Interview with head IBJJF doctor Ethan Kreiswirth

Interview with head IBJJF doctor Ethan Kreiswirth


Dr. Kreiswirth is the medical director for the IBJJF. He is also a black belt and has been helping athletes since the mid-1990s. He holds a PhD in Athletic Training and has been researching The Epidemiology of Muscoskeletal Injuries among Brazilian Jiu Jitsu Fighters.

It’s very safe to assume that he knows quite a bit about injuries and BJJ and we are happy to have had the chance to ask him a few questions. We covered particularly dangerous positions, additional training, strength and  conditioning, advice for older grapplers and more! To find out more about dr. Kreiswirth, go to his Rocktape page here.

Let’s begin with the first question:

1. In your experience as the IBJJF head medical doctor; are there any particular situations in which a lot of injuries occur, both in tournaments and training?

In my 20+ years of BJJ training, and 15 years of covering BJJ medically, I’d say playing De La Riva  guard has presented the most chronic knee injuries of instability within the knee joint. Although this is the case for chronic knee injuries, the data suggests the elbow injuries are the most common. See

2. What are the most important measures we can take to elongate our carreer on the mat? (other than tapping quick and frequently)

Awareness of body position is imperative. If you do not have the range of motion to play inverted guard, dont play it!

3. Recovery is crucial in all demanding activities. What can we learn from other professional sports?

Watching MMA, UFC, and Crossfit athletes and their attention to training volume presents and tough situation. It is important that these sports put in the hours necessary to become an expert, but it also creates massive exposure risk. Attention to recovery via small doses of low threshold exercise, massage, yoga, etc. can be beneficial. BUT, volume will trump any good recovery.

4. When we have had a problem for a long time or if it keeps coming back (chronic), what general advice can you give us?

Be seen by a clinician that understands the complexities of BJJ. More often than not, most physicians and clinicians that do not understand BJJ, will tell you to quit. Exercise modification can be beneficial to your recovery outcomes.

 ”In my 20+ years of BJJ training, and 15 years of covering BJJ medically, I’d say playing De La Riva  guard has presented the most chronic knee injuries          of instability within the knee joint.”

5. What do you believe is the best all round warmup for a normal BJJ sparring class?

A dynamic routine that is ballistic and generates activation of the nuerological system is great. Stay away from long slow steady state stretching, as it may create more parasympathetic tone and reduces effort to contract rapidly.

6. Which are the most effective complementary activities to BJJ, out of rock climbing, kettlebells, yoga, swimming, olympic lifting, floating (sensory withdrawal), crossfit, judo, tai chi, etc.

They all have their place. BJJ is highly intense. Have 3-4 of BJJ is a lot depending on the person. Having an event that creates parasympathetic tone should be the contrast. Resistance training is needed, as well. Its hard to balance all needs, if you dont train full time.

7. If you have reached the age of 35 or older, what can one do to survive the wear and tear of rolling?

A: Larger tendons such as the rotator cuff and achillies begin to have issues at these ages and up. Becareful of all over head lifts, as well as large drop downs (eccentrics) from boxes, etc. recovery time is essential for the older athlete. Understanding your limitations and training with like minded people is important. Data suggests the stretching alone does not reduce injury rates, therefore, implications of stretching AND corrective exercises to maintain posture, core control and breathing is great.

8. Anything else you would like us to consider, to make our time on the mat more joyful and free from injuries?

A: Dont take yourself too seriously. Rolling should be fun, a learning environment, and a workout. Sometimes opponents are much to bigger, faster, stronger no matter what belt that carry.

Dr. Kreiswirth thank you so much for your time and for your insightful answers. In addition to all the athletes you’ve helped throughout the years!