Abstract
Limited research has systematically examined injuries resulting from Brazilian Jiu Jitsu (BJJ), Judo, and mixed martial arts (MMA), especially when compared to more well-known or -established martial arts. These three combative sports differ substantially regarding their rules and techniques. BJJ emphasizes ground positioning and submission, Judo rewards throwing an opponent on their back with submission ending the match, and MMA emphasizes knocking out or forcing the submission of one’s opponent. We examined injuries, among people of any age, experienced from participation in BJJ, Judo, and MMA. We analyzed data from the United States (U.S.) Consumer Product Safety Commission National Electronic Injury Surveillance System to create estimates of injuries presenting to U.S. emergency departments (EDs). We compared injury profiles between sports, including estimated numbers of injuries, their site, type, and mechanism. Participation in BJJ, Judo, and MMA resulted in an estimated 39,181 injuries presenting to U.S. EDs from 2008 through 2015. Strains and sprains were the most common diagnoses for BJJ and Judo participants, whereas abrasions/contusions were the most commonly diagnosed MMA injury. Being struck resulted in the majority of injuries for all three sports. The head was the most injured body region for BJJ and MMA, whereas the leg was the most injured body region for Judo. Finally, the majority of BJJ and Judo injuries occurred during noncompetitive grappling, whereas most MMA injuries occurred during competition. Our study adds to the limited literature examining injuries from BJJ, Judo, and MMA using data from a probability sample and is an initial step towards understanding the national burden of injury from participation in these sports. Given the quantity and severity of injuries sustained by participants, additional research is needed to assess the riskiness of participation and the effectiveness of interventions, such as improved personal protective gear and mats, as a means to prevent commonly occurring injuries.
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References
Birrer, R., & Halbrook, S. (1988). Martial arts injuries: The results of a five year national survey. The American Journal of Sports Medicine, 16(4), 408–410. https://doi.org/10.1177/036354658801600418.
Bledsoe, G. H., Hsu, E. B., Grabowski, J. G., Brill, J. D., & Li, G. (2006). Incidence of injury in professional mixed martial arts competitions. Journal of Sports Science and Medicine, 5(CSSI), 136–142.
Buse, G. J. (2006). No holds barred sport fighting: A 10 year review of mixed martial arts competition. British Journal of Sports Medicine, 40(2), 169–172. https://doi.org/10.1136/bjsm.2005.021295.
Comstock, D., Collins, C., & Currie, D. (2014). National high school sports-related injury surveillance study. Columbus, OH. Accessed June 1, 2017, from http://www.ucdenver.edu/academics/colleges/PublicHealth/research/ResearchProjects/piper/projects/RIO/Documents/2012-13.pdf.
Datalys Center, Inc. (2016). NCAA injury surveillance program. Accessed June 1, 2017, from http://www.datalyscenter.org/ncaa-injury-surveillance-program/.
Davis, B. A., Hiller, L. P., Imbesi, S. G., & Chang, E. Y. (2015). Isolated lateral collateral ligament complex injury in rock climbing and Brazilian Jiu-jitsu. Skeletal Radiology, 44(8), 1175–1179. https://doi.org/10.1007/s00256-015-2108-6.
de Sá Oliveira, T., & Pereira, J. S. (2008). Frequency of articulation injuries in judo practicing. Fitness & Performance Journal, 7(6), 375–379. https://doi.org/10.3900/fpj.7.6.375.e.
Diesselhorst, M. M., Rayan, G. M., Pasque, C. B., & Peyton Holder, R. (2013). Survey of upper extremity injuries among martial arts participants. Hand Surgery, 18(02), 151–157. https://doi.org/10.1142/s0218810413500172.
Galanis, N., Anastasiadis, P., Grigoropoulou, F., Kirkos, J., & Kapetanos, G. (2014). Judo-related traumatic posterior sternoclavicular joint dislocation in a child. Clinical Journal of Sport Medicine, 24(3), 271–273. https://doi.org/10.1097/jsm.0000000000000020.
Gauthier, J. (2009). Ethical and social issues in combat sports: Should combat sports be banned? In R. Kordi, N. Maffulli, R. R. Wroble & W. A. Wallace (Eds.), Combat sports medicine (pp. 74–75). London: Springer.
Hashiguchi, H., Iwashita, S., Ohkubo, A., Sawaizumi, T., & Takai, S. (2015). Stress fracture of the radial styloid process in a Judo player: A case report. Journal of Nippon Medical School, 82(2), 109–112. https://doi.org/10.1272/jnms.82.109.
Heath, C. J., & Callahan, J. L. (2013). Self-reported concussion symptoms and training routines in mixed martial arts athletes. Research in Sports Medicine, 21(3), 195–203. https://doi.org/10.1080/15438627.2013.792082.
Hojjat, H., Svider, P. F., Lin, H.-S., Folbe, A. J., Shkoukani, M. A., Eloy, J. A., et al. (2016). Adding injury to insult: A national analysis of combat sport–related facial injury. Annals of Otology, Rhinology & Laryngology, 125(8), 652–659. https://doi.org/10.1177/0003489416644617.
Hutchison, M. G., Lawrence, D. W., Cusimano, M. D., & Schweizer, T. A. (2014). Head trauma in mixed martial arts. American Journal of Sports Medicine, 42(6), 1352–1358. https://doi.org/10.1177/0363546514526151.
International Brazilian Jiu-Jitsu Federation (IBJJF). (2015). Rule Book. Rio De Janeiro. Accessed June 1, 2017, from http://ibjjf.org/wp-content/uploads/2015/04/RulesIBJJF_v4_en-US.pdf.
International Judo Federation (IJF). (2014). International Judo Federation referee rules 2014–2016. Accessed June 1, 2017, from http://media.usja.net/committee/2014RefereeRulesUSAJudoCommentsFinal140124.pdf.
Itagaki, M. W., & Knight, N. B. (2004). Kidney trauma in martial arts a case report of kidney contusion in Jujitsu. The American Journal of Sports Medicine, 32(2), 522–524.
James, G., & Pieter, W. (2003). Injury rates in adult elite judoka. Biology of Sport, 20(1), 25–32.
Kamitani, T., Nimura, Y., Nagahiro, S., Miyazaki, S., & Tomatsu, T. (2013). Catastrophic head and neck injuries in judo players in Japan from 2003 to 2010. The American Journal of Sports Medicine, 41(8), 1915–1921.
Kim, K.-S., Park, K. J., Lee, J., & Kang, B. Y. (2015). Injuries in national Olympic level judo athletes: An epidemiological study. British Journal of Sports Medicine, 49(17), 1144–1150. https://doi.org/10.1136/bjsports-2014-094365.
Kochhar, T., Back, D., Mann, B., & Skinner, J. (2005). Risk of cervical injuries in mixed martial arts. British Journal of Sports Medicine, 39(7), 444–447. https://doi.org/10.1136/bjsm.2004.011270.
Koshida, S., Deguchi, T., Miyashita, K., Iwai, K., & Urabe, Y. (2010). The common mechanisms of anterior cruciate ligament injuries in judo: A retrospective analysis. British Journal of Sports Medicine, 44(12), 856.
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/10.4085/1062-6050-49.1.11.
Kurosawa, H., Nakasita, K., Nakasita, H., Sasaki, S., & Takeda, S. (1996). Complete avulsion of the hamstring tendons from the ischial tuberosity. A report of two cases sustained in judo. British Journal of Sports Medicine, 30(1), 72–74.
Liao, B., Xie, Y., & Gray, A. M. (2015). Epidemiology of knee injuries in Judo professional atheletes of Guangdong Province Of China: 2351 Board# 98 May 29, 9:30 AM-11:00 AM. Medicine & Science in Sports & Exercise, 47(5S), 630.
Lystad, R. P. (2015). Epidemiology of injuries in full-contact combat sports. Australasian Epidemiologist, 22(1), 14.
Lystad, R. P., Gregory, K., & Wilson, J. (2014). The epidemiology of injuries in mixed martial arts: A systematic review and meta-analysis. Orthopaedic Journal of Sports Medicine. https://doi.org/10.1177/2325967113518492.
Lystad, R. P., Pollard, H., & Graham, P. L. (2009). Epidemiology of injuries in competition taekwondo: A meta-analysis of observational studies. Journal of Science and Medicine in Sport, 12(6), 614–621. https://doi.org/10.1016/j.jsams.2008.09.013.
McHugh, M. (2012). Interrater reliability: The kappa statistic. Biochemia Medica, 22(3), 276–282. https://doi.org/10.11613/bm.2012.031.
McPherson, M., & Pickett, W. (2010). Characteristics of martial art injuries in a defined Canadian population: A descriptive epidemiological study. BMC Public Health, 10(1), 795. https://doi.org/10.1186/1471-2458-10-795.
Nambu, S., & Noji, M. (2014). Case of fatal head trauma experienced during Japanese judo. Current Sports Medicine Reports, 13(1), 11–15. https://doi.org/10.1249/jsr.0000000000000024.
NCCSIR. (2016). National Center for Catastrophic Sport Injury Research. Accessed June 1, 2017, from http://nccsir.unc.edu/about/.
Ngai, K. M., Levy, F., & Hsu, E. B. (2008). Injury trends in sanctioned mixed martial arts competition: A 5-year review from 2002 to 2007. British Journal of Sports Medicine, 42(8), 686–689. https://doi.org/10.1136/bjsm.2007.044891.
Noh, J.-W., Park, B.-S., Kim, M.-Y., Lee, L.-K., Yang, S.-M., Lee, W.-D., et al. (2015). Analysis of combat sports players’ injuries according to playing style for sports physiotherapy research. Journal of Physical Therapy Science, 27(8), 2425–2430. https://doi.org/10.1589/jpts.27.2425.
Pappas, E. (2007). Boxing, wrestling, and martial arts related injuries treated in emergency departments in the United States, 2002–2005. Journal of Sports Science and Medicine, 6(Special Issue 2), 58–61.
Pieter, W., Fife, G. P., & O’Sullivan, D. M. (2012). Competition injuries in taekwondo: A literature review and suggestions for prevention and surveillance. British Journal of Sports Medicine, 46(7), 485–491. https://doi.org/10.1136/bjsports-2012-091011.
Pocecco, E., Ruedl, G., Stankovic, N., Sterkowicz, S., Del Vecchio, F. B., Gutiérrez-García, C., et al. (2013). Injuries in judo: A systematic literature review including suggestions for prevention. British Journal of Sports Medicine, 47(18), 1139–1143. https://doi.org/10.1136/bjsports-2013-092886.
Potter, M. R., Snyder, A. J., & Smith, G. A. (2011). Boxing injuries presenting to US emergency departments, 1990–2008. American Journal of Preventive Medicine, 40(4), 462–467. https://doi.org/10.1016/j.amepre.2010.12.018.
Reis, F. J., Dias, M. D., Newlands, F., Meziat-Filho, N., & Macedo, A. R. (2015). Chronic low back pain and disability in Brazilian jiu-jitsu athletes. Physical Therapy in Sport, 16(4), 340–343. https://doi.org/10.1016/j.ptsp.2015.02.005.
RIO. (2017). Welcome to the 2015–16 High School RIO™ (Reporting Information Online) internet-based injury surveillance system! Accessed June 1, 2017 from https://highschool.riostudies.com/.
Rosenberg, H., & Beck, J. (2011). Jujitsu kick to the abdomen: A case of blunt abdominal trauma resulting in hematochezia and transient ischemic colitis. Annals of Emergency Medicine, 58(2), 189–191.
Schroeder, T., & Ault, K. (2001). The NEISS sample (Design and Implementation) 1997 to present. Washington, DC. Accessed June 1, 2017 from http://www.cpsc.gov//PageFiles/106617/2001d011-6b6.pdf.
Scoggin, J. F., III, 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.
Shepard, N., Westrick, R., Owens, B., & Johnson, M. (2013). Bony avulsion injury of the pectoralis major in a 19 year-old male judo athlete: A case report. International Journal of Sports Physical Therapy, 8(6), 862–870.
Sims, K., & Spina, A. (2009). Traumatic anterior shoulder dislocation: A case study of nonoperative management in a mixed martial arts athlete. The Journal of the Canadian Chiropractic Association, 53(4), 261.
Slowey, M., Maw, G., & Furyk, J. (2012). Case report on vertebral artery dissection in mixed martial arts. Emergency Medicine Australasia, 24(2), 203–206. https://doi.org/10.1111/j.1742-6723.2011.01496.x.
Souza, M., Monteiro, H., Del Vecchio, F., & Gonçalves, A. (2006). Referring to judo’s sports injuries in São Paulo State Championship. Science & Sports, 21(5), 280–284. https://doi.org/10.1016/j.scispo.2006.06.002.
Sports Club Advisors, Inc. (2017). Martial arts clubs industry snap shot 2016. Accessed August 16, 2017, from http://sportsclubadvisors.net/martial-arts-clubs-industry-snap-shot/.
UFC. (2017). Fighters train in multiple disciplines. Accessed June 1, 2017, from http://www.ufc.com/discover/fighter/martialArtsStyles.
United States Consumer Product Safety Commission (U.S. CPSC). (2017). National electronic injury surveillance system. Accessed June 1, 2017, from https://www.cpsc.gov/Safety-Education/Safety-Guides/General-Information/National-Electronic-Injury-Surveillance-System-NEISS/.
Yard, E., Collins, C., Dick, R., & Comstock, R. (2008). An epidemiologic comparison of high school and college wrestling injuries. The American Journal of Sports Medicine, 36(1), 57–64. https://doi.org/10.1177/0363546507307507.
Yard, E. E., Knox, C. L., Smith, G. A., & Comstock, R. D. (2007). Pediatric martial arts injuries presenting to Emergency Departments, United States 1990–2003. Journal of Science and Medicine in Sport, 10(4), 219–226. https://doi.org/10.1016/j.jsams.2006.06.016.
Zazryn, T. R., Finch, C. F., & McCrory, P. (2003). A 16 year study of injuries to professional kickboxers in the state of Victoria, Australia. British Journal of Sports Medicine, 37(5), 448–451. https://doi.org/10.1136/bjsm.37.5.448.
Zetaruk, M. N., Violan, M. A., Zurakowski, D., & Micheli, L. J. (2000). Karate injuries in children and adolescents. Accident Analysis and Prevention, 32(3), 421–425. https://doi.org/10.1016/s0001-4575(99)00120-7.
Zetaruk, M., Violan, M., Zurakowski, D., & Micheli, L. (2005). Injuries in martial arts: A comparison of five styles. British Journal of Sports Medicine, 39(1), 29–33. https://doi.org/10.1136/bjsm.2003.010322.
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The researchers would like to acknowledge Nafisa Afrin, Humera Uddin, and Shaheer Ahmed for their assistance with coding variables.
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Stephenson, C., Rossheim, M.E. Brazilian Jiu Jitsu, Judo, and Mixed Martial Arts Injuries Presenting to United States Emergency Departments, 2008–2015. J Primary Prevent 39, 421–435 (2018). https://doi.org/10.1007/s10935-018-0518-7
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DOI: https://doi.org/10.1007/s10935-018-0518-7