Are Your Shoulders Ready for Brazilian Jiu Jitsu?

I have been keeping busy down here in Miami, Florida. I am about a quarter of the way through my first semester as a PhD student and I have been kept busy with teaching my first class (Introduction to Athletic and Sport Injuries) and by being a research assistant for my adviser as well. I have also had the opportunity to keep myself busy yet physically active by taking back up a long-lost but much loved hobby of mine: Brazilian Jiu Jitsu (BJJ).

BJJ took a backseat for me after training regularly during my bachelor's degree. It stayed on the back burner as I worked on my master's degree but my schedule has normalized enough to allow me to resume training. My sports medicine breadth of knowledge has grown and advanced while my BJJ was placed on hold, and because of that I feel that I have a expanded view on the biomechanics of the sport that I didn't necessarily have previously.

Specifically, I am going to touch briefly on a bit of injury prevention for anyone out there that may be into BJJ or for those of you that may treat people that participate in BJJ (actually this stuff applies to everybody not just BJJ guys). Nevertheless, this post is definitely geared more for the BJJ practitioner and not the clinicians out there...this may not even be new information for those who have visited this blog before.

While I am not somebody that you should go to for submission or any BJJ advice for that matter...I feel that I can give some good insight to help you stay on the mats. Specifically, when I was training I often saw a lot of people struggle with shoulder injuries. In fact, traumatic shoulder dislocations and subluxations were more prevalent than one might assume. Perhaps one wouldn't be surprised considering this is a sport where people enjoy catching each other in joint locks and submission-holds that work by forcibly placing one another's joints at their respective end ranges of motion. So when it comes to a sport where we are already pushing the limits with our body (within reason) then we need to ensure that we are not already at risk of damaging ourselves or our training partners.

I'm no Kenobi.

Having strong, mobile, and stable shoulders is just as important for your ability to submit as well as your ability to not get submitted. The status of your shoulders can also have repercussions up and down the kinetic chain. This is evident when a shoulder issue can manifest itself as a grip strength (I won't be touching on it in this post but proper grip strength can also play a huge role on proper shoulder stability) problem. Not to mention proper shoulder function, especially based upon the tests that I am about to show you, is entirely interdependent on proper function of the elbow joint, glenohumeral (shoulder) joint, the scapula (shoulder blade), the thoracic spine, and arguably the neck or cervical spine as well.

You can bet this guy needs some help, even if he doesn't have symptoms...yet.

So what is a quick an easy way to check for potential shoulder dysfunction? If you know me by now you know I am a fan of the Selective Functional Movement Assessment (SFMA) and think its a great way for everybody to look at movement despite the fact that we may all treat movement in many different ways. So that is where these tests originate!

1) Upper Extremity Pattern #1

What does this shoulder position look like?

This test requires adequate motor control and mobility of many different segments including: Shoulder internal rotation, shoulder extension, and horizontal adduction of the shoulder. Additionally it requires elbow flexion and thoracic spine extension/rotation. Any issues found here indicate a potential stability and/or mobility problem. One must not assume that it is a mobility/flexibility issue that needs stretching or cranking on.

Looks a lot like our test above...If you can't easily put your own arm here, how do you expect it to feel when does it for you?

What is a passing test? The ability for the finger tips to reach the inferior angle of the contralateral scapula without excessive scapular winging of the moving arm, without excessive effort, no deviations in starting posture, and a symmetrical result when compared to the other side. A failing test would require a local biomechanical assessment and to break down of the components of the movement to search for the weakest link. This is a normal range of motion to be able to move through. Deficiency here can lead to increased strain, tension and shearing forces through your upper extremity and its soft tissues.

#2) Upper Extremity Pattern #2

For this test you need adequate shoulder external rotation, shoulder abduction, shoulder flexion, and elbow flexion on top of thoracic extension/rotation as well. To pass this test you must be able to reach your fingers to your contralateral scapula. Where at on the scapula? The midpoint of the spine of your scapula is our targeted destination. However, you need to look for symmetry of movement from side to side, check out how much effort is required, and if there is any deviation of posture to achieve this position. Additionally, a person is not allowed to "crawl" their hands up or down their back for either test. It has to be done with one smooth motion and without "warming" up.

This is not the same as Upper Extremity Pattern #2 but it IS the same. Get it?

If you want a quick and easy way of doing this if you are unsure of your anatomical landmarks just grab yourself a tape measure and assess the distance from your longest finger tip to the first wrist "crease" or wrinkle of your wrist just below your palm. Got that measurement? Okay well you want your hands to be within 1.5 times that measurement to be considered acceptable and don't forget to switch arms and check both ways.

So what do you do if fail these tests? That is a debate for another day but you honestly need more information. However, if you want to use a trial-and-error method then all you need to do is try something out like flopping on a foam roller, lacrosse ball, or getting a massage and seeing if there is  a difference afterwards. How will you know if there is a difference? Retest! Mobility may work may not fix this so don't assume that is what it is! It could just as easily be a motor control or stability issue. Here is a sample of what breaking down one of these tests looks like.

While these tests are far from all-inclusive or the be-all-end-all they are a great starting place to screen or assess for potential risk of injury. If you can do this it doesn't mean you won't injury your shoulder or that you are 100% good to go but if you can't I do know that you deviate from normal into abnormal. Abnormal or dysfunction in my book is the same as pathological and may lead to future injury down the road. Get to work on bullet-proofing your shoulders before it is too late and you are under the scalpel.

!!Update!!

 Some people asked for a video to help clarify a few questions that they had regarding this post and I have finally gotten the time to deliver. Here it is...

Categories: athletic trainer, biomechanics, BJJ injuries, BJJ injury prevention, brazilian jiu jitsu, Gray Cook, selective functional movement assessment, SFMA, shoulder injuries in BJJ, sports medicine for jiu jitsu