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Injuries in judo: a systematic literature review
including suggestions for prevention
Elena Pocecco,
1
Gerhard Ruedl,
1
Nemanja Stankovic,
2
Stanislaw Sterkowicz,
3
Fabricio Boscolo Del Vecchio,
4,5
Carlos Gutiérrez-García,
6
Romain Rousseau,
7,8
Mirjam Wolf,
1
Martin Kopp,
1
Bianca Miarka,
5
Verena Menz,
1
Philipp Krüsmann,
1
Michel Calmet,
9
Nikolaos Malliaropoulos,
10,11
Martin Burtscher
1
▸Additional material is
published online only. To view
please visit the journal online
(http://dx.doi.org/10.1136/
bjsports-2013-092886).
For numbered affiliations see
end of article.
Correspondence to
Elena Pocecco,
Department of Sport Science,
Medical Section, University of
Innsbruck, Fürstenweg 185,
6020 Innsbruck, Austria;
elenapocecco@yahoo.it
Accepted 13 October 2013
To cite: Pocecco E,
Ruedl G, Stankovic N, et al.
Br J Sports Med
2013;47:1139–1143.
ABSTRACT
Background There is limited knowledge on
epidemiological injury data in judo.
Objective To systematically review scientific literature
on the frequency and characteristics of injuries in judo.
Methods The available literature up to June 2013 was
searched for prospective as well as retrospective studies
on injuries in judo. Data extraction and presentation
focused on the incidence rate, injury risk, types, location
and causes of injuries.
Results During the Olympic Games in 2008 and 2012,
an average injury risk of about 11–12% has been
observed. Sprains, strains and contusions, usually of the
knee, shoulder and fingers, were the most frequently
reported injuries, whereas being thrown was the most
common injury mechanism. Severe injuries were quite
rare and usually affected the brain and spine, whereas
chronic injuries typically affected the finger joints, lower
back and ears. The most common types of injuries in
young judo athletes were contusions/abrasions, fractures
and sprains/strains. Sex-differences data on judo injuries
were mostly inconsistent. Some studies suggested a
relationship between nutrition, hydration and/or weight
cycling and judo injuries. Also, psychological factors may
increase the risk of judo injuries.
Conclusions The present review provides the latest
knowledge on the frequency and characteristics of
injuries in judo. Comprehensive knowledge about the
risk of injury during sport activity and related risk factors
represents an essential basis to develop effective
strategies for injury prevention. Thus, the introduction of
an ongoing injury surveillance system in judo is of
utmost importance.
INTRODUCTION
Judo is a martial art and an Olympic sport compris-
ing standing and ground fighting.
12
It entered the
Olympic Programme for men in 1964 as a demon-
stration sport and officially in 1972 for men and in
1992 for women.
3
During competitions, contest-
ants are divided by sex, sometimes by grade or
judo experience, and organised in age classes and
weight divisions.
4
Nowadays, judo ranks among the most popular
Asian martial arts in the world.
5
The International
Judo Federation comprises more than 200 affiliated
countries spread over all five continents, counting
an estimated 20 million individuals.
6
Considering
such a high participation rate in a combat sport and
the suggested relatively high injury risk,
7
the safety
of practitioners is of the highest priority. Therefore,
research on judo injuries would be essential in iden-
tifying risk factors and suggesting potentially pre-
ventive strategies.
To protect the health of its athletes, the
International Olympic Committee initiated and
developed the injury and illness surveillance system
during the 2008 Beijing and 2012 London
Olympics.
89
With this systematic injury registration,
the most common and severe injuries, for example,
in judo athletes, are identified to ensure new knowl-
edge on injury trends over time, to form the basis for
further research on injury risk factors and mechan-
isms, and finally to develop injury prevention pro-
grammes.
10
However, the collection of
epidemiological data is just the first step in the direc-
tion of injury prevention, which should be followed
by more deepening studies on judo peculiarities.
In the literature, a few prospective and retro-
spective studies as well as case reports dealing with
judo injuries are available.
11–13
However, to our
knowledge, no systematic overview on this import-
ant topic is available. Therefore, the aim of this
paper was to perform a systematic review of injur-
ies sustained by judo athletes.
METHODS
Literature search: A comprehensive search of the
literature was performed electronically in different
databases from their inception up to June 2013.
The use of the Medical Subject Headings (MeSH)
terms ‘martial arts’and ‘judo’and ‘injuries’pro-
duced 40 publications from PubMed/Medline.
Twelve of these were deemed relevant to the
present work because of the useful information on
judo injuries. Further searches using the same terms
were carried out in the ISI Web of Knowledge,
Scopus and The Cochrane Library, and injury
reports from recent Olympic Games have been
investigated. Of 61 publications, 13 were found to
be relevant for the present review. The exclusion
criteria adopted for all search strategies were cases
or case series reports dealing with less than eight
participants or Japanese language. Furthermore,
two book chapters on judo comprising injury data
have been included. Finally, to complement the
present review, selected references cited in the
aforementioned literature have been considered in
the case of limited information on specific topics.
Definitions of injury
According to MeSH, injuries are primarily defined
as damage inflicted on the body as the direct or
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indirect result of an external force, with or without disruption
of structural continuity. However, as a result of different designs
of the reviewed literature, including prospective
8 9 12 14
as well
as retrospective studies,
13 15 16
it was not possible to adopt a
standardised definition, neither of injury, nor of the severity
grade of injuries. During the Summer Olympic Games (SOG),
an injury was defined when an athlete received medical atten-
tion for a newly incurred injury or reinjury after full participa-
tion following the previous injury, including in-competition as
well as training injuries during the SOG.
89
Similarly, Green
et al
12
defined an injury as a situation in which the judoka
either requested medical treatment or was unable to continue a
contest. On the other hand, James and Pieter
14
indicated an
injury as any circumstance for which assistance was sought from
the medical personnel, including time-loss injuries, which kept
the athlete from completing the actual bout and/or subsequent
bouts and from participating in judo for a minimum of 1 day
thereafter. Regarding retrospective studies, an injury was defined
as any physical complaint sustained by a competitor irrespective
of the need for medical attention or time-loss from activ-
ities,
13 15
or which caused an exclusion from sports-related
activities for at least 4 days.
16
Presentation of data
Data extraction and presentation focused on the frequency,
types, location and causes of injuries. Judo injuries were
expressed as absolute as well as relative frequencies. The
number of injured athletes divided by the number of athletes at
risk is used as an estimator of the average injury risk.
17
The inci-
dence rate is the number of injuries divided by the number of
athlete-exposures, for example, the number of fights, and is
based on the epidemiological concept of person-time at
risk.
12 14 17 18
It has to be noted that comparisons can only be
made between data using the same denominator.
RESULTS
Frequency of injuries
Online supplementary table S1 presents data on the injury risk
and incidence rate in judo practice reported in the available
literature.
The most recent injury data from the 2008 SOG in Beijing
and 2012 in London revealed an average injury risk of 11.2–
12.3% for the more than 380 participating judo athletes per
SOG.
89
Also, James and Pieter
14
and Green et al
12
found that
13–14% of the athletes studied sustained an injury while other
studies showed clearly higher injury risks of 23–29%.
13 19
The
highest value was identified by Souza et al
11
with an incidence
rate of 1.18 injuries/athlete-year. The differences might be due
to the different skill levels of participating athletes, involved age
groups, study designs as well as injury definitions.
With regard to the potential sex differences, the reported
findings were inconsistent.
12 14 19
Some studies found no sex
difference
12
while other studies showed a higher injury risk
among men
14
and women,
19
respectively. Again, these differ-
ences might be due in part to different skill levels and age
groups.
The importance of age as a risk factor is also uncertain, espe-
cially as it may interact with experience as a causal factor.
3
Recent studies on elite judokas reported a higher injury risk
(49–88%) during competition compared with training.
891120
In contrast, other authors
15 21 22
showed an about 70% higher
injury risk during training compared with competition, particu-
larly in women (94%;
21
see online supplementary tables S1–S3).
An unequal proportion of time spent in training and competition
during the different studies could have led to the discrepancies
in the results, which may even have been influenced by memory
bias.
23
Frey et al
24
reported a higher frequency of injuries during
lower level competitions compared with higher level ones.
Moreover, competitions with a high difference in the perform-
ance level of the contestants showed a higher frequency of
injuries.
24
Injury types
The distribution of injury types seems to be strongly influenced
by the study design (see online supplementary tables S2 and
S3). Regardless of the study design and sex, the most frequent
injuries were sprains (5.6–59.8%), strains (7–33.8%) and contu-
sions (5.6–56%; see online supplementary tables S2 and S3).
The frequency of fractures demonstrated in retrospective studies
based on institutional documentation (RD)
21 22 25
was consider-
ably higher than in retrospective studies utilising questionnaires
(RQ)
11 26
and in prospective studies.
12 19 27 28
Prospective
studies recorded a higher variety in the classification of sus-
tained injuries, but the percentage of serious injuries was
lower
19 27 28
when compared with RD studies.
21 22 25
Besides a somewhat higher percentage of sprains among
female judo athletes and of strains among male judo athletes, no
relevant differences have been shown between sexes (see online
supplementary tables S2 and S3).
In adult as well as top-class competitors, dislocations and
sprains prevailed, whereas in younger as well as lower ranked
judokas upper body fractures were more frequent.
28–30
Injury location
Judo injuries mostly affect body extremities, especially the knee
(up to 28%),
20
shoulder (up to 22%) and hand/fingers (up to
30%), as shown in online supplementary table S4. Depending
on the definition of injury used, fingers were sometimes indi-
cated as the most common injury locations during competi-
tion
12 13
as a consequence of grip fighting,
13 31 32
which indeed
has the biggest time share during the fight.
33
However, these
injuries were usually classified as ‘soft’.
13
On the other hand,
RQ studies identified the knee and shoulder as the most fre-
quent injury locations as a consequence of throwing or being
thrown.
11 15 20
No difference in the localisation of injuries has been reported
between male and female judokas.
15 22
In children (12.6±2.8 years, range 5–17 years), the shoulder/
upper arm (19%), foot/ankle (16%) and elbow/lower arm (15%)
were the most common injury locations.
25
Injury causes
Data on injury causes in judo are presented in online supple-
mentary table S5. Nearly 85% of judo injuries occurred during
standing fight compared with ground fight, probably because
more time is spent in standing fight, where athletes must grip
their opponent before attacking.
12 13
Indeed, as already pre-
sented, grip fighting constitutes a cause of injury to hands and
fingers.
13 31 32
Being thrown seems to be the most frequent situ-
ation leading to judo injuries, comprising about 70% (range 42–
90%) of cases,
325
including also a few severe and catastrophic
injuries
34 35
(see online supplementary table S5). Additionally, it
was indicated that the lack in falling skills is also associated with
injuries,
36
including acute as well as chronic ones.
334
No age-related or sex-related causes could be found in the lit-
erature.
19
Indeed, a biomechanical analysis of judo techniques
revealed that both men and women use similar techniques in
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contemporary Olympic tournaments.
37
However, women seem
to be more exposed during ground fight,
14
where their injuries
are frequently derived from arm lock techniques.
14
Moreover,
the loss of balance in women was the main cause of injuries
when performing throws and break falls.
21
Among men, these
causes were predominant in younger age classes, that is, from
10 to 19 years (about 48%), whereas being pressed against the
mat by the opponent or a fall on the opponent occurred most
often from the age of 20 years (33%).
21 28
Furthermore, Seoi Nage techniques, that is, the throws with
‘lever applied with variable arm’,
37
were supposed to be high-
risk techniques for shoulder injuries being thrown,
15
and for
knee injuries performing the throw
26
in all age categories and
for both genders.
19
However, results on the frequency of knee
injuries while performing this technique are discordant.
38
Moreover, there is a high risk of repeated injuries after the first
lesion sustained during these shoulder throws, mostly caused by
the too quick resumption of physical activity after the sustained
trauma.
26
Also, improper technique is supposed to be involved
in the injury mechanism of delivering throws.
39
Mechanisms of the most frequent judo injuries
The mechanisms of judo injuries are varied. A study by the
French Judo Federation
24
on 150 067 fights showed that injuries
affected the shoulder in 28.7% of cases, the elbow in 13.5%,
the knee in 12.2% and the ankle and fingers less frequently.
Glenohumeral dislocations are mostly caused by the resistance
to fall from the defender who, in an attempt to not fall on the
back (which would mean losing the fight), finally falls with an
outstretched arm.
40 41
A fall on the top of the shoulder, instead,
causes acromioclavicular or sternoclavicular disjunctions
42
or
rather clavicle fractures mainly among children and adolescents
with immature bones.
42 43
Elbow dislocations are mainly caused by a wrong
defence,
14 44
when the defender leans with a bent arm on the
mat.
45
The armlocks can lead to medial collateral ligament
(MCL) lesions.
46
Considering sport practice, a judo trauma seems to be the
injury cause of anterior cruciate ligament (ACL) rupture in
5.6% of the cases.
7
Knee sprains, which mainly affect the MCL
and ACL in the judo population,
47
are often caused by leg tech-
niques, for example, O Soto Gari.
38 48
Also, having a different
grip style from the opponent seems to be a risk factor for ACL
injuries.
38
Lesions of the collateral ligament vary according to
the violence of the trauma.
38
Isolated MCL injuries can be
caused by a trauma in the flexion and valgus.
49
Ankle injuries are usually sprains of the collateral lateral liga-
ment occurring during torsion in varus.
50
A violent external
rotation can lead to a rupture of the anterior inferior tibiofibu-
lar ligament.
51
The finger injuries are commonly dislocations or sprains of
the interphalangeal joints, mostly due to a wrong grip with the
finger/s blocked in the swell of the judogi (kimono).
48
Choking techniques are based on a push on the larynx or
carotid associated with a support behind the neck.
52
A loss of
consciousness may occur if the defender does not give up the
fight in time.
Severity of injuries and time loss
Online supplementary table S6 shows that judo is not at high
risk for sustaining time-loss injuries during the Olympic Games:
an average injury risk of 6.4–8.9% has been shown during the
last two SOGs.
89
As highlighted in online supplementary table S7, mean
absence from training and competition ranged from 1 to 7 days
(sustained by 5.7% of competitors) after injuries sustained
during the SOG
9
to 21–29 days after injuries sustained during
lower level competitions.
12
No differences concerning the frequency and/or duration of
time loss after judo injuries could be found comparing competi-
tors of different proficiency levels
12
or sex.
8912
Retrospective studies reported 65–70% of time-loss injuries
happening during training.
15 22
The highest risk for time loss
was found at the age between 20 and 24 years, probably
because it is the most intensive training and competition
period.
22
In adult athletes, the knee was the most common loca-
tion of time-loss injuries
91215202226
followed by the shoul-
der,
22
while in children (12.6±2.8 years) there were more
shoulder/upper arm, lower leg/foot/ankle and elbow/lower arm
injuries.
25
Severe injuries
The main locations of catastrophic injuries in judo are the brain
and the cervical spine.
34 35
Kamitani et al
35
reported being thrown as the leading injury
mechanism of severe head injuries (70%) among judo practi-
tioners,
35
who were mainly younger than 20 years (90%) and
practicing judo for less than 3 years (60%).
35
The authors
assumed lack of falling skills as the prominent cause for severe
head injuries among inexperienced judokas.
35
Generally, choking in judo induces only subclinical electroen-
cephalographic perturbations,
53
but could also lead to brain
damage when the ‘choker’maintains the pressure on the oppo-
nent’s neck, with blood flow interruption lasting a sufficient
time to be harmful to the central nervous system
54
; in the worst
case, this could lead to death.
34
In Japan, 26 judokas sustained a spinal cord injury during a
3-year period
55
and 19 a neck injury in 8 years.
35
Sixty-three
per cent of neck injuries occurred while performing a throwing
technique, for example, Uchi Mata.
35
Chronic injuries
Practicing judo can cause chronic injuries, especially those
affecting the finger joints, the lower back and the ears.
32 56 57
Repetitive injuries to the finger joints due to extensive judo
training are a risk factor for the development of osteoarthritis.
32
Okada et al
56
reported a prevalence of non-specificlower
back pain (nsLBP) and lumbar radiological abnormalities (LRA)
in elite Japanese judokas of 35.4% and 81.7%, respectively.
The prevalence of LRA in the lightweight categories was lower
than among middleweights and heavyweights and there was a
higher coprevalence of LRA and nsLBP in the middleweight
categories.
56
Rodriguez et al
58
found competitive active judokas having no
chronic brain damage induced by the repetitive application of
judo-specific throwing and choking techniques.
The so-called judo ear, or cauliflower deformation of the ear,
which derives from a traumatic auricular haematoma caused by
repeated direct traumas, hitting and/or rubbing to the external
ear,
59 60
is typical in judo and some other combat sports.
57
Judo injuries in children and juveniles
The most common types of injuries in young judo athletes (5–17
years old) are contusions/abrasions (25–45%), fractures (28–
31%) and sprains/strains (19–24%).
25 61
Studies on competition
injuries in young age classes found similar results but for frac-
tures.
19 62
Probably most of the reported fractures occurred
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during the learning process of throwing and falling techniques,
or during practice with heavier opponents.
15
Although there is
no consensus in the literature on age classes at risk,
3
Frey et al
24
found higher competition injury rates in judo athletes between
16 and 20 years of age, in which the judo athletes are very com-
bative but whose technical and tactical skills are still immature.
DISCUSSION
During the Olympic Games in 2008 and 2012, an average
injury risk of about 11–12% has been observed. Sprains, strains
and contusions, usually of the knee, shoulder and fingers, were
the most frequently reported injuries, whereas being thrown
was the most common injury mechanism.
The injury risk during the two most recent SOG of about 11–
12% is well in accordance with the average injury risk of 11%
for all sport disciplines together in the 2012 SOG.
89
In com-
parison, taekwondo had the highest injury risk with 39.1%
during the London Games while in archery, canoe slalom and
sprint, track cycling, rowing, shooting and equestrian sport less
than 5% of athletes were injured.
9
Compared with other Olympic combat sports, judo time-loss
injury risk of 6–9% during the last two SOGs was clearly lower
than in taekwondo (16–18%) but slightly higher than in boxing
(4–8%) and wrestling (5–6%), respectively.
89
It is notable that diverging results were influenced by different
study designs and definitions of injury: retrospective studies
showed a higher percentage of injuries as they usually cover
entire careers of judokas until the moment of the questionnaire,
while prospective studies are generally oriented to shorter and
well-defined periods.
Influence of nutrition, hydration and weight cycling on judo
injuries
Although nutrition, hydration and weight cycling are considered
important injury risk factors in combat sports,
63–67
specific
research on judo is still very scarce.
67
A higher frequency of
injuries and impairment of muscular function have been found
in weight cycling judokas and among those undergoing rapid
weight reduction before a competition compared with control
groups of judo athletes.
12 68 69
Moreover, even if bone injuries
were not higher in judokas displaying disordered eating beha-
viours,
70
the higher risk of bone injuries due to changes in bone
metabolism has been referred as a consequence of weight
cycling in judo.
71 72
Nevertheless, the strength requirements
and technical characteristics of judo practice may also be pre-
ventive factors for bone loss and bone-related injuries.
73
Furthermore, it has been reported
74
that the fluid restriction
practiced by many judo athletes when involved in weight loss
processes,
75
in conjunction with intense judo training in hot
environments, resulted in serious dehydration, which might
provoke heat-related injuries. Death has rarely been reported as
a consequence of dehydration in judo
67
and wrestling.
76
Despite the described risks, most judo athletes reduce their
weight a short time before competition.
75 77 78
The methods
used include fluid restriction, sauna or plastic clothing, diuretics
or laxatives, or food restriction, among others.
78 79
In line with
Artioli et al,
66
it can be concluded that athletes, especially pre-
pubescent ones, must avoid harmful weight loss procedures in
terms of sports injury prevention and further actions, including
specific programmes, must be promoted to dissuade judo ath-
letes from these methods. Judo should follow the example of
wrestling, where these programmes started to be implemented
since the late 1990s.
76
To create a daily energy deficit of 500–
1000 kcal, a long-term soft diet and aerobic exercise have been
recommended for losing weight without harming the athletes’
health.
80
More importantly, strict regulations would be the best
way to avoid dangerous weight loss practices in judo, as has
been the case for wrestling.
66 80
Psychological factors associated with judo injuries
The research results of recent years reinforce the assumption
that psychological factors are involved in the development of
sports injuries.
81–83
The perceived similarity and control seem
to directly contribute to the perceived risk of injury.
82
The per-
ceived similarity of an athlete with the ‘typical judoka who gets
injured while practicing judo’might especially be a pathway to
the time and effort spent in analysing the risk information critic-
ally, which might lead to developing preventive actions.
82
Some
studies in non-judokas refer to the three central elements of self-
determination theory (autonomy, competence and relatedness)
fostering intrinsic motivation and seem to be related to the
return to sport following injury.
84
Accordingly, there is prelimin-
ary evidence that positive psychological responses (motivation,
confidence and low fear) are associated with a higher rate of
returning to sport.
84
Future research on judokas should aim at reducing injuries by
testing cognitive behavioural strategies, which have shown effi-
cacy in other sport settings, by performing randomised clinical
trials based on the extended theoretical framework of
stress-injury models.
81 85
Injury prevention measures during training and competition
The knowledge on judo injuries is indispensable for the devel-
opment of preventive measurements.
Considering the relatively high frequency of upper body injur-
ies being thrown in judo, to improve falling skills,
25 35 36 86
by
means of good and frequent break fall training, avoiding to fall
on the top of the shoulder or on the palm of the hand,
87
should
be the highest priority of judo coaches, especially when teaching
beginners and young practitioners. Also, balance training as well
as testing the training effects in young judokas might be useful
in the evaluation and reduction of the risk of falls.
88
As throw-
ing could also be dangerous, throwing techniques should like-
wise be carefully and correctly apprehended from the very
beginning.
25 35 36 86
Furthermore, it is important to have good
physical preparation, especially by stimulating long-term resist-
ance training practice,
2 4 89 90
mainly focusing on women’s
upper body strength, as a high level of strength and flexibility
showed a significantly lower injury rate.
91–94
A specific programme for ACL injury prevention with pro-
prioceptive exercises and knowledge of the risk situations, in
addition to a higher emphasis on bilateral grips during training,
would be useful in reducing knee injuries. Changing the rules,
including the prohibition of direct attacks with the hand on the
pants, seems to reduce knee sprains.
6
However, this should be
assessed more extensively in future studies. Yamamoto et al
95
showed elastic taping to have a preventive function on ankle
instability. Additionally, the quality of the mat is also important:
even if collisions, that is, head impacts, would be attenuated on
relatively soft mats, the feet would penetrate into the mat,
which could lead to knee ligament injuries.
48
A soft protective
headgear could be an option to decrease head injuries as well as
‘cauliflower ear’.
14 57
The frequency of finger injuries has to be
assessed in future follow-up studies to determine if the recent
changes in the international judo rules from 2013 concerning
grip fight will have a positive influence.
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Educational programmes
Injury prevention can be improved by providing education for
athletes, coaches, referees and tournament directors
24 25 61 96 97
and establishing minimum standards of qualification and
experience for trainers and referees.
35 61 96 97
They should also be
instructed in the mechanisms, prevention and treatment of injur-
ies.
96
Furthermore, judokas need to be aware of the importance of
entering competition fully recovered from past injuries.
16 26
In
addition, one decisive criterion of the ability to compete could be
the scores in the Special Judo Fitness Test (SJFT).
98
During the
rehabilitation process, judo coaches can compare individual pro-
gress in SJFT, aiming at the achievement of the scores athletes had
before sustaining the injury.
26
Moreover, athletes should be
encouraged to give up on time in case of armlocks and choking
techniques
14
as well as to interrupt the fight in case of moderate
injuries. On the other hand, the role of the referee is also relevant,
especially during armlocks and choking techniques, stopping the
fight if the athlete is unable to give up.
6
It is also necessary to reflect on the re-evaluation of the current
competition rules.
399
Specific rules should keep on developing
for the young categories having safe practice as a main concern.
Hard or uncontrolled throwing, holding, joint locking or choking
techniques and dangerous falling techniques, for example, trying
to avoid falling on the back, can cause injuries and even serious
damage,
15 19 35 62
and should be strictly penalised for the preser-
vation of young athletes’health. Moreover, children and juveniles
or inexperienced judokas should be prevented from entering
competition prematurely.
96 99
Competitions for athletes of differ-
ent levels of experience, as those organised by the French Judo
Federation, should be encouraged.
A correct pedagogical approach should not be forgotten. Studies
on sports traumas indicate that the injury risk is lower if goals of
achievement are proposed to players: sport exercise for health,
physical maintenance or pleasure causes 9% fewer accidents than
practice driven by aspiration of good performance, success in com-
petition or desire of taking risks.
100
Therefore, a reorientation of
performance goals to goals of achievement, especially for young
judo practitioners, would probably reduce the injury risk.
CONCLUSIONS
The present review provides the latest knowledge on the fre-
quency and characteristics of injuries in judo. Comprehensive
knowledge about the risk of injury during sport activity and
related risk factors represents an essential basis to develop
effective strategies for injury prevention. Thus, the introduction
of an ongoing injury surveillance system in judo is of the utmost
importance.
What are the new findings?
▸The present review provides the latest knowledge on the
frequency and characteristics of injuries in judo.
▸Injuries of extremities, especially of the knee, shoulder and
fingers, are the most frequently affected body parts in judo
practitioners.
▸Sprains, strains and contusions are the most common injury
types.
▸Being thrown during standing fight is the predominant
situation where injuries occur.
How might it impact clinical practice in the near future?
▸Introduction of an ongoing injury surveillance system in
judo.
▸Awareness about the risk situations, with particular
emphasis on the correct learning of judo techniques,
bilateral grips during training and avoiding weight cycling.
▸Preventive measures will focus on improving protective
equipment, which could be useful especially during training.
Author affiliations
1
Department of Sport Science, University of Innsbruck, Innsbruck, Austria
2
Faculty of Sport and Physical Education, University of Nis, Nis, Serbia
3
Combat Sports Unit, Department of Theory of Sport and Kinesiology, Institute of
Sport, University School of Physical Education, Cracow, Poland
4
Sports Training and Physical Performance Research Group, Federal University of
Pelotas, Pelotas, Brazil
5
Martial Arts and Combat Sports Research Group, Sport Department, School of
Physical Education and Sport, University of São Paulo, São Paulo, Brazil
6
Department of Physical and Sport Education, University of León, León, Spain
7
Unit of Orthopaedic and Sport Surgery, CHU La Pitié-Salpétrière, Paris, France
8
Nollet Institute of Locomotor System, Paris, France
9
Faculty of Sport Science, University of Montpellier, Montpellier, France
10
National Track & Field Centre, Sports Injury Clinic, Sports Medicine Clinic of S.E.G.
A.S., Thessaloniki, Greece
11
Thessaloniki SPORTS Medicine Clinic, Thessaloniki, Greece
Contributors EP contributed to the conception and design, acquisition, analyses
and interpretation of the data, drafting, accurate and critical revision, and final
approval of the version of the paper to be submitted. She is the guarantor. GR, NS,
SS, FBDV, CG-G and RR contributed to the analyses and interpretation of the data,
drafting, critical revision and approval of the final version of the paper. MW, VM, PK
and MC contributed to the acquisition of the data, drafting and approval of the final
version of the paper. MK contributed to the analyses and interpretation of the data,
accurate and critical revision of the paper as well as approval of the final version.
BM contributed to the acquisition of the data, accurate and critical revision of the
paper as well as approval of the final version. NM contributed to the conception as
well as revision and approval of the final version of the draft paper. MB contributed
to the conception and design, accurate and critical revision as well as final approval
of the version of the paper to be submitted.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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doi: 10.1136/bjsports-2013-092886
2013 47: 1139-1143Br J Sports Med
Elena Pocecco, Gerhard Ruedl, Nemanja Stankovic, et al.
preventionreview including suggestions for
Injuries in judo: a systematic literature
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