Injuries – Eternal Jiu Jitsu

Cauliflower ear is a common and annoying injury that can be recurring for those that grapple or practice Jiu Jitsu. Throughout my Jiu Jitsu journey, I’ve had to deal with cauliflower ear multiple times. Each time I deployed a regiment of treatment and prevention to heal my ears from the injury. This article will go over what cauliflower ear is, how it happens, and strategies for treatment and prevention. As a note, I am not a medical expert and you should always consult with a medical professional on medical issues. The information in this article is my account of dealing with the injury on my own accord and is informational only and not a substitute for professional medical advice or care. The problem I ran into was finding a medical professional willing to appropriately drain my cauliflower ears so I had to take matters into my own hands before the injury permanently scarred my ears. What is Cauliflower Ear? Cauliflower ear is the end result of trauma to the ears. Trauma can be caused by repeated or sudden bending, pulling, or a blow to the ear. If the ear gets injured in one of these acts a hematoma or a pool of blood collects between the cartilage and the skin of the ear. This blood doesn’t have anywhere to go and eventually hardens and disfigures the grappler's ear. A typical life cycle of Cauliflower ear is the following: Trauma to the ear Pain similar to a bruise feeling Swelling and puffiness to the impacted ear site If left untreated the puffiness will harden resulting in permanent Cauliflower ear Cauliflower ear does not impact every grappler with some being more susceptible than others. This probably goes back to a person's genes and the structure and resilience of their skin/cartilage. Some people actually like having the look of cauliflower ear and wearing it as a badge of honor. If you grapple you know what it is and almost directly think that person wrestles or does Jiu Jitsu and they’re probably tough. Repeated trauma to the ear can cause long-term issues with the ear including hearing issues, increased risk of ear infection, and the inability to utilize earbuds with a deformed ear canal. The early stages of cauliflower ear can be painful and impact your sleep and ability to train pain-free. Once the cauliflower ear has solidified it is permanent. Generally, the pain goes away once the ear has solidified but the scarring will remain and will get worse with each repeated trauma incident. As a general hobbyist grappler, I have a professional job and a wife that doesn’t like the look of Cauliflower ears. With those factors in play, I’ve done my best to prevent and treat cauliflower ear as soon as I feel pain in one of my ears. How does Cauliflower Ear Happen While Grappling? Cauliflower ear is common in all grappling and striking martial arts. If you are susceptible to cauliflower ear and happen in just about any positional exchange where the ear is touched or struck. For me, the most recurring trauma to my ears has been getting my head locked in various pins and holds and aggressively pulling my head out causing the bending or pulling of both of my ears. This has happened while being in headlocks, guillotines, triangles, cross faces, and other pins. Other times where I’ve had trauma to the ear was during errant strikes directly to the ear. I’ve had knees, elbows, and palm strikes from head ties all traumatize my ears. Most of these “strikes” were accidents by my training partners but lead to a traumatized ear. How do you treat Cauliflower Ears? To treat cauliflower ear in its puffiness stage the ear must be drained before it solidifies and once drained it must be compressed to prevent blood from pooling again. This process can be done by a medical professional or in my case I self-treat. First and foremost you should seek out a medical professional if you are at the stage where your ear is puffy and swollen. You’ll want to find a professional that is experienced in treating cauliflower ears specifically. Some general clinics have staff that can drain ears, but you may need to see an ENT (Ear, Nose, and Throat) specialist. You can call the clinics around your area and ask them if they treat and drain cauliflower ears. In my case, I live in a smaller community with a limited number of clinics. I called just about every clinic in my area and was repeatedly told that they do not drain or treat cauliflower ears. I found that most medical professionals are inexperienced and not willing to drain and treat cauliflower ears in my area. I also heard from other practitioners horror stories about inexperienced medical providers treating cauliflower ears by slicing open the ear to drain. If cutting your ear is offered to you, be very hesitant, cutting the ear can lead to a higher probability of infection, scarring, and it doesn’t even always work. After the inability to find a medical provider to help me with my Cauliflower ear issues, I decided to self-treat my injuries. How I self-treat my cauliflower ears Step 1 Acquire a syringe needle and alcohol prep pads I drain my cauliflower ears myself using alcohol pads and a new clean sterile diabetic syringe needle. I acquired the needles and alcohol pads from my local drug store (Walgreens). When I went to buy needles I explained the situation to the pharmacist and was met with skepticism. I think that they felt the request was odd and possibly illegal drug use related. In any case, I found that they don’t sell small quantities of needles and made me buy an entire box of 100. The needles I use are: These work well for me as you want to minimize the size of the hole being made in the ear. Depending on the size of your hematoma you may need a syringe capable of holding more liquid. Step 2 drain the ears with a syringe needle To drain the ear, first, thoroughly wash your hand with soap and water for a few minutes. Next, prep the site by wiping down both the front and back of the impacted area of the ear. Next, take your new needle and insert it just below the midpoint of the impacted area at an angle so the point of the needle is at the midpoint of the hematoma and in the middle of the cartilage and skin of the ear. The skin of the ear is very thin so you won't have to push it in far. Diabetic needles are also very small and the pain is usually minimal. Once in place pull the plunger back slowly to extract the fluid from the ear. You should see blood start to fill the needle and the puffiness leaves the ear. Once you’ve extracted the maximum amount of liquid from the ear, wipe the area down again with an alcohol prep pad and move on to step 3 compression. Step 3 compress the area to prevent re-pooling of blood The next step is to compress the area to prevent your body from refilling the area with blood. If compression isn’t used, the ear will most likely refill and require draining continuously. I’ve found that the easiest way to apply compression to a cauliflower ear is by using magnets specifically designed for cauliflower ears. These magnets are usually wrapped in silicone for comfort and include spacers so that you can apply the right amount of pressure depending on the thickness of your ears. To apply, place one magnet on the inside of the ear on the impacted area and another magnet on the back of the ear. The compression shouldn’t hurt and you’ll want to use a spacer to have a gentle compression that prevents re-pooling. Generally, I’ve had to wear the magnets for 2-3 days to stop the chance of a re-pool in the ear. Here are the magnets that I currently use: When I’m treating cauliflower ear with magnets I stay off the mats. You could probably train with the magnets in, but you’d need to be careful and it would be a bit uncomfortable and look weird. There are also options now where there are specific headgears with enough clearance to allow for the magnets to be worn under the headgear while grappling, but I’ve never tried it. How to Prevent Cauliflower Ear while Grappling? Treating cauliflower ear is a pain and annoyance, so these days I try to prevent cauliflower ear from happening in the first place. To prevent cauliflower ear while grappling you can do so by technique and by utilizing headgear. Technique-wise in training I know that ear trauma usually happens to me when my head gets stuck in a lock, particularly in head locks and triangles. I make a concentrated effort to first not get locked and if I do, to not aggressively pull my head out when it’s tight. I will look to defend with my hands and posture and only when I have enough space will I pull my head out. I find that when my opponent doesn’t have a finishing choke or crank, and I wait it out, they eventually just release the lock. Overall I think that focusing on my ears has made my Jiu Jitsu defense better at the end of the day. Ears are an extension of the head and focusing on protecting my ears has helped me defend against the Jiu Jitsu adage of controlling the head controls the body. I fight aggressively to prevent headlocks and cross faces. I am also more technique based and methodical about freeing my head when locked rather than just aggressively pulling my head out and potentially ripping my ears. The technique factor I use to protect my ears is tapping. If I find my ear is bent and badly being smashed in a lock, I have no shame in tapping to ear trauma. I simply tap and tell my partner my ear was about to be jacked up. I would not do this in competition, but it's just not worth the pain and treatment if cauliflower ear happens. The other way to prevent ear trauma is to use headgear. Headgear is common and widely used by wrestlers, but for some reason, it is generally not used in Jiu Jitsu. Wearing headgear 100% of the time will greatly reduce the probability of a cauliflower ear. For me, I don’t like wearing headgear finding it uncomfortable and a pain to constantly readjust. Some training partners also don’t like to roll with people wearing headgear as it can be hard against their own body. The way I use headgear is to wear it after a trauma incident and I have pain in the area of the ear where it happened. Not all trauma and pain will lead to puffiness and cauliflower ear. I’ve found that in most cases of pain after trauma if I protect my ear from further trauma, my ear will just heal itself and not pool blood between the layers. When I feel pain I will wear the headgear during training until it’s gone. This usually takes about a week. I simply tell my partners that I have a sore ear and I’m wearing headgear until it feels better. I like to use head gears that are minimal and soft for my training partners. Here is the headgear that I currently use: What are the exact steps for treating and preventing cauliflower ear from grappling? Protect your ears by preventing locks around the head from happening in the first place. If your head gets in a locked position do not aggressively pull your ear out. Use technique to defend, create space, and pull your head out when the time is right. If your ears are in a compromised position and about to be torn, tap out and reset. If your ear experiences trauma and is sore utilize headgear until the pain goes away. If your ear swells and a pocket of fluid forms between the ear’s skin and cartilage, have a medical professional drain the ear with a syringe or self-treat your ear. Compress the ear with cauliflower-specific magnets for 2-3 days to prevent the ear from re-pooling with blood.