Physical Therapy Tips for Common Jiu-Jitsu Injuries

Brazilian Jiu-Jitsu (BJJ) is a rapidly growing martial art that incorporates grappling techniques, joint locks, and chokeholds. However, it is a sport that requires consistent repetition and time on the mats to make progress. As my instructor at Broadway Jiu-Jitsu in Boston, John Clarke, always reminded us, Jiu-Jitsu is a combat sport—so injuries are an inevitable part of the game. Whether you're a white belt just getting started or a seasoned black belt, understanding the most common injuries in jiujitsu and how to manage them is key to keeping you on the mats.

At Derek Lam Physical Therapy and Performance, I regularly work with jiujitsu practitioners recovering from injuries or seeking different ways to be more resilient to injuries. Here are some of the most frequently seen injuries in BJJ, how they happen, and what physical therapy can do to help.

Shoulder

Common Diagnoses: rotator cuff strains, labral tears, acromioclavicular (AC) joint sprains, anterior shoulder subluxation.

The shoulder area is often put in compromised positions during acute traumatic submissions like a kimura, americana, omoplata, or arm bar. However, from my experience during rolling and treating grapplers, the shoulder can also be injured with repetitive strain during transitional movements like shooting takedowns or posting on the mat in an attempt to stop a sweep.

Physical Therapy Tip: Strengthening the rotator cuff muscles, improving scapular control, and working on shoulder mobility can significantly reduce your injury risk and will also be the primary focus of rehabilitation after a shoulder injury.

Knee

Common Diagnoses: meniscus tears, medial collateral ligament (MCL)/ lateral collateral ligament (LCL) sprains, anterior cruciate ligament (ACL) sprains, patellafemoral pain, patella tendonopathy.

Knee injuries can occur during high velocity movements like takedowns, leg locks, or when a passer sprawls on your leg in guard. Knee injuries can build up over time while playing guards such as De La Riva that require repetitive knee rotation, or during passing while performing a knee cut pass when the opponent has quarter guard.  

Physical Therapy Tip: In addition to ensuring that the muscles around the knee are strong, incorporating mobility exercises in other joints such as the hip and ankle are essential in ensuring that extra torque is not passed to the knee. A good physical therapy program will incorporate hip and ankle mobility, plyometrics like jumping, double and single-leg strengthening, and balance exercises.

Neck

Common Diagnoses: Cervical muscle strain, cervical disc herniation, cervical radiculopathy

Chokes, neck cranks, posting your forehead on the mat, playing guard while the opponent stacks you, and the stress of constant head pressure in stand-up can all contribute to neck injuries. Jiujitsu also involves a constant state of mid-back flexion/bending while playing guard and cervical straightening/extension to ensure that your head stays up. This repetitive posture can lead to an achy neck and may contribute to injuries such as cervical radiculopathy and nerve pain in the arm over time.

Physical Therapy Tip: Mobility interventions for the mid-back and neck, stabilization exercises for the mid-back, neck, and shoulder, along with some manual therapy, can help relieve neck pain and restore function. If you are experiencing pain or weakness down the arm, there is a good chance that the root cause is the neck.

Elbow

Common Diagnoses: Hyperextension injuries, ulnar collateral ligament (UCL) sprains, forearm flexor tendon pain.

Armbar submissions, as well as posting during takedowns and sweeps, can often cause pain on the inside of the elbow—either in the forearm flexor muscles or near the outside aspect of the ulna elbow bone, where the ulnar collateral ligament is located. Additionally, the repetitive gripping and sustained wrist flexion position common in jiu-jitsu can contribute to symptoms of forearm flexor tendonopathy.

Physical Therapy Tip: The elbow joint often remains in a flexed position after an injury, so it's important to regain full elbow extension to restore proper joint mechanics. Strengthening the muscles of the hand, wrist, forearm, and shoulder also contributes to a healthy elbow joint.

Lower Back

Common Diagnoses: Lumbar muscle strain, sacroiliac joint pain, lumbar disc herniation

Constant guard play in a curled position, inverting, and explosive movements during takedowns can increase strain on the lumbar spine. Without a strong and flexible lower back and hips, the lumbar region becomes more susceptible to injury.

Physical Therapy Tip: Strengthening the lumbar spine throughout its different motions (bending, extending, side bending, and rotation) is important in a dynamic sport such as jiujitsu. Hip mobility also plays a role in how much stress is placed on your lumbar spine. I often see limited hip flexion and internal rotation in jiujitsu athletes that causes the lumbar spine to compensate to make up for the decrease in range of motion.

Injury Management Is Key To Sustainable Training

Injuries in jiujitsu are not 100% preventable, but with proper mobility, strength, recovery, and technique, many can be managed so that you can continue training. If you're experiencing nagging pain or recovering from an injury, I can tailor a treatment plan to get you back on the mats safely—and stronger than before.

Derek Lam at the 2023 New Haven Open

Need Help with a Jiujitsu Injury?

At Derek Lam Physical Therapy and Performance, I specialize in treating martial artists and athletes through individualized, hands-on care. Whether you’re recovering from an injury or looking to prevent one, I’ll help you move better, perform stronger, and roll longer.

Ready to book your evaluation? Contact me at www.derekorthopt.com or click here to schedule online.

I’m here to help you get back to doing what you love—pain-free.

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