Tony “El Cucuy” Ferguson’s left knee injury and recovery

Tony “El Cucuy” Ferguson’s left knee injury and recovery

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Hey everyone – it’s Raj from 3CB Performance. On April 1st 2018, Tony “El Cucuy” Ferguson
slipped during a promo event in the leadup to his much anticipated lightweight title
match with undefeated Khabib. In the following days and week, Ferguson felt persistent pain
in his left knee but tried to train through it. However, an MRI revealed a completely
ruptured left lateral collateral ligament – LCL – which led to El Cucuy pulling out
of the fight. Three months later he posted a video of himself
doing a “durability test” with seemingly no ill effects from the injury with many MMA
insiders and fans alike wondering how he rehabbed so quickly. To answer that question, I’ll
dig a little deeper starting with the injury itself. The LCL is one of the four major stabilizing
knee ligaments. It’s a cord-like structure that sits on the lateral (outer) aspect of
the knee, starting at the femur (thigh bone) and then ending at your fibula. One fun fact
about the LCL is that it actually inserts into one of the hamstring tendons (the biceps femoris) before reaching final destination. Think of the LCL like a rubber band that’s
tensioned during movement and helps keep the knee within its normal range of motion. Specifically,
the LCL resists “varus” motion and external rotation. When either varus force or external
rotation force – or quite commonly both in combination – is too great, the LCL is overstretched
and fibers tear. In Tony’s case, the slip resulted in all
of the LCL fibers being torn apart aka a full grade 3 rupture. A traumatic mechanism of
injury is the typical profile for a complete LCL rupture. However, isolated LCL ruptures
are extremely rare – less than 2% of all knee injuries. Accordingly, it’s very likely that Tony
also had damage to what’s known as the “posterolateral corner” (PLC) which, in addition to the
LCL, also consists of the popliteus tendon, popliteofibular ligament, and the posterolateral
capsule. Further reinforcing the likelihood of a combination
injury is that isolated LCL ruptures are very very rarely operated on and we know Ferguson
went under the knife in mid April. Following surgery, Ferguson entered into a
grueling rehab process that in the early stages consists of scar mobility… controlling pain and inflammation… restoring full range of motion… Normal gait (walking) mechanics… and low level strength. One method that Ferguson used to control pain
and inflammation is known as cupping. This technique originated in China centuries
ago and you might have first heard about it when Michael Phelps appeared at the Olympics
with huge circles on his back, shoulder blade, and neck. You place little cups on the skin and then
use a device to pull out all the air, purportedly resulting in increased blood flow, muscle
relaxation, and expedited healing Research is very much still up in the air but when
done right by an appropriate medical provider, it’s basically no risk. As rehab progressed, the emphasis shifted
towards higher level strength, power, and endurance, along with balance, proprioception,
and agility – becoming more and more individualized and sport specific with intensity gradually
ramping up. At thirteen weeks, Tony was back to doing
heavily dynamic activities. Many were left saying that he’s either a
“freak of nature” or “he’s rushing his rehab”. Not to be the burster of bubbles
but his rehab timeline fell right in line with the expected 12 to 16 week return to
sport timetable after a combined LCL PLC rupture. At 13 weeks, Ferguson was right at that mark
and then you factor in that he’s an elite athlete with a high level of pre-injury fitness
and excellent care afterwards, and that video didn’t surprise me much at all. Does that video mean he was ready to get back
into the ring at that point? Absolutely not. His rehab progress was a great positive indicator
but the physical and mental stress of an MMA fight is a whole different animal. To that point, he wasn’t cleared to fight
until August after very likely passing numerous more benchmarks and challenges. One of the
last things to subside after a major injury – and this is borne out by the research – is
the fear of movement or re-injury aka kinesiophobia. Ask any athlete who’s come back from major
injury and they’ll talk about getting through the fear and re-building confidence as one
of the toughest hurdles to clear. After being cleared, El Cucuy returned to
the octagon on October 6th 2018 – approximately six months post injury – against Anthony Pettis,
beating him in round 2. That timeline of six months would be more than enough time to complete
rehab effectively and get ready for the fight. If Tony had any deficits, it was likely his
physical endurance rather than knee related. He hasn’t shown any signs of slowing down
since and I’m looking forward to seeing him continue on his current streak of 12 unbeaten. And maybe one day we’ll actually get to
see that showdown with Khabib. That’s a wrap for this video. Thanks for
watching. My goal is to provide you with in-depth, evidence based, narrative free analysis and
you can always find me on IG and Twitter @3CBPerformance. Make sure to sub to the channel for the latest
updates. 3CB out.

6 thoughts on “Tony “El Cucuy” Ferguson’s left knee injury and recovery”

  1. Awesome video! I remember hearing his lcl had not just ruptured, but had actually detached from the bone. Does this make any difference to recovery time compared with a ligament that rips in the middle?

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