Jiu-Jitsu exposes the body to joint angles, pressures, and scrambles that most physios don’t fully understand. As a black belt and physiotherapist I’ve treated and frustratingly experienced a lot of the injuries common to grapplers. Here are the most frequent issues, why they occur, and how proper rehab gets you safely back on the mats.

1. Rib Cartilage Injuries (“Popped Ribs”)
How it happens: Pressure passing, twisting under load, takedown scrambles.
Symptoms: Sharp pop, pain with rotation or deep breathing.
Rehab focus: Maintain movement, rebuild trunk control, graded return over 4–8 weeks depending on severity.

2. MCL (and other ligament) Knee Injuries
How it happens: Guard retention, knee torque in half guard, leg entanglements.
Symptoms: Inside knee pain, irritation with lateral force.
Rehab focus: Early isometrics, strengthening adductors/hamstrings, improving rotational tolerance, structured return-to-rolling plan.

3. AC Joint Sprains (From Posting or Takedown Impact)
How it happens: Hard posts, sprawls, awkward transitions.
Symptoms: Pain on top of the shoulder, painful frames or underhooks.
Rehab focus: Rotator cuff endurance, shoulder stability, progressive return to posting and takedowns.

4. Finger and Grip Issues
How it happens: Gi grips, sleeve and collar control, lapel guards.
Symptoms: Swelling, ligament sprains, grip fatigue or weakness.
Rehab focus: Tendon loading, finger extensor work, taping strategies, modified grip rounds.

5. Neck Pain (“Grappler’s Neck”)
How it happens: Guillotines, chin straps, head posting, wrestling tie-ups.
Symptoms: Local neck pain, stiff rotation, discomfort shooting or defending takedowns.
Rehab focus: Cervical isometrics, deep neck flexor work, thoracic mobility, gradual exposure to positional force.

6. Shoulder Instability
How it happens: Kimura traps, omoplatas, inversion, awkward posting.
Symptoms: Slipping sensations, deep ache after rolling, weakness with frames.
Rehab focus: End-range cuff strengthening, closed-chain stability, technique adjustments to reduce risky positions.

Why BJJ Athletes Need Martial-Arts Specific Physio
Generic rehab doesn’t prepare you for posting, framing, pressure passing, inversions, scrambles, takedowns, or grip fighting. Rehabilitation must be sport-specific and ideally guided by someone who understands the techniques, pressures, and positions of Jiu-Jitsu.

How I Approach BJJ Rehab
As a physio and black belt, I focus on: accurate diagnosis (usually without scans), keeping you training safely, strengthening the positions that trigger your symptoms, adjusting technique where needed, and guiding a staged return to drilling, flow rolling, and full rolling.

If You Train Jiu-Jitsu on the Northern Beaches, I Can Help You Stay on the Mats
If you training at one of the many Jiu Jitsu gyms in the Northern Beaches , you don’t have to stop rolling because of an injury. Book an appointment at BeachLife Physiotherapy (Narrabeen or Frenchs Forest) and I’ll help you diagnose the problem, rehab it properly, and return to training with confidence.

By Alex Barr — Physiotherapist, Jiu-Jitsu Black Belt, Former Grappling Coach at Manly MMA Gym