Injuries in judo: a systematic literature review including suggestions for prevention

Comparison of Force, Neuromuscular, and Metabolic Responses During Sustained, Isometric Handgrip Holds to Failure Anchored to Low and High Perceptual Intensities in Men: An Exploratory Study

ABSTRACT

Kwak, M, Succi, PJ, Benitez, B, Mitchinson, C, Samaan, MA, Abel, MG, and Bergstrom, HC. Comparison of force, neuromuscular, and metabolic responses during sustained, isometric handgrip holds to failure anchored to low and high perceptual intensities in men: An exploratory study. J Strength Cond Res 38(8): e405-e416, 2024-This study examined the responses of force alterations, relative to critical force (CF), neuromuscular parameters, and muscle oxygenation (SmO2) for isometric handgrip holds to failure (HTF) anchored to ratings of perceived exertion (RPE) of 3 and 7. Twelve men completed pre-maximal voluntary isometric contractions (pre-MVIC), submaximal HTF at 4 percentages of pre-MVIC, HTF at RPE = 3 and 7, and post-MVIC. Mechanomyograpic (MMG) signals and SmO2 were recorded during the RPE HTF. Analyses included paired-samples t-tests and repeated-measures ANOVAs at an alpha level of p ≤ 0.05. Time to task failure was not different between RPE 3 (478.7 ± 196.6 s) and RPE 7 (495.8 ± 173.8 s). Performance fatigability (PF) and MMG amplitude (AMP) were greater for RPE 7 (PF: 37.9 ± 12.9%; MMG AMP: 15.7 ± 7.4% MVIC) than RPE 3 (PF: 30.0 ± 14.5%; MMG AMP: 10.2 ± 6.5% MVIC), but MMG mean power frequency (MPF) was greater for RPE 3 (146.2 ± 31.1% MVIC) than RPE 7 (128.8 ± 23.0% MVIC). There were RPE-dependent decreases in force (p ≤ 0.01) across 3 discernable phases during the HTF. There were decreases in MMG AMP across time for both RPEs, but there were no significant changes in MMG MPF or SmO2. There were overall similar motor unit control strategies and local metabolic demand between RPEs. The majority of the HTF performed below CF at RPE 3 and 7 indicated CF did not reflect the highest sustainable force. When prescribing isometric exercise anchored to RPE, practitioners should be aware of the magnitude of force loss and relative intensity of the task to be sure desired training loads are met.

The role of psychological resilience and aggression in injury prevention among martial arts athletes

Introduction

For martial artists, the ability to manage reactions in the face of adversity and bounce back after a stressful event can have major impact on performance. The scope of the research is to investigate martial artists' level of resilience and aggression (Go-ahead, Foul play, and Assertiveness factors), what is specific to athletes and who have suffered from moderate and/or severe injuries (in terms of resilience and three factors of aggression examined), and test the possibility that a psychological variable under investigation can predict athletes' injury severity.

Materials and methods

A total sample of 154 athletes from striking combat sports-SC (karate, taekwondo, kickboxing, and boxing), grappling combat sports-GC (judo and BJJ), and mixed martial artists (MMA) participated in the research. For assessing resilience, the Romanian adaptation of the Brief Resilience Scale (BRS) was used, and for aggression, the Romanian adaptation of Makarowski's Sports Aggression Questionnaire was used. An injury report form was also created and applied to athletes.

Results

The post-hoc tests (after running a single-factor multivariate analysis of variance) revealed significant differences for resilience and Foul (violent) play between the sports disciplines analyzed. A significant positive correlation was found between athletes' injury severity and assertiveness in SC and between injury severity and resilience in GC. Through the t-test for independent samples, it was highlighted that the average value for Foul (violent) play is significantly higher in athletes who have suffered mild, moderate, and/or severe injuries compared with martial arts athletes who have suffered from only mild/minor injuries. A binomial logistic regression was also performed to verify to what extent Foul play predicts athletes' injury severity.

Conclusion

A low level of Foul (violent) play is linked with a decreased likelihood of moderate and/or severe injuries in martial arts athletes. The study findings suggest that resilience, foul play, and assertiveness have an important role in injury prevention among martial artists.

Intergenerational Judo: Synthesising Evidence- and Eminence-Based Knowledge on Judo across Ages

In alignment with European policies regarding intergenerational sports, this study seeks to integrate existing evidence- (i.e., umbrella review) and eminence- (i.e., international validated educational courses for coaches) based knowledge on judo training across the lifespan. For evidence knowledge, searches of the Google Scholar, ISI-WoS, PubMed, and Scopus databases (PROSPERO ID: CRD42024535420) for studies focused on training youth and older judo practitioners, with no time restriction up to April 2024, were conducted. This resulted in 16 systematic reviews meeting the inclusion criteria, with an "excellent" (n = 6), "good" (n = 7), and "fair" (n = 3) quality according to the NIH tool. With a large sample size (n = 372,655), the reviews focused on wellbeing (n = 9; bone status, injuries, and psychophysical effects) and performance (n = 7; athlete success, combat time, rapid weight loss, and the Special Judo Fitness Test), examining athletic levels (novices to Olympics), sex, and age (children to older adults). For eminence knowledge, the International Judo Federation Academy courses encompassed the "Undergraduate Certificate as Judo Instructor" (UCJI), which provides a comprehensive structure for teaching judo, including techniques, moral code, roles, responsibilities, refereeing, safety, and age-specific belt examination requirements and progression, and the "Educating Judo Coaches for Older Practitioners" (EdJCO) curricula, which provide theoretical and applied modules (e.g., ageing, health, and organisation) to train older judo practitioners. The findings were summarised in a framework, highlighting the most relevant aspects of intergenerational judo programmes (i.e., aims, key characteristics, coaches' roles, barriers, and facilitators). To develop a comprehensive educational intergenerational judo methodology, future research should examine coaches' and practitioners' opinions on intergenerational judo activities carried out in different national contexts.

Injury Risk Analysis among Judo Athletes with Intellectual Disabilities

The main aim of this study was to evaluate injury prevalence, incidence rate, and burden in judo athletes with intellectual disabilities (ID) who participate in international competitions. This retrospective cross-sectional study analyzed data from the past year for 182 judo athletes with ID. Data was collected using a self-reported questionnaire, adapted from previous research, that included questions about injuries impacting training or competition, injury type, mechanism, severity, diagnosis, and location on the body. The injury prevalence among judo athletes with ID occurred most often during training (68.2%) and primarily affected the lower extremities (35%). Age group and injury prevalence were significantly related (χ2=7.91; P=0.04), while gender, weight, and ability level were not. Results were closer to those previously reported for conventional judo, which is likely due to the lower practice intensity among judo athletes with ID. Injury prevalence was lower than in prior studies, but the incidence rates aligned when considering training time in judo athletes with ID. Injury burden analysis revealed that females had a lower burden than males, while older athletes experienced a higher burden than younger athletes. Most injuries occur during training, which is likely attributable to safety-focused competition rules.

Headguard use in combat sports: position statement of the Association of Ringside Physicians

Headguard use is appropriate during some combat sports activities where the risks of injury to the face and ears are elevated. Headguards are highly effective in reducing the incidence of facial lacerations in studies of amateur boxers and are just as effective in other striking sports. They should be used in scenarios - especially sparring prior to competitions - where avoidance of laceration and subsequent exposure to potential blood-borne pathogens is important. Headguards are appropriate where avoidance of auricular injury is deemed important; limited data show a marked reduction in incidence of auricular injury in wrestlers wearing headguards.Headguards should not be relied upon to reduce the risk of concussion or other traumatic brain injury. They have not been shown to prevent these types of injuries in combat sports or other sports, and human studies on the effect of headguards on concussive injury are lacking. While biomechanical studies suggest they reduce linear and rotational acceleration of the cranium, changes in athlete behavior to more risk-taking when wearing headguards may offset any risk reduction. In the absence of high-quality studies on headguard use, the Association of Ringside Physicians recommends that further research be conducted to clarify the role of headguards in all combat sports, at all ages of participation. Furthermore, in the absence of data on gender differences, policies should be standardized for men and women.

Epidemiology of Injuries and Their Implications in Jiu-Jitsu Practitioners: An Integrative Systematic Review

Objective  To investigate the epidemiology of injury types among jiu-jitsu practitioners, as well as the incidence regarding different skill and experience levels, through the question: "What are the characteristics and prevalence of musculoskeletal injuries in Jiu-Jitsu practitioners?". Methods  Since the beginning of the study, in August 2020, we conducted a search on the MEDLINE, LILACS, and SciELO electronic databases. We included cross-sectional studies published between 2018 and 2023 on the epidemiology of the types of injuries among jiu-jitsu practitioners that compared their incidence regarding different levels of ability and experience. Two independent researchers performed the data extraction and assessed the risk of bias. Results  Seven studies were included. The common outcomes involved 2,847 jiu-jitsu practitioners. A high prevalence in the knee joint and chest and rib areas was reported. Considering the difference in experience level among the practitioners, we could observe that most of the individuals included were beginners. Among the age groups observed, male practitioners older than 30 years of age were the ones who presented the highest rate of musculoskeletal injury, especially during training sessions. Conclusion  There is a high prevalence of musculoskeletal injuries among jiu-jitsu practitioners. The most affected anatomical segments are the knee joint, the chest, and the rib region, followed by the shoulder joint. The related factors change according to certain variables, being more common during training in male individuals over 30 years of age and beginners in the sport.

Strength and Conditioning (S&C) Practices of Judo Athletes and S&C Coaches: A Survey-Based Investigation

ABSTRACT

Weldon, A, Cloak, R, Kirk, C, Ruddock, A, Langan-Evans, C, Detanico, D, Loturco, I, and Kons, R. Strength and conditioning (S&C) practices of judo athletes and S&C coaches: A survey-based investigation. J Strength Cond Res 38(4): e160-e173, 2024-The benefits of strength and conditioning (S&C) for improving judo performance and reducing injuries have been widely studied. However, the S&C practices used and perspectives held by those delivering S&C have yet to be elucidated. Therefore, this study investigated the S&C practices and perspectives of judokas and S&C coaches working within judo. Forty-two judokas and 9 S&C coaches completed an online survey comprising 6 sections: (a) written informed consent; (b) background information; (c) education, qualifications, and prescription; (d) views on S&C; (e) exercise selection; and (f) issues and improvements. Frequency analysis was used to report responses to fixed-response questions and thematic analysis for open-ended questions. Results indicated that S&C coaches were primarily responsible for delivering S&C programs (60%), and S&C information was predominantly sourced from S&C coaches (43%). Strength and conditioning was deemed very important for randori (78-88%), overall judo performance (67-79%), and judo fitness (62-78%). Similarly, S&C was considered very important for the development of speed and power (76-89%), strength (71-89%), and injury reduction (69-78%). Novel findings were also observed, such as integrating judo-specific training within S&C practice, which may be partly explained by more S&C coaches holding judo belts (67%) than S&C qualifications (11%). This study supports practitioners delivering S&C in judo by offering a base of information to critique or align with their existing S&C practices and perspectives. Furthermore, our results may help identify potential gaps between methods used, proposed guidelines, and actual practice, facilitating the development of research and education resources tailored to the current climate.

A Case Report of a National Judo Champion: Is Return to High-Level Contact Sports Possible After Meniscus Allograft Transplantation?

Meniscus allograft transplantation (MAT) is a surgical procedure reserved for (relatively) younger individuals who remain symptomatic after the resection of a voluminous part of the meniscus. Return to sports and certainly the level of sport post-MAT are highly variable. We present a unique case of a national judo champion who was able to compete at the highest level following MAT. Considerations regarding the rehabilitation and follow-up of this patient are provided, and the risk of rerupture is discussed. Although returning to high-level contact sports post-MAT is possible, the risk of rerupture should be considered.

Investigating the value of balance and proprioception scores to predict lower limb injuries in professional judokas

We investigated the ability of balance and proprioception screening tests to predict lower limb injuries in professional male judokas. Fifty-three male judokas of the national teams (Mean ± SD, age 18.68 ± 3.08 years, weight 75.34 ± 11.62 kg, height 175.28 ± 7.24 cm) participated in this study. Limits of stability (LOS), single leg stability (SLS), and knee joint position sense (JPS) was recorded as the screening tests before starting the 10 month follow up. Lower limb injury was recorded all through the follow up. Fifteen lower limb sport injuries were recorded for 53 judokas during the follow-up recordings. Significant accuracy of SLS, overall bilateral ratio (AUC 0.646, 95% CI 0.452-0.839, p = 0.046), as well as JPS 60° bilateral ratio (AUC 0.657, 95% CI 0.480-0.834, p = 0.044), and LOS overall (AUC 0.696, 95% CI 0.551-0.840, p = 0.031) were revealed discriminating between injured and uninjured judokas. The optimum cut-off of SLS, overall bilateral ratio, JPS 60° bilateral ratio, and LOS overall associated with belonging to uninjured judokas group was ≤ 1.15%, ≤ 1.09%, and ≤ 1.09 respectively (sensitivity, 0.763, 0.711, 0.789 respectively; specificity, 0.600). Although the absolute unilateral balance and proprioception scores were almost the same between injured and non-injured judokas, the bilateral ratio of both these indices were different between the two groups. Lower limbs bilateral balance and proprioception asymmetries is a more important risk factor than the absolute unilateral balance and proprioception scores for sustaining lower limb injuries in professional male judokas. Medical professionals and coaches are suggested to use these findings as pre-participation screening tools identify injury-prone athletes.

Effectiveness of Protective Measures and Rules in Reducing the Incidence of Injuries in Combat Sports: A Scoping Review

In recent years, much effort has been made to reduce the injury rate in combat sports. However, the question remains to what extent these measures are effective. Analysis of studies could provide evidence of the effectiveness of measures aimed at reducing the incidence of injuries. This scoping review aims (1) to map research articles dealing with the effectiveness of proper use of protective measures in reducing the incidence of injuries in combat sports; (2) to investigate to what extent the proper use of protective measures and compliance with sports rules help to reduce the incidence of injuries in combat sports; and (3) to identify gaps in the existing literature and suggest future research on this topic. The literature search was conducted on articles published between 2010 and 2023. The main inclusion criteria were studies investigating the effect of sports rules and protective equipment used during training or competition in combat sports on reducing the incidence of injuries. After meeting the criteria, only seven articles from boxing, karate, and taekwondo were included in this study. Results showed that mandatory head guards, along with modern thicker gloves, significantly reduced the rate of knockouts (KOs) and head injuries in boxing despite an increase in the number of head blows. However, the number of facial cuts increased significantly due to the removal of head guards as a piece of mandatory equipment. The use of mouth guards has significantly reduced the number of oral injuries. Changes in rules, such as shortening the duration of bouts, along with the introduction of greater competencies of referees in the supervision of bouts (the standing count, outclassed rule, and medical stops) have helped to reduce the rate of injuries in boxing. The application of a computerised scoring system also contributed to the rate of injuries reduction. The increase in the number of weight divisions had the same effect on U21 karate athletes. However, a higher incentive to attack the head area in taekwondo did not increase the incidence of injuries in youth athletes. It can be concluded that the proper use of protective measures (head and mouth guards) in combination with the rules established for health protection (higher competencies of referees and more weight divisions in competitions) effectively reduces the occurrence of injuries in combat sports. In all Olympic combat sports, the injury incidence should be regularly assessed using the Injury Incidence Rate (IIR) per 1000 min exposures (MEs). Nonetheless, further studies are needed to monitor how established rules (e.g., prohibited behaviour) affect the IIRs.

Prevalence of cauliflower ear in high level judoka

Judo is an Olympic sport, and the way of its performing can lead to repetitive blunt injuries on head and ears. The chronic consequences of such traumata on the auricle are the formation of so-called cauliflower ear. This condition is painful, can lead to interruptions in the training process and long-term consequences for the athlete's health. There is limited knowledge of epidemiological data about cauliflower ear deformities in judo. Evaluation of the prevalence of cauliflower ear among judokas based on their profile pictures on the international judo federation was performed. A large cohort of judo athletes from around the world was studied. Two different classifications for the severity of ear deformities were used. Statistical calculations of the collected data and correlations to different parameters were performed. Images of 1632 top athletes were evaluated in the study. Ear deformities were found in 55.5% of the judokas. There was gender-specific differences. Male athletes were affected much more often than female athletes. In addition, ear deformities were more pronounced in male athletes. A correlation was found between the age of the athletes and the presence of an ear deformity. It has also been shown that judokas with a high world ranking are more likely to have an ear deformity. Ear deformities are a common consequence of injury among leading judo athletes. The current study represents the largest and high heterogeny cohort ever conducted on the prevalence of cauliflower ear in judoka. Knowledge of the prevalence of cauliflower ear in judoka based on reliable data from this study, may be important prerequisites for further studies on the impact of this traumatic consequence on training preparation and judoka health.

Influence of Practice Periodization and Sleep Duration on Oxidative Stress in High School Judo Athletes

Numerous research studies have investigated the relationship between exercise, oxidative stress level, and condition in athletes who engage in intense training on a daily basis. However, it is known that oxidative stress is affected by exercise, sleep, and the psychological state, but there are only a few studies that have comprehensively examined oxidative stress based on the actual practice periods and living conditions of athletes. Therefore, our study aimed to explore the influence of three distinct training periods (short training period, intensive training period, and pre-competition periods) as well as life situations (sleep and number of steps) on oxidative stress levels (diacron reactive oxygen metabolites: d-ROMs) in high school judo athletes. The results showed that, among the three periods, the level of oxidative stress increased the most during the pre-competition period, and the value was higher than during the training period, when the intensity of training was highest. The levels of the d-ROMs values during the pre-competition period were negatively correlated with the amount of sleep on the previous day. The findings suggest that, besides the exercise intensity, factors such as sleep duration and other life situations should be regarded as critical considerations for high school judo athletes.

Association of Scapular Dyskinesis with Neck and Shoulder Function and Training Period in Brazilian Ju-Jitsu Athletes

Background and Objectives: Neck and shoulder injuries are common in Brazilian ju-jitsu (BJJ) athletes, and scapular dyskinesis (SD) is associated with these injuries. This study aimed to investigate the prevalence of SD in BJJ athletes, their neck and shoulder function and strength, and the BJJ training period. Materials and Methods: Forty-eight BJJ athletes participated in the study. Years of experience with BJJ, belt, shoulder internal and external rotation strength, neck strength, neck disability index (NDI), and SD were measured. Results: Approximately 31 BJJ athletes (64.6%) showed SD, and the nondominant arm showed a more obvious SD (n = 22, 45.8%) than the dominant arm (n = 18, 37.5%). Those with over five years of BJJ training experience showed a significantly higher rate of SD (p = 0.006) than those with less than five years of experience. Shoulder isometric internal rotation strength was significantly weaker in the obvious SD group than in the normal SD group (p = 0.014). Neck isometric strength and NDI did not differ significantly between individuals with or without SD. Conclusions: SD was common among BJJ athletes, and more experienced BJJ athletes exhibited higher rates of SD. Shoulder rotational strength was weaker with SD. Further studies are necessary on the neck and shoulders of BJJ athletes with SD.

Incidence of anterior cruciate ligament injury patterns in Japanese judo players from a nationwide insurance database

Objective

This study aimed to characterize the age- and sex-specific Anterior cruciate ligament (ACL) injury rates and related injury patterns in judo players in Japan using the nationwide insurance database.

Methods

This was a descriptive epidemiological study. We examined a total of 2142 adolescents with anterior cruciate ligament injuries registered in the insurance system of the Japan Sports Council between January 2009 and December 2018. The age- and sex-specific incidences were estimated for the levels of 7th, 8th, and 9th grades of junior high school and 10th, 11th, and 12th grades of high school. The anterior cruciate ligament injury circumstances were classified into three patterns based on the impact to the involved knee: high-impact valgus force, low-impact trunk displacement, or no-impact knee twisting.

Results

The incidence of anterior cruciate ligament injury from the 7th to 12th grades were 0.5, 0.9, 0.9, 6.9, 8.6, and 6.1 per 1000 athlete-years in male players and 1.3, 3.8, 3.4, 16.8, 19.5, and 13.6 per 1000 athlete-years in female players. The most prevalent injury pattern was a low-impact contact injury (42.6%) with Osoto-gari, followed by a high-impact contact injury (29.8%). The concomitant medial collateral ligament (MCL) injury rate was 18.1%, which was correlated with a high-impact contact injury (p = 0.005) by multiple regression analysis.

Conclusions

The highest incidence of age- and sex-specific anterior cruciate ligament injury was 19.5 per 1000 athlete-years in female high school students in the 11th grade. The most frequent injury pattern was low-impact contact injury with trunk displacement, indicating that trunk stabilization training could help prevent anterior cruciate ligament injury in judo.

A-trait and risk-taking behavior in predicting injury severity among martial arts athletes

Introduction

Trait anxiety (A-trait) can be seen as a multiplicative function of the person-situation interaction. Considering risk-taking behavior (R-TB), literature highlights instrumental and stimulating risk. The aim of the research is to investigate the level of A-trait (in physically dangerous conditions and in new, unusual situations) and the level of R-TB (instrumental and stimulating risk) in athletes, and to verify to what extent A-trait and risk-taking behavior predict injury severity.

Materials and methods

One hundred and fifty-four senior martial arts athletes from grappling combat sports, striking combat sports and mixed martial artists (MMA) participated in the study. For assessing trait anxiety and risk-taking behavior, the Romanian adaptation of the Endler Multidimensional Anxiety Scales (EMAS), respectively the Romanian adaptation of the Makarowski's Stimulating and Instrumental Risk Questionnaire were used.

Results

Using multivariate analysis of variance, significant differences between athletes (according to the sports disciplines practiced), in terms of A-trait and R-TB, were examined. Next, we checked the existing correlations between injury severity, A-trait and R-TB scores in athletes practicing striking combat sports, grappling combat sports and MMA. To verify whether there are significant differences in terms of trait anxiety, stimulating and instrumental risk between athletes who have suffered mild, moderate and/or severe injuries and athletes who have suffered only minor/mild injuries, t-Test for Independent Samples was used. Binomial logistic regression procedures were, also, performed, predicting athletes' likelihood of injury, based on R-TB and A-trait.

Conclusion

A moderate or slightly below average level of anxiety in new, unusual situations and a higher level of instrumental risk are linked with a decreased likelihood of severe injuries in athletes. Martial arts athletes (in entire sample) who have suffered more severe injuries are more adrenaline-seeking in competition and use less rational thinking, taking more pleasure in just performing technical executions, regardless of the outcome.

Axillary Artery Transection and Brachial Plexus Injury After Open Inferior Glenohumeral Dislocation: A Case Report

CASE

A judo athlete presented with an open inferior shoulder dislocation that occurred during competition. Examination revealed a transection of the axillary artery and neuropraxia of the posterior cord. Neuropraxia was resolved within 2 weeks. The axillary artery was repaired with a femoral vein graft. He regained full strength, range of motion, and function at 8 months.

CONCLUSION

Inferior glenohumeral dislocations are rare, and their management can be complicated by vascular and neurological injuries. We emphasize the importance of examination, diagnosis, and treatment of neurovascular pathologies to avoid catastrophic outcomes.

Musculoskeletal pains among amateur and professional athletes of five disciplines in Senegal: a preliminary study

BACKGROUND

Musculoskeletal pains (MSPs) in sport are cause of poor performances and loss of competition in athletes. The present study aimed at determining the prevalence of MSPs with regard to sport disciplines and athletic status.

METHODS

A cross-sectional study was conducted among 320 Senegalese professional and amateur athletes practicing football, basketball, rugby, tennis, athletics, and wrestling. Rates of MSPs in the past year (MSPs-12) and week (MSPs-7d) were assessed using standard questionnaires.

RESULTS

Overall proportions of MSPs-12 and MSPs-7d were 70 and 74.2%, respectively. MSPs-12 were more frequently reported on shoulders (40.6%), neck (37.1%) and hips/thigh (34.4%), while MSPs-7d were predominant on hips/thigh (29.5%), shoulders (25.7%), and upper back (17.2%). Proportions of MSPs-12 and MSPs-7d varied significantly by sport disciplines, with highest values among basketball players. Again, highest MSPs-12 proportions on shoulders (29.7%, P = 0.02), wrists/hands (34.6%, P = 0.001), (40.2%, P = 0.0002), and knees (38.8%, P = 0.002) were seen among basketball players. High proportions of MSPs-7d were seen on shoulders (29.6%, P = 0.04) for tennis players, wrists/hands (29.4%, P = 0.03) for basketball and football players, and hips/thigh (38.8%, P < 0.00001) for basketball players. Football players had reduced risk of MSPs-12 by 75% on lower back (OR = 0.25; 95% CI. 0.10-0.63; P = 0.003) and by 72% on knees (OR = 0.28; 95% CI. 0.08-0. 95; P = 0.04). In contrast, tennis players were more at risk of MSPs-12 on shoulders (OR = 3.14; 95% CI. 1.14-8.68; P = 0.02), wrists/hands (OR = 5.18; 95% CI.1.40-11.13; P = 0.01), and hips/thigh (OR = 2.90; 95% CI. 1.1-8.38; P = 0.04). Professionals were protected from MSPs-12 on neck pain with a significant reduction of risk by 61% (OR = 0.39, 95% CI. 0.21-0.75, P = 0.03).

CONCLUSION

MSPs are a reality among athletes and their risk is modulated by sport disciplines, athletic status and gender.

Risks and Benefits of Judo Training for Middle-Aged and Older People: A Systematic Review

This systematic overview aimed to review studies investigating the benefits and risks of judo training in older people, and to explore practical methodological applications (Registration ID: CRD42021274825). Searches of EBSCOhost, ISI-WoS, and Scopus databases, with no time restriction up to December 2022, resulted in 23 records meeting the inclusion criteria. A quality assessment was performed through the following tools: ROBINS-I for 10 experimental studies, NIH for 7 observational studies, and AGREE-II for 6 methodological studies. A serious risk of bias emerged for 70% of the experimental studies, whereas 100% of the observational and 67% of the methodological studies presented a “fair” quality. When involving 1392 participants (63 ± 12 years; females: 47%), the studies investigated novice (n = 13), amateur/intermediate (n = 4), expert (n = 4), and unknown (n = 3) level judoka by means of device-based, self-reported, and visual evaluation measures. Mean training encompassed 2 ± 1 sessions. week−1 of 61 ± 17 min for 7 ± 6 months. In relation to judo training exposure and outcomes, three main themes emerged: (i) health (56% of studies; e.g., bones, anthropometry, quality of life); (ii) functional fitness (43%; e.g., balance, strength, walking speed); and iii) psychosocial aspects (43%; e.g., fear of falling, cognition, self-efficacy). Although the included studies presented relevant methodological weaknesses, the data support the positive effects of judo training with advancing age. Future research is needed to help coaches plan judo programs for older people.

Epidemiology of Injuries during Judo Tournaments

Objective

To determine the injury incidence proportion, distribution of injuries by anatomical location; injury type; injury severity, time loss; mechanism and situations of injuries; and the relative risk of injuries by gender, age, and weight categories during judo tournaments. Study Design. It is a systematic review. Data Sources. A systematic review of the literature was conducted via searches in PubMed, EMBASE, Web of Science, CINAHL, SPORTDiscus, Google Scholar, and PEDro. Eligibility Criteria. All original studies on the incidence of injuries during judo tournaments were included.

Results

Twenty-five studies were included out of the 1979 studies. Using the modified AXIS tool score for quality assessment, seven were rated as having good quality, nine were rated as having fair quality, and four were rated as having poor quality. The injury incidence proportion during tournaments ranged from 2.5% to 72.5% for injuries requiring medical evaluation and 1.1% to 4.1% for injuries causing time loss (i.e., inability to continue game participation). The most commonly reported injury location was the head, followed by the hand, knee, elbow, and shoulder. The most frequent types of injury were sprains, followed by contusions, skin lacerations, strains, and fractures. In judo tournaments, injuries were more often sustained during standing fights (tachi-waza) than in ground fights (ne-waza).

Conclusion

The tournament injury incidence proportion ranged from 2.5% to 72.5% for injuries requiring medical attention and 1.1% to 4.1% for injuries causing time loss. The head was the most frequently injured body part, and sprain was the most frequent injury type. However, current reports on injuries during judo tournaments are heterogeneous and inconsistent, limiting our understanding of in-match injury risks. Future studies should utilize the guidelines of the International Olympic Committee consensus meeting statement on the methodological approach to injury reporting. We recommend a judo-specific extension of this statement to fit the unique features of judo sports practice.

Effectiveness of a judo-specific injury prevention programme: a randomised controlled trial in recreational judo athletes

OBJECTIVES

To evaluate the effectiveness of a trainer-supervised judo-specific injury prevention warm-up programme on overall injury prevalence.

METHODS

We conducted a two-arm, cluster randomised controlled trial; the Injury Prevention and Performance Optimization Netherlands (IPPON) study. Judo athletes aged≥12 years were randomised by judo school to IPPON intervention or control group who performed their usual warm-up. Primary outcome was overall injury prevalence (%) over the follow-up period (16-26 weeks) measured fortnightly with the Oslo Sports and Trauma Research Centre Questionnaire. A modified intention-to-treat analysis was performed due to COVID-19, with estimates for the primary outcome obtained using generalised linear mixed models. Secondary outcomes included: prevalence of severe injuries, overall incidence, time-loss injuries, exposure, adherence and experiences of trainers and athletes.

RESULTS

269 judo athletes (IPPON: 117, Control: 152) were included. Mean injury prevalence over 16-26 weeks was 23% (95% CI 20% to 26%) in the IPPON and 28% (95% CI 25% to 30%) in the control group. We observed no significant difference of all reported injuries (OR 0.72 in favour of the IPPON group; 95% CI 0.37 to 1.39). Secondary outcomes also demonstrated no significant differences between groups. Specifically, no significant difference of severe injuries was reported (OR 0.80 in favour of the IPPON group; 95% CI 0.36 to 1.78). All trainers and 70% of athletes perceived the IPPON intervention as successful.

CONCLUSION

The IPPON intervention did not significantly reduce the overall and severe injury prevalence. Despite this, we suggest the IPPON intervention be considered as an useful alternative to regular judo warm-up, given the high adherence and the positive clinical experiences of trainers and athletes.

TRIAL REGISTRATION NUMBER

NTR7698.

A New Developmental Approach for Judo Focusing on Health, Physical, Motor, and Educational Attributes

Judo is currently the most practiced combat sport in the world. There is no doubt of its importance for children, adolescents, adults, and seniors. However, due to its inherent complexity, coaches tend to place greater or lesser emphasis only on one of its multiple domains during the judoka formative years. The present study presents a novel developmental approach signaling Judo as an excellent way for physical, motor, educational, and health development across the lifespan. In this study, we consulted 23 Judo coaches, aiming to clarify the relevance and adequacy of the domains (Competitive, Health, Technical-Tactical, and Philosophical-Educational) and phases of the proposed model. Our findings showed that the model contents-physical, motor, educational, and health-are entwined with its four domains, which were considered of utmost importance by experts in the development of judokas. We, therefore, contend that our model is essential to better understand the growth and development of young judokas. Also, it may be a useful tool for Motor Development experts.

Injury Symmetry in Judo

Background: Each combat sport carries different risks of injury due to the specifics of the sport (including the weight categories and sex) and the fighting techniques used according to different sports regulations. The purpose of this study is to examine injury symmetry in judo. Methods: Injuries recorded in 195 people (93 women, 102 men) suffered during top-level judo tournaments were verified. Using the European Judo Union medical questionnaire, information on injuries was obtained from each injured athlete. Results: Based on the analysis of the results, it can be concluded that injuries are almost evenly distributed on the left and right sides of the body in both men and women. In women, there were 129 injuries to the left side (41.2%), 134 injuries to the right (42.8%), and 50 (16.0%) to the middle part of the body. Conclusions: injuries in judo are evenly distributed and slightly more common on the right side. Injuries occur at a greater rate during defending maneuvers than attacking maneuvers in judo. Identification and monitoring of who (tori or uke) and which side of the body sustains an injury are crucial and important in injury prevention. This knowledge makes it possible to modify existing sports regulations by eliminating behaviors (e.g., certain types of defense) to improve the safety of athletes participating in top-level competitions and the training process in terms of ensuring safety in both attack and defense.

Using Inertial and Physiological Sensors to Investigate the Effects of a High-Intensity Interval Training and Plyometric Program on the Performance of Young Judokas

The use of inertial and physiological sensors in a sport such as judo is scarce to date. The information provided by these sensors would allow practitioners to have a better understanding of sports performance, which is necessary for an accurate training prescription. The purpose of this study was to use inertial and physiological sensors in order to investigate the effect of a plyometric and high-intensity interval training (HIIT) training program on Special Judo Fitness Test (SJFT) performance and speed of execution of throws in young judokas. A total of 32 participants were divided into two groups: experimental and control. The intervention consisted of six sessions with a duration of 60 min for 3 weeks. Physiological sensors collected heart rate data to assess the Special Judo Fitness Test, and inertial sensors collected angular velocity. The results show a significant decrease in the SJFT index (Score pre: 22.27 ± 2.73; Score post: 19.65 ± 1.70; p ≤ 0.05; d = 0.61) and a significant increase in the angular velocity of the X-axis (Pre: 320.87 ± 51.15°/s; Post: 356.50 ± 40.47°/s; p ≤ 0.05; d = 0.45) and Y-axis (Pre: 259.40 ± 41.99°/s; Post: 288.02 ± 65.12°/s; p ≤ 0.05; d = 0.31) in the experimental group. In conclusion, this study demonstrates that using inertial and physiological sensors allowed us to analyze the effect that a high-intensity interval training program and plyometrics had on the performance of young judokas. Strength and conditioning coaches should consider these results because including plyometric training and HIIT in judokas' workout programming can be especially positive for eliciting increases in performance. However, future training interventions should investigate the training adaptations to longer interventions.

ESTUDIO COMPARATIVO LESIONAL EN JUDOCAS DE ÉLITE

El Judo es un deporte estático alto y dinánimo bajo, con alto riesgo de colisión corporal y lesional. El objetivo de este trabajo es determinar la incidencia lesional y comparar los distintos factores de riesgo que pudieran estar implicados. Se estudió a un total de 86 judocas del Equipo Nacional de Judo español (ENJE) durante dos períodos olímpicos: Beijing-Río. Se produjeron 2028 lesiones con mayor frecuencia en miembro inferior, sin diferencias significativas por sexo. Se objetivó mayor incidencia lesional cuando el judoca era tori y durante el momento del entrenamiento. No existen trabajos previos que comparen estos parámetros, por lo que este estudio aporta datos que pueden ser utilizados para prevenir los riesgos de lesión en el judo de alta competición.

Concussion vs. resignation by submission: Technical–tactical behavior analysis considering injury in mixed martial arts

This research study verified the technical–tactical actions during the mixed martial arts (MMA) fights to generate serious enough injury to stop the MMA round, determining technical-tactical potential risk factors for injury in official MMA combats, according to Concussion or Resignation per Submission. A total of 990 rounds with concussions and 627 resignations per submission were considered with severe injury (i.e., a fight ended by a doctor or referee). All injuries were diagnosed and managed by attending ringside physicians during the MMA fights and rounds and had a continuous technical–tactical behavior analysis, p ≤ 0.05. The leading cause of concussion was due to head trauma (~90%), with higher dependence on head strikes scored actions. Comparisons between Concussion and Resignation per Submission combats demonstrated differences between distance head strikes actions [13(6,25) vs. 9(4,18) frequencies], clinch head strikes actions [1(0;4) vs. 1(0;3) frequencies], ground head strikes actions [1(0;8) vs. 2(0;10) frequencies] and takedowns actions [0(0;1) vs. 1(0;2) frequencies]. This information may provide significant evidence regarding the doctor stoppage in concussion combats and when it could be called by officials supervising MMA.

Injuries in Judo Athletes With Disabilities: Prevalence, Magnitude, and Sport-Related Mechanisms

CONTEXT

The participation of judo athletes with disabilities in competitions has increased over the years as well as the burden of sports-related injuries and illnesses in this population. However, there is limited knowledge about sports-related injuries in judo athletes with different disabilities.

OBJECTIVE

To investigate the prevalence of injuries in judo athletes with disabilities, considering the different impairment groups, magnitude of injury (ie, mechanism, nature, and severity of injury), and specific body parts.

DESIGN

Cross-sectional study (level of evidence, 3).

SETTING

Brazilian Judo athletes with disabilities.

PATIENTS

Fifty-one judo athletes with disabilities (15 men and 36 women) participated in this study.

MAIN OUTCOME MEASURES

Data were obtained from an adapted injury report form. The prevalence of injuries was assessed, considering type of impairment, body parts, mechanisms, and severity as well as differences between male and female athletes, with the significance level set at P < .05.

RESULTS

The results demonstrated a high prevalence of injuries in female athletes with visual impairment (n = 11, 73.3%) and male athletes with amputations (n = 14, 38.8%). A high prevalence was found in the national group, especially for male athletes (n = 29, 80.5%). Among athletes who had injuries, 69.4% (n = 12) of male and 80.0% (n = 25) of female athletes' injuries occurred due to direct contact with other athletes, and 72.2% (n = 26) of male and 86.6% (n = 13) of female athletes' injuries were in the training environment. The magnitude of injuries ranged from moderate to severe for male and female athletes. The knee (n = 25, 49.0%) and shoulder (n = 12, 23.5%) were the body parts most affected by injuries in both male and female athletes.

CONCLUSION

A large percentage of judo athletes with disabilities reported experiencing an injury during the previous 2 years; percentages were greater in athletes with visual and physical impairment. Moreover, most injuries occurred in the knee or shoulder, during training, and in direct contact with other athletes and were of severe magnitude.

Factors affecting the shoulder functional profile in elite judo athletes

AbstractThe aim was to investigate the effects of sex, age, preferred judo technique, dominance, and injury history on the shoulder functional status of elite judo athletes. Sixty-one elite judo athletes (38 males, age: 18.1 ± 1.2 years, body mass: 69.3 ± 13.3 kg, body height: 172.2 ± 9.8 cm, brown belt to second-degree black belt) completed three questionnaires: Western Ontario Shoulder Instability, Western Ontario Rotator Cuff, and Shoulder Instability-Return to Sport after Injury. They performed four physical tests: the glenohumeral rotator isometric strength test, upper quarter Y-balance test, unilateral seated shot put test, and modified Closed Kinetic Chain Upper Extremity Stability Test. The results showed that the female athletes had less shoulder functional abilities than the male athletes (p < 0.001 to p = 0.02). The younger athletes had poorer shoulder stability and upper extremity power than the older athletes (p < 0.001 to p = 0.02), but their glenohumeral muscles were stronger in both internal (p = 0.03) and external (p = 0.005) rotations. All the judo athletes had similar bilateral differences in shoulder functional status, except for judokas who preferred throwing techniques (p = 0.01). Injury history affected self-perceived functional status (p < 0.001), as well as upper extremity muscle capacity and neuromuscular control (p = 0.01 to p = 0.05). This study provides new insight into the shoulder functional status of elite judo athletes, which may aid in the development of sports-specific injury prevention and return-to-sport programs to reduce the risk of shoulder injury occurrence and recurrence.

Diagnostics of tissue involved injury occurrence of top-level judokas during the competition: suggestion for prevention

Background

Judo, as a high-intensity contact sport, may lead to the occurrence of injuries, especially in competitions. This work aims to assess the likelihood of soft and hard tissue injuries in top-level judokas during competition with defining factors that determine the probability of injury occurrence.

Methods

The injuries that occurred in 123 official international competitions from 2005-2019 were recorded by the European Judo Union (EJU) Medical Commission as a survey that was a part of the EJU Injury Registration form with internal consistency shown by a Crombach Alpha of 0.69. This survey data identified factors such as: sex, anatomical localisation of injury, type of injury, tissue involved and mechanisms of the injury. A total of 650 tissue injuries were reported correctly in terms of tissue injury definition.

Results

The most frequent soft tissue injury (STI) reported was a ligament STI (48.15%), closely followed by skin STI (12.15%) and muscles STI (11.38%). In turn, the most frequent hard tissue injury occurred in bones (8.56%). The highest rates of injuries occurred during the fight in the standing position (78%). Injuries in the standing position mainly occurred while executing a throw (25.85%) and followed by the attempt to throw, i.e., the action of reaching the throwing position (22.30%), grip fighting (15.07%), and during falls (14.77%). Opposite to this, fight in groundwork reached only 18.30% soft and hard tissue injuries combined. The ongoing registration of injuries during judo combat and training and the early diagnosis of risk factors for injuries are the basis for the development of effective strategies for injury prevention and further treatment.

Video Biomechanical Analysis of Shoulder Impact Kinematics in Tai-Otoshi and Morote-Seoi-Nage Judo Throws: A Cross-Sectional Study

Background: Shoulder injuries in judo are common as the falling player (uke) lands. Two throws implicated in shoulder injury are tai-otoshi and morote-seoi-nage. Kinematic investigation can provide insight into possible shoulder injury mechanisms and allow for appropriate preventative measures to be suggested. We used two-dimensional (2D) video analysis to measure and compare: (a) the peak acceleration and (b) the peak velocity of uke’s shoulder when tai-otoshi and morote-seoi-nage were performed by elite adult judoka. Methods: Eight male participants were recruited from the Budokwai Judo Club in London, UK. The mean age, height, and weight of participants were 25.4 ± 5.2 years (18–34), 1.7 ± 0.0 m (1.7–1.8), and 75.0 ± 5.2 kg (66–80), respectively. Throws were recorded using an iPhone 6S camera and uploaded onto Kinovea for subsequent processing. Results: The peak acceleration (m/s2) was greater in tai-otoshi (71.6 ± 12.4) compared to morote-seoi-nage (67.9 ± 9.9), although this was statistically insignificant. The peak velocity (m/s) was significantly greater (p = 0.030) in tai-otoshi (5.1 ± 0.8) than in morote-seoi-nage (4.5 ± 0.6). Conclusions: A greater peak velocity in tai-otoshi suggests that the shoulder is subjected to increased loads upon impact. This may indicate that tai-otoshi carries a greater risk of shoulder injury. Nage-komi (repetitive throwing) practices in training should follow gradual loading principles—beginning with morote-seoi-nage, before moving to tai-otoshi, for example. We must be aware of any assumptions made in estimations of impact force, and future in vivo research is required to provide more definitive values. Meanwhile, coaches must continue to ensure that correct ukemi (breakfall) technique is displayed by athletes before performing throws.

A Systematic Review on the Biomechanics of Breakfall Technique (Ukemi) in Relation to Injury in Judo within the Adult Judoka Population

Objectives: To investigate the biomechanics of Ukemi in relation to head and neck injury in adult judokas with varying skill sets. Design: Narrative systematic review. Methods: An extensive literature search was performed using PubMed, Google Scholar, Science direct and EMBASE from inception to April 2021. Studies were included if they: (1) reported biomechanical analysis of judo throws and Ukemi; (2) were on adult judoka populations; (3) discussed injury related to judo technique. The included studies were assessed for risk of bias using a five-part modified STROBE checklist. A narrative synthesis was performed due to the heterogeneity of included studies. Results: 173 titles and abstracts were screened with 16 studies (158 judokas, 9 of which were female) included. All studies used 3D biomechanical analysis to assess Ukemi. Ukemi implementation produced reduced kinematic data in comparison to direct occipital contact, which was always below the injury threshold. Analysis of lower limb and trunk kinematics revealed variances in Ukemi between novice and experienced judoka. Whilst no significant differences were seen in neck flexion angles, hip, knee and trunk angle time plots revealed greater extension angles in experienced judokas. Conclusions: Ukemi is essential in preventing head and neck injuries; however, technique differs between experienced and novice judoka. Larger flexion angles of the hip, knee and trunk are seen in novice judoka, which correlate with increased kinematic data. The association of greater neck muscle strength with improved Ukemi is weak. However, a negative correlation was established between fatigue and breakfall skill by one study.

Maximal isokinetic elbow and knee flexor-extensor strength measures in combat sports athletes: the role of movement velocity and limb side

Background

Maximal isokinetic strength ratios of joint flexors and extensors are important parameters to indicate the level of muscular balance at the joint. Further, in combat sports athletes, upper and lower limb muscle strength is affected by the type of sport. Thus, this study aimed to examine the differences in maximal isokinetic strength of the flexors and extensors and the corresponding flexor–extensor strength ratios of the elbows and knees in combat sports athletes.

Method

Forty male participants (age = 22.3 ± 2.5 years) from four different combat sports (amateur boxing, taekwondo, karate, and judo; n = 10 per sport) were tested for eccentric peak torque of the elbow/knee flexors (EF/KF) and concentric peak torque of the elbow/knee extensors (EE/KE) at three different angular velocities (60, 120, and 180°/s) on the dominant and non-dominant side using an isokinetic device.

Results

Analyses revealed significant, large-sized group × velocity × limb interactions for EF, EE, and EF–EE ratio, KF, KE, and KF–KE ratio (p ≤ 0.03; 0.91 ≤ d ≤ 1.75). Post-hoc analyses indicated that amateur boxers displayed the largest EE strength values on the non-dominant side at ≤ 120°/s and the dominant side at ≥ 120°/s (p < 0.03; 1.21 ≤ d ≤ 1.59). The largest EF–EE strength ratios were observed on amateur boxers’ and judokas’ non-dominant side at ≥ 120°/s (p < 0.04; 1.36 ≤ d ≤ 2.44). Further, we found lower KF–KE strength measures in karate (p < 0.04; 1.12 ≤ d ≤ 6.22) and judo athletes (p ≤ 0.03; 1.60 ≤ d ≤ 5.31) particularly on the non-dominant side.

Conclusions

The present findings indicated combat sport-specific differences in maximal isokinetic strength measures of EF, EE, KF, and KE particularly in favor of amateur boxers on the non-dominant side.

Trial registration: This study does not report results related to health care interventions using human participants and therefore it was not prospectively registered.

Principles of Judo Training as an Organised Form of Physical Activity for Children

When organising judo training for children, it is essential to ensure maximum safety, and use an appropriate training methodology adapted to the age of the youngest judo athletes. This paper aims to review the current literature containing judo training principles and safety-related considerations for preschool (4-6 years) and school-age (7-12 years) children as an organised physical activity. Data were collected until October 2021 from eight international scientific databases (PubMed, Scopus, UpToDate, Web of Science, Cochrane, EBSCOhost, ScienceDirect, Google Scholar). In the overviews, we found various times and frequencies of judo training for children. In preschool, the training time was 30-60 min with a frequency of 2-3 times per week, whereas in the school-age group, the training time was extended from 45 to 90 min 3-4 times per week. The most common injuries included upper arm injuries, followed by those of the lower limbs. In the future, it would be an advantage to systematise the methodology of judo training as an organised form of physical activity that can complement the daily dose of exercises recommended by the World Health Organization for maintaining children's general health.

Injury Patterns, Risk Factors, and Return to Sport in Brazilian Jiu Jitsu: A Cross-sectional Survey of 1140 Athletes

Background

Brazilian jiu jitsu (BJJ) is a growing martial art that focuses on grappling techniques.

Purpose

To quantify the 3-year incidence of BJJ-related injuries and detect common injury patterns as well as risk factors among those practicing BJJ. It was hypothesized that there would be a high incidence of injuries, they would be caused by submissions in sparring situations, and they would occur predominantly at the extremities.

Study Design

Descriptive epidemiology study.

Methods

Active BJJ athletes were invited to take an English-language online survey developed by orthopaedic surgeons together with BJJ athletes and a sports scientist. Data were recorded regarding athlete demographics, sporting activity level, injuries within the past 3 years that caused at least a 2-week time loss, injury mechanisms, and return to sport.

Results

Overall, 1140 responses were received from 62 different countries; 88.9% of all athletes were male, and 63.9% were regular competitors. Within the investigated cohort, 1052 injuries were recorded in 784 athletes, for an injury incidence of 308 per 1000 athletes per year. The lower extremity (45.7%) and upper extremity (30.2%) were predominant sites of injury, with injuries to the knee (27.1%) being the most common. The most frequent knee injuries were meniscal injuries (n = 65), anterior cruciate ligament (ACL) tears (n = 36), and medial collateral ligament injuries (n = 36). ACL tears were especially associated with long time frames for return to sport. Most injuries occurred during sparring (77.6%) and were caused by submissions (29.7%) and takedowns (26.4%). Competing regularly (P = .003), older age (P < .001), and higher belt rank (P = .003) were significant risk factors for injury.

Conclusion

Injury incidence was high among BJJ athletes surveyed, with 2 out of 3 athletes reporting at least 1 injury within a 3-year period that caused a 2-week absence from training. Most injuries occurred during sparring, and we believe that a high potential for injury reduction lies in drawing awareness to common injury patterns and sites in athletes.

Variation characteristics of stress distribution in the subchondral bone of the knee joint of judo athletes with long-term stress changes

OBJECTIVE

To investigate the distribution of bone density in the subchondral bone tissue of the knee joint due to the mechanical stress load generated by judo, the bone tissue volume of different densities and the bone remodeling characteristics of the subchondral bone of the knee joint.

METHODS

CT imaging data of the knee joint were collected from 15 healthy individuals as controls and 15 elite judo athletes. Firstly, they were processed by the CTOAM technique, and secondly, the distribution pattern of high-density areas of the knee joint was localized using nine anatomical regions. In addition, three tomographic images were selected in the sagittal, coronal, and axial 2D image windows to observe the distribution of different densities of bone tissue. Finally, the percentage of bone tissue volume (%BTV) and bone remodeling trend of bone tissues with different densities were determined.

RESULTS

In this study, high-density areas were found in the 4th, 5th, and 6th regions of the articular surface of the distal femur and the 1st, 2nd, 3rd, 4th, 5th, 6th, 7th and 8th regions of the tibial plateau in judo athletes; the distribution of high-density areas on the articular surface of the distal femur in control subjects was similar with judo athletes, and high-density areas were mainly found in the 4th and 5th regions of the tibial plateau. The %BTV of low (401-500HU in the distal femur; 301-400 HU and 401-500HU in the tibial plateau), moderate, and high bone density was higher in judo athletes than in controls in the subchondral bone of the distal femur and tibial plateau (P< 0.05).

CONCLUSION

The history of compressive stresses, struck stresses, soft tissue tension and pull, self-gravity and intra-articular stress loading generated by the lower limb exercise technique of judo leads to specific forms of stress distribution and bone tissue remodeling in the subchondral bone tissue within the distal femur and tibia plateau.

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Comparison of incidence, prevalence, severity and profile of health problems between male and female elite youth judokas: A 30-week prospective cohort study of 154 athletes

OBJECTIVES

To describe and compare the incidence, prevalence, severity, and profile of injuries (acute and overuse) and illness between female and male youth elite judokas during 30 weeks of a sports season.

DESIGN

Prospective cohort study.

METHODS

A total of 154 elite youth judokas (83 males and 71 females) were assessed from January to August 2019 in a training period organized by the Brazilian Judo Confederation. We conducted a prospective 30-week follow-up study on acute and overuse injuries and illness among youth female and male judokas through the Oslo Sports Trauma Research Center questionnaire on health problems (OSTRC-H). Every week, the OSTRC-H was sent to all youth judokas electronically, starting in the first week of preseason. The incidence rate, prevalence, and severity of illnesses and acute and overuse injuries were compared between sexes using an independent t-test (variables with normal distribution) or Mann Whitney U test (variables with non-normal distribution) with α set a 0.05.

RESULTS

Female and male judokas showed 16.96 and 16.57 injuries per 1000 athletic exposures, respectively (p = 0.383). Female judokas showed a higher average weekly prevalence of health problems (38.8%) than male judokas (29.0%). In addition, females had a greater prevalence of substantial health problems (p < 0.001), injuries (p < 0.001), and overuse injuries (p < 0.001) than males.

CONCLUSION

There were no differences in the incidence rate of injuries between sexes. Youth female judokas showed a higher prevalence of all health problems than youth male judokas. For both sexes, the knee and shoulder were the most affected joints for acute and overuse injuries, respectively.

Isokinetic Profile of Elite Serbian Female Judoists

Elite judo athletes undergo vigorous training to achieve outstanding results. In pursuit of achieving competitive success, the occurrence of injuries amongst judo athletes is not rare. The study aimed to perform a knee flexors and extensors isokinetic torque analysis in elite female judo athletes. Fifty-eight elite female judo athletes of the Serbian national team (21.02 ± 3.11 years; 62.36 ± 11.91 kg, 165.04 ± 10.24 cm, training experience 12.72 ± 2.98 years) volunteered to participate in this study. The range of motion (ROM) was set at 90°. Testing was performed in a concentric-concentric mode for the testing speed of 60 °/s. Five maximal voluntary contractions of knee extensors and knee flexors muscle groups were measured for both legs. The obtained data showed a statistically significant difference in absolute torque values among different categories as heavier athletes demonstrated higher values. Post hoc analysis showed a significant difference between weight categories, as heavier athletes demonstrated higher values, while no significant differences in normalized torque values for different weight categories were observed. The implementation of new elements and training modalities may improve performance and prevent lateral asymmetry, thus reducing the risk of injury.

MRI-Detected Knee Ligament Sprains and Associated Internal Derangement in Athletes Competing at the Rio de Janeiro 2016 Summer Olympics

Purpose

Describe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury.

Patients and Methods

All knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport.

Results

11,274 athletes participated in the 2016 Olympic Games: 113 athletes received at least one knee MRI with some having bilateral or repeat MRI on the same knee. Anterior cruciate and medial collateral ligament (ACL/MCL) sprains were most common, accounting for 32 of the 43 sprains (74.4%). Wrestling (10), hockey (7), athletics (7), and judo (5) accounted for over half of ligament sprains. ACL sprains showed a significant positive correlation with medial, lateral meniscal tears and bone contusions. The positive correlation between posterior cruciate ligament (PCL) sprains with MCL/lateral collateral ligament sprain, and popliteus tendon tear was statistically significant with 50% of total PCL sprains occurring in hockey. When athletes were stratified by gender, ligament sprains had a similar occurrence and distribution between men and women.

Conclusion

Knee ligament sprains, at the Rio 2016 Games, were most common in wrestling, hockey, athletics and judo with ACL and MCL sprains most frequent. Meniscal tears and bone contusions occurred often with ACL sprains. PCL sprains tended to be multi-ligamentous injuries. Sustained ligament sprains had similar occurrence between genders, while men had a peak incidence of sprains at a younger age and women at an older age.

Judo Injuries Frequency in Europe's Top-Level Competitions in the Period 2005-2020

Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration Form at Europe’s top judoka tournaments. Results: Over the 15 years of the study, 128 top-level competitions with 28,297 competitors were included; 699 injuries were registered. Of all competitors, 2.5% needed medical treatment. The knee (17.4%), shoulder (15.7%), and elbow (14.2%) were the most common anatomical locations of injury. Sprains (42.2%) were by far the most frequent injury type, followed by contusions (23.1%). Of all contestants, 0.48% suffered an injury which needed transportation to hospital. There was a statistically significant higher frequency of elbow injuries in female athletes (p < 0.01). Heavy-weight judokas suffered a remarkably low number of elbow injuries, with more knee and shoulder injuries. Light-weight judokas were more prone to elbow injuries. Conclusions: We found there was a low injury rate in top-level competitors, with a greater frequency of elbow injuries in female judokas. During the 15 years of injury collection data, an injury incidence of 2.5% was found, with a remarkable high injury rate in the women’s −52 kg category, and statistically significantly more elbow injuries in women overall.

Biomechanical Analysis of Serious Neck Injuries Resulting from Judo

To establish a basis for initial diagnosis and for proposing preventive measures for the serious neck injuries occasionally experienced by judo practitioners, the biomechanical mechanisms of these injuries were analyzed. Two male judo experts repeatedly threw an anthropomorphic test device (POLAR dummy) using three throwing techniques (Seoi-nage, Osoto-gari, and Ouchi-gari). The dummy’s kinematic data were captured using a high-speed digital camera, and the load and moment of the neck were measured with load cells. The neck injury criterion (N_ij) and beam criterion were also calculated. In Seoi-nage, the anterior and parietal regions of the dummy’s head contacted the tatami (judo mat). Subsequently, most of the body weight was applied, with the neck experiencing the highest compression. However, in Osoto-gari and Ouchi-gari, the occipital region of the dummy’s head contacted the tatami. Significantly higher values of both N_ij (median 0.68) and beam criterion (median 0.90) corresponding to a 34.7% to 37.1% risk of neck injury with an abbreviated injury scale score ≥2 were shown in Seoi-nage than in either Ouchi-gari or Osoto-gari. In judo, when thrown by the Seoi-nage technique, serious neck injuries can occur as a result of neck compression that occurs when the head contacts the ground.

EPIDEMIOLOGY OF ORTHOPEDIC INJURIES IN JIU-JITSU ATHLETES

OBJECTIVE

This study aims to identify the epidemiology of orthopedic injuries in jiu-jitsu practitioners.

METHODS

Ninety-six jiu-jitsu practitioners aged between 18 and 45 years, male and female, answered a questionnaire addressing personal data and history of injuries related to the sport during the last 24 months.

RESULTS

In the period cover, 85% of the sample presented injuries related to the practice of jiu-jitsu, with an average of 60 days of absenteeism from sports practice. Fingers, shoulders, and knees were the joints most affected by orthopedic injuries.

CONCLUSION

Orthopedic injuries are quite prevalent among jiu-jitsu practitioners, often distancing athletes from the sport. Level of Evidence IV, case series / cross sectional study.

Injury incidence, severity and profile in Olympic combat sports: a comparative analysis of 7712 athlete exposures from three consecutive Olympic Games

OBJECTIVES

To describe and compare the epidemiology of competition injuries in unarmed combat sports (ie, boxing, judo, taekwondo and wrestling) in three consecutive Olympic Games.

METHODS

Prospective cohort study using injury data from the IOC injury surveillance system and exposure data from official tournament records at three consecutive Olympic Games (ie, Beijing 2008, London 2012 and Rio de Janeiro 2016). Competition injury incidence rates per 1000 min of exposure (IIR_ME) were calculated with 95% CIs using standard formulae for Poisson rates.

RESULTS

The overall IIR_ME was 7.8 (95% CI 7.0 to 8.7). The IIR_ME in judo (9.6 (95% CI 7.8 to 11.7)), boxing (9.2 (95% CI 7.6 to 10.9)) and taekwondo (7.7 (95% CI 5.6 to 10.5)) were significantly higher than in wrestling (4.8 (95% CI 3.6 to 6.2)). The proportion of injuries resulting in >7 days absence from competition or training was higher in wrestling (39.6%), judo (35.9%) and taekwondo (32.5%) than in boxing (21.0%). There was no difference in injury risk by sex, weight category or tournament round, but athletes that lost had significantly higher IIR_ME compared with their winning opponents (rate ratio 3.59 (95% CI 2.68 to 4.79)).

CONCLUSION

Olympic combat sport athletes sustained, on average, one injury every 2.1 hours of competition. The risk of injury was significantly higher in boxing, judo and taekwondo than in wrestling. About 30% of injuries sustained during competition resulted in >7 days absence from competition or training. There is a need for identifying modifiable risk factors for injury in Olympic combat sports, which in turn can be targeted by injury prevention initiatives to reduce the burden of injury among combat sport athletes.

Sport Injuries in Elite Paralympic Judokas: Findings From the 2018 World Championship

BACKGROUND

To provide information regarding injury incidence, injury pattern, and associated injury risk factors in elite Paralympic judokas.

METHODS

Participants in this observational research were elite judokas taking part in the IBSA 2018 World Judo Championship. The entire championship was videotaped, and all injuries were prospectively documented using an all-complaints definition.

RESULTS

The tournament featured 267 judokas, (B1 = 58; B2 = 105; B3 = 104). The injury proportion was estimated at 18.9 injuries/100 fighters (B1 = 13.8; B2 = 22.3; B3 = 18.5). A total of 745 athletic exposures were registered. The overall injury rate was 68.5 (95% CI, 52.5-89.2); 62.5 (95% CI, 32-122.3); 79.6 (95% CI, 53.8-17.8); and 61.2 (95% CI, 40-93.5) for the total sample, B1, B2, and B3 judokas, respectively. When only injuries resulting in medical attention were analyzed, the overall injury rate was calculated to be 22.8 (95% CI, 14.3-36.5), and the injury proportion was estimated at 6.3 injuries/100 fighters. No significant differences were found for sex, weight, and visual class regarding injury proportion and injury rates.

CONCLUSION

Paralympic judokas show a high injury rate. However, when only injuries that needed medical attention were taken into account, the proportion of athletes injured was low. The degree of visual impairment was not considered as an injury risk factor.

Systematic development of an injury prevention programme for judo athletes: the IPPON intervention

Objectives

To systematically develop an injury prevention programme in judo and test its feasibility: Injury Prevention and Performance Optimization Netherlands (IPPON) intervention.

Methods

We used the five-step Knowledge Transfer Scheme (KTS) guidelines. In the first two steps, we described the injury problem in judo and showed possibilities to reduce the injury rates. In the third step, the Knowledge Transfer Group (KTG) translated this information into actions in judo practice. Expert meetings and practical sessions were held. In the fourth step, we developed the injury prevention programme and evaluated its feasibility in judo practice in a pilot study. As a final step, we will evaluate the injury prevention programme on its effectiveness to reduce injuries.

Results

In the first two steps, information collected indicated the need for reducing judo injuries due to high incidence rates. Injury prevention programmes have shown to be effective in reducing injuries in other sports. For judo, no injury prevention programme has yet been systematically developed. In the third step, the KTG reached consensus about the content: a trainer-based warm-up programme with dynamic exercises focusing on the shoulder, knee and ankle. In the fourth step, the intervention was developed. All exercises were approved in the pilot study. Based on the pilot study’s results, the IPPON intervention was extended and has become suitable for the final step.

Conclusion

We developed the IPPON intervention using the systematic guidance of the KTS. This trainer-based programme focuses on the prevention of shoulder, knee and ankle injuries in judo and consists of 36 exercises classified in three categories: (1) flexibility and agility, (2) balance and coordination and (3) strength and stability. The effectiveness and feasibility of the intervention on injury reduction among judo athletes will be conducted in a randomised controlled trial.

Martial arts injuries: a longitudinal study about judo, karate and wushu carried out in the Community of Madrid, Spain

BACKGROUND

Martial arts are currently being practiced throughout the world by about 100 million people. Considering that sports injuries account for 20% of all emergencies treated in hospitals, this is an issue that should be further studied. Our objective was to determine the prevalence and type of injuries in wushu, judo, and karate practitioners in Community of Madrid, Spain.

METHODS

A descriptive epidemiology study was carried out. A questionnaire was used to collect data from 457 men and women practicing karate, judo and/or wushu, including injuries from the past five years, type of injury and occurrence during training or competition.

RESULTS

Injuries that disrupted training occurred in 56% of judokas, in 36.7% of karatekas and in 38.9% of wushu practitioners (WP). For judokas, the most common injury site was "shoulder/arm/elbow" (13.43%), for karatekas, it was "lower leg/foot/ankle" (9.95%), and for WP it was "groin/hip/thigh" (9.45%) (P=0.000). The most common injuries in judo and karate were "ankle sprains and joint injuries" (4.98% and 3.98%), while for WP the most common injury were "hamstring strains" (5.47%) (P=0.008). There was no relationship between occurrence of a first injury and sex, age or belt rank.

CONCLUSIONS

Judo is the martial art with the highest percentage of injuries, followed by wushu and then karate.