Rib Injuries in Jiu Jitsu

This article was written by Marc Barton, who is a 2nd degree Jiu-Jitsu Black Belt under Mauricio Gomes.  Marc is the head instructor at Kingston Jiu Jitsu and is also a qualified medical doctor. Marc has also contributed educational articles for a medical education website.

The first significant injury I dealt with back when I was a white belt was a fractured rib. Damn, it was painful, lifting stuff hurt, walking hurt, even breathing hurt, and there was absolutely no way that I could train.

Rib injuries are extremely common in the grappling arts, and several of my students have suffered them over the past few years. The nature of grappling provides numerous scenarios that can cause these types of injury, and I have seen them occur due to throws, scrambles, guard passes, and submission attempts. I even suffered a relatively minor rib injury when having a mount transition from side control demonstrated on me once.

If you are one of the unlucky ones currently dealing with a rib injury, then there is good news and bad news. The good news is that it is likely not serious and will get better (I will discuss a few caveats to this below). The bad news is that you're not going to be training again for at least 4 to 6 weeks.

Types of rib injuries

Rib injuries can be broadly divided into two different types: soft tissue injuries and rib fractures.

Common soft tissue injuries include:

• Bruising – where blood vessels are damaged and leak into the surrounding area
• Intercostal strains – where the muscles between the ribs become strained, usually from forceful twisting of the torso or swinging of the arms
• Costochondral separation – where the rib is torn loose from the costal cartilage (this is so common amongst BJJ practitioners that I have heard it described as 'BJJ rib')

Rib fractures are less common than soft tissue injuries due to the curved design of the rib, which makes them somewhat resistant to fractures. The ability of the rib to flex also helps the bone absorb the force of a blow. Grappling, however, is more than capable of generating the forces required, and takedowns, in particular, can cause fractures. Ribs are most likely to fracture at the outer curve, which is the weakest point of the rib, and this is the exact spot where my first rib fracture happened.

Symptoms of rib injuries

Soft tissue rib injuries and fractures are both extremely painful. The pain is usually made worse by breathing, coughing, sneezing, lifting, and pretty much any movement will have an effect. Bruising may be present at the site of the injury, and sometimes a 'pop' will be felt or heard at the injury site when it occurred. Breathing can be difficult due to the pain that it causes.

If you suspect that you have fractured your rib, it is very worthwhile getting a medical professional to examine you. Sometimes an X-ray is required, and you will likely need some strong painkillers to get you through the next few weeks.

What is the treatment for rib injuries?

This article is not intended to teach you how to manage your own rib injuries, and, as mentioned above, I highly recommend seeking proper medical attention. The following advice is simply designed to give you an idea of what to expect from the doctor or healthcare professional you see.

The most important treatment for rib injuries is good quality pain relief. This will help you to be able to move, breathe deeply, and cough. Over the counter painkillers are often not enough, and stronger prescription medications may be needed. Over the first few days after the injury has occurred, holding an ice pack over the part of the chest that is injured can also be very helpful in reducing pain and swelling.

Make sure you stay mobile and avoid lying down or staying still for too long, apart from at night. It is also advisable to carry out deep breathing exercises, e.g. taking ten slow, deep breaths every hour or so, making sure you fully inflate your lungs. One of the more unpleasant potential side effects of a rib injury is that chest infections can occur, and this will help to prevent them. For the exact same reason, do not strap or bandage tightly around your chest as, although this may help the pain, it will stop the lungs from expanding properly.

Are there any possible complications?

The vast majority of rib injuries heal without any problems whatsoever within about 4-6 weeks. There is no point trying to rush back after a couple of weeks because it is almost inevitable that you will make the injury worse and end up having to spend an even longer period of time off the mats.

There are a few possible complications, but as already mentioned, these are rare, and a doctor or healthcare professional will definitely look for them and make sure that they are not present. By far, the commonest complication is a chest infection. Other more serious problems include a punctured lung (pneumothorax) or blood within the lung (haemothorax). The likelihood of you suffering either of these from grappling is exceedingly rare indeed.

If you start to cough up yellow or green sputum, develop a fever, cough up blood, develop worsening chest pain or breathlessness, or start to get abdominal pain, you should seek medical advice urgently.

Avoiding rib injuries

Most rib injuries will occur regardless of any preventative measures you take and are simply down to bad luck. There are, however, a couple of things that can make a difference.

Conditioning can definitely help. Building up core strength, strong abdominal muscles and good flexibility can make a huge difference in preventing rib injuries. If you are a grappler, then I would definitely recommend adding exercises that address these into your weekly routine.

Breakfalling is another difference-maker. If you can't breakfall properly, then your chances of suffering any number of injuries from a takedown rises exponentially. Most BJJ practitioners neglect to practice breakfalling; make sure this doesn't apply to you.

If you are suffering from a rib injury at the moment, you have my sincerest sympathies, and hopefully, this article will help you. Hang in there, the pain will settle soon, and you will be back on the mats before you know it.

[Disclaimer: This article does not constitute medical advice. If injured, always seek care from a licensed medical practitioner]