Is GSP the Next Adrian Peterson? Understanding ACLs and MMA

Will Carroll@injuryexpertSports Injuries Lead WriterMarch 15, 2013

Nov 17, 2012; Montreal, QC, Canada; Georges St-Pierre punches Carlos Condit during their Welterweight title bout at UFC 154 at the Bell Centre. Mandatory Credit: Tom Szczerbowski-USA TODAY Sports
Tom Szczerbowski-USA TODAY Sports

Georges St-Pierre takes to the Octagon on Saturday night at UFC 158 to face off against Nick Diaz.

It will be his second fight since damaging his right knee's ACL (anterior cruciate ligament), which resulted in surgery to reconstruct the ligament and fix damage to his meniscus.

Given how other athletes, such as Adrian Peterson, have come back from similar surgery in a shorter amount of rehab time, the positives are definitely there for St-Pierre.

Will the surgery and reconstructed knee affect his fight or how Diaz will attack? Let's dig deeper.


Will St-Pierre's Repaired Knee Hold Up?

The ACL repair should hold up well.

St-Pierre is more than one year post-surgery, which has given the graft plenty of time to solidify and his body time to get used to the newly structured knee. The vast majority—well over 95 percent—of ACL repairs have no problems, but the vast majority aren't getting kicked and punched, either.

He also has the confidence of having one fight on the repaired knee under his belt. 

The biggest concern is when the knee is most at risk. Those motions would be when it is at full extension, such as when St-Pierre is kicking with his left leg. The ACL will also be tested by twisting motions, especially if his foot "sticks" during a kick or punch.

Finally, there would be a major concern if St-Pierre were to take a straight blow directly on or just above the knee. 


How Will the Knee Affect St-Pierre's Attacks?

The easiest defense is to take the fight to the ground.

St-Pierre has shown he can grapple with the best of them, dominating Josh Koscheck and Carlos Condit (in his November title defense) largely on his wrestling skills. St-Pierre showed no deficits when changing levels and shooting quickly off the repaired knee last time out against Condit. 

About the only place the knee should affect his attacks is in kicks; however, St-Pierre has never relied on kicks as a major part of his offense. High kicks will put his knee in a weak spot, and I don't expect to see many of those, if at all. 


How Will the Knee Affect St-Pierre's Movement?

In the limited workouts that have been open to the public, St-Pierre has shown no real movement deficits. He's been able to circle both ways and seems to have a normal level of movement.

This is no change from the Condit fight, where the knee did not seem to be an issue at all. Condit was able to slow St-Pierre toward the end of the fight, with some observers saying that St-Pierre was more vulnerable due to conditioning and reduced movement.


Will Diaz Attack the Knee?

I don't pretend to know what goes on in the mind of Nick Diaz. I am sure that he'll try several things to test the knee and see if St-Pierre has any limitations.

First, I expect Diaz to try to keep the fight on the feet, just as Condit tried to do, to see if St-Pierre has any movement deficits or is rotating away from contact. 

Second, I believe Diaz will attack the right leg, if not the knee itself. Diaz can give himself a psychological advantage or make St-Pierre at least think more about the knee by attacking it early, although a couple of kicks might do nothing and reverse the advantage.

The "best" kick would be a straight kick to the thigh. 

A strategy built around attacking a perceived weak point can backfire if the opponent has no weakness. Diaz would be better suited to making just a few pointed attacks and then doing what he does best.


Can St-Pierre Protect the Knee in Any Way?

UFC rules do not allow St-Pierre to wear any sort of hard brace, for obvious reasons. St-Pierre could elect to wear a neoprene sleeve or similar device, though he did not in the Condit fight (as seen in the picture).

While they offer little in the way of protection, there is often some psychological effect when these devices are worn. This type of sleeve will also keep the area warm, which can have a positive effect on the soft tissue underneath. 

St-Pierre can protect the knee through stance and motion as well, making it harder for Diaz to shoot on the knee or to kick it from advantageous angles. 


What's This About St-Pierre and Steroids?

Nick Diaz said, "I don't think they do drug testing around here."

I guess no one informed Diaz that Montreal is the home of the World Anti-Doping Agency and one of the world's top drug testing labs. While the UFC has not given details on drug testing, the organization normally contracts with a local organization when it is out of the United States. 

There's no evidence that St-Pierre has used steroids or that steroids or other PEDs would have any effect on his recovery. 


What Should I Look for to See How St-Pierre's Knee Is Doing?

There are three things to watch.

First, is St-Pierre's knee stable in the early moments? Getting through the first minute will be key and should set the tone for the fight. Condit was never able to test the knee and seemed to have no inclination to do so. 

Second, look for St-Pierre to be able to circle in both directions. Again, this was not an issue in the early stages of his fight with Condit since St-Pierre seemed to control the action and pace until the late rounds.

Third, if the fight goes very long, watch to see if St-Pierre experiences any wear or inflammation in the knee. He could limp, stop moving in one direction or move to guard the leg.

Changes in stance to move the leg out of Diaz's range or to stop him from shooting in on the leg would be a very big negative. This remains a worry after the end of the Condit match.


What Do You Expect?

Given what we've seen of St-Pierre in workouts and other appearances, I think he ends up standing tall on both legs with one arm raised in victory.

I do expect that he may try to end the fight more quickly than normal in order to avoid any wear in the knee.


Will Carroll has been writing about sports injuries for 12 years. His work has appeared at,, and he is the Lead Writer for Sports Medicine at Bleacher Report.


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