Brazilian Jiu-Jitsu (BJJ) is truly a captivating martial art. It is a chess-like match played with the human body that is unique and complex. I can make a never-ending list of all of the benefits, both physically and mentally, that come with training BJJ. However, due to its aggressive potential and physical toll on the body, training in the savage science can come with its unique risk of injury and physical breakdown. Whether you are an elite black belt, or a beginner white belt, the risk of injury does not discriminate and can happen to any participant. Understanding these risks and developing the right approach can be the difference maker between training with lingering injury and having a long BJJ career.
If you are a BJJ athlete that is dealing with an injury, or a PT professional that is looking to learn the demands of BJJ to optimize your athletes rehab, this is the blog post for you. We are going to take a dive in some of the common injuries in BJJ, how they can occur, and why understanding the sport (or working with a PT that has a BJJ background) can be the secret weapon to your recovery!
Understanding The Common Injuries In BJJ
As a PT professional that trains BJJ, I have learned that the injuries that can occur are more complex than the diagnosis. The sport is a complex connection of generating leverage, maximizing positions, and placing your body under extreme pressures depending on the situation. This combination can leave certain regions of the body particularly vulnerable to injuries based on the anatomy of the joint and the muscles ability to resist the forces on those joints. Injuries can happen from a specific incidence (aka acute injuries) or they can slowly build over time (aka chronic injuries). This is not always the case, but let’s discuss some common acute and chronic injuries that can occur.
1. Knee Injuries (MCL sprains, meniscus tears, ACL tears, hamstring strains)
The knee is the most common area of injury in BJJ due to the constant twisting, turning, and pressure on the knees during grappling exchanges compared to other regions of the body. The dynamic movements, sudden twists, and potential for hyperflexion or hyperextension during takedowns and guard passes can strain the ligaments and cartilage of the knee. These are also common in submissions such as the Heel Hook and Knee Bar. This is where it becomes extremely important to know the differences between the types of submissions and what can get damaged.
For example, a Heel Hook is performed by twisting the foot and lower leg on a fixed upper leg which creates an extreme rotational stress on the knee joint, like twisting a cap off of a bottle. The main ligaments that stabilize the twisting forces in the knee are the ACL and PCL. It can also place extreme stress on the medial meniscus and MCL depending on how aggressive the submission is and how much pressure is being placed in the inside of the knee joint.
On the other hand, a Knee Bar is a submission that forces extreme hyperextension in the knee joint. Think of it as a motion similar to forcing a door to open further than the door hinges allow. This extreme range of motion can stress the PCL, hamstring tendons, and calf tendons, whose job is to prevent excessive knee extensions and prevent the shin bone from being forced backwards.
2. Shoulder Injuries (rotator cuff tears, labral tears, AC joint sprains, dislocations)
Anyone who has been training long enough in BJJ knows that the shoulder is a very common region of the body for injury. The shoulder joint is considered to be the most mobile joint in the human body. The shoulder is so mobile that there are muscles specifically designed to stabilize the shoulder during movement (aka the rotator cuff). This sounds ideal on paper, but it can be a double-edged sword in a sport like BJJ; especially if the dynamic stabilizers of the shoulder are weak.
So what does this mean? Simply put, the shoulder will naturally have a higher risk of injury. In BJJ, there are styles and submissions that emphasize attacking the shoulder joint. For example, a common injury that has plagued the BJJ community is a rotator cuff tear. This makes sense since the primary function of the rotator cuff is to stabilize the shoulder joint. For example, in a Kimura submission, the shoulder is placed in a position of extreme external rotation. This can create an extreme stretch on one of the rotator cuff muscles, known as the subscapularis, which is an internal rotator of the shoulder. If the subscapularis is not able to tolerate stress, it can lead to a muscle strain or even a full tear of the muscle.
Shoulder injuries also commonly occur during transitions such as takedowns. In BJJ, it is a common reaction to brace using your upper body if you’re opponent attempts a takedown. This can put a lot of force into the shoulder joint and can even force the arm bone to be pushed up into other structures, leading to injuries such like an AC joint sprain or dislocation.
Why a BJJ PT Can Be Your Secret Weapon In Rehab:
Look I know what you’re thinking. If certain areas of the body are so high-risk for injury, does that mean I’m destined for injury eventually? Well, not necessarily. Although complete prevention of injury in a sport like BJJ is unrealistic, it can be minimized with the right plan of attack that addresses these weaknesses and turning them into strengths. This is where working with a clinician that knows what it’s like to put the hours in on the mats and learn the demands of BJJ. Here are some ways that you can benefit from working with a BJJ PT.
1. Accurate Mechanism of Injury (MOI) Identification
We use our background in BJJ and biomechanics to immediately recognize how a specific submission, transition, or defensive posture likely led to your injury. This isn’t just theoretical; it translates into more precise assessments and targeted interventions.
2. Sport-Specific Assessment and Testing:
Beyond standard tests, a BJJ-savvy PT can assess your movement patterns within the scope of jiu-jitsu movement. This makes it easier for us to identify weaknesses or imbalances that are directly affecting your ability to perform techniques or defend against submissions safely. This might involve evaluating your hip mobility for guard retention, shoulder stability for framing, or neck strength for surviving a choke.
3. Tailored Rehabilitation Programs:
Generic exercises can be helpful in the beginning. However, when returning to a sport like BJJ, standard exercises don’t cut it. A PT who trains BJJ can design a rehab program that directly addresses the demands of the sport. This means:
- Modifying Training So That You Can Keep Training: If there is one thing that is agreeable to many PTs, it is that ceasing activity is usually not the best approach to rehab. Instead, we can tailor and modify using appropriate progressions based on your pain-free capabilities. This way, you can continue to train and feel like an athlete with taking a step back in your rehab.
- Sport-Specific Strength & Mobility Plan: This is a fundamental standard for BJJ in both rehab and prehab. Prepping your body to tolerate the movements of BJJ can be achieved by performing drills that mimic the demands of BJJ. With the right guidance, this approach can be the difference maker in your rehab and overall performance.
Invest in Your BJJ Career By Getting The RIGHT Care
If you’re a Brazilian Jiu-Jitsu athlete dealing with an injury, or a PT that wants to work with combat athletes, the approach is this. Look for a clinician or become a clinician who understands the art.
For athletes, finding a physical therapist who also trains BJJ isn’t just about convenience. It’s about maximizing your recovery, minimizing your time off the mats, and building a more resilient body longterm. We will be your teammate to help you understand the challenges of injury, learn how to return to training safely, and develop a clearer picture of the demands of the sport both you and I love.
For PTs, getting some personal skin in the game will not only expand your clinical knowledge but will also allow you to connect with and serve a dedicated community of incredible athletes with unique and specific needs. If you are treating an athlete and you are do not understand the demands of the sport, you are missing a critical piece to the reach puzzle. As clinicians, it is our responsibility to maximize the recovery process of an athlete and get them back to their sport. What better way than to try the sport yourself? Who knows, you may fall in love with it also.
Don’t let injuries derail your BJJ journey. Work with a clinician who speaks the language of the mats, understands the demands of the roll, and is dedicated to getting you back to tapping, training, and thriving, the right way.
Thanks for reading,
Dr. Z