Can jujitsu cause capsulitis?

Can Jujitsu Cause Capsulitis?

Yes, jujitsu can cause capsulitis, particularly adhesive capsulitis of the shoulder, due to repetitive microtrauma and potential macrotrauma from joint manipulation techniques and falls during practice or competition.

Mechanism of Injury in Jujitsu

Jujitsu involves several mechanisms that can lead to capsulitis:

1. Repetitive microtrauma:

   • Chronic repetitive stress to joint capsules during grappling and submission techniques
   • Similar to how judo athletes develop finger polyarthrosis from repetitive trauma 1

2. Acute macrotrauma:

   • Joint manipulation techniques (especially arm bars targeting the elbow)
   • Falls and impact during takedowns
   • Submission holds that stress joint capsules

3. Joint-specific vulnerability:

   • Shoulder joints are particularly vulnerable during arm locks and takedowns
   • Elbow joints are the most commonly injured in Brazilian Jiu-Jitsu competitions 2

Clinical Presentation of Capsulitis

Adhesive capsulitis presents with:

• Gradual onset of shoulder pain
• Progressive stiffness and restriction of motion
• Decreased range of motion, especially in external rotation
• Pain that may be severe enough to interfere with sleep and daily activities 3

Diagnosis

The diagnosis of capsulitis in jujitsu practitioners is primarily clinical:

• History: Gradual onset of pain and stiffness following jujitsu training or competition
• Physical examination: Restricted active and passive range of motion in all planes
• Imaging: While not necessary for diagnosis, MRI may show coracohumeral ligament thickening with high specificity for adhesive capsulitis 3

Management of Jujitsu-Related Capsulitis

Treatment should follow a stepwise approach:

1. Initial conservative management:

   • NSAIDs for pain control
   • Activity modification to avoid aggravating movements 4
   • Gentle stretching and range of motion exercises 4

2. Physical therapy:

   • Progressive stretching exercises focusing on external rotation and abduction 4
   • Strengthening of shoulder girdle muscles
   • Early intervention is crucial to prevent permanent dysfunction 4

3. Interventional treatments (if conservative management fails):

   • Intra-articular corticosteroid injections (triamcinolone) for significant pain 4
   • Suprascapular nerve blocks for refractory cases 4

4. Surgical options (for persistent cases):

   • Consider surgical referral if conservative management fails after 3-6 months 4
   • Arthroscopic capsule release
   • Manipulation under anesthesia 3

Prevention Strategies

To prevent capsulitis in jujitsu practitioners:

• Proper warm-up before training or competition
• Gradual progression of training intensity
• Proper technique to avoid excessive joint stress
• Early recognition and treatment of shoulder pain
• Avoid shoulder immobilization after minor injuries, as it can lead to frozen shoulder 4

Prognosis

With appropriate treatment, approximately 80% of patients recover completely within 3-6 months 4. However, without proper treatment, recent evidence suggests persistent functional limitations can occur, challenging the traditional view that adhesive capsulitis always resolves spontaneously 3.

Jujitsu practitioners should be aware that while the overall injury rate in Brazilian Jiu-Jitsu is lower than in other martial arts, joint injuries remain common, with the elbow being most frequently affected, followed by shoulder injuries 2.