Returning to Jiu-Jitsu Training After A Rib Injury: Rehab Strengthening & Prevention Tips for Jiu-Jitsu Practitioners
Rib injuries are not as common in most sports as you might think, but in jiu-jitsu, they are among the top injuries sustained during training. Since jiu-jitsu is a contact sport, there is often significant trauma to the body, particularly the rib cage. The physical demands of jiu-jitsu, including the need for core strength and mobility, speed, and explosiveness often increase can increase the risk of rib injuries.
What are rib cartilage injuries?
The rib cage comprises 12 pairs of ribs that attach to the sternum through cartilage. The most common area for rib cartilage injuries is in the false ribs, which are ribs 7-10 and are located just above the abdominal region. In many cases, swelling and “tenting” of the ribs may be visible after the injury, and they are often painful to touch and move.
Many jiu-jitsu practitioners may hear a pop or click when these injuries occur. In addition, there can be a feeling of the rib “slipping” and pain with bracing the core.
This can be an indication that you hurt the rib cartilage and more often than not, there is also injury to the muscles between the ribs (intercostal muscles).
How do Jiu-Jitsu Rib Injuries Happen?
Rib injuries in jiu-jitsu are extremely common due to the contact nature of the sport. They often occur during takedowns, knee-on-belly positions, when someone falls on you, during the stacked position, body triangles, or when attempting to forcefully lock
down a submission while applying pressure with the abdominals, such as in a triangle choke. Of course, there are other ways to injure the ribs, but direct compression to the rib cage with rotational movement is the most common cause.
As a result of rib injuries, it is important to rule out any fractures, dislocations, or other issues within the rib cage. This can be done via X-ray, CT scan, MRI, or even a trained professional.
How long do rib injuries take to heal?
Rib injuries are tricky to heal because often, jiu-jitsu players return to the sport too soon. Doing this can delay your healing time but can also serve as a guide in getting better. Generally speaking, these types of injuries tend to be slow to heal and can linger for several weeks to a few months. The average time to heal should be about 10-12 weeks.
What can you do to help rib injuries heal faster?
First, you need to know what kind of injury you have, whether it’s to the rib cartilage fracture/disruption, rib head, an intercostal muscle strain, or another type of rib-related injury. It may be a good idea to visit your doctor and get an X-ray and/or CT scan, especially if it’s not healing.
Assuming this is a rib strain or rib cartilage injury that is not severe, you can start treatment by immobilizing the area. Most people experience pain relief from the immobilization of the ribs, especially when they are compressed or taped. We recommend using Rocktape (KT tape). When you injure a rib or several ribs, it causes the rib cage and surrounding structures to become less stable. By taping it, you are stabilizing it and allowing the rib cage to move less so that the ribs can heal. Some people even place a compression wrap around the ribs for a couple of weeks to help reduce the strain on the ribs.
We prefer to use the “Asterisk” taping technique.
Taping For A Rib Injury
Most people will ask, “What stretches should I do to help the ribs?” Again, the first two things you need to do are stabilize the area and NOT continue to increase rib pain or “slip” the ribs.
During this pain relief stage, your goal should be to calm down the pain and not focus on mobility, but rather stability of the rib cage. A big mistake many patients with rib injuries make is continuing to stretch it too early in their healing journey, thus unknowingly causing more irritation and instability to the region.
In addition, one of the easiest and best ways to help the ribs/core is to practice diaphragmatic breathing. I often recommend doing this while lying down with your knees bent, as it is the easiest to do and won’t strain the rib cage too much. Working on your breathing and breathing patterns not only mobilizes the ribs but also oxygenates the body, relaxes the nervous system, and stimulates core activation. This can be done several times a day for 30 seconds up to 5 minutes. You can even use this as an exercise to strengthen the core and prevent further injuries.
Doing these simple things for the first few weeks will really help reduce your pain. Remember to pay attention to what helps as well as what hurts your ribs. Sometimes the best thing you can do is avoid the triggering activity for a short period of time, and this can be a crucial part of your recovery.
Finally, it’s important that if you enjoy training and working out, you do not let yourself decondition. A well-conditioned individual tends to heal better. I highly recommend using a recumbent bike. Doing this keeps your body posture in a good position while allowing you to exercise, practice your breathing, and maintain your conditioning without declining too quickly.
In addition, many jiu-jitsu practitioners like to lift weights, and we do recommend doing so, but when you have an injury in the ribs, you may need to modify it. It may be a good idea to do your lifts with lighter weight and on a bench or a supported surface, so you have more stability.
This also means you will not be doing intense compound lifts that challenge the core, but you will be maintaining strength the best you can so that you can avoid injuries in other areas and make it easier to transition back to BJJ when you feel comfortable. Remember, if you experience pain while exercising, you’ll want to back off and modify so that you can maintain fitness levels without increasing your rib pain.
Sleeping with rib pain?
You likely noticed that sleeping at night is difficult, especially when you have to flip to the opposite side. When sleeping, try to start on your side with the “bad side” up. This helps to take the pressure off the rib.
When switching side to side, make sure you are doing this slowly so that you are not irritating the ribs.
Finally, when you get up from sleeping, don’t throw yourself out of bed quickly! Doing this is like doing an aggressive sit-up can cause the ribs to get worse. Instead, go onto your side, and slowly push yourself up.
You’ll be surprised by how well this works when you start the day off by not hurting the ribs.
Popped Ribs (Jiu-Jitsu Rib Injury)
Are there other types of therapy and treatment for rib injuries?
There are many different types of therapies for rib injuries, and I often recommend treatments such as Active Release Techniques, Myofascial Release, Graston Technique, manual therapy, and/or massage techniques to the rib cage.
Finding a skilled practitioner who is well-versed in the sport of jiu-jitsu, as well as the strength, conditioning, and rehab aspects of the sport, is critical to your recovery from all injuries!
Additionally, you will want the practitioner (Physical therapist, Chiropractor, Physiotherapist, etc.) to focus on gentle rib mobilizations, especially when you are planning to return to training. More aggressive Chiropractic adjustments or manipulations from a therapist can be done, but it may not be advised in the early stages of care as this can cause further damage or irritation.
Getting high-quality treatment on the rib cage can significantly reduce healing time and help you get back on the mats faster.
What are some exercises you can do to strengthen your ribs and prevent rib injuries in jiu-jitsu?
Watch the full episode on rib injuries here.
It’s very important to strengthen and mobilize the areas above and below the ribs. Since jiu-jitsu is a dynamic sport with a lot of rotations, it’s important to train in rotational movements and get your body used to them. Below is a list of exercises that can help prevent rib injuries:
- Foam Rolling the Mid-Back & Ribs: Using a foam roller or peanut on the thoracic spine can improve extension and mobility in the spine and rib cage, helping with upper back pain and posture.
How To Get Better Rib Mobility
- Thoracic Spine Extension and Rotations: This mobility exercise involves using your breath to stretch and mobilize the upper back, chest, and rib cage, as rotation is a key movement in jiu-jitsu. Aim for 5-10 reps per side, noting that one side may need more work than the other.
- 90/90 Bar Hangs: This exercise not only works on grip strength but also isolates the hips and core in an isometric fashion, similar to an active guard position in jiu-jitsu.
Focus on engaging your core and controlling your breath, and start with 30-second holds for 3 sets.
- Planks/Side Planks (Modified Planks): Planks are effective for enhancing core strength, and can be modified to suit your tolerance level. Begin with 20-30-second holds and progress to longer times or more advanced variations.
- Paloff Press & Rotational Strength: Rotational movements such as the Paloff press are a great way to train the ribs and work the obliques. This exercise can also be used for rib injury rehabilitation. There are several different variations of this exercise, so start with a milder one and gradually progress.
- Single Arm Rows: Jiu-Jitsu involves a lot of pulling movements, such as arm drags and guard pulls, so it’s important to train your back. Doing single-arm rows can help improve rotational strength for pulling and should be a staple in your BJJ strength training routine.
- Med Ball Throws: Practicing throwing a ball against a wall can help develop explosive rotational movements. Aim for about 5-10 throws per side and complete 3 sets.
*Please consult a professional prior to attempting exercises.
What else should I know about rib injuries? How to know if you’re ready to get back to training?
It’s obvious that you need to pick the right training partners and modify the intensity and positions in jiu-jitsu after a rib injury. I highly recommend considering drilling before starting sparring again. Go with the intention to drill and flow, and don’t go back 100% right away. You need to adapt to the training again following an injury.
If you are experiencing pain, discomfort, or soreness after drilling, training, or solo drills, it’s likely that you are not ready to go back to full sparring. Use these solo drills and exercises to guide you. As you improve and feel less rib pain or discomfort, you’ll become more capable.
In addition, focus more on a top game when you return to training. Playing guard requires more abdominal, core, and rib strength that you may be lacking after an injury. The guard game has an increased risk of rib compression and being stacked, which is not a good position to be in following a rib injury. So make sure you train properly and with the right people as you rehabilitate your injury.
Finally, when you do return to training, use progressive training methods. Tracking the number of rounds and minutes you are doing allows you to monitor your progress. This serves as an objective measure of how long you can roll and what you can tolerate. For example, if you can train for 15 minutes before your ribs start to get sore (that day or the next), you can stay at this amount of time for 1-3 weeks before progressing. This progressive training approach is crucial for injury recovery and conditioning without the risk of re-injury.
To progress properly, I recommend increasing your training time by about 10% of your rolling time every 2 weeks. For example, if you can roll for 15 minutes for 2-3 weeks without pain, you can progress to about 17 minutes and stay there for another 2 + weeks. This method of progressive training helps ensure that your body adapts to the strength, conditioning, cardio, and technical aspects of jiu-jitsu while considering your injury.
*Please note that this information is for educational purposes only and is not designed to treat you or your specific condition.
About the author
Dr. Josh Jagoda is a sports chiropractor in Boca Raton, FL, and received his BJJ Black belt from Andre Galvao. He has been in practice treating athletes and active individuals since 2010. If you want