CAULIFLOWER EAR BJJ

All Brazilian Jiu Jitsu students have seen those big Brazilian black belts with the mangled ears, which they wear like a badge of honour. This is a condition called cauliflower ear, or the more technical term perichondrial hematoma. This can become common jiu jitsu injuries, as the injury is a result of a blunt force trauma that can happen directly to the ear, and this usually happens during BJJ competition, or training sessions. The Brazilian art is a highly energetic, and intense Martial Art, that can involve a series of heavy impacts to an athlete's face, and body. There are many different transitions used in Brazilian Jiu Jitsu that can force a competitor to grind their way over an opponent, using a heavy amount of pressure. There are ways to avoid these types of injuries, but in some cases the trauma to the ear, and head region is unavoidable. 

What this article covers:

• What is a cauliflower ear
• How do athletes get cauliflower ear
• How is cauliflower ear diagnosed
• How to treat a cauliflower ear
• Are there any prevention methods to stop cauliflower ear

The cauliflower ear is a common injury that can happen in wrestling, grappling, and striking Martial Arts too, as all of these combat sports involve heavy impacts to the head region. In Brazilian Jiu Jitsu there are moments that can turn into several minutes, where an athlete is stuck in a choke like a guillotine, a darce choke, or a rear naked choke. Sometimes athlete's will be forced to grind their head out of these types of submissions, which can cause significant bleeding in the ears, which can result in the athlete sustaining the dreaded cauliflower ears. Even though this injury can be quite debilitating, most Brazilian Jiu Jitsu athletes will weirdly strive to earn these mangled badges of honour.

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WHAT IS A CAULIFLOWER EAR

The cauliflower ear is also known as a perichondrial haematoma, and this is an irreversible condition that can occur when the outer portion of the ear suffers from some sort of blunt force trauma. After a significant impact, the ear can develop a blood clot, or other fluid build up under the perichondrium. This will cause some separation from the cartilage, and the overlying perichondrium, which can cause it to die. As a result of this process the overlying skin can form fibrous tissue, and can cause the outer ear to swell extensively, this deformity is known in the Martial Arts world as the cauliflower ear. The human ear is quite vulnerable to this type of condition, and this is because the outer ear skin is tightly bound to the perichondrium, and the absence of subcutaneous fat (which is the deeper layers of skin) on the anterior of the ear, can leave the ear heavily exposed to damage from any form of trauma. These sorts of injuries can be extremely daunting to an athlete, as blood will accumulate between the perichondrium, and the cartilage within the ear. This causes an obstruction of the blood flow from the perichondrium to the avascular cartilage. The lack of blood perfusion, which is vital for normal tissue physiology, puts the cartilage at a significant risk of becoming infected, or even dieing. If this process is left untreated, then disorganised fibrosis, and cartilage formation will begin to occur around all components of the ear. The cartilage will then begin to deform, as blood fills the ear, with kinks, and swelling as a direct result, causing the appearance of a cauliflower. 

The most common cause of a cauliflower ear is blunt force trauma sustained directly to the ear, which leads to a perichondrial hematoma. If this condition is left untreated it can become extremely serious, to the point that the ear will need cosmetic surgery. The structure of the human ear is supported by a series of distinctive components like the helix, antihelix, concha, tragus, and antitragus. The skin that covers the ears cartilage is extremely vulnerable, and thin, with no deep layers of fat, this means that any significant trauma will cause an immediate swelling reaction. The cauliflower ear can also present itself as an inflammatory injury, instead of a blunt force trauma. There are rare conditions like relapsing polychondritis, which is a repetitive inflammation issue that results in deformation of cartilage of the ears, and the nose. This can also cause significant problems in the joints, the eyes, the audiovestibular system, the cardiovascular system, and the respiratory tract.

HOW DO ATHLETES GET CAULIFLOWER EAR

There are many different ways that an athlete can injure their ear, and wind up with a perichondrial haematoma. The most common way to receive a serious ear injury in any Martial Arts, is receiving a punch, or a kick directly to the ear. All striking Martial Arts can be extremely dangerous when it comes to head injuries, this is why beginners usually wear headgear, so they can protect the delicate places like their ears, from receiving a significant amount of damage. In Brazilian Jiu Jitsu contracting a cauliflower ear can happen a few different ways, and one of these ways is through a significant impact to the ear during a training session. Impacts in Brazilian Jiu Jitsu can happen when a student takes another student to the mat from the standing position, and this is where an opponent can land on their ear. Brazilian Jiu Jitsu takedowns are always accompanied by a student following up the take down by scrambling furiously to gain a control position, and therefore landing heavily upon an opponent's ear is a high possibility. 

The other most common way a student will receive a cauliflower ear is through their opponents transitioning between control positions. The main goal for an athlete when they are securing the top position is to take away their opponents space. This means they will often use a significant amount of pressure while they transition between the control positions. A common problem during these types of transitions, is that an athlete will grind their pressure over their opponent's ear, while they are attempting arm bars, kimuras, or a north south position. This is a common way that an athlete can suffer from significant ear injuries. One of the first questions a beginner will ask is how long does it take to get cauliflower ear from bjj. Hematomas in the ear can blow up extremely quickly after an impact, sometimes it may be instantaneous, and other times it can slowly swell over an hour, this is why it is important to take the necessary precautions. 

Brazilian Jiu Jitsu is a highly dynamic art that involves an extensive series of high level movements. Experienced grapplers within the art are experts at transitioning, and knowing where they can put their body to best maximise their position. On the other hand, beginners of the art are nowhere near the same calibre as a high level practitioner, as they are often clumsy, and reckless with their functioning movements. During a Brazilian Jiu Jitsu training session, or a competitive match, students may often injure their opponents with an accidental knee, elbow, or headbutt, to many of the delicate areas. This may include an unintentional impact, or grinding of the ear, which can be a common way for beginners to receive a perichondrial haematoma. Of course accidental impacts will always happen, but students should be well aware of the risks involved when they first begin training in the art of Brazilian Jiu Jitsu.

HOW IS CAULIFLOWER EAR DIAGNOSED

A perichondrial hematoma, which is the technical term for a cauliflower ear, is diagnosed clinically by a doctor. Of course an instructor at an academy has had a lot of experience with this condition, and can provide insight into the matter, but subsequently a student must go to a doctor to check out the severity of the injury. This means that the medical clinic that a student visits will make the diagnosis by using a strict series of tests, designed to check out the cartilage, and the inner sanctums of the ear. A doctor will examine a student and plot the appropriate course, and form the best treatment plan required for the injury. Doctors have created a classification system for deciding when surgery is needed, and this is how they are guided towards the best approach. In most cases all the ear really needs is a good drain, and some rest, so the student can get back to training. A doctor may prescribe antibiotics, as a way to curb any infection, and they will usually advise wearing ear splints, or bandages to stem the flow of bleeding. 

HOW TO TREAT A CAULIFLOWER EAR

There are several different ways to treat the dreaded cauliflower ear. Although there is no actual cure, nor is there any definitive way that can offer the best single form of treatment. The most common way that an athlete will resolve an ongoing perichondrial haematoma is by draining their ear with a syringe, as this seems to be the best bjj recovery for a damaged ear. In most cases an acute hematoma will lead to the cauliflower ear, and if a student acts fast, and drains the blood then it can prevent any permanent deformities. There are several ways that an athlete can drain the blood from their ear, with the most common way, letting a doctor use a needle to syringe the blood out. Other ways include continuous suction devices, placing a wick inside the ear damage, and an incision into the ear for drainage. After any blood has been drained from an ear, the biggest concern becomes the recurring build up of the blood inside the ear, as this can be an ongoing problem. 

Just like an athlete that begins taping fingers for jiu jitsu, they must learn how to appropriately tape their ears. This can be achieved with many different techniques like: direct pressure dressings, in and out mattress sutures, buttons placed on sutures, thermoplastic splints, sutured cotton balls, and absorbable mattress sutures. It is vitally important that athletes drain their ears less than six hours after the significant trauma, this is for the best results. Athletes that suffer from recurring hematomas, the simple draining of the ear may start to become ineffective. In this instance an athlete may need to look into open surgical treatment. Cosmetic surgery can help return the natural appearance of the ear, while rendering the damage minimal. Another problem with perichondrial haematoma is that it is prone to infections, which will subsequently bring about the need for antibiotics. Pressure should be applied by bandaging the affected area, which can help the skin, and the cartilage to reconnect. This can also be done with pegs, magnets, and custom molded ear splints. In many cases students would need to take significant rest periods to allow the issue to settle down, so they do not cause more permanent damage. Without medical intervention a perichondrial haematoma can cause significant health issues surrounding the ear, and even deep into the ear canal, which can cause all sorts of ear aches, nasal issues, and equilibrium problems.

ARE THERE ANY PREVENTION METHODS TO STOP CAULIFLOWER EAR

After training consistently inside of a Brazilian Jiu Jitsu academy, students will want to know how to prevent cauliflower ear bjj. The obvious prevention methods are to not allow an opponent to grind their pressure over a student's ear. Using strong frames is a good way to keep an opponent from being able to apply any amount of significant pressure. Another common cause of cauliflower ear is when an athlete tries to drag their head out of a submission, as they may inadvertently cause their own ear damage. A good prevention method is to defend the submission properly, instead of relying on brute strength to escape. Any student can just drag their head out of a position, but if an athlete uses the correct technical escapes, then they will ultimately avoid taking any significant damage to the ear region.

Build a submission oriented gameplan with the help of 10th Planet rockstars JM Holland and Zach Maslany!  Get it here at BJJFanatics.com!

Brazilian Jiu Jitsu practitioners are extremely hardcore, and are well known for their intensity, their traditions, and their honour. Brazilians have been known to be extremely brutal, as seen in the age old tradition of the Brazilian Jiu Jitsu Gauntlet, where students that level up are whipped with belts as their right of passage. The cauliflower ear has also become somewhat of a tradition, as many high level competitors wear it like a badge of honour. There are ways that athletes can protect their ears, especially while they train. A specialty ear splint can be worn to help keep a student's ear compressed, so that the damaged ear cartilage is unable to fill with blood during rigorous training sessions. Ear guards, and head protection can also be worn in training, this is to help stop any more forceful impacts to the ear region. Ear protection is illegal to wear during competition, but it is a good preventative injury method that students can use during a training session, which can be extremely beneficial to an athlete. 

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