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What Is Cauliflower Ear: Why Is It So Common in in BJJ and Martial Arts?

Cauliflower ear is a physical deformity of the ear that occurs due to a blunt trauma or repeated impacts leading to a hematoma or blood collection beneath the skin. In martial arts like Brazilian jiu jitsu or wrestling cauliflower ear is quite common.

The condition arises when the collected blood clots and interrupts the blood flow and nutrients to the ear cartilage, causing separation between the ear’s skin and cartilage with fluid filling the resulting space. The ears may appear swollen, lumpy, or misshapen, resembling a cauliflower.

From a survey done at my Brazilian jiu jitsu gym (10th Planet San Diego), on average, only about 20-25% of all bjj practitioners will get cauliflower ear from training.

If you are susceptible to cauliflower ear, you will likely see signs within the first 2 years of your bjj training. However, if you don’t notice any swelling or lasting damage to your ears during that time, the odds that you will get cauliflower ear during your training are very low.


In Brazilian Jiu-Jitsu (BJJ) and other martial arts, cauliflower ear is particularly prevalent due to the nature of close combat and frequent, forceful contact with the head area, including the ears. Some bjj practitioner’s may choose to wear headgear to prevent or treat cauliflower ear.

Key Takeaways

  • Cauliflower ear results from trauma leading to blood clotting beneath the skin of the ear.
  • While more scientific studies need to be done, I surveyed fellow students in an advanced bjj class at my gym, and only an estimated ~25% of all bjj practitioners had cauliflower ear
  • It seems that some people are more susceptible to cauliflower ear
    • my younger brother got cauliflower ear within the first 6 months of jiu jitsu training whereas I’ve never gotten cauliflower ear and have been training for almost 6 years
  • In bjj certain positions and techniques can lead to excessive rubbing or friction of the ears which can cause cauliflower ear for example:
    • tight passing like body lock passing, over under passing or passing where you are using your head to pressure into your opponent
    • certain submissions or submission escapes can lead to damage to the ear as well like
      • triangles
      • guillotines
      • head and arm chokes
    • impacts to the ear during wrestling exchanges or scrambles are often a major cause as well

Cauliflower ear can develop from one single impact or from smaller impacts over the course of time.

Understanding Cauliflower Ear

Cauliflower ear is a distinctive physical condition associated with combat sports, notably Brazilian Jiu-Jitsu (BJJ) and martial arts, due to the high prevalence of direct and repeated trauma to the ear.

Definition and Description

Cauliflower ear, medically known as auricular hematoma, occurs when the ear’s cartilage is damaged due to an accumulation of blood or fluid between the cartilage and the overlying perichondrium. This damage gives the ear a swollen, lumpy appearance that resembles a cauliflower.

Causes and Development

Cauliflower ear develops as a result of repetitive impact to the ear, which leads to a blood clot or fluid collection – a hematoma – that interrupts the blood supply to the cartilage.

Without proper treatment, the cartilage can die and result in permanent deformation. In martial arts and BJJ, these injuries are often due to friction or strikes to the side of the head.

Anatomy of the Human Ear

The human ear consists of three main parts:

  1. Outer ear (auricle or pinna): largely comprised of cartilage covered by skin.
  2. Middle ear: includes the eardrum and ossicles.
  3. Inner ear: contains the cochlea and vestibular system for hearing and balance.

Cauliflower ear affects the outer ear’s structure when the cartilage’s supply of nutrients and oxygen is disrupted after an injury.

Cauliflower Ear in BJJ and Martial Arts

Cauliflower ear is a physical condition often seen in practitioners of Brazilian Jiu-Jitsu (BJJ) and other martial arts due to the high likelihood of ear trauma in these sports.

Prevalence in Combat Sports

Cauliflower ear is notably common among athletes in combat sports such as BJJ, wrestling, and mixed martial arts (MMA). It is caused by direct impact to the ear, leading to a hematoma or blood collection underneath the skin. This trauma separates the cartilage from the overlying skin, causing the distinctive swelling. If untreated, the fluid can harden, leading to permanent ear deformity.

  • Reasons for Higher Prevalence in Combat Sports:
    • Frequent Friction: Regular contact and rubbing of the ears during grappling and clinching maneuvers.
    • Impact Trauma: Strikes, slams, and pressure applied to the side of the head.
    • Less Protective Gear: In comparison to sports like boxing, there’s often minimal or no headgear worn, leaving ears exposed.

Comparison to Other Sports

While cauliflower ear can occur in any activity where the ear is susceptible to trauma, it is less common in non-combat sports due to the decreased risk of such injuries.

  • Contrast with Ball Sports:
    • Ball sports like basketball or soccer may involve incidental contact, but the likelihood of sustaining a blow to the ear severe enough to cause cauliflower ear is relatively low.
    • Routine use of protective gear in sports such as American football or rugby reduces the incidence of this condition.
  • Comparison with Aquatic Sports:
    • In aquatic sports such as swimming or water polo, the ears are not typically subjected to the same level of trauma as in combat sports.
    • When ear injuries do occur in these settings, they are often the result of accidental impact rather than repetitive trauma.

Cauliflower ear, therefore, serves as an indicator of frequent and intense ear trauma, which is why its presence is much more common in the world of BJJ and other related martial arts.

Prevention and Management

Prevention and management of cauliflower ear involve protective measures during physical activities, immediate treatment following injury, and strategies to mitigate long-term damage.

Protective Gear Usage

Protective headgear is essential for athletes participating in contact sports like Brazilian Jiu-Jitsu (BJJ) and other martial arts. This gear should fit snugly and cover the ears adequately to shield them from trauma. For instance, wrestlers and martial artists often use:

  • Headgear: Specially designed to reduce impact to the ear area.
  • Helmets with ear guards: A common preventative tool in sports with higher risks of head contact.

Immediate Treatment

When an ear injury occurs, prompt action can decrease the risk of developing cauliflower ear. Key steps include:

  • Cold Compression: Apply ice to the affected ear to reduce swelling.
  • Medical Evaluation: Seek a healthcare provider promptly to potentially drain any hematoma before it solidifies.

Long-Term Management Strategies

For individuals with existing ear deformities or those prone to repeated injuries, ongoing strategies include:

  • Regular Check-ups: Monitor ear health with scheduled healthcare visits.
  • Surgery: In severe cases, reconstructive surgery may be necessary to restore the ear’s shape and function.

Medical Procedures

Cauliflower ear is often treated through medical procedures aimed at correcting the deformity and preventing further damage. The treatment approach can be either surgical or non-surgical, depending on the severity and stage of the condition, and is followed by aftercare to ensure proper healing and recovery.

Surgical Interventions

Surgical Correction: In severe cases where cauliflower ear has developed to a significant deformity, surgery may be necessary. The surgical procedure often involves:

  • Incision and Drainage: A surgeon makes an incision to drain the accumulated blood.
  • Removal of Necrotic Tissue: Dead tissue is removed to prevent infection and further complications.
  • Reconstruction: The ear’s shape is restored using sutures, and sometimes cartilage grafts are required to rebuild the structure.

Timing: Surgery is typically advised if the condition is not responsive to initial treatments or if there is a long-standing deformity.

Non-Surgical Treatments

Aspiration: A less invasive procedure which involves:

  • Needle Aspiration: Removing the blood from the hematoma with a syringe shortly after the injury.

Compression: A crucial step post-aspiration to prevent fluid reaccumulation, often includes:

  • Special Dressings: Applying pressure dressings to adhere the skin to the underlying cartilage.

Medication: Administration of antibiotics may be prescribed to prevent infection following non-surgical interventions.

Aftercare and Recovery

Follow-up Appointments: Regular check-ups to monitor the progression of healing and to adjust treatments if necessary.

Protection: Wearing protective headgear during sports to prevent re-injury during the healing process.

Monitoring: Patients should watch for signs of infection or any changes in the ear’s shape and seek immediate care if needed.

Frequently Asked Questions

Cauliflower ear is a common concern for Brazilian Jiu-Jitsu (BJJ) and martial arts practitioners due to the nature of these sports. Understanding prevention, risks, and treatments is crucial for athletes.

How can cauliflower ear in BJJ and martial arts be prevented?

Prevention strategies include wearing headgear during training to protect the ears from trauma. Early treatment of any ear injury can also minimize the risk of developing cauliflower ear.

What is the typical time frame for developing cauliflower ear in grappling sports?

The onset of cauliflower ear can occur within hours after the ear sustains a significant injury. Immediate medical attention can help prevent permanent deformity.

What are the statistical risks of acquiring cauliflower ear from consistent BJJ training?

Statistically, individuals involved in grappling sports such as BJJ have a higher likelihood of developing cauliflower ear due to frequent exposure to blunt force trauma to the ear area.

Are there any specific headgear recommendations to protect against cauliflower ear in combat sports?

Quality headgear with adequate padding and a secure fit is recommended for anyone participating in combat sports to reduce the risk of ear injuries that can lead to cauliflower ear.

Can cauliflower ear pose serious health risks or complications?

If left untreated, cauliflower ear can result in complications such as infection, permanent hearing loss, or severe cosmetic deformity.

What are the underlying causes of cauliflower ear in practitioners of martial arts?

The primary cause is repeated blunt trauma to the ear, causing a hematoma that disrupts the connection between the skin and the cartilage, leading to the characteristic swelling and deformation associated with this condition.