#239 Injury Rates and Types in Sport Brazilian Jiu-Jitsu with Ethan Kreiswirth

Romulo Barral knee injury BJJ
Ethan Kreiswirth (far left) and a member of his staff work on the knee injury of Gracie Barra’s Romulo Barral at the 2010 BJJ World Championship. Photo courtesy cohost Dan.

Come on, admit it: part of you has always wondered exactly how dangerous Brazilian jiu-jitsu might be. How does it compare with other activities you might do? Is it more likely that you’ll get injured doing BJJ or soccer? How about BJJ and basketball, or football, wrestling, or judo, or…?

Today on the show we are going to look at the beginning of research aimed at answering those questions, because at the moment, we simply do not know. Ethan Kreiswirth is the Director of Athletic Training Education at Concordia University, Irvine and a brown belt in BJJ. If you’ve ever attended an International Brazilian Jiu-Jitsu Federation event in Southern California, you’ve seen Kreiswirth and his team of injury specialists attend to athletes who get hurt.

Kreiswirth has begun compiling data on the types and rates of injuries that he encounters at these BJJ competitions so more can be learned about exactly what types of injuries are most common, among what age groups, genders, and so on. His research will even continue at the upcoming 2011 Brazilian Jiu-Jitsu World Championship (if you are asked to answer a few questions about injuries during the registration process, please answer them!).

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The following is published with Kreiswirth’s permission.


Kreiswirth, EM*, Myer GD*†, Rauh, MJ*: * Rocky Mountain University of Health Professions, Provo, Utah † Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Context: Submission wrestling (SW) is a modern combat martial art that employs joint locks during competition to submit an opponent and achieve match victory. This martial art is a gateway sport for Mixed Martial Arts (MMA) which is a relatively young but popular combat sport worldwide. Due to it relatively new infrastructure there is currently limited injury incidence data available for SW or MMA. While SW has gained international attention in the martial arts community, little is known of the impact of injury in this sport. Since its inauguration in the United States in 1990, SW and its relevance to mixed martial arts is the fastest growing sport in America, with a consistent 100% annual increase in online interest. SW tournaments are growing rapidly worldwide in which thousands participate each year. SW may provide a preview of joint injury patterns we might expect in future SW and MMA competitions.
Purpose: The purpose of the current investigation was to determine the cumulative injury incidence sustained at an international level SW tournament, and to evaluate the risk of injury by belt rank and body region. Design: Prospective cohort Setting: 2009 Worlds No-Gi Championship. Patients or Other Participants: 951 male athletes aged 18 to 50 years old enrolled to compete in the 2009 No-Gi Championships. Participants were categorized into belt graduation levels for group comparisons (belt rank progression level: blue [least experienced], purple, brown, and black [most experienced]). Interventions: A reportable injury was defined as any joint injury that occurred during competition for which an athlete received any level of care from the on-site medical staff. Other injuries reported such as back, rib, head, fingers, and skin injuries were also recorded but were not included in the analysis. Data which met the inclusionary criteria were categorized by joint (elbow, shoulder, knee, and ankle) and aggregated. Group data were evaluated by rate ratios and 95% confidence intervals (CI). Main Outcome Measure: Incidence rates (IR) per 1000 athletic exposures (AEs) and rate ratios (RR) per belt rank Results: During the tournament there were 1606 recorded AE and 58 total reported injuries. Of these injuries, 40 were joint-related for an overall IR of 24.9 /1000 AEs. The joint IR for each specific belt rank was 21.5/1,000 AEs, 21.3/1,000 AEs, 25.2/1,000 AEs, and 35.1/1,000 AEs for blue, purple, brown, and black, respectively. No significant differences were found for RR of joint injury between individual belt groups (p>0.05). In addition, while the more experienced (brown/black belts) competitors had a higher injury risk compared to the less experienced (blue/purple) competitors, the difference was of borderline significance, RR 1.65, 95% CI:0.9 to 2.9, p=0.06). The incidence of joint injury was highest at the knee (7.5/1000 AEs) and elbow (7.5/1000 AEs).
Practical Applications: The data from this SW tournament suggest that the risk of joint injury is similar for belt rank/experience during SW competition. In terms of injury prevention planning, the data suggest the need to examine why the rates of joint injury are highest at the knee and elbow in efforts to minimize their occurrence. Future investigation of injury incidence is warranted to identify and understand mechanism of injury in SW, in addition to reduce potential risk factors attributed to injury.

5 Replies to “#239 Injury Rates and Types in Sport Brazilian Jiu-Jitsu with Ethan Kreiswirth”

  1. Very, very interesting post. I’m surprised that the higher ranks have the higher incidence of injury, but it makes sense with how much better their submission execution is

  2. @couch2cage: The higher rate is boarder-line significant, meaning you can’t definitely say that the higher belts have a higher rate of injuries.

    Also, there are other factors that affect injury outcomes…

    Future research should include (if possible) number of matches fought by each competitor in the same tournament and number of tournaments each competitor has competed in. The second will be much more difficult to obtain, but IBJJF might be able to provide you with some kind of data to use. Also, it’d be nice to know if the division weight class has an impact – are fighters in the open weight class more likely to get injured? Are smaller or bigger fighters more likely to get injured?

    I have a feeling that the number of matches a fighter has, the more likely they are to be injured. I’m not sure whether competition experience would have an effect – perhaps more experienced competitors are less likely to get injured. Finally I suspect that smaller fighters in an open weight class would be more likely to get injured.

    Can’t wait to see more data!
    (*pushes up glasses*)

  3. Great start to what will undoubtedly surprise all involved and perhaps lend credence to “tap out” before you “pop out”… good stuff!

  4. Any information on a a torn rib muscle/cartilage?I have recently sustained such injury, I couldn’t move the first couple days and it has been 2 weeks and a simple sit up still hurts. How long does something like this would take? Anything I can do to speed up recovery?


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