My Brazilian Jiu Jitsu Stroke (Part II): What You Need to Know about Dangerous Practices.
Part 2 — By Chris Martin
Just months before my jujitsu accident in August 2017, a report came out on an internal carotid artery dissection that could cause stroke. The report, released in June of the same year, attributed the artery dissection directly to a specific Brazilian jiu jitsu maneuver, the choke.
According to the article released in The Journal of Cerebrovascular and Endovascular Neurosurgery, only 2% of all strokes are from carotid artery dissection. However, dissection is the leading cause of stroke patients under the age of 45. Arterial dissection is a potentially devastating and under recognized problem in young and healthy jujitsu enthusiasts. Awareness is crucial.
Ironically, I endured the same injury as described in the article only a month after that article was published. You can learn more about the injury in an episode of my podcast, Grappling Central.
It’s been one year since I had a stroke on the BJJ mat and was paralyzed on my right side instantly. Now I am almost fully recovered healthy 40-year-old athlete with no preexisting conditions, but I want to bring awareness to the BJJ community, so they know the dangers of the sport.
In my first follow up after the accident in January 2018, my Neuro Doctor Jeff Binder shared some information I’ll share with you today.
One of my carotid arteries was torn and clotted before walking onto the mat for jiu jitsu practice in August 2017. How long was it torn? We’re not sure. The doctor says he thinks it was a couple weeks before the stroke.
After practice we were sparring and a particular north-south choke suddenly left me lying on the mat. I was unable to move my right side and was unable to speak. A clot had been sitting on my carotid artery (on my left side) for some time trying to repair my torn artery. When my partner put me in the choke, it caused the clot to dislodge and fly up to the brain.
In other words, Dr. Binder confirmed the stroke was caused by jiu jitsu, but my good health provided a swift recovery; I walked out of the hospital 3 days later.
After the accident, my daughter Izzy reminded me of a conversation she and I had days before the accident. I had described discomfort under my jaw. I felt sick, like I had Strep throat, but the discomfort was only on the left side of my mouth. I felt a pressure in my neck and couldn’t tell if it was a sore muscle or a slight illness like allergies. I described it to my daughter Izzy as a “weird feeling”.
When describing my conservation with my daughter to my Doctor he proceeded to show me a picture of the damaged artery. He said, “This [picture] is kind of scary. So, this is the carotid artery you were feeling on your neck. And this big white thing is a blood clot. It makes me scared just to look at it.”
The big clot had been sitting on the carotid for some time before the accident. It was so large, the doctor said it was still there, even in post-surgery photos. Since the clot was still present after my surgery, they decided to put a stent in to prevent the clot from going back to the brain.
The doctor showed me a picture of the stent and explained that the surgeon who had inserted it protected the whole division area under my chin, about 3 inches long. Think of it as being embedded in the walls of the artery. The “skin” inside the artery isn’t skin at all: it’s cells that have covered the stent. Even microscopically, you could look inside the blood vessel and not see the stent since it’s covered by the endothelium.
So it’s embedded in there, and it’s going to be there the rest of my life. It shouldn’t cause any problems, but, the doctor couldn’t say with scientific evidence what would happen to the stent if I were to be placed in a choke hold again. He said, “It won’t dislodge but it could damage the stent in some way. It could cause it to bend or buckle… or even rip, I suppose.”
Unfortunately, there isn’t a procedure for me to check whether damage to the stent could occur when practicing jiu jitsu so when training with the stent in the neck I do need to practice caution.
The Damage Now To My Brain
Now, one year later, I still have trouble with typing, spelling, and slurring my speech. Yet, after much physical and speech therapy, I’m physically as strong as I was before the stroke, except a numbness in my right hand which affects my grip in BJJ sparring.
When the doctor showed me the pictures of my brain, the parietal lobe was damaged. The area is right above the ear. The parietal lobe regulates sensation on the right side of the body. “So, this explains this weird sensation you are having in your hand” Dr. Binder told me, “There isn’t anything weird going on in the skin or on the hand per se, but, the signals sent to the brain from the hand are being misinterpreted when they get there. They are not being processed correctly. And so your brain interprets it like pressure.”
I am now cautious about being choked, and certainly approach my training differently. I treat my partners differently and make sure we are practicing our art while mitigating damage to the neck as best as we can, especially with kids!
Of course, I have suffered a setback with this stroke, but it has been a learning lesson for me. Since my accident, I have received Facebook messages and emails from other practitioners who have had similar accidents on the mat so awareness is crucial. If my stroke saves other people from going through a similar nightmare, I will find comfort in knowing I did my job to prevent this from happening to others. Moving forward, I will continue to share my story and other similar stories to the BJJ community in hopes that it will be taken seriously.