Injuries in Brazilian Jiu Jitsu and How to Prevent Them
BJJ has many benefits:-
- increased strength
- weight loss
- muscle gain
- increased cardiovascular endurance
However, whether new to the sport or experienced, the injury risk is high due to groundwork, head, arm and leg locks, and chokeholds, although not as high as other martial arts which involve throws, such as judo. While a positive attitude to training can help to reduce the risk, injury is inevitable.
Research has reported the following statistics:-
• 59.2% of people suffer at least one injury every 6 months
• 9.2 per 1000 exposures on tournament days resulted in injury, with 7.2 of these being orthopaedic injuries
• most common injuries involve the knees, hand and fingers, feet and toes, elbows and shoulders
• more experienced athletes suffer more with lower back injury, while less experienced athletes are more affected by head, upper extremity, and elbow injuries
• upper extremity injuries occur more often than lower extremity injuries nut tend to be less severe
• 6-month injury incidence is more linked to training days per week and instructor status rather than with years of training and body weight
• those who spent less than 50% of the time training with a gi were at higher risk of ankle injury
MOST COMMON BJJ INJURIES AND HOW TO REDUCE THE RISK
MAT BURN
A minor injury in comparison but when excessive friction with the mat causes the outer layers of skin to be removed, this can be painful for quite a few days.
CAULIFLOWER EAR
• due to grappling
• impact related trauma to the cartilage of the ear causes separation from the skin, forming a haematoma
• repeated haematomas cause internal bleeding and external inflammation and hardening
• if untreated the fluid between the cartilage and skin calcifies and creates scar tissue
• there is an increased infection risk with cauliflower ears
TREATMENT:-
• draining the fluid in the ear with a syringe and compressing the skin and cartilage together to heal
• ice
• anti-inflammatories
PREVENTION:-
• wear protective headgear
• aim to prevent your opponent applying too much head pressure
• aim to avoid any head pressure on the mat
• apply ice to ear pain after rolling, and try to avoid rolling for a few days
NECK INJURIES
The neck is one of the most delicate areas of the body and being stacked on your neck with your head being pushed and pulled can cause various injuries, most commonly cervical sprain or strain. The cervical spine is the most mobile part of the back, so it’s easy to overlook injury when in a hold, but neck injuries can take a few months to heal.
Herniated discs
The 7 cervical vertebrae support the head and the cartilage discs between them act as shock absorbers, preventing the vertebrae from rubbing against each other.
Age and poor weight bearing can cause the discs to fall over the inner gel-like material, causing inflammation around the spinal nerve, tingling or numbness along the arms and radiating pain.
Whiplash
Sudden force which pushes the neck forward or backward can cause muscle tears or strains.
PREVENTION:-
• make your partner aware of the fact you have an injured neck
• avoid positions where you can’t control your opponent grabbing your head
• do not use your head as a base point
• it’s not always possible to roll gently so if there are persistent neck issues, BJJ should be avoided
• exercises to strengthen the surrounding muscles of the neck, enabling greater shock absorption
• warm up before training
• don’t suffer pain at the expense of your ego
RIB INJURIES
• bruised ribs, broken ribs, damage to the sternum, damage at the bone-cartilage intersection
• bruising around the ribs
• pain with deep breath, cough, sneeze, laugh or heavy lifting
• creaky sounds at the injury site upon touch or movement
• obvious deformity at the site of injury
• difficulty breathing
• 4 to 6 weeks recovery time…no BJJ -returning before this time even if pain has subsided will most likely result in a worse injury due to the tackling nature of BJJ
BACK INJURIES
• back pain is common when the lower back gets compressed due to an opponents full weight bearing down on guard player when stacked
• poor technique during a poorly timed takedown ie. lifting with the back instead of the hips
• strained muscle due to pulling/lifting in uncomfortable positions which cause spinal flexion in the wrong direction - pain starts a couple of hours after injury , treated with ice and gentle stretching
• herniated disc - immediate injury causing pain down the lower back to the leg ,requires immediate medical attention
PREVENTION
• learning correct technique to roll
• strained muscle - avoid positions that compromise the spine, close guards, mount, and bridging
• stretching/yoga to increase flexibility and stability of the back
SHOULDER INJURIES
The shoulder consists of 4 joints:–
• the glenohumeral joint (ball and socket joint between the head of the humerus and the glenoid cavity of the scapula)
• the acromioclavicular (AC) joint (where the clavicle meets the acromion of the scapula)
• the sternoclavicular (SC) joint (where the clavicle meets the chest bone [sternum])
• the scapulothoracic joint (where the scapula meets with the ribs at the back of the chest) and dense musculature that allows free movement.
Shoulder injuries in BJJ result from:-
• overuse
• explosive movements - stubborn arm attacks, twists from rolling, or prolonged active posting
• shoulder lock submissions can result in rotator cuff injuries if held too long
TREATMENT:-
• muscle strain - ice and rest
• severe dislocation-medical attention immediately and before returning to the mats
• rotator cuff injuries – ice, rest
TRAUMATIC SHOULDER INJURY Eg. getting taken down and landing on your outstretched shoulder can injure the rotator cuff muscles or other parts of your shoulder
PREVENTION:-
• tapping regularly and early • learn how to break your falls properly
ATRAUMATIC SHOULDER INJURY - gradual onset due to overuse/underuse - shoulder doesn’t feel right, then pain develops on movement, getting worse until unbearable
PREVENTION:-
• if you have a mild shoulder injury - tying one hand up with your belt and rolling is difficult but will help
• strengthen your shoulder - the rotator cuff helps move the shoulder in different directions. In BJJ, some of the rotator cuff muscles are prone to overuse while others are underused, and this imbalance can cause injuries
• strengthen the surrounding muscles which also help stabilise the shoulder ie. biceps, triceps, pectorals, latissimus dorsi muscles, and trapezius muscle
WRIST INJURIES
sprained wrist
• suddenly bending the wrist in order to stabilise when breaking a fall with the arm out
• wrist locks & attacks
ELBOW INJURIES
The elbow is a fragile joint, unable to tolerate hard impacts prone to injury, & if there is a repetitive injury this will most likely become permanent & result in chronic pain.
• the armbar submission hyperextends the arm & carries a high risk of elbow injury, which can include broken bones or torn ligaments & tendons if you do not submit quickly
• posting on the mat is the next most common cause of injury - the impact of our body can cause hyper extension which can cause ligament damage
STRAINS & SPRAINS
• strain = torn muscle or tendon
• sprain= torn ligaments
• caused by bones or tendons moving past their natural position & range of motion
• causes swelling, pain & inability to move the arm or elbow
• sprain causes a pop sound at time of injury & bruising
• treatment - rest, ice, compression & elevation , if serious seek medical attention
TENDONITIS
• inflammation of tendon caused by repetitive movements/overuse
• use warm/ice packs on the injured area & anti inflammatories
• 2 types of tendonitis: lateral epicondylitis (tennis elbow) & medial epicondylitis (golfer’s elbow)
BURSITIS
• inflammation of the fluid sacs (bursae) which cushion the joints, reducing friction between moving bones, tendons, & muscles
• caused by repeated impact on the same area
• causes swelling around the joint
• treat with ice packs
• avoid training until healed
DISLOCATION
• one of the most common elbow injuries
• results from resistance to submission moves when taken down hard or pushed into the mat
• caused by the bone being pulled or pushed out of place
• can be partial or complete dislocation
• can be a simple, a complex or a severe dislocation
• seek prompt medical attention
• avoid fighting until completely healed
FRACTURES
• can put an end to competing - take long time to heal & sometimes don’t fully recover
• caused by hard fall impacting the elbow through twisting or a hard push or pull
• cause severe pain & bruising
• treatment - plaster as soon as possible
COMPRESSED NERVES
• also known as an ulnar nerve entrapment
• caused by repeated impacts on the elbow
• causes numbness & tingling in fingers
• weakens a fighter’s grip
• treatment - bracing, splinting, nerve gliding exercises & anti-inflammatories, releasing tight muscle/tendon with sports massage
• if the condition worsens seek medical attention
UCL INJURY
• ulnar collateral ligament damage
• takes long time to heal & may not recover fully
HEALING AND PREVENTION
• healing the elbow is slightly different to other joints • 1st stage – inflammation
• 2nd stage - the elbow needs to get in motion to be able to move
• 3rd stage - strengthening the elbow with forearm & gripping exercises
KNEE INJURIES
Certain moves will put the knee at increased risk of injury:-
• heel hook - banned by many organizations, opponent’s leg can suffer multiple breaks as well as torn ligaments around the knee
• knee bar - opponent’s knee can snap due to hyperextension
• the rubber guard- puts strain on the knees of the person who does it, placing their shin over the opponent’s back while in their guard, thus overstretching the knee. Doing the full lotus position will ensure enough hip and knee flexibility to reduce the risk of injury.
Performing leg locks incorrectly can push the knee joint in the wrong direction and most likely cause torn ligaments, so if discomfort is felt during rolling, you should tap out to avoid further damage.
If you have had a knee injury returning before properly healed is never a good idea, but to ease yourself back in, you can concentrate on hand defence with the knees tied together with your belt.
BROKEN BONES/DISLOCATIONS
• due to heavy impact
• due to holding onto submissions during competitions, without tapping
PREVENTION
• regarding submissions, tap quickly, tap often
• learn how to fall properly
HYPEREXTENSION When a synovial (hinge) joint ie.elbow or a knee, is extended in a straight position beyond the normal range of motion, usually in submissions such as armbar and kneebar, injuries are common.
PREVENTION
• stop the synovial joint from being hyperextended
• tap before hyperextension is reached ie.as soon as pain is felt
TORN LIGAMENTS
• result from incorrect technique
• result from rotational submissions -particularly the heel hook which places the knee under significant stress due to rotation of the ankle
PREVENTION
• strengthening - squats, deadlifts etc to strengthen the tendons
• tap early and often
MCL, ACL,MENISCUS INJURIES ANTERIOR CRUCIATE LIGAMENT (ACL):-
• prevents hyperextension of the knee
• injured when overdoing a move like the kneebar
• ACL tears will destabilise the knee and usually require surgery
MEDIAL COLLATERAL LIGAMENTS (MCL):-
• at the side of the knee
• hold leg and thigh together
• often injured by doing twisting the knees
• MCL injuries will cause pain, swelling, and instability of the knee
• MCL injuries often heal on their own in time without surgery but rest is essential
MENISCUS TEARS:-
• the meniscus cartilage discs are shock absorbers
• injured through incorrect and sudden explosive movements
• torn meniscus will cause pain, swelling, weakness and knee may “give way”
• sporadic knee lockups are common with meniscus injuries
These injuries happen due to:-
• not knowing how to defend/not submitting in a leg lock
• explosive grappling and scissor takedowns
• sudden knee hyperextension when suddenly changing direction stopping
• ligament injuries often need surgery and a lot of time out
HOW TO REDUCE THE RISK OF KNEE INJURIES
• strength training eg. running, squats, weighted squats, deadlifts
• improve hip flexibility - the hips move in different directions, whereas the knees only bend and extend, so if the hips are stiff, then your knees will overcompensate and take more impact
RETURNING TO BJJ AFTER INJURY
People are often in too much of a rush to return to a sport before their injury has properly healed, which simply increases the risk of a repeat injury. By following 3 simple steps this risk can be reduced:-
Step 1: Be sensible when it comes to training
• the right intensity – intensity should be increased slowly, so if there has been a longer recovery period, it may be worth returning to a beginners class to start with
• the right positions - the way you compete may change eg. following neck injury, the risk of re-injury would be reduced by replacing an upside-down guard with a more closed guard
• tap quickly and often - you can’t control your opponent’s play so if in a compromised position that increases the chance of re-injury, choosing to tap is the better option
• the right partners – when starting back choose to partner up with someone you trust, who lets you move at a good pace with control. Initially you may feel fully recovered but until the injured area has faced the challenges that come with BJJ, you may be unaware that there is still some weakness there.
Step 2: Self-Assessment It is important to reflect on how your training methods may have contributed to your injury and think about any changes that could be made, for example:-
• Were you overtraining?
• Did you warm up properly?
• Did you get a good night sleep the day before you got hurt?
• Were you stressed all day?
• Did you not tap when you should have?
Step 3: Assess Your Training Program Training should not only include strength and flexibility training, but also corrective exercises following an injury. Any muscle imbalances or overuse should be addressed regularly, through sports massage, for example. Your aim is to train for the long term, not just the immediate post injury period.