Injury Patterns, Risk Factors, and Return to Sport in Brazilian Jiu Jitsu: A Cross-sectional Survey of 1140 Athletes

Maximilian Hinz; Benjamin D Kleim; Daniel P Berthold; Stephanie Geyer; Christophe Lambert; Andreas B Imhoff; Julian Mehl

doi:10.1177/23259671211062568

Injury Patterns, Risk Factors, and Return to Sport in Brazilian Jiu Jitsu: A Cross-sectional Survey of 1140 Athletes

Orthop J Sports Med. 2021 Dec 20;9(12):23259671211062568. doi: 10.1177/23259671211062568. eCollection 2021 Dec.

Authors

Maximilian Hinz¹, Benjamin D Kleim¹, Daniel P Berthold¹, Stephanie Geyer¹, Christophe Lambert², Andreas B Imhoff¹, Julian Mehl¹

Affiliations

¹ Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
² Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Cologne, Germany.

Abstract

Background: Brazilian jiu jitsu (BJJ) is a growing martial art that focuses on grappling techniques.

Purpose: To quantify the 3-year incidence of BJJ-related injuries and detect common injury patterns as well as risk factors among those practicing BJJ. It was hypothesized that there would be a high incidence of injuries, they would be caused by submissions in sparring situations, and they would occur predominantly at the extremities.

Study design: Descriptive epidemiology study.

Methods: Active BJJ athletes were invited to take an English-language online survey developed by orthopaedic surgeons together with BJJ athletes and a sports scientist. Data were recorded regarding athlete demographics, sporting activity level, injuries within the past 3 years that caused at least a 2-week time loss, injury mechanisms, and return to sport.

Results: Overall, 1140 responses were received from 62 different countries; 88.9% of all athletes were male, and 63.9% were regular competitors. Within the investigated cohort, 1052 injuries were recorded in 784 athletes, for an injury incidence of 308 per 1000 athletes per year. The lower extremity (45.7%) and upper extremity (30.2%) were predominant sites of injury, with injuries to the knee (27.1%) being the most common. The most frequent knee injuries were meniscal injuries (n = 65), anterior cruciate ligament (ACL) tears (n = 36), and medial collateral ligament injuries (n = 36). ACL tears were especially associated with long time frames for return to sport. Most injuries occurred during sparring (77.6%) and were caused by submissions (29.7%) and takedowns (26.4%). Competing regularly (P = .003), older age (P < .001), and higher belt rank (P = .003) were significant risk factors for injury.

Conclusion: Injury incidence was high among BJJ athletes surveyed, with 2 out of 3 athletes reporting at least 1 injury within a 3-year period that caused a 2-week absence from training. Most injuries occurred during sparring, and we believe that a high potential for injury reduction lies in drawing awareness to common injury patterns and sites in athletes.

Keywords: BJJ; grappling; injury prevention; knee injury; martial arts; return to sport; shoulder injury; sports injuries.