The Doctor Jiu Jitsu Show

From the Cage to the OR: Dr. Lucius Pomerantz on Combat Sports Injuries & Recovery

• Doctor Jiu Jitsu • Season 1 • Episode 8

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In this episode, I sit down with Dr. M. Lucius Pomerantz—fellow orthopedic surgeon, black belt in Brazilian Jiu Jitsu, and lifestyle medicine expert—to dive deep into the fascinating intersection of combat sports, injury, recovery, and longevity. We talk about what pulls high-performing doctors into such a physically intense world, and why so many of us can’t resist the challenge and community of Jiu Jitsu despite the inevitable injuries. We get real about the toll this sport takes on the body, the psychological rollercoaster of recovery, and the difference it makes to be treated by a physician who truly gets what you’re going through. 

 

Episode Highlights:

[0:12] Kicking off with Dr. Pomerantz—how we both ended up surgeons who also love getting wrecked on the mats.
[2:48] Why orthopedic surgery is addictively satisfying, and how the stress of perfectionism weighs on us.
[5:20] What draws doctors to combat sports even though it’s a surefire way to get injured.
[8:22] Fighting MMA during residency and what that dynamic looked like with attendings and co-residents.
[10:27] Getting hospitalized from pushing too hard—when the body says “no more”.
[11:40] The most common hand injuries we see in combat athletes and why buddy taping is life.
[14:28] Coolest injuries we’ve treated and the emotional weight behind what stays with us.
[18:17] Lucius’s own pec tear—what it felt like, and how it forced him to face life off the mats.
[25:01] How being injured changed the way we treat our own patients.
[30:16] The harsh truths of ACL recovery and the mental game behind getting back.
[34:04] Why we don’t tell athletes “just stop” and how community and understanding matter in care.
[35:30] Advice for young athletes on recovery and managing ego.
[40:23] Advice for the 40+ crowd who want to keep training without breaking themselves.
[43:38] Learning body awareness and ego management for true longevity in combat sports.

 

Links & Resources:

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To learn more about Dr. Megan Jimenez, check out her website: doctorjiujitsu.com

David White:

This is Dr jujitsu. Your go to podcast for combat sports, military performance, injury prevention and treatment now. Here's your bad ass host, Dr Megan Jimenez, bow to your sensei. I'm

Dr. Megan Jimenez:

here with Dr Pomerantz Lucius. He is a black belt in jujitsu and orthopedic surgeon like myself, so we both enjoy hurting ourselves, and then going to work and treating people that hurt themselves. He's also certified in lifestyle medicine, which we're going to talk about a little bit as the interview goes. He is a hand surgeon specializing in the upper extremity, and we're going to talk a little bit about why doctors get pulled into orthopedics in particular, or why doctors get pulled into jiu jitsu in particular. Why? Other doctors of surgeons, everybody gets pulled into this sport when it's so injury prone. Yeah. So thanks for coming on. Thanks for having me. Great. Yeah. Okay, so why don't you talk a little bit about what pulled you into orthopedics and what pulled you into combat sports? Sure, you

M. Lucius Pomerantz:

know the parallel tracks and you know, in the world of orthopedic surgery, it's a lot of the jocks, the people who end up going to medicine, but played sports growing up, that tends to be the trend towards orthopedic surgery. And I was definitely that kid growing up playing sports. I never had the catastrophic injury, which is usually the catalyst of when some kid has a surgery, and then they learn about orthopedic surgery, and then that's what they do. I didn't have that, but I think that's kind of part of what pulled me into it, sports medicine, maybe, you know, that kind of intrigued me. But was funny, as I was going through medical school, which took me a while to decide that I actually wanted to do medical school, but decided I thought I was going to do emergency medicine, sure of it. And everyone's like, No, you're going to be an orthopedic surgeon. I'm like, I don't even know what that is. I'm not gonna, you're not gonna fit me into that peg or a hole. Like, I'm not, I don't know what that is. I'm not gonna be a surgeon. They're assholes. And then I did my first rotation of orthopedic surgery and realized,

Dr. Megan Jimenez:

yeah, I'm an asshole.

M. Lucius Pomerantz:

And, you know, yes. And putting things together, you know, with your hands. Got tools, you got drills, you got hammers, you got screws, you got the ability to give someone the chance to go back to the things they really like doing. You know, me being an athlete, seeing other people want to do things like that, and I can do that for them. That's awesome. Yeah, it's funny.

Dr. Megan Jimenez:

You say that about, like, emergency medicine and not wanting to go into orthopedics. I did the same thing. I thought I was going to be emergency medicine or family medicine, then do a sports medicine, like, one year fellowship, but then not operate right, and be a non op sports doc. But once I got into the operating room, I was like, damn it, yeah, because it's a competitive field, and it's a lot of years and and then you're a surgeon, and now it's, it's still a lot of hours, and it's, it's not right, it's not easy,

M. Lucius Pomerantz:

it's a lot of work. There's a lot of responsibility that goes along with it. But there's so few things in medicine where you get the chance to do something, do something, and see pretty immediate results. You know, sure, you know the little lady with the broken hip fix it they're walking the next day. That is incredible. And there's those opportunities that you get in orthopedic surgery that really isn't anywhere else. And you know, life and death is not a big thing in orthopedic surgery. It's function and all that kind of stuff. And so you're not having to deal with the sickest of the sick and dealing with those things, which is also not, depending on

Dr. Megan Jimenez:

which one you go into, like your and, and I'm sports surgeon, so we have a little bit is a little bit stressed too, because it's trauma. I always joke trauma like, you can't really make them worse, right? People come in they've been run over by train, or in the army, something's blown up, or they've been shot, and you're like, Okay, I can most likely make you better. But in sports, in hand, they were already at a very top level. A lot of times, you know, you're doing hand for combat, and you have to get them back there. So it's pretty stressful, sure,

M. Lucius Pomerantz:

sure, it's definitely stressful. And I think a lot of us are maybe not perfectionist, but we expect a lot of ourselves, and we expect our we expect to be able to get patients to a very high level. And when that doesn't happen, it's hard. That weighs on, I think all of us and and so, yeah, those trauma situations were like, you know, I didn't shoot the guy in the arm, but I'm going to put it back together. Yeah, there's a little less stress, but at the same time, you want to do as good a job as you can. But yeah, then there's, then there's the treating athlete who performing an incredibly high level tears their ACL, yeah, the Special Forces soldier. The government has put a lot of money and time and investment in getting them to be elite, and you got to get them back out there. And so there's that stress.

Dr. Megan Jimenez:

And they're young, and they're young, and they were already at a very high level, and and, or like a multi leg, that's one of the worst to me, because the percentage of return is so low, especially back to that level. I mean, so many injuries are it's not perfect, like 70% 80% return. And if you're in that other. Year, like quarter, quarter, it's, it's really hard to see.

M. Lucius Pomerantz:

It is, it is. And, yeah, there is a failure rate. You could be the best surgeon in the world. No, it's not a hard percent. You're gonna have failure rates, and it's hard and, all

Dr. Megan Jimenez:

right, so why combat sports when you're a doctor? Yeah, protecting your hands, right?

M. Lucius Pomerantz:

So combat sports is kind of interesting. Being into sports. Growing up, I was a very late bloomer. We were kind of talking about this a little bit. I was really small, but I had some athletic ability. But as people started growing in high school, when I was way smaller than people, it just got really hard. Couldn't play football. I was getting smashed soccer. I was, you know, people were just faster, stronger than me. But and there was wrestling with weight classes, like, oh, okay, even then, I didn't fit the lowest weight class in high school until I was a junior really. I was really small. I didn't have to cut weight until junior year. But 105 the lowest, lowest, yeah, 103 and then at the end of the season, there'd be an allowance for a couple pounds by the end of the year. And so, but yeah, 103105 and I broke 100 pounds as a sophomore standing on the scale. Oh yeah. I was eating a banana, still wearing my warm ups, and I broke triple digits. I could see triple digits on the scale. That was a landmark for me. But yeah, weight classes and so wrestling, and I was okay at it. I enjoyed it. There was something fun about trying to beat somebody. And it wasn't out of violence. It wasn't a, you know, wanting to hurt someone at all. It was just this, I think, a primal satisfaction of figuring out where you are in this hierarchy of athletics that is very direct. There's no hiding. It's you and another person. There's no balls, there's no other equipment. It's just you and another person, and the best person wins. And there's just something that I liked about it. Then the next leap for me was being very fortunate growing up in Santa Cruz, high level Brazilian Jiu Jitsu black belt from Brazil, Claudio Franca, ends up in Santa Cruz. My wrestling coach, Garth Taylor, starts doing it. And towards the end of high school, he's like, Hey, man, you should, you should try out Jiu Jitsu. Okay, yeah, you know, like, let's try it out. And that turned into me doing Jiu Jitsu, and at the time, then in early 2000s the Venn diagram of jiu jitsu guys and MMA guys was a lot of overlap. And so did MMA start making friends with guys who are doing MMA, and they're like, hey, we'll get you in a fight. Okay, I'll do that. Sure. Try it out. And I guess a common theme through all this was, was just wanting to see if I had it. You know, there's a lot of people, oh, well, you know I could do that. If you know, I wanted to see if I could and, and, well, I did it. And maybe I wasn't the best in the world, but I did it. I was out there, tested myself, I trained hard. I learned more about myself along the way, my limitations, my strengths, and all in all, it was a rewarding experience. I'm very glad I did combat sports along with while doing all this and

Dr. Megan Jimenez:

you were fighting during residency, I

M. Lucius Pomerantz:

did my second and last MMA fight as a resident. So

Dr. Megan Jimenez:

how, how was that? How was the dynamic with your attending, co residents? Yeah, it

M. Lucius Pomerantz:

was, you know, so the world of orthopedics, one of the reasons, kind of why I knew it was for me, was a lot of other doctors, if you're on a rotation on pediatric, pediatrics or something, the attending would be horrified to hear that I was fighting people, whereas in orthopedics, they'd be like, Oh, okay, just be careful your hands, you know, that kind of thing. And it's like, all right, I vibe well with these people. And I kind of joke that I got into residency because I did this sort of stuff. The chief resident at the time had me and one of the other medical students on, on the sub internship. I have a wrestling match on, oh my god, on the front line of the medical school

Dr. Megan Jimenez:

cafeteria. That's probably illegal now, probably,

M. Lucius Pomerantz:

probably it was even back then, probably not the correct thing to do. But in 2007 you know, but I got the better of them, and I got decent board scores and got a spot. I got a spot in residency. And so people kind of knew that that was a thing I did. They weren't surprised. But again, it was like, Hey, be careful your hands, and as long as you're doing what you we expect you to do during residency. Like, hey, you know, do it. I always wanted to get a third fight in, but I couldn't. I got sick. I ended up in the hospital, and that was the combination of residency. The hours were just getting to be crazy. I was cutting weight and just the stress. Of everything, and got an infection, staph infection on my face, ended up hospitalized. And what was interesting is my white count. When they measure my labs, usually young, healthy person would be high, elevated. When you've got an infection, I was nutrients low, and so they were had cancer or whatever. But it's like, no, your immune system just so I just Yeah, between not eating, not sleeping and training a lot. Yeah, essentially,

Dr. Megan Jimenez:

working two jobs, pretty much two full time jobs, if not more than full time,

M. Lucius Pomerantz:

working out, certainly twice a day, and working out more than I was sleeping. And when you're young, you think you can handle it, but, you

Dr. Megan Jimenez:

know, the crazy part is, you probably can, but then you kind of pay for it as the time goes on, I think, to

M. Lucius Pomerantz:

a point and you find your limitations. I mean, during residency, there's the work hours, stuff like that, you know, limit you to 80 hours a week, whatever it is these days. And as a resident, you're like, yeah, they should limit to us. And there should be some sort of limit. I guess you could easily abuse these young doctors, but you also need to find out what you can do and when you're out in the real world. And Geez, you're gonna be in even more adverse conditions at times, sleep deprived, overworked, tired. You gotta know that you can do it, yeah, that you can still do what you need to do. And during residence, you've got a safety net, usually, hopefully, but you got to be able to do things when you're tired and not at your best.

Dr. Megan Jimenez:

Yeah, all right, let's switch gears a little bit to what you do as a surgeon. What kinds of hand injuries, upper trim injuries, are you mostly seeing in combat athletes,

M. Lucius Pomerantz:

the combat athletes with hand and wrist injuries. I mean metacarpal fractures. You know, the boxers fracture is by far kind of the most common thing. Fortunately, most of those don't require surgery. But sometimes people break more than one bone, or they break into place where, okay, you know, that's not ideal. And often, you know, the guys in the middle of fight will break their hand, and they keep punching with that hand, and what might not have been that bad of a fracture turns into an open fracture, or just really rotates it or displaces it. And so metacarpal fractures are definitely, probably the most common thing Jiu Jitsu, hard on the fingers, and especially in the ghee, and so fingers getting twisted, and sometimes it's just a bad sprain, but you get the phalangeal fractures. Sometimes it rotates all the way down to the metacarpal and they get the little bones, the little finger bones, the little little finger bones that are, you know, you could swallow them if you needed to. Yeah, they're the tiny finger bones, and it's pretty amazing what our hands can do, but the forces that they see when we're punching and grabbing and throwing people can exceed what they can handle sometimes. And I've

Dr. Megan Jimenez:

seen you wear the these little gloves, yeah? And they kind of make you look like, I don't know where, like Star Trek,

M. Lucius Pomerantz:

depends on the generation of the person, yeah, so the Spock hand buddy taping. I'm a big believer in buddy taping.

Dr. Megan Jimenez:

They're just taping, like, putting two pieces of tape, yeah? Always, when you train NoGi,

M. Lucius Pomerantz:

always, always, buddy tape my fingers. Just it keeps any one finger from being isolated. Do you tape underneath those gloves, one or the other? This is just a convenience that is nice. They're nice. Them on and off. Just slide them on, throw them in the wash, and they hold up pretty good. So that's what I've been I've been probably doing that for seven, eight years.

Dr. Megan Jimenez:

Even, has it caught on at all, or does everybody just make fun? No.

M. Lucius Pomerantz:

People kind of like, oh, I don't know about that. And then they hurt their finger. No. Like, like, Oh, okay. And then, like, you know, you could wear them after an injury, but it's best to worm before, yep. And then, just as a hand surgeon, I'm just hyper aware of

Dr. Megan Jimenez:

so like dislocating a finger or spraining something, and I've seen people at my gyms buddy tape the wrong fingers together, right so they, like sprained their middle finger and they put it to their ring, but then you're exposing your your index and your small is that anything you find

M. Lucius Pomerantz:

it mean the gloves that I get, the these grabs gloves, they do have a variation that will put the middle to the ring, but it kind of depends on what ligament was sprained, and it kind of depends on what you're doing. But yeah, the just the middle to ring leaves the small and the index finger out fine. And yeah, without a buddy for me, prevention, I want them to have buddies. Yeah, very

Dr. Megan Jimenez:

cool. What's the coolest injury you've ever treated combat athlete or not?

M. Lucius Pomerantz:

So I guess you probably know, when we get into injuries, you know, you've had those cases that just go great, like, oh, I nailed that. Then that bone came together, perfect. Can't even see the fracture line is just beautiful, and those are great, but you kind of forget about them, or they blur together and you remember they're either the ones that had a big or interesting story around it or didn't go well. So I mean, I guess the ones that stick in my mind the most are. Are, I mean, just the traumas, you know, the story behind it. And it's not necessarily combat sports, real world combat, you know, knife fights and stuff like that, horrible stories of that kind of stuff that sink in and and, you know the story behind it, and you do what you can to put them together, but, yeah, it's, it's kind of a bummer that the good cases, the ones that go really well, just kind of like, yeah, all right, that's how it's supposed to go. And you don't remember,

Dr. Megan Jimenez:

and it's the majority of them, yeah,

M. Lucius Pomerantz:

yeah, you know. So it's unfortunately rare when one really sticks out. But at the same time, it'd be nice to reward ourselves with the ones that, yeah, we did good, you know. But I don't know. It's the nature of, I guess who we are. I guess where you're gonna remember the bad more than you remember the good. Man. Yeah,

Dr. Megan Jimenez:

what's so? What's the best one you've

M. Lucius Pomerantz:

ever done? Recency bias. You know, the guy who in a fight breaks two metacarpals and you know, it's pretty bad. Definitely needs surgery. And he's a boxer, and he wants to get back to into things he's got he would like to fight in the next two months. You're like, All right, okay, you know, is that? Is that reasonable, I think, and by using the technique of putting these now, these screws, these nails, down the center of the bones. It's pretty quick surgery too. You don't have to screw in six different screws for each metacarpal, and that just takes extra time. And you can do it through these little, tiny incisions over the knuckles. And so, you know, the whole case takes a half hour. Both bones fixed. Don't even have to put them in a cast afterwards. You let them move right away. And recently, saw him back at six weeks and actually healed. He's moving pretty well. And it's like, all right, you know, you got two weeks to feel like your hands strong, if you want to, you want to try to fight. I'm okay with it, yeah. And so, yeah, that that's so started.

Dr. Megan Jimenez:

He started punching. It. Did he go fight? I will hear soon,

M. Lucius Pomerantz:

yeah. I hope it all went

Dr. Megan Jimenez:

well, but when would you let them start striking again? Usually,

M. Lucius Pomerantz:

if it's not a rush, ideally at six weeks, I'm okay with doing light pad work the speed bag, maybe working with their trainer, doing light pads. Kind of at the two month mark, we can start doing something heavier, as long as there's not pain, and then where there's unpredictable things with sparring and stuff like that, I try to try to get them to go full go at 12 weeks, but obviously, obviously, can be accelerated, and the bones can probably handle it at eight weeks. Certainly, I think it's safe. But you know, they may not have their strength or full range of motion yet, depending on how the rehab is going, but with that way of fixing it, you can get them moving right away and get them that much further down the road faster, so

Dr. Megan Jimenez:

cool, quicker than a lot of the surgeries I do. Well,

M. Lucius Pomerantz:

yeah, the ACL or you can't speed it cannot, cannot rush biology, as they say, and turning this tendon into a ligament, and all the stuff that goes along with that just takes the body time. Yeah? And it can be frustrating for the patient and the surgeon before you're like, Yeah, I know you feel good. Well,

Dr. Megan Jimenez:

not ready yet, but what is the worst injury that you've had,

M. Lucius Pomerantz:

that I've personally had? Well, my pec tour, yeah, and that was almost a year and a half ago, and I, you know, 25 years of combat sports between wrestling and jiu jitsu and MMA, and, you know, there was definitely some scrapes and nicks and, you know, maybe I'd partially torn my ACL at some point, but I got back to things. But this was the first time I had to go into the knife myself, and it was just a freak accident, you know, rolling with a guy that we'd rolled together a bunch, and he was very good, and we were going after it, and didn't want him to get behind me, cow catcher, kind of armed behind me, and pow, eccentrically loaded by Peck and

Dr. Megan Jimenez:

three, kind of like turtle type position, and he was trying To spin, yeah,

M. Lucius Pomerantz:

it was more of a scramble, yeah. And, you know, he had gone for a guillotine, and I spun out of it. And the way I was spinning out of it, he was going to try to get behind me. And so I got my arm out, and he was moving fast. And

Dr. Megan Jimenez:

just the pull, just the pull, so big pop.

M. Lucius Pomerantz:

Yep, it popped. He stopped right away because he heard it, and I stopped right away because I felt it. And being a surgeon that fixes this, this problem, you know, you kind of know right away, like, oh, that's what that feels like. That hurt a lot. There wasn't a lot of pain is. It was something like, Ow, you know, okay. But then you start getting this cramping sensation. You're like, Oh no, and you try to flex, and you know it's just not working, right. And you just like, Oh no, yeah. And it wasn't. Is more of like, the pride of or the the ego and all that kind of stuff, and knowing that there's gonna be a rehab process, and you just don't want to do that as

Dr. Megan Jimenez:

a surgeon, you go through. Everything right, as soon as it happens, you, you go through the whole process in your head.

M. Lucius Pomerantz:

And, you know, I know you've been through it yourself with surgeries, and, yeah, you just kind of know immediately, oh well, this is what this means. I'm, I'm out for a little bit. I'm out for a while. Yeah, and, and it's, it's frustrating. And you know, what was particularly frustrating at that time is just jiu jitsu had become, in hindsight, outsized in importance in life. I was training a lot and, you know, just a lot of stuff going on in life, but I was doing a lot of Jiu Jitsu. I was feeling good with my Jiu Jitsu, and I was even thinking about competing again. I was in great shape, and not dealing with a lot of other things that I should have been dealing with in life and and so when my pec went is immediately having to then encounter all of those things that I had been neglecting, which was also probably good in hindsight, but at the same time, made it that much worse.

Dr. Megan Jimenez:

It seems like injuries come when you need a break from something. That's what I've noticed. It's like, oh, you needed to take a break, like you needed to, yeah, let your body heal a little bit. There is

M. Lucius Pomerantz:

something you've said about recovery and and, I mean, we, we tell our patients, you got to rest, you got to give yourself time to recover. You got to do that stuff. But as surgeons, you know we, we you know we're taught. You know, if you, if you stop moving, you're gonna die. You know you're a shark. You know, if you, you know, you go, you go, you go, you go, you go, and and we just embrace that in everything. And, yeah, it's a lesson. You wish you didn't have to go through a big setback to learn it. But was

Dr. Megan Jimenez:

there a lot of regret when it happened? Like I shouldn't have trained today. Oh, I was tired. Oh yeah, there's

M. Lucius Pomerantz:

those thoughts that have crossed across your mind. And because I was thinking about competing again, I was starting to lift weights now. I was debating which weight class I was going to be in. I was going to try to bulk up a little bit to fit the weight class a little better. And so I don't usually lift heavy before Jiu Jitsu, and this time I had done some heavy deadlifts, and, you know, like, oh, maybe I was neuromuscular fatigued, and I just, you know, my body didn't respond the way it usually would have. And you think about all these things. And of course, the people my training partner who did it to me, of course, he's got regrets, something different, yeah, and the person who paired us up, because it wasn't the plan to go hard at that moment, but the guy paired us up, and he's like, I shouldn't have done that, you know? So everyone feels bad.

Dr. Megan Jimenez:

That's how injuries are. Every injury I've had, it's like regret, right? Immediate. And I've had injuries from not tapping, so that's a much deeper type of regret, because it's, it's really my fault, right? And so when those happen, it's like, man, and you have to learn that way, like an ACL tear, and then you have, you're almost a year out of the sport because you had to learn a lesson. Yeah, you didn't tap, right?

M. Lucius Pomerantz:

The not tapping is thing, but it's interesting. You know, you're in the thick of it, you know the technique. You know you're technically in trouble, but you're in competition. You don't want to lose adrenaline. You don't feel it, yeah, with foot locks, you especially, you know that's always the danger is you just don't feel until it's too late. And it's a lesson. I'm sure we both wish we didn't have to learn, but a

Dr. Megan Jimenez:

lot of people do, right? Like I had, I treated somebody for a UCL like that, Tommy John elbow procedure recently, and he's a Special Forces guy. And I said, How'd you do it? And I said, Let me guess You train jiu jitsu, don't you? He's like, arm bar and competition, yeah. And I've had like, three of them ever since, and they're all in the military, and just nobody wants to tap one of my financial advisors, rotator cuff tear. He's like, 60 or like 50 years old, and he's like, I was showing my kids I could be tough in a comp, in like, a Naga. And he's like, I didn't tap his arms red behind his back, rotator cuff tear. Never went back to jujitsu.

M. Lucius Pomerantz:

Yeah, that's where it's bummer if you never get back. But it is funny, you know, this, this inherent thing, you know, and I talked about kind of the primal satisfaction I was getting from wrestling. And there is something I think, in all of us, where a 50 year old accountant is willing to get hurt over a$10 medal, it's and you're paying, you're paying to participate in that tournament, and you might get this medal that is not worth as much as you spent to Register. But there is just something in us, I think, and combat sports is an outlet for that. And you think about like, oh, man, if I if I hadn't been doing Jiu Jitsu, I wouldn't have tore my pack, or, you know, maybe my knee wouldn't hurt or but at the same time, I think of all the stuff that I have done and I've learned about myself and the people I've met, and that just who I am is because I've done these things, and it's worth it's totally worth it. So that PEC tear, all right? Bummer. Lessons Learned. Lessons Learned. But I'm back into it. I learned I could come back from it. You know? That was, that was an obstacle I had never had to overcome before. I had never had to come. Back from a surgery. I bet

Dr. Megan Jimenez:

you also treat patients differently. Now for that injury in particular, there is, yes,

M. Lucius Pomerantz:

I have, I have so much respect for the people who can come back and reach the level they were at before and continue doing it, because it is really hard to do the rehab and come back and then, I mean, my injury is not nearly an ACL.

Dr. Megan Jimenez:

Those are PEC stuff too, you know? I mean, you know, I recently threw my biceps and I had surgery for that, but it's been smooth, like the surgery barely hurt the I kind of wish it hurt, because now I'm like, Yeah, because I'm like, it doesn't really hurt. Let's go peloton like a maniac. Let's go lift the laptop, and then I try to lift heavy on the other side, and your right side, when you lift on the left, the right side starts contracting. And I'm like, Oh, you gotta settle it down, right? But this now I see my patients who had the procedure I had, which is putting the biceps back to the bone and and they're crying. And like, I had one of my army guys come in. I was two days out of surgery seeing patients. He was three weeks out. He's like, Doc, it hurts. I literally looked at him and I said, grow a pair. There's that,

M. Lucius Pomerantz:

you know. So while I have that much more respect for the people who get through it and return to all the things that are before doing before i i now have a harder time on those patients that don't make the recovery that you would expect. And I guess, you know, could I done something different about their surgery? But at the same time, you know, it's a surgery you do perhaps hundreds of times. You know how people are supposed to go and they don't. This particular patient doesn't do it. Why and why, like, and it's, you know, you know. So, yeah, you know, I didn't use pain, Medic, Tylenol, naproxen, yeah. And I, if it wasn't Thanksgiving right after my surgery, I would have been back back to work, like, two days later. And and then these people who have a surgery, that's really not that big of a deal, and it's still three months later and they don't want to go back to work, and it's like, well, this isn't on me. This is you, yeah, and that's that much harder for me. Yeah, I'll tell you

Dr. Megan Jimenez:

the shoulder versus knee thing. Everybody's asking me, like, how does it compare to an ACL? And granted, it wasn't a rotator cuff. Which rotator cuffs? When I see my patients, it looks miserable, like people get stiff, it seems very painful. This is nothing near that. But I don't wish an ACL like on my worst enemy, not that I think I have enemies. But yeah, it the recovery for a knee surgery is more mentally draining than physical and the the amount of recovery you have, like a rehab you have to put into it, it's like a daily thing, and you're on crutches and you're swelling. The shoulder doesn't swell as much. You could still walk. We were saying you could still walk around and do everything, but the knee is a different beast. Getting the motion back in that thing, and just the mental aspect is the hardest part. Like you're crying, you're depressed because you're not doing what you want to do. And, you know, it's another year, right? So,

M. Lucius Pomerantz:

yeah, no, the pardon and the mental side, and kind of certainly as orthopedic surgeons, we we put things back together and go, go do rehab. All that matters is PT, yeah, yeah, do the PT, but there is a huge mental component to it. And you can probably sense that patient comes in before surgery and they're just so anxious, you kind of already know, like, oh man, they're gonna need a lot of hand holding therapy. Is gonna have to work that much harder just to get them to start moving. You know, this is going to be a longer road for them, whereas, you know, then you see a combat sports athlete who's motivated and like might go, you're gonna go, okay, look, you're gonna have to take it easy. You cannot do certain things for however long you're gonna say. And it's, it's interesting how you have to factor these things in, and it's the mentality, the mental side of these patients that you really have to factor in. I've

Dr. Megan Jimenez:

noticed a lot of the younger females, like maybe high school volleyball, high school basketball, and males too, like these young kids, they really struggle. A lot of them mentally because, like, all their friends are doing things and hanging out, and then they're so nervous about re injury. And I think everyone's nervous about re injury, maybe not. Some of the combat athletes, they're like, let's go. And I talked to Paige Yvette a little earlier today, and she's on the podcast too, and she was just like, I was committed to get back at six months. She's like, I went on Google and I saw people getting back at six months. And I was like, How'd that work out, you know? And she's just like, yeah, there's no way. Like, there's just not and she had really good coaches like J flow telling her, you're not allowed here until nine months. And, you know, time in my opinion, and I think a lot of PTS have said the time is a soft, soft recommendation, yeah, right after a surgery, I say the earliest is nine months, but really, at a sale, you're a year, right? Like, maybe nine months, you're back to doing things, but you're still nervous and you're still easing in and like, you're not gonna, or you should not be competing at nine months, right? Like, very, very rare situations, very rare,

M. Lucius Pomerantz:

exceptionally rare. Yeah, you know, even to. Into professional sports a year being 100% at a year extremely hard to do. And unfortunately, there's stuff out there on the internet that perhaps convinces people that it can happen sooner. And that's a battle to fight too,

Dr. Megan Jimenez:

because some people do go back and get lucky, right? Yeah, so of course, there's like, that one outlier,

M. Lucius Pomerantz:

right? Yeah, the one outlier. Who you for? Who knows what reason did extremely well. You know, maybe it's their genes. Maybe they just got lucky. Maybe there's something else going on.

Dr. Megan Jimenez:

My favorite is smoking. Like, when people smoke and they're like, Yeah, my grandma smoked till she was 90, like, she lived forever. I was like, that is the outlier. Guys

M. Lucius Pomerantz:

like, yeah, yes. It's clear that smoking is not good for you. It shortens your life. Maybe your grandma would have made it 205 Yeah, maybe. So, yeah, the and, you know, just the information that's out there. There's so much information that's out there, and, you know, we have to embrace that there. That's how people are going to get their information. And you know, instead of, you know, the respect for experts perhaps being diminished, perhaps people are going to get their they're going to get their information, they're going to do their own research, and that's fine, but having to balance kind of what the expectations are, because they're doing that, and what you know is the truth, and it's a new dynamic of having to balance those things. And

Dr. Megan Jimenez:

that's also kind of why I started this podcast, right? I was an orthopedic surgeon, and I trained Jiu Jitsu. I'm having you here, orthopedic surgeon, train jujitsu, and it's such a different thing to have a doctor who's in the sport knows what you want to get back to. We kind of know what you can get back to. So I think it's a really cool dynamic. Like, if I did gymnastics, I'd be like, I'm gonna find a surgeon that does gymnastics, right? Yeah, because then when you're recovering, what can I do, right? Right? Like, my patients are like, What can I do? I'm like, All right, you had an ACL let's not do like, reverse Delhi. But right now, maybe not deliberate right now, maybe we start on top. Let's not wrestle. And maybe another theater surgeon would be like, you can go light, but everybody knows what that means. In the jujitsu gym, and you have that partner where you start light and everybody escalates, and all of a sudden you're having a full on match, and everybody's bleeding. So yeah, yeah, forums like this, and like, your YouTube channel is awesome because it just breaks things down nicely, uh, cut to the bone, to break things down nicely, and you just give it like a doctor, but also like an athlete. And it's it's awesome, and I think it helps athletes get information, yes, simple, being

M. Lucius Pomerantz:

able to understand the forces that are going to be going through their body. And you know that so many people get turned off by their surgeon when the surgeon tells him, well, just don't do that anymore,

Dr. Megan Jimenez:

right? I think I posted something about that recently that was like, it's, that's

M. Lucius Pomerantz:

not an option for these people, you know, it for whatever reason. And I it kind of happened with me. Jiu Jitsu becomes really important for various reasons. It's, you know, this outlet of energy. It's this pursuit of mastery. It's being around friends. It's exercise, the community, feel good, community, social interaction, all these things that it becomes for you, and then just to, like, tell someone, No, you shouldn't do that anymore. So I've

Dr. Megan Jimenez:

had a lot of people come to me like that, other sports too, like my doctor told me I shouldn't do this. And I was like, Well, do you want to do this? I think I've only told one person, and it wasn't even me that told them that they couldn't do football anymore, and it was because they had, like, congenital So, like they were from birth, narrowing of their cervical spine, like their spinal cord. You know, I'm not spin, but their spinal cord was narrowed, and I caught it because they were having numbness, tingling, and they thought it was just constant stingers, right? So I ordered all the imaging, and I just looked at it, and my heart sank this 17 year old kid that loves football. And I had to be like, Listen, I'm gonna have you talk to the neuro, the neurosurgeon, about it. And that was the only person I think I've ever told like, so far, so far along

M. Lucius Pomerantz:

the discussion of life and limb. You know, paralysis is, is no joke. And so, yeah, you know the that is certainly a time where you might have to have a talk with someone, but otherwise,

Dr. Megan Jimenez:

there's ways around things, right? The 80 year old runner that wants to keep running, but their knees are killing them, and maybe you should stop doing that. You stop that, and you die. How I look at it, right? I'd rather you have that than be obese with a heart attack, right? I'd rather you and we can help you with the knee pain and get you doing what makes you happy, right?

M. Lucius Pomerantz:

Yes, and that's the cool thing about the peaks, is we really do have the chance if, and it's that much better if we understand what the patient is going through and their mindset and how important certain things are to them. And then the community. You know, we were kind of friends on Instagram, but now we've gotten to know each other, and it's kind of cool. I mean,

Dr. Megan Jimenez:

because we're at that awesome course, the UFC sports medicine course, combat

M. Lucius Pomerantz:

sports medicine course, and like minded surgeons kind of talking about how to treat these athletes, because they are

Dr. Megan Jimenez:

unique, awesome. Well, let me, let's close out with one more question. What tip can you give to athletes? Actually two questions, what tips can you give to athletes, maybe younger, that are competing, that want to have a long career, versus just going hard in the paint and getting injured and then being like 25 and not being able to go at the capacity they want to for longer? And then the second question would be, what would you tell like the 3545 like even like the 40s, I would say 40 year old athlete that still wants to get in there, but isn't like myself, right? I get in there and I'm nervous because I keep getting injured, and it's like, how do we prevent that?

M. Lucius Pomerantz:

Yeah, so starting with a young person learning to rest and recover and being tough and fighting through an injury is not always the best thing, and if your goal is longevity, then you've got to give your body a chance. And it's funny, we see these 20 year olds, so strong and so muscular, so athletic, but then they go out and party, and they're not getting sleep and they're not getting great nutrition, but they can make up for it, because they're 20.

Dr. Megan Jimenez:

We talked about that. I was like, yeah, when I was like, yeah, when I was 20, man, if I wish I did what

M. Lucius Pomerantz:

I do now, yeah, but it does add up. And you know, at that, at that combat sports medicine thing, that was the question I asked Chuck Liddell is kind of like, what could 50 year old Chuck tell the 20 year old Chuck was like, I learned how to recover. What

Dr. Megan Jimenez:

is recovery to you? What are the big things? Big things

M. Lucius Pomerantz:

being into lifestyle medicine,

Dr. Megan Jimenez:

we'll go, well, the other podcast, I

M. Lucius Pomerantz:

think sleep is crucial, and US surgeons are bad at it, because we train to think that sleep is a weakness, and I can get by with four hours of sleep, whatever. Sometimes

Dr. Megan Jimenez:

you had to, right? You get woken up by an attending yelling at you. Why'd you do this?

M. Lucius Pomerantz:

Yes, it's part of the job, but at the same time, you think, like, well, this is what I do, and so even when I can sleep more, I'm still gonna just do the four hours. I'm gonna go out and party tonight, even though I'm not working, and because I'm not working, I'm gonna go party and still get that four hours and I'm good to go and but sleep is so crucial to everything, our brain learning, our body's recovering,

Dr. Megan Jimenez:

so sleep prior is it like seven to nine hours for the adult? For

M. Lucius Pomerantz:

the average adult, yes, seven to nine hours. And it was a battle for me on my own to figure out how to get to seven hours. It's hard, it's it's really hard, and it's taken some changes in what I do, especially

Dr. Megan Jimenez:

when you train at night, because I train at night, yeah, early for work,

M. Lucius Pomerantz:

your sympathetic system is that much more revved up, and it's that much harder to settle down. And then maybe you sit in front of the TV, and then you got that stimulation going, and soon it's 11, but you got to get up at five and well, six hours, whatever I can live on, six hours. So yes, learning how to prioritize sleep and optimizing that crucial and then nutrition. When you're young, you think you can eat anything, and often you can eat anything and still look good, feel good, but it does add up. And we know the people who are in their 20s getting Type Two Diabetes, what used to be old person fat disease is becoming a youth disease, and that adds up quickly over time, and can be devastating to recovery and all the other organ systems of survival. So nutrition, and I'm not going to get into what diet is best.

Dr. Megan Jimenez:

That's just, I think that's so dependent on the person. And I don't think there's one. There

M. Lucius Pomerantz:

is no there is no one diet. I totally agree with that.

Dr. Megan Jimenez:

And understanding your body and knowing what like when I go to restaurants, I'm like, no broccoli, no cauliflower, no mushrooms, I know. Like, if it looks like it's trying to hurt me, and it's a vegetable, like, yeah, and they laugh, like, stay away, yeah,

M. Lucius Pomerantz:

so and, but it's knowing your body and knowing how you're going to feel when you eat something. And you know, there's some diets out there that the all meat diets, I can say with confidence are probably not the healthiest diet, but I have no problem with someone wanting to get their protein from meats. It's an efficient source of protein, and protein is crucial for rebuilding the tissues that have broken down from hard workouts. So it's funny,

Dr. Megan Jimenez:

you talk about the meat thing. I know I'm I was supposed to end the podcast, but the meat thing, so I have to get my functional medicine doctor on here at one point, because we went full carnivore for a little short term, and I really did learn about the anti inflammatory effects of it, and it like cured all my gut issues. But it was temporary, and it's not really sustainable, but my body was operating on fats, and I was strong. I was sleeping like nine hours. I was just but I was also tired because my body was learning to adapt with different fuel. And then Marc, I went back to, like, adding carbs and and like, honey and fruit. Then I felt like I felt really good again, yeah, but I felt great once my body switched over. But that's a whole other conversation. It's super interesting. Like, all these things

M. Lucius Pomerantz:

interesting. How, how I mean when you're paying attention, diet, clear. Really influences how we feel, and should not neglect it. So, yeah, I would say the biggest things about recovery are sleep, rest and and nutrition that unfortunately, when you're young, you neglect. And then to talk about the older person, you know, maybe they got a job now and they got a family and but they want to get into it. Maybe their kids started doing jiu jitsu and they're looking across and maybe I'll do the adult class while my kids doing the kids class. And

Dr. Megan Jimenez:

just to clarify, 40 is not old. It's just that in jujitsu where you're really, like, putting a lot of strain on your body, yes, it's it's not super young anymore. No,

M. Lucius Pomerantz:

it's definitely not, not old. It's not, definitely not. I hope to be doing jiu jitsu because of longevity when I'm 70 or 80, if I make

Dr. Megan Jimenez:

it, though I said I want to die in my Ghee or with a belt on. So with

M. Lucius Pomerantz:

those goals of doing this for four more decades, I think the biggest thing, along with learning how to rest and eat right, hopefully you've learned that as you've gotten older, but not having an ego, and that's the lesson I'm really well, I guess I could say I've learned it a little bit more recently, but you're going against the 20 year old who's got you in a kimura tap. Yep. You don't need a terry rotator cuff. You don't need that $10 medal. No one's going to care. But you got to work. You got to pick up your kids, and no one cares if you tap, especially in practice, because that's when everyone's trying to get better anyways. So it's

Dr. Megan Jimenez:

a hard it's a hard one. I'm learning it still Yeah, because you talk about and you're like, Yeah, I don't have an ego. And then you get in the situation, the adrenaline's going, Yeah, and it's a kid and their parents are watching and your coach is yelling at you.

M. Lucius Pomerantz:

It's like, it's true in those those situations. It can be hard, and

Dr. Megan Jimenez:

it sounds ridiculous when I say it, but that's like all the stuff that's happening, you know,

M. Lucius Pomerantz:

no, all those things, all those influences, and you want it. You want to be at you want to do your best, and you don't want to give up. And giving up is the worst thing. But if you're an accountant without a rotator cuff, you know, that's also a huge bummer. And if

Dr. Megan Jimenez:

you're competing, if you're competing in your chair because you had too much of an ego to tap during training, oh gosh,

M. Lucius Pomerantz:

yeah, right. You know, missing out on competition because you had too big of an ego in competition or in practices.

Dr. Megan Jimenez:

Yes. I mean, competition is bad too, but there's way more adrenaline in that situation. Yeah,

M. Lucius Pomerantz:

yeah. So Ego is the Enemy, as they say, as far as longevity is concerned, and I think a lot of us, as we transition from our younger competitive days to wanting to keep it in our lives, especially when we've got our jobs as surgeons, is is swallowing that ego, and tapping a little bit more often, and realizing Yeah, you got limitations, and giving you a chance, giving your chance, your body a chance to rest and you can do it. Yeah? I plan on doing it, yeah,

Dr. Megan Jimenez:

for a long time. And I mean, I've also learned that the awareness before is important. So when I tore my ACL not tapping, I I was like, Oh my gosh. I didn't feel that. I wasn't even aware it was happening during it, right? I was like, I'm gonna win. Like, you know, you're just not so actually, one of my friends, Lauren Sears, taught me that. She's like, I go into these matches, and I think, listen, I want to compete. I want to train tomorrow or the next day or whatever. And so I need to be aware of these positions and know when I need to tap, and so I think I've, since that injury, I've created that more awareness of, like, even if it's a weird position, that it's not really a hold, or it's not a submission, and I feel uncomfortable I tap and my partner's like, what? Like, my arm was just not in a place I wanted it to be in. You know that awareness? Yeah,

M. Lucius Pomerantz:

aware body, one of the skills you can get from Jiu Jitsu, body awareness and that kind of stuff, learning, learning how you move and how you feel it's is crucial, and also, not only being aware, but being able to act on it, right? And, yep,

Dr. Megan Jimenez:

so, like, okay, telling yourself beforehand, like, before competition, I'm like, listen, I'd have to talk about myself. If you're in a compromising position, you need to tap. And I know that's not the like probably people say, Oh, that's terrible. You're going in ready to lose. Like, no, I'm going in ready if I need to. And they get the better of me and they win. It's a game of chess, right? That's a checkmate, and let's call it right, instead of letting it go to the end where they tip the King and I get injured again. Well, thanks for coming. Thanks for for being on my podcast, watching it again. Yeah, for sure. Where can people find you? Well,

M. Lucius Pomerantz:

I practice here in San Diego, and beautiful San Diego can make a vacation out of your visiting me. Hopefully not for not, hopefully you're not really hurt and, but I can help you if you are. And and then cut to the bone, the YouTube channel, combining combat sports and orthopedic surgery and and then, you know the social media, LinkedIn and Instagram and all that kind of stuff I'm trying to put out there that hopefully educate and only

Dr. Megan Jimenez:

there's two of you, Lucius Pomeranz, Lucius Pomeranz,

M. Lucius Pomerantz:

I'm probably the only person with that name,

Dr. Megan Jimenez:

I think. So, yeah. All right. Well, thanks again. Thank you. You.

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