to give us some insight and help educate some of these people that are out there [inaudible]. I appreciate it.

MIKE: No problem. Glad to be here.

Episode #89 Dr. MIchael Piekarski, aka Doctor Kickass, Discusses Injuries, Therapy and Improving Recovery for Fighters

Full Transcription of Our Podcast with Dr. Michael Piekarski, aka Doctor Kickass

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