Relationship between techniques and injuries among judo practitioners

Abstracts

Criado em 1882, o judô, arte marcial caracterizada por um grande número de técnicas e bases filosóficas, tem sido apontado por vários estudos como um dos esportes que apresenta os maiores números em ocorrências de lesões. Entretanto, existe uma carência para levantamentos detalhados de modo a possibilitar uma correlação causal entre aspectos técnicos e o panorama percentual das lesões encontradas. A amostra, constituída de 78 relatos de casos, foi obtida através da aplicação de questionário fechado, em 46 atletas do sexo masculino, com idade média de 23 ± 10 anos, e em 32 atletas do sexo feminino com idade média de 19 ± 7 anos. O tempo de prática dos atletas do sexo masculino foi de 9 ± 6 anos, sendo a graduação distribuída entre 20% com faixa preta, 50% com faixa marrom e 30% com graduação inferior à marrom. As atletas apresentaram tempo médio de prática de 5 ± 3 anos, sendo 9% com faixa preta, 25% com faixa marrom e 66% com graduação inferior. Através da aplicação de um questionário, observou-se que as lesões ocorreram com prevalência de 23% em articulação do joelho, seguido de 16% para ombro, 22% em dedos de mãos e pés; as demais ocorrências totalizaram 39%. Encontraram-se 10% de lesões leves, 9% moderadas e 63% de ocorrências graves. A relação de ocorrência de lesões em treino atingiu 71% dos casos; 42% desse total ocorreram quando existiu a participação de um adversário mais pesado. Os golpes mais freqüentes que ocasionaram lesões foram o Ippon seoi Nague, com 23%, o Tai otoshi com 22% e o Uchi mata com 9%.

Lesões esportivas; Judô

EXPERIMENT REPORT

Relationship between techniques and injuries among judo practitioners

Relación entre las técnicas y lesiones en los practicantes del judo

Daniel BarsottiniI, ^*; Anderson Eduardo GuimarãesII, ^*; Paulo Renato de MoraisIII, ^*

^IPhysical Educator, post-graded in Exercise Physiology, UniFMU

^IIPhysical Educator, Mastership in Biomedical Engineering, UNIVAP

^IIIProfessor and Researcher, Research and Development Institute, UNIVAP

^{Correspondence to}

ABSTRACT

Judo is a Martial art created in 1882 characterized by a great number of techniques and philosophical basis, and it has been mentioned in several studies as one of the sports presenting a higher amount of injury occurrences. Nevertheless, there are few detailed surveys to allow performing a causal correlation between the technical aspects and the percentage picture of the injuries found in this sportive modality. The sampling was constituted by seventy-eight case reports attained after applying a close questionnaire in forty-six 23 years old ± 10 years male athletes, and thirty-two 19 years old ± 7 years female athletes. The mean time of practice for male athletes was 9 ± 6 years, and their level was distributed as follows: 20% black belt, 50% brown belt, and 30% with lower than brown belt level. The female athletes presented a mean time of practice of 5 ± 3 years, distributed as follows: 9% black belt, 25% brown belt, and 66% with lower than brown belt level. After applying a questionnaire, it was observed that injuries occurred in 23% prevalence in the knee joint, followed by 16% in the shoulder, 22% in fingers and toes, and the remaining occurrences amounted 39%. 10% of injuries were mild, 9% were moderate injuries, and 63% were severe injuries. The relationship of the training injuries attained 71% of the cases, and 42% of that total occurred when heavier fighter participated in the training. The most frequent strokes that caused injuries were the Ippon seoi Nague, with a 23% incidence, the Tai otoshi, with 22%, and the Uchi mata, 9%.]

Keywords: Sports injuries. Judo.

RESUMEN

Creado en 1882, el judo, un arte marcial caracterizado por un gran número de técnicas y bases filosóficas, ha sido apuntada por varios estudios como uno de los deportes que presentan un número más grande en la aparición de lesiones. Sin embargo, existe una carencia para los levantamientos detallados de la manera de hacer posible una correlación causal entre los aspectos técnicos y el panorama del percentil de las lesiones encontradas. La muestra se constituyó de 78 informes de casos; se obtuvo a través de la aplicación de encuesta cerrada, en 46 atletas varones, con la edad promedio de 23 ± 10 años y, en 32 atletas mujeres con la edad promedio entre 19 ± 7 años. El tiempo de la práctica de los atletas masculinos era de 9 ± 6 años, mientras la graduación distribuida se comprendió entre 20% con la cinta negra, 50% con la cinta marrón y 30% con la graduación inferior a marrón. Los atletas presentaron tiempo de práctica de 5 ± 3 años, siendo 9% cinta negra, 25% cinta marrón y 66% la graduación inferior. A través de la aplicación de una encuesta, se observó que las lesiones pasaron con el predominio de 23% en la articulación de la rodilla, siguiendo por 16% para el hombro, 22% en los dedos de manos y pies, y las otras ocurrencias ascendieron a 39%. Las mismas fueron de 10% de lesiones ligeras, 9% moderadas y 63% de afecciones serias. La relación de ocurrencia de lesiones entrenando alcanzó al 71% de los casos, y 42% de este total pasaron cuando habia la participación de un antagonista más pesado. Los golpes más frecuentes que causaron lesiones fueron de Ippon-seoi Nague, con 23%, Tai otoshi con 22% y Uchi mata con 9%.

Palabras-clave: Lesiones deportivas. Judo.

INTRODUCTION

Judo was created in 1882 by Jigoro Kano. This Martial Arts is characterized by a great amount of techniques, and highly valuable philosophical basis that helps in an individual's formation. Presently, it is one of the sports modalities presenting major adhesion index, mainly among prepubescent and pubescent individuals. Maybe this phenomenon has been boosted by the Olympic conquests attained by Aurélio Miguel and Rogério Sampaio, as well as by the deriving divulgation on television, spreading the news on the international participation of the Brazilian team in the last decades⁽¹⁾.

Judo implies in a remarkable risk for injuries, and it has been quite mentioned due to the relevant relative risk analyzed through the comparative analysis there has been performed among different sports modalities^(2-8).

In such sense, several researches have focused the relationship of this sports and the occurrence of injuries reporting specific cases, such as, for instance, injuries in the knee, ankle and elbow joints, elbow osteodystrophia and junction of the fingers^(4-5), and even the influence of the high output training on the development of postural deviations in adolescents⁽¹⁾.

Nevertheless, another study has showed that the impact on the judo athletes' cerebral function presented normal levels, and this is similar to what was found in amateur pugilists and the control group, being different from the professional pugilists⁽³⁾.

Due to the increasing promotional wave of the physical and recreational activities among the general public, and with the purpose to reduce the risk for chronic diseases^(9-15), there must be a concern as to the knowledge of the statistical basis on the possible injuries, the risk index to the occurrence of these injuries, or even to other negative effects, in order to allow to the individual to decide whether to practice or not a specific physical activity which may be most appropriate to a given public^(16,17).

The incentive programs to the sports is limited to the risks and benefits related to each modality, in order to allow the individual to make a choice as to the best investment considering his personal needs and the related phase of his motor development. This concern has motivated some authors to develop surveys based on a large group of participant from different physical activities, recreational, and sportive groups, allowing to perform an adequate comparison with the purpose to estimate the risk for injuries^(2,7).

Although there are few studies reporting the follow-up for specific injuries, or even an estimate of the occurrences of an injury per hours of activity, where judo is mentioned as being a high risk sportive modality, presenting a concerning mark of 18.3 occurrence records per 1,000 hours of the activity⁽²⁾, as to our knowledge, there is not a detailed survey on the situations under which the injuries occurred, in order to allow a causal correlation between the technical aspects and the percentage of injuries found.

Thus, the questionnaire applied in this study has collected information such as the stroke applied at the moment when the injury occurred, characteristics of the fighters, the rating of the injury as to its severity, time of practice and the athlete's level, among others. The purpose of this paper was to attain a relationship between the percentage of injuries and the technical aspects related to the judo. Such database is of great interest, in order to allow a discussion as to the training methodologies.

MATERIALS AND METHODS

All information was collected through a close questionnaire applied by physical educators in different judo teams from the São José dos Campos city, SP, and in regional competitions performed in 2004. The results represent the percentage of the distribution of the occurrences.

Every athlete was informed on the accomplishment of the study, and they voluntarily allowed in having their data published after signing a consent term assuring the privacy feature of their personal information.

The results were statistically analyzed through the x² test at a 5% significance level.

The data were classified according to preestablished criteria related to the location, etiology, and diagnosis, and it was considered mild those injuries that did not result in removal from the training or the competition; moderate, injuries were those that caused a removal from the training and/or competition; and severe, when the removal was higher than one day from the training and/or the competition^(2,7,18).

It was also considered in this study the uke situations when the athlete receives the stroke, and the tori, when the athlete applies the stroke.

RESULTS

It was interviewed forty-six 23 ± 10 years old mean male athletes, and thirty-two 19 ± 7 years mean female athletes, and they were submitted to a close questionnaire. For each referred case, it was applied a sequence of questions searching for detailed information, such as: spot of the injury, if the athlete was in the Tori or Uke condition; if the occurrence was during a training or competition; if the opponent was lighter or heavier, among other information (^{attached 1}).

The time of practice for each male athlete was 9 ± 6 years, and the level of expertise was distributed as follows: 20% black belt, 50% brown belt, and 30% lower than brown level. The female athletes presented a mean time of practice of 5 ± 3 years, being 9% black belt, 25% brown belt, and 66% a lower level.

Those injuries consequence of situations such as warming up, isolated accidents, and other cases, such as absence of an opponent were not considered when distributing the percentage of each of the aspects, such as: type of the stroke, opponent's profile (weight and level). Therefore, in these situations, the total analyzed was 64 cases.

After performing the analysis of the data attained, it was observed that the injuries occurred with a 23% prevalence considering the total reports of the knee joint, followed by 16% of the shoulder, 22% of the toes and fingers, and the other occurrences amounted 39% (table 1).

Related to the severity of the injuries, it was found 10% mild injuries and 64% were severe occurrences, and among this total, the data was regathered as to the training or competition situation. Thus, it was attained 8% injuries in training situations classified as mild, 9%, moderate, and 54% severe.

So, in competition situations, it was attained 5% mild injuries, 2% moderate, and 22% severe injuries (table 2).

Another aspect observed in the injury occurrence process it was the relationship between the difference or equality of the opponent's profile as to his weight and the level. It was observed that in 21% of injuries the opponent was lighter, 42% occurred having a heavier opponent, and 31% with an opponent of the same weight. Only 6% of the interviewed athletes were not aware on this detail.

Related to the level, 31% of the injuries occurred with a higher leveled opponent, 24% with a lower leveled opponent, and 39% with an opponent of the same level. Only 6% athletes was not aware as to this point (table 3).

Two strokes can be detached, and the Ippon seoi Nague was responsible by 23%, and the Tai otoshi was responsible by 22% of the reports. The Uchi mata attained the mark of 9%, and 22% of athletes did not remember the associated stroke. The other injuries accounted for in the questionnaire represented 24% (table 4).

As the Ippon seoi and the Tai otoshi are the strokes presenting higher prevalence of injuries, it can be observed the percentages related to the anatomic portions hit (table 5).

DISCUSSION

As main limitations of this study, it is important to point out the fact that the interviewed athletes were from the same geographic region (Vale do Paraíba), and this may influenced the use of certain techniques.

The questionnaire that was applied did not allow to know the exact weight of the athletes, but it is commonly among athletes to know how to differentiate their opponents (whether they are or not of the same level). In future studies, this parameter must be more precisely evaluated, due to the high amount of complaints related to this aspect.

The analysis of the results found in this study must consider that the interviewed athletes were not able to remember the injuries suffered. Nevertheless, it is necessary to point out that this possible omission actuated only in a sense to decrease the amount of the occurrences. However, the details associated to the severe cases were considered trustworthy, probably because they were more remarkable than others.

An alternative to increase the detailing of the data and to introduce clinic aspects it would be to deepen this study through a partnership with the medical department responsible by the athletes' attendance in big clubs. In this case, besides of mentioning the technical aspects related to the injuries, it will be possible to add the diagnosis supplied by the medical department.

On a survey performed during the 1995 Mar del Plata Pan American Games, the amount of clinic and traumatologic attendance recorded that judo was the fourth sports in the general rating of medical attendances, considering clinic and traumatologic attendances, and it was the first place when it was considered the traumatologic attendances⁽⁸⁾.

Related to the site of the injury (table 1), this survey has shown a 23% total occurrences in the knees, and this was the anatomic spot with the higher index of complaints. A paper performed during the 1995 Pan American Games has shown the existence of medical attendances predominance of joint injuries. According to the authors, judo together with volleyball is mentioned as being the sportive modality with a higher incidence of this nature of injuries⁽⁸⁾. The predominance of injuries in the ankles and knees has been mentioned in several papers, and the ankle joint is one of the spots with higher incidence of occurrences among those athletes^(19,20). In our study, the ankle injuries attained an expressive mark of 14%, being the third most mentioned item.

These numbers reinforce the impression found by other authors suggesting the use of bandages or stabilizers in the ankle and knee joint to decrease or minimize the sprain injuries^(5,21,22).

Second, the shoulder joint represented 16% of the occurrences. This amount may be result of the high competitiveness and the expressive physical evolution of the athletes. Thus, there is a yet non-investigated possibility but quite discussed among the judo professionals, who have observed an increasing change in the techniques that has generated biomechanical adaptations of the strokes. Other possible factor is also related to the competitiveness that the opponents have been assumed a risky posture during the fall, in order to avoid the perfect stroke, the ippon, where the looser player hits the ground in the whole extension of his back.

A treatment suggested in athletes presenting such type of injury was to apply the cryotherapy (ice) and the immobilization using the Velpeau bandage for two weeks, presenting good results in high physically active individuals⁽²³⁾.

Related to the injured spot, our results recorded an amount of 22% complaints related to the toes and fingers, and this confirms a study performed encompassing a 15 year period, where judo seems to be a risk factor to develop the osteodystrophia in the finger joints due to the micro and macro chronic-repetitive injuries⁽⁵⁾.

As to the severity of the injuries (table 2), this study found 10% severe injuries, 9% moderate injuries, and 63% severe occurrences. From the total cases, it was observed that 71% of the processes happened during the training, and only 20% occurred during competitions. These differences are statistically significant at a 5% significance level, when it is applied the x² test. It is extremely relevant the fact that the prevalence of the training occurrences is approximately 2.5 times higher than the already expressive amount found in other studies^(2-18). Similar to other sportive modality, judo presents a training volume that can originate the discussion on its influence on the results, but we did not find other studies that allowed a more appropriate comparison in such extent.

Anyhow, this uneven relationship is a concerning fact, and it may be related to some factors. Due to the high number of variables that may be involved, a more accurate concept is really quite complex. In this research, the suggested main factor seems to be the uneven weight between athletes. In this aspect, it was found 21% injuries involving lighter opponents, 31% involving opponents of the same weight, and 42% involving heavier opponents (table 3). However, these differences are not statistically significant at a 5% level.

At this moment, it is appropriate to consider the vantages and disadvantages towards the athletes' technical improvement facing situations at a higher difficulty level, as for instance the utilization of heavier or highly leveled opponents.

In this item, we have found 24% injuries involving lower leveled opponents, 31% higher leveled opponent, and 39% of opponents of the same level. However, these differences are not statistically significant when they are considered at a 5% level. As the combinations presented did not show quite expressive differences as the prior ones, the choice to mix graduation levels as to improve the technical performance of the athlete seems to be best indicated than the choice to use opponents of different categories (table 3).

At last, another interesting observation is that the percentage relationship of the strokes connected to the occurrence of injuries where the Ippon seoi Nague stroke represented 23% of the mentioned cases, the Tai otoshi represented 22%, and the Uchi mata, 9% (table 4).

These results suggest that the type of stroke can have a direct relationship to the anatomic spot hit. Nevertheless, in order to clarify this issue, future studies must comprise a large sampling, since the collection of similar case-reports expressively decreases the amount of each occurrence related to the total reports attained in the study. Due to this reason, the correlation between techniques and injuries cannot be confirmed using the x² test that did not consider statistically significant those differences found at a 5% level.

The relationship between the Ippon seoi Nague stroke and the shoulder injuries presented 31% of the occurrences (table 5). From this amount, 100% occurred in the Tori situations. The tai otoshi presented a 51% relationship to the knee injuries (table 5). From this amount, 86% occurred in the Uke situations. This situation is also very interesting, since the projected opponent was also subject to a great percentage of risk when he chooses to sacrifice his own shoulder to keep on fighting, and thus avoiding the ippon. Nevertheless, it must be performed a larger survey of cases in order to allow to clarify such issues.

CONCLUSIONS

The knee, shoulder and ankle injuries were the most frequent injuries found.

The more frequent strokes that have caused injuries were the Ippon seoi Nague, the Tai otoshi, and the Uchi mata.

The Ippon seoi Nague presented a relationship with the shoulder injuries, all of them consequence of the Tori. The Tai otoshi presented a relationship with the knee injuries, in the majority in the Uke situation.

The relationship of the training injuries is very concerning, mainly due to the evidence that the major part of the reports occurred whenever a heavier opponent participated, and that is a quite common situation in the trainings.

The authors declared there was no potential conflict of interest related to this article.

All the authors declared there is not any potential conflict of interests regarding this article.

REFERENCES

Received in 3/9/04.

Final version received in 1/9/05.

Approved in 5/9/05.

• 1. Fraga LAC. Presença de atitudes escolióticas em meninos judocas e não judocas [Dissertação de Mestrado em Ciências do Movimento Humano]. Universidade Federal do Rio Grande do Sul, Escola de Educação Física, 2002.
• 2. Parkkari J, Kannus P, Natri A, Lapinleimu I, Palvanen M, Heiskanen M, et al. Active living and injury risk. Int J Sports Med 2004;209-16.
• 3. Rodriguez G, Vitali P, Nobili F. Long-term effects of boxing and judo-choking techniques on brain function. Ital J Neurol Sci 1998;19:367-72.
• 4. Oka Y. Debridement for osteoarthritis of the elbow in athletes. Int Orthop 1999; 23:91-4.
• 5. Raschka C, Parzeller M, Banzer W. 15 years insurance statistics of incidents and accident types of combat sports injuries of the Rhineland-Pfalz Federal Sports Club. Sportverletz Sportschaden 1999;13:17-21.
• 6. Kujala UM, Taimela S, Antti-Poika I, Orava S, Tuominen R, Myllynen P. Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data. BMJ 1995;311:1465-8.
• 7. Moreira PG, Oliveira CD. Prevalência de lesões na temporada 2002 da Seleção Brasileira Masculina de Basquete. Rev Bras Med Esporte, 2003;9:258-62.
• 8. Carazzato JG, Rossi JP, Fonseca BB, Freitas HFG. Equipe médica do Comitê Olímpico Brasileiro: Atendimento médico desportivo Jogos Pan-Americanos Mar del Plata 1995. Rev Bras Med Esporte 1995;1:69-79.
• 9. Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol 1990;132:612-28.
• 10. Ekelund LG, Haskell WL, Johnson JL, Whaley FS, Criqui MH, Sheps DS. Physical fitness as a predictor of cardiovascular mortality in asymptomatic north American men: the Lipid Research Clinics Mortality Follow-up Study. N Engl J Med 1988;319:1379-84.
• 11. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RSJR. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991;325:147-52.
• 12. Kujala UM, Kaprio J, Sarna S, Koskenvuo M. Relationship of leisure-time physical activity and mortality. The Finnish Twin Cohort. JAMA 1998;279:440-4.
• 13. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA 1994;272:1909-14.
• 14. Paffenbarger RSJR, Hyde RT, Wing AL, Lee IM, Jung DL, Kampert JB. The association of changes in physical-activity level and other life-style characteristics with mortality among men. N Engl J Med 1993;328:538-45.
• 15. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämälainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1390-2.
• 16. De Loës M. Medical treatment and costs of sports-related injuries in total population. Int J Sports Med 1990;11:66-72.
• 17. Sandelin J, Santavirta S, Lättilä R, Vuolle P, Sarna S. Sport injuries in a large urban population: occurrence and epidemiologic aspects. Int J Sports Med 1987; 8:61-6.
• 18. Requa RK, Garrick JG. Epidemiology of sports injuries. In: Caine DJ, Caine CG and Lindner KJ, editors. Adult recreational fitness. Champaign (IL): Human Kinetics, 1996;14-28.
• 19. De Löes M. Epidemiology of sports injuries in the Swiss organization outh and Sports 1987-1989. Injuries, exposure and risks of main diagnoses. Int J Sports Med 1995;16:134-8.
• 20. Raschka C, Glaser H, Marees H. Etiological accident types and recommendations for prevention in basketball. Sportverletz Sportschaden 1995;9:84-91.
• 21. Cohen M, Abdalla RJ, editores. Lesões nos esportes: diagnóstico, prevenção e tratamento. Rio de Janeiro: Revinter, 2003;394-7.
• 22. Zvijac J, Thompson W. Basketball. Epidemiology of sports injuries. Champaign: Human Kinetics Publishers, 1996;3:86-97.
• 23. Zarzycki W, Lorczynski A, Ziolkowski W. Nonoperative treatment of acute, grade III acromioclavicular dislocation in judo competing athletes. Chir Narzadow Ruchu Ortop Pol 1998;63:321-7.

*

Authors with equal participation share.

Publication Dates

• Publication in this collection
  02 May 2007
• Date of issue
  Feb 2006

History

• Accepted
  05 Sept 2005
• Reviewed
  01 Sept 2005
• Received
  03 Sept 2004