Assessment of Injuries During Brazilian Jiu-Jitsu Competition

Abstract

Background: Brazilian jiu-jitsu (BJJ) is a unique style of martial arts with rapid growth in the United States and internationally. Although studies have examined injuries in other martial arts and combat sports, to date, no published medical study has examined injuries in BJJ competitions.

Purpose: (1) To estimate the incidence of injuries in BJJ competitions and (2) to identify and describe the types and mechanisms of injuries associated with competitive BJJ.

Study design: Descriptive epidemiology study.

Methods: Injury data were obtained from records of on-site medical coverage at 8 statewide BJJ tournaments in Hawaii, USA, between 2005 and 2011.

Results: The identified injury incidence on the day of matches was 9.2 per 1000 exposures (46 injuries out of 5022 exposures, ie, match participations). Orthopaedic injuries were the most common and accounted for 78% of all injuries (n = 36), followed by costochondral or rib injuries (n = 7) and lacerations requiring medical care (n = 3). The elbow was found to be the joint most commonly injured during BJJ competitions, with the arm bar being the most common mechanism. We propose that this BJJ-specific injury mechanism, the "arm bar," be recognized as another mechanism of hyperextension injury to the elbow in sports.

Conclusion: Comparison of the BJJ injury data with injury data reported for judo, taekwondo, wrestling, and mixed martial arts showed that BJJ competitors were at substantially lower risk of injury compared with these other sports. With orthopaedic injuries being most common and the elbow being the area most vulnerable to injury in BJJ, it is important that participants, referees, and physicians be properly educated about the unique mechanisms of injury that can occur, particularly to the elbow.

Keywords: Brazilian jiu-jitsu; arm bar; elbow hyperextension; elbow injury; hyperextension injury; jiu-jitsu; jiu-jitsu elbow; martial arts; mixed martial arts.

Figure 1.

(A, B) Brazilian Jiu-Jitsu Grand Master Relson Gracie demonstrates the correct technique for an arm bar. The arm is trapped while the elbow is hyperextended. This was the most common mechanism of injury in our study.

Figure 2.

There was 1 neck injury, a cervical strain, caused by the “triangle” technique, demonstrated by Brazilian Jiu-Jitsu Grand Master Relson Gracie. This technique is a type of choke executed by encircling and securing the legs around the opponent’s neck and arm, thus putting pressure on the neck.

Figure 3.

There were no injuries as a result of other jiu-jitsu chokes, such as the “Mata Leão” choke demonstrated by Brazilian Jiu-Jitsu Grand Master Relson Gracie.

Figure 4.

There were 2 injuries resulting from the “kimura” technique, demonstrated by Brazilian Jiu-Jitsu Grand Master Relson Gracie. Both the elbow and the shoulder are forcibly internally rotated, posing a risk of injury to both joints.

Figure 5.

The “heel hook” is performed by trapping the opponent’s knee and forcibly internally rotating the foot, ankle, and lower leg, as demonstrated by Brazilian Jiu-Jitsu Grand Master Relson Gracie. This technique has been shown to pose a high risk of injury and was not allowed in the tournaments included in the study.