Document Type

Article

Publication Title

Orthopaedic Journal of Sports Medicine

Abstract

Background: Brazilian jiu-jitsu (BJJ) is a rapidly growing grappling-based combat sport, but emergency department (ED) surveillance and sport-specific mechanism classification are limited.

Hypothesis: We hypothesized that BJJ-related ED visits have grown disproportionately compared with overall martial arts ED presentations and that sport-specific mechanisms predict nonroutine disposition.

Study Design: Descriptive epidemiology study.

Methods: Retrospective cross-sectional analysis of the National Electronic Injury Surveillance System (NEISS), 2015-2024. BJJ cases were identified from product code 3257, which corresponds to martial arts equipment and activity-related injuries, followed by a 2-reviewer narrative review. Trends were analyzed using survey-weighted quasi-Poisson regression. An 11-category force vector mechanism taxonomy was developed from narratives. Pre- versus post-COVID eras were compared with false discovery rate correction. Survey-weighted multivariable logistic regression identified predictors of nonroutine disposition.

Results: Of 7618 martial arts ED visits, 1448 (19.0%) were BJJ related (58,170 weighted national cases). Annual BJJ volume rose nearly 5-fold (incidence rate ratio, 1.148/year; 95% CI, 1.090-1.209; P \ .001) while total martial arts volume remained stable; BJJ’s share climbed from 7.3% to 27.7%. The cohort was 78.0% male (mean age 25.7 6 12.3 years); pediatric patients (17 years) comprised 29.5%. Strain/sprain (23.2%), fracture (15.5%), and contusion/abrasion (9.3%) predominated. The taxonomy classified 69.8% of cases into 8 defined categories, led by direct impact (21.8%), joint torque (16.4%), and fall (11.2%), with the remaining 30.2% indeterminate; the era profile was stable after multiplicity correction. Four independent predictors of nonroutine disposition emerged: internal injury (adjusted odds ratio [aOR], 20.62; 95% CI, 7.55-56.26), neck compression (aOR, 5.26; 95% CI, 1.84-14.98), fracture (aOR, 3.76; 95% CI, 1.30-10.90), and age (aOR, 1.50 per decade; 95% CI, 1.18-1.90); optimism-corrected C-statistic = 0.748.

Conclusion: Our study showed that BJJ-related ED presentations are rising rapidly while the injury profile remains stable; because denominators are unavailable, these are presentation counts rather than a measured change in per-capita injury risk. The injury taxonomy and disposition model further identified predictors of injury patterns and ED disposition. These hypothesis-generating findings warrant prospective, exposure-denominated validation.

DOI

10.1177/23259671261486951

Publication Date

10-8-2026

Keywords

Brazilian jiu-jitsu, sports epidemiology, emergency department, NEISS, injury mechanism, martial arts, combat sports

ISSN

2325-9671

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