Breakage Breakdown; How Do Armbars Damage Elbows?
Luke Pollard fought tirelessly to reach the purple belt absolute finals of the 2014 All Stars tournament in Santa Cruz, California. After several grueling matches, he had only one opponent left to clear before claiming his place on the podium. By his calculation, he was up on points. But with less than 20 seconds remaining, his opponent locked on a tight armbar.
He performed the same mental calculation many of us have, measuring the risk of injury against the prospect of victory. He chose the latter and decided not to tap.
“I could feel my elbow hyperextend,” says Pollard. “I could feel a lot of pressure, and then I felt two or three pops in a row. That was the moment when I knew there was serious damage.”
In less than a second, Pollard endured bone-breaking damage that ultimately warranted surgery. His story is violent, but it’s far from rare in jiu-jitsu circles. Whether persisting through a locked submission in competition or enduring pain out of pride, many jiu-jitsu athletes have courted and met catastrophic damage.
Luke Inside the Elbow
By the nature of our training, we routinely approach the brink of life-altering injury. But how many of us know exactly what happens inside our bodies when we endure a fully executed submission? To answer that question, we’ll first need to explore the basic anatomy of the elbow.
“The anatomy of the elbow is that it’s basically a cup with a lip on either side,” says emergency room physician Bob Pollard from Santa Cruz, California. In addition to being a physician for over 25 years, Bob is also Luke’s father and a longtime fan of jiu-jitsu and sports in general.
Bob’s cup analogy begins with the ulna, the long bone of your forearm that runs from your pinky to your elbow. Trace your finger from the outside of your wrist down to your elbow. There, the ulna terminates in a cup shape, which receives the bulbous end of your humerus, the bone that forms your upper arm.
Extend and retract your arm. The boney lips on either side of the ulna’s cup keep your forearm from moving outside a range of 180 degrees. The first lip, known as the coronoid process, restricts your arm from fully retracting. Curl your arm as tight as you can, the coronoid process prevents your arm from curling any further.
Similarly, the second lip, known as the olecranon process, also restricts movement. Like a doorstop, the olecranon process bangs against the humerus in full flexion, preventing your arm from extending past 180 degrees. The olecranon process is a key player in the mechanics of an armbar, which we’ll explore next.
Break the Stick, Break the Arm
“I equate an armlock to breaking a stick with your hands,” says seasoned black belt and Luke’s coach, Garth Taylor. “I grip one side of the stick with my four fingers then I grip the other side with my other four fingers, my thumbs apply pressure in the middle, and I snap the stick in half.”
The key to a truly damaging armbar, says Taylor, is a proper connection.
“When I apply an armlock, I want my hip and legs tightly connected to my opponent’s torso, and I want a strong connection to the wrist. Using the hip as a fulcrum, I extend my entire posterior chain — the strongest movement the human body can do — against that little elbow joint. It’s just like breaking a stick.”
What happens when you break the stick? In Luke’s case, the olecranon process — the entire boney lip — broke completely off. That bit of bone that once prevented movement now floated freely inside his arm.
As it broke free, the olecranon process was driven into the bone of the humerus. That bruised the periosteum — the thin membrane that surrounds most of the bone surface within our bodies — which prompted the tissue comprising Luke’s elbow to develop bone spurs. A surgeon later sawed off several of these spurs, leaving a pile of bone chips roughly the size of quarters.
In 2004, Jacare Souza suffered a similar injury while fighting Roger Gracie at the World Jiu-Jitsu Championship in Brazil. Persisting through Gracie’s undoubtedly tight armbar, Souza endured breakage at the elbow. Watch the match, says Bob, and you’ll see that “…his arm was just completely floppy at the elbow. It was because he had destroyed those endpoints.”
The human elbow, however, is more complex than just a cup with two lips. “When you hyperextend,” says Bob, “a lot of different tissues are involved.”
The bicep and muscles of the forearm are anchored to tendons on either side of the elbow, which can be ripped loose from the bone. The fibers that compose tendons and ligaments can fray when under mechanical stress, says Bob, which can lead to bruising, bleeding, and inflammation. The synovial capsule inside the joint, which contains lubricating fluid, can be torn. Depending on the angle of extension, a range of tissues can suffer damage.
When to Tap?
The promise of catastrophic injury leads us to ask: at what point should we tap? Jiu-jitsu convention tells us to “tap early, tap often.” But in the heat of competition, many forget the mantra.
“I should have tapped out, obviously,” Luke says. “But as a competitor, it’s hard to tap out when you see ten seconds on the clock. It can be hard to make that judgment call.”
Though the temptation of victory is strong, it’s important to remember proportion, Luke adds. When you compete at the intermediate level of a local tournament, the stakes are low and don’t warrant the extreme risk of life-altering injury. In the case of elite level competition, however, the line is less defined.
“The majority of the time I would say ‘tap out.’ But when I think of Jacare, it’s hard to tell someone, knowing that he won the match with his damaged arm, it’s hard to go back and say you should have lost via submission instead of winning the Black Belt Absolute Finals. That’s really the only case where I could swing either way. In pretty much every other case, it’s not worth it.”
Luke, now a brown belt, tells his students to mind their adrenaline during competition as it can dull the sense of pain and steer competitors toward greater injury. Bob echoes Luke’s sentiments.
“As a medical doctor,” says Bob, “I want to tell people that when you’re a white or blue belt, just tap really early. You don’t want to jack up your elbow for the rest of your career because you were trying to be super tough as a white belt, which is the time when you’re going to be armbarred the most.”
If you do find yourself on the receiving end of an armbar and suffer injury, Bob recommends three things: proper medical attention, physical therapy, and patience. Physical therapy increases the joint’s chances of returning to a full range of motion.
“One of the things about scar tissue is, if you give it time, it contracts. If someone has a burn on their neck, for instance, we have to do a lot of physical therapy as the burn is healing to keep the chin up and prevent them from always looking at the floor. Similarly, if you hurt your elbow and just leave it, you’ll end up with a stiff, scarred up elbow.”
Despite our affinity for joint destruction, Bob says jiu-jitsu athletes are among the healthiest people he’s seen.
“When I’m in the emergency room,” says Bob, “I see people that are not so healthy. But in jiu-jitsu tournaments, I see people who are working out, who watch what they eat, and who don’t smoke. It’s a great sport for health, both mentally and physically.”