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What Causes the Most Knee Injuries in BJJ: Key Risk Factors and Prevention Tips

Knee injuries are the most common injury found in Brazilian jiu jitsu (BJJ).


Knee injuries in BJJ commonly come from the knee being twisted or compressed at unusual angles, rather than from leg lock submissions. Falling body weight, scrambles, incorrect technique execution, and takedowns are the most common cause of these injuries.


So what can we do to better understand these bjj injuries and prevent them in training?

Key Takeaways

Common Causes of Knee Injuries:

  • Knee hyperextension
  • Impact from takedowns and falls
  • Shear forces from rapid directional changes
  • Twisting motions while foot planted (as seen commonly in knee reaping injuries)

Prevention:

  • Tap early
  • Warm up properly
  • Avoid overtraining
  • Avoid wrestling if possible
  • Consider using a knee sleeve
  • Move slowly and deliberately
  • Do some weight or strength training

How Dangerous Is BJJ Really? (Examining Injury Rates)

Based on several surveys (linked below), we compliled the above data to show the average injury incident rate based on 100 competition rounds/matches.

Again, hese estimates were taken and combined from several different studies linked above.


A couple things we can assume based on these findings are that:

  • grappling based (non striking martial arts) are generally safer than striking based ones
  • Jiu jitsu and wrestling have a pretty low injury incident rate

We have also linked studies to each of the estimate figures below in the references section.


Looking further at some scientific data on injury rates in Brazilian jiu jitsu:

One study highlighted that within a three-year period, 31.2% of athletes remained injury-free, while 48.7% reported one injury, and 16.6% reported multiple injuries (Injury Patterns, Risk Factors, and Return to Sport in Brazilian Jiu Jitsu).

Another survey study reported that 59.2% of BJJ practitioners experienced at least one injury over a six-month period, with the knee being the most common site of injury (Injury rate and pattern among Brazilian jiu-jitsu practitioners).

What Injuries Are Most Common in Brazilian Jiu Jitsu?

data pulled from beltchecker.com

When examing the above data, we see that the most common injuries in bjj are:

  • Knee Injuries (22.5%)
  • Shoulder Injuries (13.7%)
  • Rib Injuries (8.4%)
  • Back Injuries (6.7%)

Now let’s take a look at some common causes of these knee injuries.

Common Causes of Knee Injuries in BJJ

Knee injuries in Brazilian Jiu-Jitsu often result from the complex and dynamic movements inherent in grappling sports. The interplay of rotational force and bodily contact makes the knee susceptible to various injuries.

  • Rotational Stress: BJJ involves numerous twisting motions while competitors seek control or attempt submissions. Such rotations, particularly when the foot is planted, can place abnormal stress on knee ligaments.
  • Direct Trauma: Knee joints can also be compromised through direct impact with the mat or an opponent, especially in takedown maneuvers.
  • Hyperextensions: When a practitioner’s leg is forced straight with excessive pressure, it may result in hyperextension. This action can stretch or tear ligaments, notably the Anterior Cruciate Ligament (ACL).
  • Shearing Forces: Sudden stops and changes of direction can lead to shear forces on the knee, increasing the risk for injuries such as meniscus tears.

Among these mechanisms, ACL injuries are frequently noted due to the stabilizing nature of the ligament and the vulnerability it has to the aforementioned stressors. The ACL is critical for knee stability during complex BJJ movements.


As we mentioned earlier, the primary mechanisms leading to knee injuries in BJJ are usually:

  • Twisting motions while foot planted
  • Impact from takedowns and falls
  • Knee hyperextension
  • Shear forces from rapid directional changes

Are Knee Injuries Only Found in Jiu Jitsu?

No, knee injuries are not exclusively found in jiu jitsu. Unfortunatley, injuries to the knee are very common across multiple sports and martial arts – below we have a quick comparison of knee injuries in popular sports:

According to a study published in the “Journal of Athletic Training,” sports with the highest rates of ACL injuries in collegiate athletes in the United States included women’s gymnastics, women’s soccer, and men’s spring football (American football) (Arendt & Dick, 1995).

Another study found that the highest incidence of ACL injuries in high school athletes occurred in girls’ soccer and boys’ football (Joseph et al., 2013).

Although BJJ hasn’t been studied nearly as much as other sports it’s safe to assume that other sports including soccer, football, and gymnastics all have high knee injury rates.

Knee Injury Risk Factors in BJJ

Knee injuries in Brazilian Jiu-Jitsu (BJJ) often result from a combination of factors including training practices, skill level, physical conditioning, and individual attributes like age and flexibility.

Training Intensity and Frequency

BJJ practitioners who engage in high-intensity training sessions or train frequently without adequate rest are at a higher risk of knee injuries. The constant strain on the joints during repetitive movements can lead to overuse injuries. It is crucial to balance training with recovery time to prevent such injuries.

  • High Risk: Daily, high-intensity training without rest
  • Lower Risk: Regular, moderated training with rest days

Technique and Skill Level

Inexperienced practitioners might apply techniques incorrectly or with improper form, increasing the likelihood of knee injuries. Advanced techniques that involve twisting motion can place greater stress on the knee if not performed correctly. Competent instruction and a focus on proper form are essential to mitigate injury risks.

  • Beginners: More prone to incorrect form and technique-related injuries
  • Advanced practitioners: Risk injuries from complex maneuvers

Physical Conditioning

Athletes with strong, well-conditioned muscles surrounding the knee joint are less likely to suffer from knee injuries. A lack of conditioning can cause instability and misalignment during physical exertion. Regular strength and stability exercises contribute to knee injury prevention.

  • Recommended Exercises: Squats, lunges, and leg presses
  • Muscle Groups to Strengthen: Quadriceps, hamstrings, and calf muscles

Age and Flexibility

As practitioners age, their flexibility and resilience to injury can decrease. The young may be more adaptable and recover quicker, while older practitioners often need to pay closer attention to their body’s signals. Regular stretching can improve flexibility and reduce the likelihood of knee injuries.

  • Youth: Generally more flexible and resilient
  • Older practitioners: May require targeted flexibility training

Types of Knee Injuries in BJJ

Ligament Tears

Ligament tears are among the most serious knee injuries in BJJ. They involve tears to the Anterior Cruciate Ligament (ACL) and/or Medial Collateral Ligament (MCL). ACL injuries often occur during sudden directional changes or when landing awkwardly from a jump. MCL tears typically result from a forceful blow to the outside of the knee.

  • ACL Injuries
    • Cause: Sudden twists, direct impact
    • Symptoms: Swelling, instability, pain
  • MCL Injuries
    • Cause: Side impact, excessive twisting
    • Symptoms: Pain along the inner knee, swelling, stiffness

Meniscus Injuries

The meniscus, a C-shaped cartilage in the knee, can be torn when the knee is twisted while bearing weight.

  • Symptoms:
    • Sharp pain in the knee
    • Swelling
    • Difficulty bending and straightening the leg
    • A tendency for the knee to get ‘stuck’ or locked up

Tendon Strains

Excessive force or overuse can lead to tendon strains in BJJ. Strains may affect the patellar tendon, connecting the kneecap to the shinbone.

  • Symptoms:
    • Pain below the kneecap
    • Swelling
    • Pain when jumping, kneeling, or squatting

Bursitis and Tendinitis

Repetitive movements or prolonged pressure can cause bursitis and tendinitis. These conditions involve the inflammation of the bursae (small fluid-filled sacs) and tendons, respectively.

  • Symptoms:
    • Pain and swelling
    • Warmth and redness around the joint
    • Pain that worsens with activity

I’ve actually has bursitis in my right knee from my own training, luckily a knee sleeve is an easy fix for this more minor knee injury

Preventative Measures for Knee Injuries

Proper Warm-Up and Stretching

Warm-up: A targeted warm-up routine increases blood flow to the muscles and prepares the joints for activity. An effective warm-up for BJJ practitioners could include 5-10 minutes of light aerobic exercise followed by dynamic stretching of the major muscle groups, particularly those around the knees.

Stretching: After training, incorporating static stretches that focus on flexibility of the hips, thighs, and calves can help maintain joint health. Stretches should be held for 20-30 seconds to gain the most benefit.

Strength Training

Leg Muscles: Strengthening the quadriceps, hamstrings, and calf muscles provides better support for the knee joint. Exercises like squats, lunges, and leg curls can be particularly beneficial. They should be performed with proper form to minimize the risk of injury.

Core and Hip Muscles: A stable core and strong hip muscles contribute to better body control during grappling. This can help prevent awkward movements that cause knee injuries. Exercises such as planks and hip abductors should be part of a regular conditioning routine.

Protective Gear Use

Knee Sleeves: Wearing knee pads or sleeves can offer cushioning and support, lessening the impact during takedowns and falls. They also retain heat around the joint, which can improve flexibility and reduce stiffness.

Braces: For those with prior knee issues, a brace may provide additional support. However, one should consult with a healthcare professional to determine the appropriate type of brace for their specific condition.

Injury Awareness and Reporting

Recognition: Practitioners should be educated on recognizing the early signs of knee strain or injury, such as pain, swelling, and instability. Early identification is crucial for preventing more serious injury.

Reporting: Immediate and open communication of any discomfort or injury to coaches and medical staff is key. The sooner an injury is addressed, the more effective the treatment and rehabilitation will be, reducing the time away from the sport.

Treatment and Rehabilitation of BJJ Knee Injuries

Effective management and rehabilitation of knee injuries in Brazilian Jiu-Jitsu are crucial for a practitioner’s return to the mat. These processes involve a structured protocol, starting from immediate care to physiotherapy, and possibly surgery, followed by a gradual return to training.

Initial Injury Management

  • Rest: Essential to prevent further injury.
  • Ice: Applied for 20 minutes every two hours to reduce swelling.
  • Compression: Utilize an elastic bandage for support and decrease swelling.
  • Elevation: Keep the injured knee raised above heart level.

Physiotherapy and Exercises

Strengthening Exercises:

  • Straight Leg Raises to fortify quadriceps.
  • Hamstring Curls to enhance the stability of the knee.

Flexibility Exercises:

  • Gentle stretching to restore the knee’s range of motion.

Surgical Options

  • Meniscus Repair: For significant meniscal tears.
  • ACL Reconstruction: In cases of complete ACL tears, using grafts from other tendons.

Recovery and Return to Training

Phased Approach:

  1. Light Activities: Gradual weight-bearing exercises as tolerated.
  2. Conditioning: Low-impact cardio to maintain fitness.
  3. Sport-Specific Drills: Transition to BJJ drills without live sparring.
  4. Full Training: Only when cleared by medical professionals.

Frequently Asked Questions

What are the primary causes of knee sprains in Brazilian Jiu-Jitsu?

In Brazilian Jiu-Jitsu, knee sprains often result from the application of force during twisting motions or sudden directional changes. These situations occur frequently during grappling exchanges and can strain the ligaments in the knee.

How can practitioners prevent knee injuries while training in BJJ?

Practitioners can prevent knee injuries by maintaining proper technique, engaging in strength and flexibility training, and avoiding overtraining. Wearing a properly fitting knee brace and warming up thoroughly before training can also reduce the risk of injury.

What techniques are most often associated with ACL injuries in BJJ?

ACL injuries are commonly associated with movements that involve pivoting or sudden deceleration. Techniques like shooting for a takedown or defending against aggressive guard passes can place stress on the ACL, leading to potential injuries.

Are knee sleeves effective in preventing injuries during Jiu-Jitsu matches?

Knee sleeves can provide additional support and cushioning, potentially reducing impact and stress on the knee joint during Jiu-Jitsu matches. They may not prevent all injuries but can be a useful part of a comprehensive injury prevention strategy.

What steps can be taken to strengthen and ‘bulletproof’ the knees for BJJ?

To strengthen the knees for BJJ, practitioners should incorporate targeted exercises that focus on building the muscles around the knee joint, such as squats and lunges. Balancing and proprioceptive drills can also enhance knee stability.

What are the differences in knee injury occurrences between BJJ and MMA?

The occurrence of knee injuries differs between BJJ and MMA due to the striking aspect and the diversity of movements in MMA. MMA fighters may experience a higher risk of knee injuries from striking, take-downs, and the increased intensity of competition.


References:


Brazilian Jiu Jitsu Competition Injury
Scoggin, James & Brusovanik, Georgiy & Izuka, Byron & Rilland, Eddy & Geling, Olga & Tokumura, Seren. (2014). Assessment of Injuries During Brazilian Jiu-Jitsu Competition. Orthopaedic Journal of Sports Medicine. 2. 10.1177/2325967114522184.

Professional Boxing Risk/Injury Rate
Bledsoe GH, Li G, Levy F. Injury risk in professional boxing. South Med J. 2005 Oct;98(10):994-8. doi: 10.1097/01.smj.0000182498.19288.e2. PMID: 16295814.

Wrestling Risk/Injury Rate
Van den berg C, Black A, Richmond SA, Babul S, Pike I. Evidence Summary: Wrestling. Active & Safe
Central. BC Injury Research and Prevention Unit: Vancouver, BC; 2018. Available at http://activesafe.ca/

Brazilian Jiu Jitsu Risk/Injury Rate
Hinz M, Kleim BD, Berthold DP, Geyer S, Lambert C, Imhoff AB, Mehl J. 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. PMID: 34988235; PMCID: PMC8721390.

MMA Risk/Injury Rate
Rainey CE. Determining the prevalence and assessing the severity of injuries in mixed martial arts athletes. N Am J Sports Phys Ther. 2009 Nov;4(4):190-9. PMID: 21509103; PMCID: PMC2953351.

Kreiswirth, E. M., Myer, G. D., & Rauh, M. J. (2014). Incidence of Injury Among Male Brazilian Jiujitsu Fighters at the World Jiu-Jitsu No-Gi Championship 2009. Journal of Athletic Training, 49(1), 89–94. https://doi.org/10.4085/1062-6050-49.1.03

Scoggin, J. F., Brusovanik, G., Izuka, B. H., Zandee van Rilland, E., Geling, O., & Tokumura, S. (2014). Assessment of Injuries During Brazilian Jiu-Jitsu Competition. Orthopaedic Journal of Sports Medicine, 2(2), 2325967114522184. https://doi.org/10.1177/2325967114522184

Andreato, L. V., Esteves, J. V. D. C., Coimbra, D. R., Moraes, A. J. P., & de Carvalho, T. (2017). Injury rate and pattern among Brazilian jiu-jitsu practitioners: A survey study. Science & Sports, 32(6), e173-e178. https://doi.org/10.1016/j.scispo.2017.06.006

Knapik, J. J., Hoedebecke, S. S., Rogers, G. G., Sharp, M. A., & Jones, B. H. (2019). Injury Prevalence in Brazilian Jiu-Jitsu and Mitigation Strategies for Brazilian Jiu-Jitsu Practitioners and Instructors: A Literature Review. The Sport Journal. Retrieved from https://thesportjournal.org/article/injury-prevalence-in-brazilian-jiu-jitsu-and-mitigation-strategies-for-brazilian-jiu-jitsu-practitioners-and-instructors-a-literature-review/

These references are formatted according to the American Psychological Association (APA) style, which is commonly used in the social sciences. When including these citations in a reference section, ensure they are double-spaced and have a hanging indent.

    About the Author:

    Zack Nicholas

    Zack Nicholas:

    Zack is an avid jiu jitsu practitioner and weight lifting nerd. When not on the mats or in the gym, he can be found going for walks with his wife, attempting (and often failing) to train his dog, and frequently obsessing over a specific hobby only to forget about it a week later. He can be reached over his LinkedIn or at info@heavybjj.com