How to Overcome Low Back Pain and Disc Herniations/Bulges in Brazilian Jiu-Jitsu: Causes, Risks, Prevention, and Management
Brazilian Jiu-Jitsu is a physically demanding sport that requires technique, strength, flexibility, and agility. Due to the complex nature and dynamic movements in Jiu-Jitsu, injuries are common and should be expected. There are many different types of injuries that can occur in Jiu-Jitsu, but one of the most common ones is lower back injuries. In particular, disc herniations or bulges can pose a significant risk to Jiu-Jitsu practitioners. This type of injury can greatly impact the Jiu-Jitsu athlete, and in this article, we will explore the causes, signs and symptoms, prevention, and management of low back pain and disc herniations with specific emphasis on Jiu-Jitsu.
How the lower back & spine gets injured in jiu-jitsu?
In Brazilian Jiu-Jitsu, the lower back and spine can be injured in several ways. The spine is made up of individual vertebrae separated by intervertebral discs that act as shock absorbers and provide stability. A disc herniation or bulge occurs when the outer layer of the disc tears or bulges out, potentially compressing nearby nerves and causing pain, such as sciatica.
In Jiu-Jitsu, the most common forms of lower back injury result from repetitive strain on the lower back. However, movements such as takedowns, guard passes, slams, being in the stacked position, and being in positions that cause excessive flexion (e.g. inverted guards) can also place significant strain on the spine, accompanied by force and submissions. These actions increase the risk of disc herniations or bulges in Jiu-Jitsu practitioners.
What are common signs/symptoms of disc bulges or herniations?
The most common signs or symptoms of a disc herniation or bulge can include lower back pain, difficulty with bending forward, numbness/tingling in the glute, thigh, leg, or foot. Many Brazilian Jiu-Jitsu (BJJ) players often experience constant tightness in one side of the hamstring, glute, or Piriformis region, which may feel like it always needs to be stretched. However, this condition often does not respond well to stretching. Additionally, spasms, weakness, or faster leg fatigue on one side may also be experienced.
Furthermore, BJJ players may notice increased pain at night and in the morning, with difficulty getting up from bed. Once movement starts and the body warms up, the pain may temporarily subside, only to repeat the cycle the following day.
Who is most at risk for lower back pain and disc injuries in jiu-jitsu?
Injuries in Brazilian Jiu-Jitsu tend to be more common among newer practitioners who may not yet be proficient in the movements and whose tissues have not fully adapted to the forces and stresses of the sport. It takes time, often weeks, months, or even years, to adapt to these demands, and even then, no one is immune to injury, especially in a contact sport.
However, even more seasoned athletes and long-term Jiu-Jitsu players may be at risk of chronic lower back pain and disc injuries. Evidence suggests that chronic lower back pain and positive disc findings on MRI may be more prevalent as individuals age, regardless of their experience level in the sport. It should be noted that positive disc findings on MRI do not always correlate with pain. Therefore, there is evidence that the longer one practices Jiu-Jitsu, the higher the risk of chronic lower back pain and injury may be.
The nature of Jiu-Jitsu, with its twisting, bending, and grappling movements, can place significant stress on the lumbar spine, increasing the risk of low back pain and disc herniations/bulges. It is crucial for Jiu-Jitsu practitioners to be aware of these risks and take steps to prevent and manage these injuries in order to ensure optimal performance and maintain long-term spinal health.
Do lumbar disc bulges/herniations heal?
Yes, most disc herniations do heal! In a recent study of 277,941 people with a herniated disc, 97% of those people healed with nonoperative treatments! This means only 3% needed to have surgery or invasive treatemnts, so the chances of you healing are very good, if you do the right things.
In addition, another study noted that 66.66% of disc herniations tend to reabsorb! While some discs can reabsorb 100%, some may not but taking a little pressure off the disc or nerve can make all the difference in terms of pain and recovery.
How long does it take to heal from a lumbar disc?
In my experience, most BJJ players can return to training on the mats within 2-3 months after an injury, but they will have to modify their training and may not be at 100% capacity.
This injury needs to be managed intelligently, and the mechanics of your spine must be adjusted to reduce the forces that impact the spine.
While there is no definitive timeline for recovery, textbooks may suggest 8-12 weeks, and some even mention 3-6 months for full recovery. Based on my professional experience, I recommend starting with a formal care program of at least 3 months, and then gradually building on that. It may take more time to get patients from pain to performing at a high level with minimal risk.
For this reason, we coach and mentor patients on how to manage their own back pain and provide guidelines for self-care. According to Stu McGill, in one of his books, 65% of lower back pain patients may experience some level of pain up to 1 year after the injury. In my opinion, this can range from a simple flare-up to a mechanical disturbance, indicating that the underlying mechanics of the body were not adequately addressed and the pain has increased.
The bottom line is, if you truly want to address this issue and minimize the risk of further damage or injury after experiencing severe low back pain, you should give yourself at least 4-6 months with proper guidance.
What should I know about rehabilitation of my low back & disc injury?
In jiu-jitsu, there are different belt ranks that signify progression in training and skill levels. Similarly, when it comes to lower back pain, there are different phases of care or stages of recovery. However, just like in jiu-jitsu, these stages are not always linear and may overlap, requiring a combined approach.
- The first stage is the pain relief stage, which should focus on reducing pain and inflammation in the lower back. Many people may not realize that certain activities they engage in, such as continuing to train at a higher level in jiu-jitsu, getting up from bed, or avoiding stretching or irritating exercises/postures, can constantly increase their pain. The goal in this stage is to bring the pain down to a level below 4/10 and maintain that consistently.
McKenzie extension to help reduce lower back disc pain
- The second phase is the recalibration/corrective phase, which focuses on retraining new movement patterns, improving mobility, and restoring proper mechanics of the spine. During this phase, you should start to feel stronger, notice improved mobility, and see progress in your recovery. However, it's important to note that many people may experience flare-ups or relapse in pain during this phase, often because they don't spend enough time here. Similar to jiu-jitsu training, some individuals may rush through this phase once they start feeling better, but that can be a mistake. It's crucial to dedicate enough time to rehab and corrective exercises to ensure long-term recovery and prevent setbacks.
- The third phase is the strengthening/performance phase, where your exercise and rehab program begins to resemble your regular workout routine. During this phase, you'll focus on gaining strength and working at a level that complements your jiu-jitsu training. As you continue to progress, you'll be able to perform exercises and movements that support your overall performance and function, helping you get back to your regular training routine with improved strength and resilience. It's important to work closely with a healthcare professional or qualified trainer to ensure that you progress safely and effectively during this phase to optimize your recovery and minimize the risk of reinjury.
Maintaining a strengthening program is crucial after recovering from lower back pain and completing your rehab. It's important to remember that the goal of rehab and recovery is not just to get back to your previous level of activity, but to also prevent future injuries.
By consistently maintaining a strengthening program, you can continue to build strength, stability, and mobility in your back muscles, which can help reduce the risk of reinjury. Regular exercise can also help improve your overall fitness and resilience, making you less susceptible to future episodes of lower back pain.
Incorporating exercises that specifically target the muscles of your lower back, core, hips, and glutes can help maintain proper mechanics and support your spine during physical activities like jiu-jitsu training. It's important to work with a qualified healthcare professional or a trained fitness expert to develop a customized strengthening program that meets your specific needs and goals.
Remember, prevention is key. By proactively taking steps to maintain the progress you've made through rehab and continuing to prioritize your spinal health, you can enjoy a more sustainable and injury-free jiu-jitsu practice.
If you want our lower back pain guide, you can click here to get it for free! It will give you access some of the best exercises for pain relief, mobility, and strengthening to help your lower back pain and disc injury.
What exercises can help me?
The selection of exercises for rehab and strengthening of the lower back depends on various factors such as the phase of care, current pain level, mobility, and type of injury. Deadlifts, when performed correctly and with proper progression, can be a beneficial exercise for jiu-jitsu practitioners, as it involves engaging the core, hips, and glutes, which are important muscle groups for supporting the lower back.
The end goal for me to say with confidence that you have progressed well, is for you to complete a deadlift or some sort of deadlift variation, without pain! I know most people say deadlifts are bad for you, but in jiu-jitsu, this is a must! You don’t need to lift extremely heavy weight either, and to get to this point, this needs to be trained properly.
In addition to core strengthening and mobility training, it's also important to address any other areas of the body that may contribute to restrictions or pressure on the lower back. This may involve addressing issues with hip mobility, posture, or muscle imbalances that can affect the mechanics of the spine. A comprehensive and individualized approach to rehab and strengthening can help you progress towards safely incorporating exercises like deadlifts into your routine, and ultimately, support your jiu-jitsu practice with a stronger and more resilient lower back.
Having a clear goal in mind, such as being able to safely perform deadlifts, can help guide your rehabilitation and strengthening program. It's important to work with a healthcare professional who understands the specific demands of jiu-jitsu and can tailor a program that addresses your individual needs, including the components of spinal rehabilitation, mobility training, and core strengthening.
Jiu-jitsu requires specific conditioning and movement patterns that may differ from other sports or activities, and a healthcare professional who understands these nuances can design a program that is tailored to your needs as a jiu-jitsu practitioner. By working with a knowledgeable professional, you can ensure that you are progressing safely and effectively towards your goal of returning to the mats with a stronger and more resilient lower back.
Recovering from lower back pain, sciatica, or disc herniation/bulges can be a challenging process, but with proper guidance and a comprehensive approach, it is possible to regain your strength, mobility, and confidence in your jiu-jitsu practice.
Remember to prioritize your health and seek professional help to develop a customized plan that meets your specific needs and goals.
What are some myths or misconceptions in lower back pain?
Most people think that flexibility is the key to success when it comes to injury prevention or injury recovery. While flexibility is an important component, the truth is that most people actually benefit more from a stability or strengthening program.
A stability program will prioritize core control, strength, and inherently improve mobility.
Countless patients come into the clinic, and 99.9% of them claim to have been stretching, yet they are still experiencing pain. If stretching alone were the solution, it would have worked by now. By focusing on strengthening, you can establish a solid foundation and base for flexibility, but it's crucial to address the root cause first, which often involves addressing excessive movement at the spine.
In addition to a stability program, jiu-jitsu players must also emphasize proper mechanics, strength, and mobility of the hips. The hips heavily influence the spine, and jiu-jitsu requires a significant amount of strength and mobility in the hips.
In Conclusion:
In conclusion, while flexibility is important, a stability or strengthening program is often more effective for injury prevention or recovery. Many jiu-jitsu athletes who have been solely focusing on stretching may not find relief until they address the root cause, which often involves excessive movement at the spine. Proper mechanics, strength, and mobility of the hips are also crucial for jiu-jitsu players. Seeking professional guidance that understands the unique demands of jiu-jitsu and spinal rehabilitation can help individuals recover from lower back pain and get back on the mats sooner.
About The Author:
Dr. Josh Jagoda is a Sports Chiroprator & BJJ black belt at Atos HQ in San Diego. He has been in practice since 2010 and specializes in sports injuries and the treatment & rehab of low back disc injuries as well as BJJ injuries. Please feel free to check out his YouTube page, clinic website, or personal site. You can even download his free low back pain guide here.
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