Concussions in Brazilian Jiu Jitsu
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head. This could also be a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, which can disrupt and cause chemical changes in the brain and even stretch or damage brain cells. Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can still be very serious.
Nothing is usually seen with MRI imaging because concussions are a functional, rather than a structural injury, and are usually diagnosed with functional testing. These tests can be performed quickly in the gym and knowing them is essential to recognizing if you have a concussion and how serious it is.
Jiu Jitsu is a sport that involves various holds for submission and grappling positions. There are many transitions that can result in a concussion - making head to head contact, head to the mat, head to other body parts (an elbow or knee). The average lifetime incidence of concussion when participating in Brazilian Jiu Jitsu (BJJ) is 25%. Those at increased risk include females (43% F vs. 29% M), someone who has had a prior concussion, boxing (MMA recieves fewer blows to the head), and heavier weight classes (regardless of sex). On average, 30% returned to sport the same day, and most returned within 3 days. Younger age can mean a prolonged recovery.
" I have practiced jiu jitsu for over seven years in which time I have had my share of injuries ranging from head to toe. Some of my injuries have included unintentional hits to the head during practice sessions or competitions. On a few occasions I have hit my head hard enough to suffer cuts, headaches, along with feelings of being lightheaded and dizziness. I had no idea I was exhibiting the signs and symptoms of a concussion. Concussions do occasionally occur in this sport, but with education and awareness, head traumas can be managed safely, preventing a long lasting injury." -Amy Campo Jiu Jitsu Athlete
What are the symptoms of a concussion?
Physical symptoms:
Neck pain
Headache
Nausea
Vomiting
Clumsy when moving
Behavioral changes:
Feeling more emotional, crying, getting angry easily
Sleepy all the time, or difficulty sleeping, sleep cycles may change - you will sleep during the day and be awake at night.
Confusion, difficulty making decisions, getting lost
Trouble remembering things - even if they just happened
Fogginess, difficulty concentrating or staying focused, slow to respond
Inner ear/vision:
Dizziness, vertigo, feeling light headed
Blurry vision
Difficulty reading, watching T.V., looking at your phone
Sensitive to light and sound
Sideline Testing:
When to test?
Neck pain/tenderness, double vision, weakness/tingling in arms or legs, headache, seizure, loss of consciousness, vomiting, increasingly restless/agitated/combative
What to test?
Observation
Blank or vacant look
Lying motionless on the ground
Appears disoriented, confused, not responding to questions appropriately.
Neurologic
Look from side to side and up to down without moving the head. Do they get double vision?
Finger to nose (5 times quickly)
Balance - Hold each position for 20 seconds with hands on hips and eyes closed. Watch for swaying, inability to hold the position, eyes opening
Double leg stance
Single leg stance (non-dominant foot)
Tandem stance (non-dominant foot behind)
Concentration
Say the months in reverse order
Memory
Where are we? Who scored last? What day of the week is it?
Ask them to remember 5 words, then ask them to repeat back the words immediately, then again in 5 min
Return to sport or school:
Your return to regular activities such as attending school and participating in sports should be monitored by a medical provider that has completed concussion training in the last two years. Make sure that you ask your doctor if they have completed this training, because there is a specific protocol to follow to make sure you make a safe return to your daily activities.
Physical therapists and athletic trainers are trained to evaluate and treat your concussion. You should receive a written clearance from a physician before returning to sports.