Ultimate Fighting champion Anderson Silva delivers kicks so vicious they have ended careers. Unfortunately, Silva's own career took a detour when he broke both bones of his lower leg after landing a kick to Chris Weidman's tibia.
Recovery from leg fractures, like all injuries, is a challenge with its own set of complications. As the 38-year-old Silva starts the healing process, training will likely be far down his list of priorities.
Dr. Steven Sanders, the surgeon who inserted a titanium rod to stabilize Silva's broken tibia, gave his patient a recovery timetable of three to six months. Dr. Sanders said Silva could resume training as early as six to nine months and that once healed, the bone would be back at its original strength.
After the fracture heals, you can test the soft tissue, which is tricky because it includes skin, fascia, muscle, tendon and joint capsule.
Silva's kick is powerful, but this particular kick landed with the smaller end of Silva's shin catching Weidman on the tibial plateau with his leg bent. Its position stabilized Weidman's leg, and Silva got the worst of the hit.
Silva avoided some of the early complications that can come with this injury. The skin never broke, which would have raised his risk of infection. Also, he had no initial artery or nerve damage, both of which can occur when both bones break and the soft tissue twists in a low-leg fracture.
Corey Hill, a UFC fighter who sustained the same kind of injury, described the pain as an "absolute, indescribable feeling." He tells people, "Find a steel pole and just give it the hardest [kick] you can—your best round kick to that pole. Literally. Don't pull up. Try to kick through the pole. That will be less than half of the actual pain you'll have. It's just horrendous."
But that is just the beginning. The fracture recovery doesn't begin until after surgery, which comes with its own pain. Immediately after surgery, you must lie face up, elevate and ice the leg, rest, and take pain meds.
Silva should be able to bear weight within a few weeks while on crutches. He will have a titanium rod in his tibia forever, along with other repairs to his fibula.
Theoretically these parts of the bone should be strong, but areas above and below the rod are still at risk.
When the incisions heal, scar tissue forms in the superficial skin, the fascia, tendon and some muscles. Scar tissue is neither explosive nor pliable. It must be aggressively manipulated to restore as much mobility as possible. This all falls under that three-to-six-month healing period.
It took Hill a little over a year to return to fighting. If it takes Silva a year, he will be 39 years old. Getting back to top form at that age will be difficult.
Swelling can prolong full recovery. When the lower leg is swollen, it is more painful, stiffer and weaker. Treatment to reduce swelling includes elevating the leg above the heart, lightly moving the ankle for blood flow, and massage. Once the incisions are healed, it helps to get into a pool to allow hydrostatic pressure and electrical modalities or ultrasound to move the fluid. This all helps, but gravity is constantly inhibiting your progress when you're doing simple tasks like going to the store, eating meals and showering.
Early recovery conditioning
With a lower-leg injury, once swelling and pain go away, most athletes are in a walking boot. Once you can bear weight and safely move around in a weight room, it's time to begin upper extremity exercise. To ensure safety and prevent an accidental re-injury, a training partner is a must.
Conditioning can take place throughout the process. Performing reps at a constant rate with low resistance is a good way to begin.
- Cable column exercises—Curls, Press Downs, Lat Pulls, Seated Rows, Rotator Cuff Work
- Seated Dumbbell Presses
- Flat Bench Pressing
- Incline Bench Pressing
- Single-Leg Press
- Single-Leg Bridge
For the exercises below, progress to doing them with Swiss Ball variations, TRX straps and rings as your strength improves.
- Planks with one leg on the ground
- Hanging Leg Lifts with legs bent
- Hanging Leg Lifts with legs straight
The key to performing these exercises is to maintain your weight-bearing status, whether it's non-weight-bearing, partial weight-bearing with crutches or full weight-bearing in a boot. Get help with carrying plates or dumbbells, getting off the pull-up bar and changing position, as needed. Be aware of increased swelling, which can slow the healing process.
Mobility and movement
Restoring movement to the injured area requires a combination of treatments, including caring for the flexibility of the ankle musculature and mobility of the joint. The knee may stiffen up along with the quads and hamstrings, requiring restoration as well.
Skilled hands can start the process with massage, joint mobilization and stretching techniques.
Next, bodyweight mobility exercises can be incorporated. Squats with different foot positions are great for rehabbing lower-body injuries.
Overhead Squats with a kettlebell are good for challenging lower-body mobility.
Kettlebell Swings restore functional mobility to the hips as well.
Yoga is another necessity for an athlete like Silva, who must contort his body to meet the demands of his sport.
Strength and power
After the three-month mark, you can begin strength training in earnest.
- Deadlifting high reps to low to develop strength
- Squatting variations - box, wide stance, standard, split stance
- Lunges - Perform in multiple planes of movement with goblet variations, dumbbell holds and barbells
- Single-leg training - Bulgarian Split Squats, Good Mornings, Romanian Deadlifts
- Plyometrics - Box Jumps, Single-Leg Jumps, Jump Rope, Depth Jumps performed at maximum effort with progression to wearing a weighted vest.
The progression should go from water or anti-gravity–such as on an AlterG Treadmill—to jogging on a treadmill (to control speed safely), to running outside on a track, to sprinting and finally to performing high-speed change-of-direction movements.
Training for the octagon
Once optimal strength and mobility have been restored, it should be possible to test the leg's ability to withstand contact and the rigors of the Octagon.
- Heavy bag training
- Grappling to challenge the bone's strength and the pain threshold
- Wave training with heavy ropes
- Sled Drags
- Prowler Pushes
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