Injuries in Brazilian Jiu-Jitsu (Part 2): First Steps & Goals Following Injury
So you’ve been training BJJ now and unfortunately sustained an injury. Hopefully it was nothing major, but still frustrating and something that you’ll now have to work through to safely get back on the mats. Continuing on from my previous post, we cannot fully prevent injuries from happening but there are factors that we can control in order to reduce the risk! If you haven’t read that, check it out to see how our physical preparation and the management of our training load/schedule can impact our longevity and injury risk. I’ll write more in depth articles discussing physical preparation and how you can best prepare for your time on the mats in the future!
The scariest part of an injury is often when it first happens. Maybe you were actively training and experienced the injury on the mats or you woke up the next morning after a solid session and began feeling the pain or limitation. However it happened, it’s unsettling and now you have to figure out what’s going on and how to proceed from here. The good thing is, the majority of injuries can and will heal without emergency medical intervention. That’s fantastic! Even somewhat significant injuries (ex. meniscus or ligament tears) can heal over time if treated appropriately. Even knowing this, you need to understand when it’s time to seek emergency medical care for further evaluation and treatment. Here are some considerations following the injury:
Was there an apparent fracture, joint dislocation, or is there an open wound?
Is the pain severe or uncontrollable?
Is there significant or severe swelling around the injury?
Are you unable to walk or bear weight on the injured limb?
Is there any joint catching, locking, or instability (shifting/unable to hold weight)?
Did you experience loss of consciousness during the injury?
Is there shooting pain, numbness, tingling down into the extremities that may signal involvement of the nervous system/spine?
Are you experiencing significant weakness or muscle atrophy (loss in size; typically this may happen over time and may signal nervous system/spinal involvement)
This is not an exhaustive list but if you answered yes to any of the above questions, seek out medical care! If you are ever unsure of what to do next or feel you cannot appropriately handle the situation alone, seek medical advice. The majority of injuries will not require emergency medical care, but you need to cover your bases and always err on the side of caution.
So you ruled out a medical emergency, what next? Working with a skilled rehab professional that understands the demands of BJJ or any other activity that you enjoy is extremely important. In our current medical system, pain is often poorly treated and if you’re seeking advice from your physician or even rehab professionals without combat sports experience, then the recommendations are often poor. BJJ is a unique sport and martial art. It will require time and focused effort to make sure you fully regain your abilities and can safely return to full training. In most states, including Oregon where I’m located, you are able to see a physical therapist without a referral from your physician (except if you have Medicare) so you can hopefully find one nearby that either trains or understands the sport. This is going to be the most efficient and safest way to recover from your injury but here are some goals that you may think about early on to get the process started:
Pain and edema management:
Unload and protect the injured area. Following an injury, the acute inflammatory process begins and the injured tissue and surrounding area is less tolerant to stress than prior to the injury. Pain in this case is also a protective mechanism to avoid overloading the area while the healing process begins. Make sure that you don’t damage it further by doing something irresponsible (like jumping immediately back into training the next day).
You can use compression like an ace bandage to help minimize and control swelling. Even a small amount of swelling around a joint can impact how the muscles function (ex. Knee joint swelling will begin to inhibit how the quadriceps functions leading to weakness and over time further atrophy if left untreated)
Elevation to help with swelling. The higher the limb the better, gravity is pulling straight down and you’re trying to keep fluid from accumulating in the area.
Ice as needed for pain control within the first few days. There are arguments on whether you should ice or not but if it helps with the pain and allows you to move more (my next point) then use it!
Early Mobilization:
The goal will be to get the injured area moving as early as possible, while still protecting it. This is where having professional guidance comes in as it can be difficult to determine how much should be done based on the injury sustained.
Early stimulation of the tissue will help guide the healing process and improve the tissue’s capacity for stress. This is exactly what we want so that overtime, your body can heal to its fullest potential and this area will regain its strength and durability (**this takes time**)
While protecting the area and providing focused, controlled stimulation via gentle movement, range of motion exercises, and even strengthening as tolerated, you’ll want to see what movements you can still perform and what you are limited with. Maintaining your overall movement capabilities throughout the body is very important to minimize any other setbacks during your recovery.
Unless there was a fracture or severe injury that warrants immobilization, this is exactly what you don’t want to do. My job as a physical therapist is to guide the healing process, and that requires active input (i.e. movement and force input) so early mobilization is key!
Regain your range of motion:
This is often one of the first goals that we’ll set in the clinic/gym. It can take time but make sure you focus on this while progressing through other activities.
If you skip this step, it can lead to compensations with movement patterns or activities and put you at higher risk of re-injury. One of the biggest risk factors to a re-injury, is just the fact that you injured that area in the first place so over time you’ll want to regain and maximize your range of motion then progress into full strengthening activities to build resilience and further tissue tolerance.
Maintain the strength that you have and prevent any further loss if possible:
Revisiting the idea of early mobilization, focus on what you can do to maintain your current abilities while still allowing for your body to heal.
If you injured your knee but are still able to do partial range of motion squats with no pain or issue, then practice these and progress as you’re able. If you can hop on the bike for cardiovascular training, do it! Don’t let the injury set you back in other areas when you’re able to work around it.
In summary, injuries are scary and frustrating. If you train BJJ long enough you’ll likely experience one that you’ll have to work through just like in any other sport. From the start, rule out any medical emergencies then move on to the first steps that I discussed here. Manage the pain and swelling, get moving early on following the injury, focus on regaining your range of motion, and maintain your current strength while gradually building strength back in the injured area.
If you’re currently struggling to get back to training from a recent injury or chronic pain, remember that you’re not alone and there are resources out there. Reach out if you need help and remember, working with a knowledgeable rehab professional to help you through this process can save you an immense amount of time, money and frustration. My goal when working with an athlete is to get them back to doing what they love at an even higher level than before they were injured. Send me a message if you’d like to hear more about how I can help!
**Disclaimer: This article was written for informational purposes and is not to be taken as direct medical advice.
