PART II: Tendon Injuries in Brazilian Jiu Jitsu

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What can I do to treat this?

If you should sustain a muscle or tendon injury, immediately stop the activity, ice and compress the area.  A bag of crushed ice or frozen vegetables works great and should never be applied for longer than 20 minutes at a time (longer will can create adverse effects).  If you use a commercial gel pack, be sure to have barrier between your skin and the pack to prevent a freeze burn or frostbite.   It is recommended to refrain from training jiu jitsu and any other activity that causes pain to reduce the tendon loading until the injury is healed.  This can, in some cases, take up to 8-12 weeks.  You may also consider seeing your healthcare professional should the injury persist beyond a few days without improvement, as this may indicate a more severe injury.  A physician may prescribe non-steroidal anti-inflammatory medications and recommend rest or exercises.  A physical therapist will carry out a thorough examination to determine the severity of the injury and begin intervening immediately to get you back to the mats.  These interventions may include stretching, specific exercises, joint or tissue techniques, and a home exercise program.  They will explain the cause of your problem and the best way to address this for your specific needs.  This is then followed with a gradual return to training on the mats.

What can I do to reduce my risk?

As with most things in life, you need to careful about what you do.  If you have been working a lot, are fatigued, malnourished, stressed, and do not get adequate sleep, then you are more susceptible to injuries and sickness.  Make sure that you take the time to properly warm up before you train jiu jitsu (don’t run in late to a class and jump right in).  Along with proper warm up, be sure to incorporate a regimented flexibility program.  Flexibility is good for your tendons and muscles, as well as good for your jiu jitsu game.  A regular strength training program that includes body weight exercises, weight training, dynamic movements and endurance activities are important for your health, but equally to your tendons and muscles.  These exercises will increase the tensile load to the tendons.  If you have a desk job or sit for a large part of your day, consider getting up every 30 minutes and move yourself to prevent stiffness in your tendons and muscles.  Some suggest a quick 2-minute walk every 30 minutes.  You may even consider using a standing workstation, which has been shown to increase productivity and prevent decreases in metabolism.

Ultimately, you also have to know your body and realize your limitations.  If you are hurt and you train hurt, you are exponentially at risk of further injury.  If you are always hurt, then training is difficult, if not impossible.  So get healthy, get strong, and get to training.

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Conclusion

When it comes to jiu jitsu, being flexible, strong, healthy and agile are necessary to reduce your risk of injury without missing training days.  Incorporate strength training to load your tendons, which increases their tensile load.  Do this early and do this often.  Starting one month before a big tournament is not going to cut it. The better a tendon can resist this load, the less likely it is to be hurt under these loads.  When exercising, always stay in control.  Controlled movements allow the muscles and tendons to work while shortening and elongating (concentric and eccentric), which are different ways to load the tendons.  Flexibility improves the capacity for the tendon to elongate, which is another type of loading to the tendon that improves tensile resistance.  Lastly, it is important to train regularly, but don’t over train.  This keeps the your tissues consistently loaded and does not allow them to be overloaded.  Overloading leads to injury, and is ultimately preventable.

Again… So get healthy, get strong, and get to training.  See you on the mats!!!

Chris Ingstad, PT, DPT, OCS, MTC, ATC, FAAOMPT

Chris Ingstad, PT, DPT, OCS, MTC, ATC, FAAOMPT

Dr. Chris Ingstad is a nationally-known Physical Therapist and Co-Founder of North County San Diego’s Leading Specialist Private Physical Therapy and Human Performance Practice for People in their 30’s, 40’s, 50’s and 60’s, who value their health and want to remain active.

You might know Dr. Chris as a National Conference presenter on various rehabilitation topics, including on treating people with shoulder, neck and low back injuries. He also teaches at the University of St. Augustine for Health Sciences in the Musculoskeletal track, where he brings clinical practice into the classroom for future physical therapists. He also is published in Jiu Jitsu Magazine and Coastal Newspaper on various areas, including low back and neck and shoulder injuries.

Dr. Chris’ background included working extensively with athletes with shoulder, knee and low back injuries, taking them from post-injury or post-operative to return to sport. He prides himself on the ability to get positive outcomes, even with difficult cases. Level4 Physio-Wellness-Performance is now a large multi-physical therapy specialty practice in Carlsbad, CA. 
Chris Ingstad, PT, DPT, OCS, MTC, ATC, FAAOMPT

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