Injury Prevention in Grappling Sports - Part VA

Last week we discussed various knee injuries that occur in grappling sports.  This week we are going to dive into more lower limb and hip injuries that occur. 

Hamstring Strain - As you can see from this picture, the hamstring cross both the knee joint as well as the hip joint and is comprised of three muscles.  Not only does this complex of muscles (hamstring) aid in knee flexion but also aids in hip extension.  For upper belts, a common mechanism of injury is the resistance of a knee bar.  With this position, the hamstrings is working eccentrically to resist the knee bar and is often a type of resistance that the hamstring is weakest in and therefore more susceptible to.  In lower belts, strain to this muscle can come from scrambling, pulling dela heva or spider guard.  Typically strain is felt in the posterior region (in the muscle belly) or sometimes at the origin at the ischial tuberosity (proximal hamstring tendon pictured).  There are various levels of injury to this muscle.  If there is discoloration (bruising) or balling up of the muscle, you should see a physician.  If this is painful to resistance and localized tenderness, you need to exercise caution with returning to the mats.  The guide I usually use is if you can drill or do live training without pain and control your pain afterwords with the use of ice, you are good to train with.  If you have pain during and are not able to control or prevent from getitng worse, you need to cut back. 

Adductor Strain - The adductor is really a group of four muscles (adductor brevis, longus & magnus and gracilis).  As a group, these are very commonly injured in jiu jitsu.  With pulling someone into your guard and actively resisting their trying to break your guard, you often over power the adductor's ability to resist the strain.  Doing this repetitively will eventually lead to pain when you are attempting to hold someone in your guard.  Another common mechanism of injury is when someone does a knee slide pass on you.  Both the excessive range of motion combined with the attempt to resist can add strain to this muscle.  Most of the time you will feel this in the muscle belly or at the origin of the muscle up toward the groin area toward the center of the pelvis (closer to the pubic symphysis).  Part of the reason this occurs is that most do not train their adductors and for new white belts, you are suddenly in a sport where you are having to use this all the time which can lead to over use.  Most people think that smashing the adductor on a roller or stretching it will help to prevent.  Although the stretching will help with increasing range of motion and help from a preventative standpoint, the key is to make sure to add some strengthening to your program.  This should be high reps (15-30) reps with lower weight.

Labrum of the hip - the labrum of the hip is a cartilaginous structure in the hip that provides some stability to the hip by aiding in securing the femoral head within the acetabulum.  This is commonly injured due to the excessive motion that the hip goes through with this sport as well as pressure it is under with this motion.  Going from Xpasses to knee slide pass to smash pass, the labrum is put under a lot of pressure.  When this is injured, you may feel pain up in the groin area (closer to the hip).  You may also feel pain when someone does a knee slide pass on you our as you are moving your hip around.  In some cases, you may feel a clicking or popping sensation deep in your hip.  If you experience the pain with popping in the hip, you should have this evaluated by a physician.   

As with the previous blogs of this series, we are not listing all the injuries that can occur in the hip, just some of the most common injuries. As with all of these injuries, you can prevent them and most of the time, this does not mean you have to take long periods of training off. 

Next week, we will expand this discussion to discuss what you can do to prevent these injuries.  We hope you found this information valuable.   If you did enjoy, please share with your colleagues, training partners and BJJ enthusiast and please be sure to follow us on instagrm @ bjjpt_acl_guy and twitter @acl_prevention.  Train hard and stay well.  #ViPerformAMI #ACLPlayItSafe

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment and ACL injury prevention.  He is the founder | developer of the ViPerform AMI,  ViPerform AMI RTPlay, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject.  Trent has performed >5000 athletic movement assessments in the US and abroad.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams.  Trent has also been training in Brazilian Jiu Jitsu for 5 years and complete BJJ junkie.