Readaptation of the functional reserves of elite mixed martial arts athletes during long-term rehabilitation after musculoskeletal injuries

Abstract

Purpose. To study the distinctive characteristics of functional reserve readaptation in elite Mixed Martial Arts (MMA) athletes during long-term rehabilitation after musculoskeletal injuries using various physical therapy protocols.

Material & Methods. The study examined 24 elite athletes who sustained musculoskeletal injuries after competitions, predominantly involving the neuromuscular system and limb ligaments. 50 % of the athletes had previously practiced Muay Thai boxing, while the others specialized in Greco-Roman wrestling before MMA. The monitoring of the athletes’ functional reserve readaptation during rehabilitation lasted seven months. The study included four control stages (before injury, and after two, five, and seven months of rehabilitation), each accompanied by a set of test loads designed to evaluate the effectiveness of the readaptation. To assess the adaptive and compensatory responses of the body to the applied loads, a series of blood biomarkers was analyzed, including creatine phosphokinase, lactate dehydrogenase, cortisol, and creatinine. Changes in body composition were tracked using bioimpedance analysis.

Results. The most noticeable signs of adaptation failure in elite MMA athletes occurred during the first two months of rehabilitation. Compared to pre-injury data, both groups of athletes showed a decrease in baseline creatine phosphokinase and creatinine levels. This was accompanied by an increase in lactate dehydrogenase activity in their blood serum, marking a significant drop in the body’s functional reserves and overall resistance. During the three-month rehabilitation period, athletes exhibited only partial signs of functional readaptation, despite the implementation of protocols that significantly differed from standard physical therapy approaches. Moreover, a decrease in blood cortisol concentration in response to physical load was detected in both groups, suggesting a low level of resistance and the need for additional energy supply. During the last eight weeks of the seven-month rehabilitation program, exercises replicating 85-90% of MMA technical skills facilitated both the activation and enhancement of functional readaptation. Modifications to the protocols led to an increase in baseline creatinine and creatine phosphokinase levels, along with a decrease in lactate dehydrogenase activity in both groups. Simultaneously, the changes observed in biochemical blood markers in response to the test loads indicated activation of mechanisms supporting short-term adaptation.

Conclusions. The findings indicate the limited effectiveness of standard physical therapy protocols in supporting the readaptation of functional reserves among elite MMA athletes during long-term rehabilitation. Despite the high resistance of physiological systems to physical loads recorded before injury, the lack of sufficient muscular activity during the five-month rehabilitation period led to the manifestation of compensatory reactions. Restructuring the rehabilitation protocols with adjusted training loads and exercises simulating 75-80% of combat movements positively influenced the athletes’ recovery. The study results helped to identify and analyze the low effectiveness of functional reserve readaptation observed in many elite MMA athletes during long-term rehabilitation after musculoskeletal injuries.