Updated: Apr 12, 2021
Last updated: April 2021
A guide to the safe return to sport after injury.
Brazillian Jiu-Jitsu (BJJ) is a rapidly growing combat sport, with a wide range of participants from enthusiasts to elite athletes. Participants of this grappling based martial art are subject to a range of injuries in both training and competition. Despite the significant growth in BJJ participation and interest, there is an evident lack of research to understand the sport and its injury characteristics. Injury-related research to date has included small scale prevalence and injury type, without consideration for return to sport guidance.
There are many models of how athletes should safely return to full sporting activities following injury, but very little specifically for grappling athletes and no published research to support athletes in sport-specific rehabilitation protocols or return to play decisions. Of the recent models, I particularly like the ‘control-chaos continuum’ (Taberner, 2019). With some amendments, the concept has excellent applicability to combat sport.
This blog presents a return to grappling framework using the control to chaos continuum. Following a recent Instagram post on this topic, this blog expands on the topic and presents a model to support grapplers and clinicians working with grapplers after injury.
Once you have clearance to return to training from your health professional (for the more severe injuries), a progressive sport-specific plan should be followed to prevent re-injury. Athletes often re-injure themselves when they do too much, too soon and return to the same activity level without accounting for the de-conditioning they inevitably experienced during the time off the mats.
Time off the mats due to injury sucks, but premature return to full training and competition can lead to long-term issues and reduced performance. Graduated safe return to full and regular training should follow these progressive steps. The speed of progression through these steps will depend on the type and severity of the injury, however, the principles of progression remain consistent - structured and graduated return to full training is critical.
The return to grappling framework provides a model for progressive loading and technical challenge. It offers an opportunity to return to the mats earlier in the rehabilitation process, integrating technical skills and sports specific conditioning to build chronic (pre-injury) training loads with consideration for the tissue's biological healing. The model applies to both short-term and long-term injuries using shorter or longer phases at each stage. It's recommended that athletes take the time needed to give confidence in each stage and build physical robustness in their tissues to avoid setbacks and (re)injury.
As a continuum, the framework allows for a continuous sequence in which adjacent elements are not significantly different from each other, but the extremes are quite distinct. Depending on the injury and the athlete experience, the will be times when the stages overlap or vary slightly.
N.B. Progression is criteria based, not time dependent. The framework includes general ‘progression criterion’ for athletes to move to the next stage. These are separate to, and in addition to any injury-specific rehabilitation criteria you may be given by your health professional. They are designed to complement the strength, stability, mobility and other rehab goals you may be working through. Work with a health professional if you're not progressing or would like support through the process.
Return to Grappling Framework
Stage 1: Technical Independent Drilling - High Control
Begin with solo drilling at home or in the gym. This allows you to better understand your injury and the positions that you may need to avoid for a little bit. If you’re stuck for ideas, try going through John Danaher’s solo drills series (available free on BJJ Fanatics here). Start by avoiding any drills that put load through the healing body part, and slowly build those in.
This is an important first step to allow you to gain the benefits of solo work for technical proficiency, while respecting the biological healing times and providing relative rest to the injured area.
You are confident that your injury is beginning to heal and you understand what’s happening - and for more serious injuries, you’ve had it checked out by a health professional.
You feel ready to step back onto the training mats in a controlled way.
Stage 2: Technical Partner Drilling - High Control
Work with a trusted partner who is aware of your injury. Drill with minimal resistance to get used to moving you and your partner's body weight through a range of positions. Start with positions that don't stress the injured part, and progress through all common positions you'd typically find yourself during a roll.
You have built to moderate intensity in fixed positions and feel ready to dynamically move through positions while continuing to protect the healing body part.
Stage 3: Flow rolling - Moderate Control
Build confidence and movement skill with light flow rolling. Be aware of the positions that might put your injury at risk, and work around them. Progressively build these into your flow rolls as your injury recovers. Use the time to focus on your positional awareness and start to include light catch and release submissions.
Ensure you work with a trusted partner in this stage. We've all been in a 'let’s flow roll’ situation, that five minutes later is total war - work with your partner to ensure this doesn't happen.
You are able to flow roll at light to moderate intensity
You are not experiencing increased pain or discomfort during light flow rolling
Stage 4: Positional Specific Training - Control > Chaos
Positional specific sparring allows you to reduce the uncontrolled scenarios and safely build the intensity. Begin with relatively controlled scenarios with a clearly defined start and end with a specific goal i.e. start in back control with hooks and harness and finish when two hooks are removed. Progress to more open scenarios to allow for more variability and a higher degree of chaos i.e. start in back control and finish when there is an escape or sub.
Start with drills that will put little to no stress on the healing body part, and progress to specific positions related to that area. Be sure to include both top and bottom positions, and not just the ones you’re comfortable in.
You have built intensity in a range of controlled positions
Your healing body part does not feel like it will be aggravated by more vigorous training
Stage 5: Technical standing drills - Control > Chaos
Get comfortable with standing positions and being taken down. Work through take-downs and being taken down in various ways - You don't want live rolling to be the first time being taken down since the injury. Progressively build the intensity and make sure you're confident with your injury before returning to full grappling.
Continue to build intensity in positional specific training and maintain regular flow rolling through this phase.
You can confidently complete take-downs against a resisting opponent and are happy getting taken down with moderate intensity.
Stage 6: Full (floor-based) Grappling - Moderate Chaos
Your injury has now recovered, and you're ready to increase in intensity in open sparring. Start by limiting the positions to floor-based training and re-set if scrambles take you and your partner to a standing position.
With time in both top and bottom positions, you have progressed through all common ground positions, with full intensity.
You are confident the body part has fully healed.
You no longer need to think about the healed body part, and focus purely on the grappling exchanges.
Stage 7: Full grappling - High Chaos
Full grappling involves the mix of standing and ground positions, which adds a further degree of chaos to the activity. You've progressively worked from positions of high control, to positions of high chaos.
You've built the confidence and earned the right to return to full grappling and competition now - Enjoy it!
There are many options for grapplers to stay active and work around injuries while working through their rehab. I advocate for all athletes to keep some form of training to maintain fitness levels and build higher chronic loads when injuries occur. This framework supports this principle, allowing athletes to spend less time off the mats due to injury and more time building skills and ultimately improving performance.
Build the degree of chaos, build the confidence. Use the time to focus on technical skills and you'll come back stronger.
P.s. As an individual sport, it's up to you to take control of this process and manage the variables which influence the risk of (re)injury. Consider these as you work through the return to grappling framework:
The size of your training partner
The intensity (how hard) of the roll
The pace (how fast) of training
Progressing from controlled to progressively chaotic training
Don't be afraid to tap early and often
(I'll have more to come on this in a future blog).
Taberner M, Allen T, Cohen DD. Progressing rehabilitation after injury: consider the ‘control-chaos continuum’. Br J Sports Med 2019;53:1132–6. https://bjsm.bmj.com/content/53/18/1132
Petrisor BA, Del Fabbro G, Madden K, Khan M, Joslin J, Bhandari M. Injury in Brazilian Jiu-Jitsu Training. Sports Health. 2019 Sep/Oct;11(5):432-439. https://pubmed.ncbi.nlm.nih.gov/31173700/