Rivew Article

Physiological Adaptations and Injury Prevention Strategies in Brazilian Jiu-Jitsu (BJJ) Athletes: A Review

Minseo Cho^1,2,*, Yian Kim^3,*, Jongyun Shin⁴, Christian Kim³, Serah Ko³, Seung-Jae Lee⁵

Abstract

Background/Objectives: Brazilian Jiu-Jitsu (BJJ) is a globally popular combat sport that combines high-intensity physical activity, technical proficiency, and strategic execution. However, due to the frequent physical contact involved in BJJ, the risk of injury for athletes is relatively high. Therefore, it is essential to provide BJJ athletes with up-to-date information on performance enhancement, including injury prevention. 

Methods: A thorough literature search was performed using online databases such as PubMed and Google Scholar. Search terms including “jiu-jitsu,” “athletic performance,” “injury risk,” “training adaptation,” and “neurological in-fluences”, until March 31st, 2025, then we were applied to collect relevant data on Brazilian Jiu-Jitsu.

Results: BJJ athletes require high muscular endurance for short periods, requiring both anaerobic and aerobic metabolic processes. Since injury patterns differ between beginners and experts during training, it is necessary to establish management guidelines. Injury prevention strategies such as functional movement screening (FMS) and bal-anced strength training are important to reduce risk. Effective nutritional interventions are also needed. 

Conclusions: The best way to improve athletic ability is to provide personalized information to beginner, intermediate, and advanced BJJ athletes.

Keywords

Brazilian Jiu-Jitsu, Injury Prevention, Strength training, Nutrition

Introduction

Brazilian Jiu-Jitsu (BJJ) is a popular combat sport worldwide, featuring a complex game style that combines physical strength, technique, and tactical strategy. BJJ is similar to grappling sports such as wrestling, judo, and sambo but has a unique game style focusing on guard games, chokes, and submission [1]. BJJ players must per-form high-intensity physical activities during the game, exert explosive power for a short period, and maintain continuous muscular endurance [2]. Therefore, proper physical training, strategic skill development, nutritional management, and psy-chological preparation are essential to maximize performance. In addition, BJJ has a high risk of injury due to direct physical contact with the opponent, and frequent injuries to significant areas such as the knees, shoulders, spine, and elbows can have a significant impact on the players' long-term performance [3–5]. Recent sports science studies seek optimal approaches to improve performance and prevent injuries through in-depth analysis of BJJ athletes' physiological responses, injury mechanisms, neuroscientific influences, and psychological factors. For example, metabolic changes such as blood lactate accumulation during competition, factors that increase injury risk due to muscle imbalances in specific areas, and the effects of anxiety and stress before competition on performance are being studied [6]. In addition, studies are being conducted to analyze the long-term effects of repetitive choking techniques on cerebral blood flow and the nervous system, which can be used as important data to ensure athletes' long-term health and safety [7]. This review paper presents an integrated approach to improve performance and prevent injuries in BJJ athletes. To this end, we will discuss the physiological characteristics and performance improvement strategies of BJJ athletes, major causes of injuries and prevention strategies. Through this, we hope to find ways for BJJ athletes to apply more scientific training methods, maximize their performance, and minimize injuries.

Physiological Characteristics and Performance Enhancement Strategies

Understanding the body's energy systems and metabolic responses is essential to enhancing the performance of BJJ athletes. Since BJJ requires explosive strength and muscular endurance in short bursts, anaerobic and aerobic metabolism must be optimally regulated [8]. Additionally, the use of supplements can contribute to performance enhancement.

Energy Systems and Metabolic Responses

During BJJ matches, athletes repeatedly engage in high-intensity physical activities, influencing their energy utilization strategies. Table 1 summarizes how BJJ athletes engage in repeated high-intensity activity, activating various energy systems, which activate multiple energy systems and physiological responses. Shortbursts of explosive movements primarily rely on anaerobic glycolysis and the phosphocreatine (PCr) system, which provide immediate energy but deplete raidly due to limited storage capacity [9]. In contrast, sustained performance requires efficient utilization of aerobic metabolism, highlighting the importance of cardiovascular endurance training [10]. Additionally, repeated high-intensity efforts lead to blood lactate accumulation, contributing to muscle fatigue; thus, structured training aimed at improving lactate threshold and clearance is essential [11]. Post-match hormonal fluctuations, particularly in the cortisol-to-testosterone ratio, influence recovery and performance maintenance, necessitating appropriate rest and nutritional strategies [12].

Table 1. Energy Systems and Recovery in BJJ atheism

*Abbreviation: phosphocreatine (PCr); adenosine triphosphate (ATP)  

Supplements and Performance Enhancement

Supplements are crucial in maintaining energy levels and enhancing performance in BJJ athletes. The effects of various supplements have been studied to improve the performance of BJJ athletes. According to previous studies, caffeine can improve reaction speed, muscle strength, and aerobic and anaerobic exercise performance when consumed at 3-6 mg per 1 kg of body weight [13,14]. In addition, studies have shown that caffeine can improve concentration during competition by reducing fa-tigue and enhancing cognitive function [15]. Creatine and beta-alanine are known to play an important role in improving short-term high-intensity exercise performance [16,17]. According to studies, creatine has been shown to enhance the ATP-PCr system to help movements that require explosive power, and beta-alanine has been reported to increase carnosine levels in muscles, delaying lactic acid accumulation and improving endurance. In addition, studies on the effects of arginine and sodium bicarbonate (baking soda) have also reported positive results. Arginine has been shown to increase oxygen supply to muscles by stimulating nitric oxide (NO) pro-duction, and sodium bicarbonate has been studied to help delay fatigue by lowering body acidity during exercise through its lactic acid buffering effect [18–20]. Therefore, previous studies have emphasized that these supplements can be useful in improving the performance of BJJ athletes and should be appropriately selected according to each athlete's physiological characteristics and playing style. It has also been reported that adhering to a scientifically validated intake protocol is important (Table 2).

Table 2. Supplements and Performance Enhancement in BJJ Athletes

* Abbreviation: nitric oxide (NO)

Injury Occurrence and Prevention Strategies

A total of eight representative flavonoid compounds were designed in both two-dimensional (2D) and three-dimensional (3D) formats using ChemDraw and Chem3D software (Figure 1). The selected compounds represent major subclasses of flavonoids, including flavone, flavanone, flavanol, isoflavone, flavonol, and anthocyanidin. Figure 1 illustrates the 2D chemical structures, while Figure 2 presents the corresponding energy-minimized 3D structures generated for subsequent molecular docking analysis.

Common Injury Sites and Causes

The most common injuries in BJJ athletes occur in the knees, shoulders, spine, elbows, and fingers/wrists [21]. Knee injuries are often caused by rotational and flexion movements during takedowns, guard play, and guard passing, increasing the risk of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries, cartilage damage, and meniscus tears. Shoulder injuries typically result from submission techniques such as the Kimura, Americana, and Omoplata, which place excessive stress on the joint and may lead to rotator cuff tears or dislocations. Repetitive breakfalls and choking techniques can contribute to spinal issues, including cervical and lumbar disc injuries and chronic back pain. Elbow injuries, particularly due to armbar techniques, often involve hyperextension, raising the risk of joint degeneration and ligament damage . Lastly, grip-intensive movements and control of the traditional martial arts uniform used in BJJ (GI) frequently result in finger arthritis and ligament injuries in the fingers and wrists (Fig.1 and Table 3).

Figure 1. Common Injury Patterns in Brazilian Jiu-Jitsu. Various types of injury patterns are observed, including (A) knee, (B) shoulder, (C) spine, (D) elbow, and (E) fingers and wrists.

Table 3. Injury Patterns and Contributing Techniques in Brazilian Jiu-Jitsu

* Abbreviation: anterior cruciate ligament (ALC); medial collateral ligament (MCL)

Strategies for Injury Prevention

To minimize the risk of injury, BJJ athletes should adopt systematic training and recovery strategies. First, Functional Movement Screening (FMS) and injury risk assessments are essential for identifying movement imbalances and potential vulnerabilities [22]. Corrective exercises aimed at resolving muscular asymmetries help maintain physical alignment and reduce injury susceptibility. Second, flexibility and strength training play a key role in prevention. Enhancing range of motion through dynamic stretching, yoga, and mobility exercises improves joint function, while strengthening core muscles enhances overall stability and reduces biomechanical stress during movement [23,24]. Lastly, implementing appropriate recovery and rehabilitation protocols is crucial. Cold water immersion (CWI) has been shown to reduce inflammation and expedite muscle recovery after intense matches [25,26]. Massage therapy and myofascial release techniques help alleviate muscle fatigue and promote blood circulation. Additionally, static stretching following training sessions aids in relieving muscle tension and maintaining flexibility, thereby supporting long-term injury prevention (Table 4).

Table 4. Injury Prevention Strategies for BJJ Athletes

* Abbreviation: anterior cruciate ligament (ALC); medial collateral ligament (MCL)

Flavonoid-Based Antioxidants and Their Effects on Exercise Performance and Recovery

Flavonoids are naturally occurring polyphenolic compounds with well-established antioxidant and anti-inflammatory properties. Among them, quercetin, New Zealand blackcurrant extract (NZBC), and 2S-hesperidin have received considerable attention for their potential to enhance athletic performance, optimize physiological responses, and accelerate recovery following intense exercise.

Quercetin supplementation, in both isolated and combined forms, has shown multifaceted benefits in endurance and resistance-trained populations. Studies report that daily intake of 200–1000 mg can significantly improve aerobic efficiency (e.g., VO₂ kinetics) and neuromuscular performance, particularly in older adults [27–29]. Notably, motor unit recruitment thresholds and firing rates were modulated by quercetin, contributing to increased muscle strength without changes in muscle mass [30]. Furthermore, quercetin has demonstrated protective effects against muscle damage induced by eccentric exercise, including reductions in biomarkers such as Creatine Kinase (CK), Lactate Dehydrogenase (LDH), Interleukin-6 (IL-6), and enhancements in anabolic signaling via insulin-like growth factors I and II (IGF-I/II) [31,32]. Acute supplementation (e.g., 1 g prior to exercise) also improved neuromuscular efficiency, torque development, and training volume, NZBC is rich in anthocyanins, which support vascular function and mitochondrial activity [33–35]. Short-term supplementation (7 days) has been associated with increased fat oxidation during moderate-intensity walking, especially in women with higher body fat percentage [36]. Additionally, NZBC has been shown to improve high-intensity intermittent running (HIIR) performance, enhance muscle oxygenation recovery, and extend climbing endurance time by ~23%, without significant effects on cardiorespiratory parameters. These results suggest that NZBC may enhance metabolic flexibility and endurance capacity, particularly under high-intensity or oxygen-demanding conditions.

2S-hesperidin, a citrus-derived flavanone, has demonstrated aerobic and anaerobic performance-enhancing effects in trained cyclists. An 8-week supplementation regimen (500 mg/day) resulted in significant improvements in functional threshold power (+3.2%) and maximal aerobic capacity, while acute intake prior to sprint efforts enhanced power output, maximum speed, and total energy production during repeated sprint exercises. These effects were partly explained by improved gasometry parameters, including elevated CO₂ levels and stable pO₂ during submaximal workloads, suggesting hesperidin’s role in maintaining physiological efficiency under stress [37].

These findings collectively support the inclusion of flavonoid-based antioxidant supplements—particularly quercetin, NZBC, and hesperidin—as adjunct strategies for enhancing exercise performance, promoting neuromuscular efficiency, and facilitating recovery in both endurance and high-intensity training environments.

Table 5. List of Flavonoids Influencing Exercise Performance and Recovery

* Abbreviation: New Zealand blackcurrant extract (NZBC); maximal voluntary force (MVF); Creatine Kinase (CK); Lactate Dehydrogenase (LDH); Muscle Fiber Conduction Velocity (MFCV); Interleukin-6 (IL-6); insulin-like growth factors I and II (IGF-I/II); High-Intensity Intermittent Running (HIIR); Functional Threshold Power (FTP)

Discussion

This review synthesized current findings on the physiological adaptations and injury prevention strategies relevant to Brazilian Jiu-Jitsu (BJJ) athletes. Unlike other combat sports, BJJ is characterized by continuous close-contact grappling, demanding both anaerobic power and aerobic endurance within a single match. This dual energy requirement results in a unique metabolic profile involving rapid ATP-PCr depletion, elevated blood lactate accumulation, and fluctuations in stress-related hormones [43]. These findings underscore the importance of developing training strategies that simultaneously enhance anaerobic capacity and aerobic recovery, while also emphasizing the need to monitor hormonal responses to prevent chronic fatigue and overtraining syndrome.

Furthermore, we highlighted the growing role of evidence-based supplementation—specifically caffeine, creatine, beta-alanine, arginine, and sodium bicarbonate—which may contribute to improved energy efficiency, delayed fatigue, and enhanced oxygen delivery [44]. However, most existing studies have been conducted on general athletic populations. Future research should focus on BJJ-specific cohorts to validate and personalize supplementation protocols based on the physiological demands and combat dynamics of this sport.

Injury occurrence remains a major concern in BJJ, with the knees, shoulders, spine, and fingers identified as the most vulnerable areas. Due to the joint-centric nature of BJJ techniques, athletes are frequently exposed to chronic mechanical stress and acute hyperextension injuries. Preventive strategies should include early screening methods such as Functional Movement Screening (FMS), combined with core stability and flexibility training to correct movement asymmetries and reduce biomechanical overload. Recovery interventions—such as cold-water immersion (CWI), myofascial release, and structured rest protocols—are essential to maintaining long-term athletic performance and health.

Beyond traditional supplementation and physical therapy, flavonoid-based antioxidants—including quercetin, NZBC, and 2S-hesperidin—have gained attention as adjunct strategies for neuromuscular recovery and metabolic enhancement. Recent studies suggest that these compounds may improve VO₂ kinetics, fat oxidation, motor unit recruitment efficiency, and muscle damage attenuation [45]. For example, quercetin has been shown to modulate motor unit firing patterns and reduce inflammatory markers following resistance exercise. Similarly, NZBC has demonstrated sex-specific benefits in enhancing fat oxidation and oxygen delivery, while 2S-hesperidin has been associated with improved power output and gasometric stability during submaximal workloads. Although these effects have not yet been directly confirmed in BJJ populations, their mechanistic relevance—especially in high-intensity intermittent efforts—warrants further investigation.

In addition to physiological adaptations, psychological stress and neuromuscular control play a pivotal role in BJJ performance and injury risk. Stress-related hormonal shifts and pre-competition anxiety may impair muscle coordination and increase injury vulnerability. Integration of autonomic nervous system monitoring tools such as heart rate variability (HRV), combined with targeted psychological training, may help optimize neuromuscular readiness and enhance training periodization.

Nevertheless, current research lacks longitudinal and stratified data that account for factors such as athlete experience level, weight class, and gender. Moreover, few studies incorporate all four components of exercise prescription—frequency, intensity, type, and time (FITT principles)—limiting reproducibility and real-world application. Future studies should aim to conduct stratified randomized controlled trials (RCTs) involving BJJ-specific training protocols. These trials should assess a broad range of outcomes, including VO₂ max, lactate threshold, neuromuscular conduction velocity (MFCV), injury rates, stress biomarkers (e.g., CK, IL-6), and perceived recovery metrics.

Conclusion

In summary, BJJ presents a unique interplay of physiological stressors, neuro-muscular demands, and injury risks. A deeper understanding of integrated biological mechanisms—encompassing metabolic function, neuromuscular adaptation, in-flammation, and psychological stress—and the development of individualized, evidence-based training and recovery strategies will be essential to enhance athlete performance, reduce injury risk, and support the sustainable evolution of BJJ as both a competitive sport and an applied exercise science model.

Conflict of Interest

The authors declare no conflict of interest.

Author Contributions

SJL conceived and designed the overall structure of the manuscript. MSC and JYS performed the literature search and critical analysis. CSK and YK contributed to the literature search. SJL, MSC, and JYS drafted and wrote the manuscript. All authors read and approved the final version of the manuscript.

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