Brazilian Jujitsu has attracted a lot of interest and involvement in recent years. Often referred to as a game of chess, in which techniques such as sweeps, and throws are used to take an opponent to the ground, with neck chokes or joint submissions used to win the training or competitive match. Sparring (eg., rolling) is generally a key part of every class right from the beginner stage, this requires participants to roll around and apply positional superiority to score points with the end goal of submitting your opponent with a joint lock. It's a high energy expenditure sport, developing fitness qualities such as muscular strength endurance and mobility. Like many martial arts the concepts are based on the economy of motion by adopting the path of least resistance, this results in yielding and redirecting your opponent’s force against them. This ability of controlling your opponent, is known as the gentle art.
Common injuries related to a Jujitsu Practitioner
Although regular engagement in physical activity such as Jujitsu is healthy and can contribute to increased lifespan beyond the average age and decreased hospitalisation. Musculoskeletal injuries are part and parcel of the process during sports training and competition leading to acute and/or chronic musculoskeletal conditions (Zang et al., 2023). So how do these soft tissues injuries occur? Well as we all know the human body is made up of various connective tissues such as ligaments, tendons, muscles to name a few. These structures are all susceptible to damage based on the stress/strain relationship, see below.
Figure 1: (Korhonen & Saarakkala 2011)
Figure 1, describes the stress strain curve, with the assumption that connective tissue (made up of collagen fibres) has a threshold point, of which forced beyond this point due to excessive loading, will eventually lead to rupture and break down of the tissue structures. For instance, when a Jujitsu player is caught in a submission, for example a ‘knee bar’ and does not 'tap-out' early enough. The ligaments around the knee joint are likely to be compromised by breaking down due to the increased strain. In figure 1, the theoretical model describes these stages of tissue deformation. Initially, these tissues are in a semi-passive state leading up to becoming ruptured, depending on the exposure to loading and their tolerance to that load. During the task of Jujitsu rolling, and before the 'knee bar' technique is applied to the jujitsu player, their knee structures are likely to be relaxed or semi-relaxed eg., the collagen fibres are considered to be in initial phase known as the ‘toe region. Once the knee bar is applied the knee ligaments are stretched or tensioned during the subsequent phase eg., the ‘elastic region’. If the threshold point is reached deformation occurs beyond the tissue capacity (resulting in tissue failure), occurring in the ‘plastic region’ final phase and reaching peak tension. It is at this point that a strain or rupture of the ligaments can occur, depending on the severity of the injury professional rehabilitation can be very helpful.
To understand the prevalence of jujitsu injuries, a small study by Hunker et al., (2023) gives us some insight into the common injury sites, see figure 2. The study used an online survey to collect the data, highlighting amateur jujitsu practitioners tend to acquire mostly upper limb, most notably the hands and fingers injuries as well as knee injuries. These occurred both during training and conditioning sessions rather than in competition.
Figure 2, Hunker et al., (2023)
Note all research publications have limitations to different degrees, in this case, a very small sample size of participates (n=56) was used in the study, with the majority being male (n=78%). Thus this limits the transferability of the findings. Additionally, as the online survey used to collect the study participants responses was completed in retrospect there are issues around recall bias and self-reporting, which means participants may not have completed the questionnaire accurately due to these limitations around the study design. However, this does give us some results that were developed in a standardised and systematic way, of which we can use these to build a picture around the type of BJJ injuries and their prevalence. This provides a step towards building the evidence based around this emerging area of research.
With that being said, we can see a range of upper and lower body injuries can occur from participating in Jujitsu mainly in the training environment. Physiotherapy management provides a range of treatments to rehabilitate your sporting injuries of which ‘exercise interventions’ are a key approach. For example, muscles and tendon type injuries respond very well to strength training protocols. Effective progressive strength training programs are essential and based on a number of factors such as, type of injury, stage of healing, muscle architectural requirements, and our functional goals (Brumit & Cuddeford, 2015). Andres & Murrell (2008) suggest an active approach such as eccentric strength training to treat tendinopathy symptoms is more effective for the long term than passive approaches eg., anti-inflammatory medication and cortisone steroid injections. Therefore, strength and conditioning principles that are specific to the injured area, delivered in a timely manner are essential to develop sufficient tissue capacity (eg., tissue robustness) to enable players to manage the weekly/monthly loading demands of BJJ training. Our integrated approach aims to keep you physically active to limiting deconditioning whilst managing your rehab. Getting you back on track by reframing the process into an opportunity for success and self-development.
SMC April 2024.
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