Most Common BJJ Knee Injuries

MOST COMMON BRAZILIAN JIU-JITSU (BJJ) KNEE INJURIES

Brazilian Jiu-Jitsu (BJJ) is the most dominant grappling sport in the world. It was founded on the concept of defeating a superior opponent in strength, size, and weight by using leverage and techniques. It emerges as an elite form of martial art with local, national, and international tournaments all over the world.

BJJ is not only a martial art but a lifestyle that helps you maintain your health and wellness. As a form of fitness, it increases flexibility, improves strength and concentration, helps release stress, and builds up your confidence. It is also a self-defense system which enables you to defend yourself when necessary.

As in any other combat sport that use full-body contact, BJJ exposes your arms, knees, fingers, toes, limbs, elbow, ankle, and thighs to injury. The knees take the worse beating which can be a result overuse or sudden, traumatic injury. Your regular rolling puts excessive pressure on the knee while other executed moves or failure to tap (we’re aware of the irony) can cause you a severe injury that requires immediate medical attention.


JUST A FEW BJJ MOVES THAT CAN DAMAGE THE KNEES


There are a lot of grappling techniques and submission holds in Brazilian Jiu-Jitsu that put your knees at risk to traumatic injury. Examples of these moves are knee bars and heel hooks make up just two examples. You can also get overuse injury from kneeling on the mat or contact with your opponent during training and tournaments.

1. Knee Bar

When you use the knee bar, you grab and pull your opponent’s leg beyond its normal range of motion, overextending the knee to tap him out. If you're not careful with this move you can cause serious damage or snap your opponent's leg. When you're the one receiving the knee bar, don't hesitate to tap rather than suffer ligament or tissue damage.

2. Heel Hook

This is just a simple move but dangerous. To execute the heel hook, you lock your opponent’s leg so he could not move it to the side and hook his heel with your hands then twist the heel to lock the ankle joint. You can dislocate or break the bone and tear muscles, ligaments, and tendons of your opponent’s knee.

3. Rubber Guard

The Rubber Guard, pioneered by 10th Planet found Eddie Bravo, is sometimes referred to as “mission control” and is a closed guard technique which involves clenching your opponent. It requires a high level of flexibility in your legs. While you’re in the bottom guard, you put your shin over your opponent’s neck and grab it with your hand. You put great pressure on your knee to control your opponent with one leg and arm. As will all BJJ positions ot is important to have developed the flexibility necessary to execute properly or you put yourself at risk of injury.

4. De La Riva Guard

The De La Riva guard (DLR) is named after Ricardo De La Riva with his trademark leg hook. With your back towards the ground, you deliver an outside hook with your open leg over your opponent’s leading leg to compromise his balance. This outside “wrap” puts a strain on your knee and hyperextend it if your opponent has a wider build unless you’re long-legged.

COMMON BJJ KNEE INJURIES

Your knee is a synovial hinge joint composed of complex structures of three bones, two types of cartilage, four ligaments, and tendons. Its different parts work together to give you agility and support your upper body when in motion. It is the largest joint formed between the thighbone (femur), shinbone (tibia), and kneecap (patella).

Up Close and Personal with Your Knee

There are two cruciate ligaments in your knee joint, the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). They are short folds of tough and fibrous but flexible connective tissues which cross each other to form an “X” band that connects the thighbone to the shinbone. The cruciate ligaments control the backward and forward motion of your knee.

The collateral ligaments run on the side of your knee, the medial collateral ligament (MCL) on the inside and the lateral collateral ligament (LCL) on the outside. The MCL connects the thighbone to the shinbone while the LCL connects the thigh bone to the fibula, the outer and smaller bone from the knee to the ankle. These ligaments control the side motion of your knee.

Cartilage is a whitish, firm, smooth and flexible connective tissue that gives support, bear weight, and withstand pressure during torsion, tension, and bending. The articular cartilage covers the ends of your thigh bone and provides a smooth and lubricated surface so your knee bones glide smoothly across each other with less friction as you move.

The meniscal cartilage, a tough and rubbery connective tissue, provides a cushion between your thighbone and shinbone and acts as “shock absorber” when you put pressure on your knee. Your knee joint has two menisci (meniscus as singular) which assist in the rotational stability provided by the anterior cruciate ligament (ACL).

Injuries Involving Your Ligaments and Cartilage

Here are the three of the most common knee injuries in Brazilian Jiu-Jitsu which involves your ligaments and cartilage:


1. ACL Sprain or Tear
Frequently, the anterior cruciate ligament (ACL) is injured in high demand sports like BJJ. This ligament connects the front of your shinbone to the back of your thigh bone to stabilize the knee joint and prevent hyperextension. Receiving the knee bar or heel hook, direct contact, collision or changing your direction rapidly, can tear or sprain the ACL and other structures in the knee.

  • Grade 1 Sprain - slightly stretched ligament with mild damage but still keeps the knee joint stable.

  • Grade 2 Sprain - loose ligament due to overstretching.  This condition is rare and referred to as the partial tear of the ligament.

  • Grade 3 Sprain - this is the most cases of the ACL injury and referred to as the complete tear of the ligament. It is split in two which causes the knee to become unstable.

When you hear a loud popping sound, that’s a warning that something is wrong with your anterior cruciate ligament. Sometimes you could not feel the symptoms right away. Within 24 hours there would be inflammation, pain, tenderness along the joint line, loose of full-range of motion, and feeling of discomfort when you walk.

If you suffer a mild Grade 1 Sprain, you need to follow the RICE: rest, ice, compression, and elevation. Avoid putting your weight on the damaged knee. Take a break from rolling or joining the tournament or you may aggravate your injury. If it gets to Grade 3  and you tear your ACL, you may require surgery to recover its full function. So, don’t push yourself too far.

At the first sign, you better visit your doctor. He may recommend imaging tests to confirm his diagnosis. An x-ray will not show the damage to your ACL but it can show if it is from a broken bone. The magnetic resonance imaging (MRI) scan provides better images of soft tissues but not usually required to make the diagnosis.

There are non-surgical treatments available such as bracing and physical therapy. You need to wear a knee brace and maybe crutches as well to stabilize your joint. When the inflammation goes down, you can start the physical therapy to restore the normal functions of your knee with specific muscle strengthening exercises.

2. MCL/LCL Sprain or Tear
The collateral ligament sprain or tear is a contact injury caused by the hard contraction of the muscles and a direct blow to the inside or outside of the knee. The medial collateral ligament (MCL) is frequently injured than the lateral collateral ligament (LCL). If you use the rubber guard and the DLR guard, you expose your MCL to direct contact with your opponent.

If you feel pain on the inside of your knee, you damage your MCL and outside if it’s the LCL. Inflammation and instability, the feeling that your knee would buckle under you are other symptoms of MCL/LCL sprain or tear. The degree of severity has the same level as the ACL injury, from Grade 1 Sprains to Grade 3 but rarely requires surgery.

You also follow the RICE treatment. However, instead of a cold pack, it is recommended to put crushed ice directly to your injury for 15 to 20 minutes with at least one-hour intervals. To aid your healing process and protect your ligament from stress, your doctor may recommend the use of braces, crutches and physical therapy afterward.

3. Meniscus Tear
Your menisci, the fibrous C-shaped pads, absorb the impact and pressure, particularly in grappling and submission only BJJ. Regular forceful twisting, cutting, pivoting or hyper-flexing of the knee joint tear your meniscus. The symptoms include pain, inflammation, stiffness, tenderness,  and trouble moving your knee in its full range.

You may be tempted to continue your sparring or tournaments even when you feel the “pop” of your meniscus. You may think you can still walk so, you  keep on playing. After 2 or 3 days you can see and feel more symptoms. If you continue without the treatment, a piece of broken meniscus may be carried into the joint and make your knee slip, pop or lock.

When you go to see your doctor, he normally administers the McMurray test. It involves bending your knee, straightening, and finally rotating it. The movements produce a clicking sound which shows you have a meniscus tear. Your treatment depends on the size and location of your meniscal injury.

The same with other knee joint injuries, the first treatment is RICE. You should not apply ice directly but use cold packs for 20 minutes at a time. Over the counter, non-steroidal anti-inflammatory medicines like aspirin and ibuprofen can alleviate the pain and inflammation. If you need surgery, you may have one of these procedures based on your injury:

  • Arthroscopic surgery - You will have a small incision that serves as a portal to insert a small camera. The orthopedic surgeon then gets a clear view of your meniscal injury. He would make other portals where he inserts the miniature surgical instruments through to trim or repair the tear.

  • Partial meniscectomy - Your orthopedic surgeon trims away the damaged meniscus tissue.

  • Meniscus repair - Stitching or suturing to repair to torn pieces of your meniscus depends on the type of tear and its condition. In this procedure, it requires a longer recovery time to allow the torn meniscus to heal together.

WAYS TO PREVENT KNEE INJURIES

1. Up Your Diet

As a practitioner of Brazilian Jiu-Jitsu, you need a higher protein intake than the regular guy. How does protein work in your body? It is a building block of your bones, muscles, cartilage, ligaments, skin, and blood. It builds and repair your body’s tissues, produce enzymes and hormones, transport oxygen, and boosts immunity.

To maintain an excellent shape, you should consume your daily protein requirement as recommended by your dietitian. So, what are the best sources of protein?

  Food Sources and Their Protein Contents

Food

Weight in Grams

Protein Per 100 Grams

  1. Soya Beans

    Protein Per 100 Grams - 36

  2. . Chicken Breast

    Protein Per 100 Grams - 31

  3. Turkey Breast

    Protein Per 100 Grams - 29

  4. Sirloin Steak

    Protein Per 100 Grams - 27

  5. Pork Blade Steak

    Protein Per 100 Grams - 26

  6. Tilapia

    Protein Per 100 Grams - 26

  7. Pink Salmon

    Protein Per 100 Grams - 25

  8. Lamb and Mutton

    Protein Per 100 Grams - 25

  9. Peanut Butter

    Protein Per 100 Grams - 25

  10. Yellowfin Tuna

    Protein Per 100 Grams - 24

  11. Shrimp

    Protein Per 100 Grams - 24

  12. Mussels

    Protein Per 100 Grams - 24

2. Exercise Your Knee

Make sure you have a low-impact warm-up before your event or workout to reduce chances of sustaining an injury. Warm-ups benefit you by increasing blood circulation through your tissues to:

  • Make your muscles more pliable and prepare them for stretching.

  • Provide more oxygen and nutrients to your cells for better cardiovascular functions.

  • Prepare the heart for the high-intensity activity.


There are several stretches you can choose to improve the range of motion of your knee. These stretches can either be done alone or even without any equipment. Try the knee to chest stretch, seated scoot, wall slide, heel slide, or with the use of a chair. Get the advice of a sports medicine specialist or physical therapist before undergoing a new exercise program.

If you want to relax, at the same time exercise your knees, you can invest in swim spas. It’s simulated to create currents just like swimming in the sea but here you stay in place. The water helps improve joint flexibility and mobility. When you swim against the current, you also strengthen your bones and muscles.


3.  If Injured, Wear Your Knee Pads

Knee pads are protective coverings to keep your knee from getting injured. It’s not a joke if you tear your ligament or cartilage. So, don’t compromise your safety. Some practitioners don’t wear knee pads because they already have the skills and techniques to protect their knees. But, you can never predict your opponent’s moves when both of you are trying to kill each other on the mat.

When looking for the right knee pads for you, always look for the following advanced engineering properties to absorb the shock while at the same time resisting impact force:

  • Ergonomic design

  • High-density material

  • Large elastic force

  • Breathable and made of wicking fabric

  • Durable and affordable (Never pay over $40.00 for knee protection)


CONCLUSION

As a BJJ practitioner, you will experience being injured one way or another. So, you need to maintain a healthy diet to repair your tissues and muscles. Improve strength and flexibility of your knee joint by regular exercises. Most importantly, you need to protect your knee and wear your knee pads all the time. Or tap when your knee pops or you feel a shooting pain.

It’s the essence of sportsmanship, you celebrate your success while you accept your defeat like a pro. However, never stop when you have been defeated. Plan another strategy and build your skills and techniques to reach your coveted goal. Practice defensive fighting, keep in mind your safety before anything else to avoid knee injuries in Jiu-Jitsu.


Benjamin Potesky