Martial Arts

01 Overview

Martial arts are traditions of combat practiced for physical and mental fitness. Forms of marital arts include: karate, taekwondo, Muay Thai, hapkido, judo, and jiu-jitsu. They involve elements of physical strikes and grappling, sometimes with the use of weapons. Modern-day mixed martial arts, or MMA, is a full-contact combat sport with a combination of elements from multiple martial arts disciplines. Injuries vary by martial arts discipline.

(see Section 04 - Prevention)
Athlete silhouette
View Common Injuries by clicking the blue dots on the silhouette

Martial arts involves striking with the hand. The hand is a common area of injury in both MMA, Judo, and Brazilian Jiu-jitsu.

Arm injuries are common in MMA. The elbow is the most commonly injured joint among Brazilian Jiu-jitsu athletes.

Due to the contact nature of the sport, head injuries can occur in martial arts. The incidence of concussions in MMA is high, ranging from approximately 8% to 21%. These numbers are lower in other martial art disciplines. The head is a common area of injury in Taekwondo; the incidence of concussion among male-sparring Taekwondo participants is estimated to be four times higher as compared to American football.

A large proportion of martial artists sustain injuries to the face. 32% of MMA injuries occur to this region.

Many martial artists sustain neck injuries; 18% of injuries in MMA are to the neck.

The foot is a common area of injury in Taekwondo (16% of injuries) and in Brazilian Jiu-jitsu.

Knee injuries are very common among Taekwondo participants of all levels (8% to 15% of injuries), and the second most commonly injured region of the body among Brazilian Jiu-jitsu athletes and among Judo athletes (up to 28% of injuries).

The ankle accounts for a large number of injuries sustained by Taekwondo participants, regardless of skill level (8% to 14% of injuries), and is a common injury site among Brazilian Jiu-jitsu athletes.

Thigh injuries account for 9% to 11% of injuries among Taekwondo amateurs and professionals.

Shoulder injuries are common among Judo and Brazilian Jiu-jitsu athletes, at up to 22% and 15% of injuries, respectively.

Female university Karate athletes frequently report low back pain. A large proportion (72%) of male Brazilian Jiu-jitsu athletes report chronic low back pain at both the recreational and professional levels of participation.

02 Injury Statistics

MMA
From 2000 to 2013 in Edmonton, AB, almost 60% of MMA competitors sustained an injury, typically contusions or bruising.

In MMA, injuries include:

  • Contusions/Bruising: 16% to 56%
  • Concussions: 8% to 21%
  • Lacerations: 8% to 37%
  • Fractures: 5% to 6%

Taekwondo
In taekwondo, injuries include:

  • Contusions: 36% to 48%
  • Strains: 13% to 15%
  • Sprains: 11% to 19%
  • Fracture: 8%
  • Concussions: 6% to 8%

Judo
In judo, injuries include:

  • Sprains: 6% to 60%
  • Strains: 7% to 34%
  • Contusions: 6% to 56%

Curious about the research on injuries?

It is estimated that...

View Summary of Incidence Rates

03 Risk Factors

A knockout (KO) is a legal strike where the opponent is unable to continue fighting, different from a technical knockout (TKO), where a referee or ring physician declares that a fighter cannot safely continue a match.

Characteristics that can affect the risk of injury in mixed martial arts include age, sex, weight category, match classification, match outcome, and knockout or technical knockouts. For taekwondo athletes, specific characteristics that influence the risk of injury have been reported as age, weight category, and annual quarter (of competition and training).

  • Age

    Age influences injury risk in mixed martial artists. Being 35 years of age or older nearly doubles both the risk of a match ending in a knockout and a match ending in a technical knockout.

  • Weight Category

    In mixed martial arts, the risk of a technical knockout from repetitive strikes is higher among participants in the heavyweight category as compared to other categories (light heavyweight, middleweight, welterweight, catchweight, and featherweight). Participants in the middleweight category have a reduced risk of being knocked out in competition as compared to the other categories.

    In Taekwondo, male participants in the less than 58 kg weight class and females in the 49 to 57 kg weight class have a higher risk of injury.

  • Annual Quarter

    Most of injuries sustained by Taekwondo participants occur during the first annual quarter.

  • Training Load

    Participation in taekwondo training for four or more hours per week increases the risk of injury compared to those who train for less than four hours per week. More than two hours of taekwondo sparring per week greatly increases the risk of injury.

  • Sex

    In judo, women are at a higher risk of injury than men during ground fighting or due to a loss of balance. In tournaments, female sparring-taekwondo athletes attempt head shots more often than male athletes.

  • Match Characteristics

    The risk of injury for MMA fighters who lose a match is greater compared to the winner. Matches that ended in either a knockout or a technical knockout were associated with a nearly four times greater risk of injury.

  • Experience

    In Taekwondo, athletes with more than three years of tournament experience are at a higher risk of injury, while athletes with experience among black belt athletes, and individuals with more than five years of experience, had a lower risk of injury.

  • Scoring Systems

    In 2000, the World Karate Federation increased the number of points awarded for kicks to the head from 1 to 3, punches to the back of the head and neck from 1 to 2, and punches to the head and trunk from 0.5 to 1.

    The World Taekwondo Federation increased the number of points awarded to a valid kick to the head or face in sparring Taekwondo (Olympic-style Taekwondo) from 1-2 to 3-4 in in 2009. After this rule change, there was an increase in the number of kicks to the head or face, which can lead to an increased risk of head injury.

View Summary of Risk Factors

04 How can I prevent injury?

Some muscle soreness or joint pain is expected when increasing your level of physical activity. It is important to listen to your body for persistent or worsening pain, and to know when to rest. Learn more about how to prevent injuries in martial arts.

  • Participant & Parent

    Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.

    Managing Concussion

    Head injuries are common in martial arts, particularly in MMA. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for participants and parents to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Strength Training and Neuromuscular Training Program

    Proper stretching, warm-up, and cool-down can reduce the risk of injury, particularly in Taekwondo. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to judo and Taekwondo.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Using properly fitted protective personal equipment, such as mouthguards, shoes, and taping, can reduce your risk of injury.

    Wearing head and hand padding in MMA can reduce the risk of injury. Research suggests that hits to the bare head with MMA gloves resulted in a significant increase in angular velocity and momentum, increasing the risk of injury.

    Sport-related Physicals
    Martial arts are physically demanding practices and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Coach & Teacher

    Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.

    Managing Concussion

    Head injuries are common in martial arts, particularly in MMA. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for coaches and teachers to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Strength Training and Neuromuscular Training Program

    Proper stretching, warm-up, and cool-down can reduce the risk of injury in your participants, particularly in Taekwondo. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to judo and taekwondo.

    Download Get Set for Android.

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Using properly fitted protective personal equipment, such as mouthguards, shoes, and taping, can reduce the risk of injury in your participants.

    Wearing head and hand padding in MMA can reduce the risk of injury. Research suggests that hits to the bare head with MMA gloves resulted in a significant increase in angular velocity and momentum, increasing the risk of injury.

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing martial arts in secondary schools.

    Learn more about implementing martial arts in your school.

    Sport-related Physicals
    Martial arts are physically demanding practices and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Official & Administrator

    Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.

    Rule Enforcement and Rule Changes

    The official plays an important role in preventing injuries in martial arts with thorough understanding of rules, rule changes and rule enforcement.

    Recent rule changes include scoring rules in the World Taekwondo Federation in 2009, and in the World Karate Federation in 2000. (see Scoring Systems under Risk Factors). The World Karate Federation also made standardized protective gloves mandatory, and stricter rules about excessive force, forbidden hits, dangerous or prohibited throwing techniques, and open-hand blows to the face were introduced.

    Managing Concussion

    Head injuries are common in martial arts, particularly in MMA. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Strength Training and Neuromuscular Training Program

    Proper stretching, warm-up, and cool-down can reduce the risk of injury in participants, particularly in taekwondo. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Encouraging the incorporation of a warm-up program like this one into the training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to judo and taekwondo.

    Download Get Set for Android

    Download Get Set for iOS.

    Other Considerations (about this section)

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing martial arts in secondary schools.

    Learn more about implementing martial arts in your school.

    Equipment
    Using properly fitted protective personal equipment, such as mouthguards, shoes, and taping, can reduce the risk of injury.

    Wearing head and hand padding in MMA can reduce the risk of injury. Research suggests that hits to the bare head with MMA gloves resulted in a significant increase in angular velocity and momentum, increasing the risk of injury.

    Sport-related Physicals
    Martial arts are physically demanding practices and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Health Professional

    The role of health professionals in preventing martial arts injuries has two main components:

    1. Providing ongoing education to participants, parents, and coaches on effective injury prevention programs such as balance and resistance training; and
    2. Ensuring that injured participants are completely healed and fit-to-perform before returning to martial arts to prevent re-injury or chronic injury.

    Managing Concussion

    Concussions can be a problem in some forms of martial arts. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to diagnose and manage a concussion. CATT also includes resources on how to assess a potential concussion, as well as detailed Return to School and Return to Sport protocol.

    Strength Training and Neuromuscular Training Program

    Proper stretching, warm-up, and cool-down can reduce the risk of injury, particularly in taekwondo. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    Learn more about exercises to help prevent knee injuries.

    For more exercises, visit http://fittoplay.org/.

    Get Set Neuromuscular Training
    The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to judo and taekwondo.

    Download Get Set for Android

    Download Get Set for iOS.

    Other Considerations (about this section)

    Equipment
    Encourage participants to use properly fitted protective personal equipment, such as mouthguards, shoes, and taping, to reduce the risk of injury.

    Wearing head and hand padding in MMA can reduce the risk of injury. Research suggests that hits to the bare head with MMA gloves resulted in a significant increase in angular velocity and momentum, increasing the risk of injury.

    Sport-related Physicals
    Martial arts are physically demanding practices and some pre-existing conditions may increase the risk of injury. An annual sport-related physical evaluation ensuring fitness to play can help to reduce risk of injury. The American Academy of Pediatrics provides information about pre-participation physical evaluation.

    Learn more about Pre-participation Physical Evaluation.