By: Dr. Kreiswirth, PhD, ATC & IBJJF Medical Coordinator
Brazilian Jiu Jitsu (BJJ) has seen a surge in practice and competition since the early 2000s (Kreiswirth 2011). That said, BJJ injuries increased because of the amount of daily activity within the sport. Research for BJJ competition suggests injury risk increases at competitive levels; about 3% (Kreiswirth 2011). The number of injury types within the sport varies from fingers, elbows, knee, ankles, neck, etc. Per the research, the most commonly reported injury within BJJ is elbow and knee at the competition level. As per BJJ practice, there are many instances that other musculoskeletal joints, and skin injury/infection also play a role in incidence data.
Regarding the hand, the thumb is the most commonly injured finger. The anatomy of the opposing thumb leaves it exposed to separation from the hand where ligaments sprains can occur. That said, all other fingers can and do often become injured in BJJ. From finger tweaks getting it caught in a Gi, or jamming it into the mat or your opponent, fingers are susceptible to injury. Potentially, fingers take a long time to heal due to many variables. Using our fingers daily, delays healing rates. It’s rare that fingers are immobilized after injury. That said, the use of fingers for daily activity nonrelated to BJJ, continue and may delay healing. Most BJJ practitioners experience finger sprains and do not immobilize as needed.
Because the finger has very little muscular support, immobilizing a finger sprain is necessary to increase its injury time to heal. Depending on the severity of the sprain, immobilizing the finger is needed to aid in comfort and proper healing. Most finger injuries can simply be put into a basic finger splint or “popsicle” type wood splint, but the need is to immobilize AT LEAST overnight, while sleeping. This will give the athlete at least seven to eight hours of tissue repair in immobilization. If possible, wearing a splint as much as possible is recommended. Taping for finger injuries is most common in BJJ. Tape cannot do the job that a splint does, but still provides some comfort and support. If a finger sprain is mild, taping with non-stretch tape can be used for support.
Icing finger injuries can be utilized for the first few days. Ice water is best suited for providing cold and reducing swelling to an acute injury. Dipping your finger into a cup of ice water is an excellent method. After 4 or 5 days, icing isn’t really necessary, as ice is used to slow down swelling, not prevent it. Finger sprains can last 6-8 weeks and longer to fully recover. It’s important that steps for care be taken to reduce this time period.
According the data, elbow injuries due to the arm bar is the number 1 injury is competitive BJJ. Elbow joint sprains are common, in addition to elbow tendinitis from excessive collar or sleeve grips. Elbow sprains are acute and should be treated with immobilization and ice for the first 2-3 days, depending on the severity. Conversely, elbow tendinitis or tendinosis is a chronic weakening of a tendon, most likely due to over gripping. This type of injury needs attention to over gripping issues first. Playing no-gi may help alleviate these issues fairly quickly. If not, a regimen of stretching and strengthening to the elbow, wrist, and shoulder is recommended. Once an elbow becomes chronically injured, other associated joints may follow, hence the reason to treat these areas as well.
The silent injuries in BJJ are skin conditions/infections. Fungal infections, such as ringworm, may look ugly but bacterial infections are much more dangerous.
Ringworm on the skin presents itself as a dry skin condition with a notable red ring around it. Fungal infections spread much slower than bacterial infections and may cause itching. If you have Ringworm and are concerned, simply draw a circle around the lesion or mark its borders to monitor its spread. Topical solutions or creams such as Tinactin or similar products can be used over time to mitigate the redness and spread. Priority should be given to training in clean Gi’s, clean mats, and clean partners as Ringworm is highly contagious. If you smell a dirty Gi, don’t be scared to point it out! Prevention is priority here. Showering directly after is highly recommended! There are many anti-fungal soaps out there, although they tend to dry out skin and may slow natural skin microbe production to protect your skin environment.
Bacterial skin infections are also high contagious and spread rapidly! Whether the condition is staph or strep, both spread at high rates. Similar to treatment of fungal infections, legion borders should be marked to monitor spread. Unlike fungal infections, these typically present as a small pimple, pustule or oozing legion. These legions can be extremity painful and need attention ASAP. Pain is truly a determinate factor of the infection, as well as a rapidly enlarging pimple. Oral and topical antibiotics are the typical course of treatment, but legion “culturing” by a medical professional to understand which bacterial strain is causing the infection is highly recommended. Most physicians will treat any skin condition with a broad spectrum of medicine. While that will work, it’s hard to say what worked for the legion and what didn’t. If the infection is resistant to some medications, (Methicillin-resistant Staphylococcus aureus, MRSA) it’s best to know which medications should be used for treatment and which to avoid as to not over medicate.