What Every Judo Coach Should Know
By Mark Lonsdale, Judo Training Development
Note: The following article is for information only and should not be construed as medical advice.
Gone are the days when an athlete took a hard hit and the crusty old coach just yelled, “Suck it up!” or “Get over it and get back in the game!” Modern coaching and sports medicine have both come a long way in the past two decades, driven in no small part by deaths attributed to head injuries and sports related concussions.
We have also learned a thing or two about heat related injuries. Traditionally, in old school judo, the instructor would never allow students to leave the mat during class to get a drink of water. Now, knowing that heat and dehydration have contributed to the death of high school athletes, it is ill-advised to deny any player the opportunity to drink and rehydrate. This is particularly important in the summer months where the greatest number of heat related sports injuries occur in the month of August.
Back to the subject of concussion, and the first question, what is a concussion?
According to medical research, the terms mild brain injury, mild traumatic brain injury (MTBI), mild head injury (MHI), minor head trauma, and concussion may be used interchangeably. Frequently defined as a head injury with a temporary loss of brain function, concussion can cause a variety of physical, cognitive, and emotional symptoms. Of particular concern to football coaches, and often detailed in investigative news reports, are repeated concussions which can cause cumulative brain damage, such as dementia pugilistica, or severe complications such as second-impact syndrome. Initial treatment of concussion involves monitoring and rest. Symptoms usually go away entirely within 3 weeks, though they may persist or complications may occur.
Based on statistical research, over 44% of documented concussions with children are caused by falls; 22% struck by an object; 17% collisions; 11% struck by a person. In the sport of judo, the majority of concussions are caused by hard throws, poor landings, or colliding with another player, wall, or object.
In Japan, since 1983, over 110 students aged 12 to 18 have been killed in judo practice in schools; 60% from brain injury. 275 others suffered serious physical injury. In 2011 a Japanese judo instructor was convicted of causing the death of a six-year-old boy, by “continuously slamming him to the ground.” The boy had died the previous year from brain swelling.
By contrast, in a 2011 news report, the head of the French Judo Federation (FFJ), Jean-Luc Rougé, said he had not heard about judo deaths in France, which has the world’s largest judoka population of 600,000 – of which 75 percent are children under 14.
The deaths in Japan, versus other countries, are indicative of the “old school” style of judo where too much emphasis is placed on toughening (brutalizing) the students. In most western countries we have adopted a more age-appropriate approach to judo training, where the emphasis with young children is on FUN, judo games, and recreational fitness. But for senior competitors, the old school training methods and hard randori sessions still exist.
That said, there remain the not uncommon incidents in the dojo or tournament where a student or competitor takes a hard fall that “rings their bell.” This is often accompanied by a look of shock, closely followed by a quivering lip and a few tears. In most cases the surprise of being thrown is more significant than the actual impact, especially if the mats have adequate cushioning and the student executed a good breakfall. But instructors need to be careful about dismissing the significance of any hard fall or impact. Only the student knows how hard they may have hit their head.
For judo, the general recommendation is that if a student or player bangs his or her head, they sit out the rest of the training session or tournament. It is best not to send them home immediately, unless the parent chooses to take them to the hospital for evaluation, but to keep them at the dojo and monitor their condition until the end of practice. Continued dizziness, loss of coordination, or vomiting, as examples, would indicate the need for emergency medical care.
Common signs and symptoms of concussion are headaches, dizziness, vomiting, nausea, lack of motor coordination, difficulty balancing, or other problems with movement or sensation. Visual symptoms include light sensitivity, seeing bright lights, blurred vision, and double vision. Tinnitus, or a ringing in the ears, is commonly reported. In one in about seventy concussions, concussive convulsions occur.
Indications that screening for more serious injury is needed include worsening of symptoms such as headache, persistent vomiting, increasing disorientation or a deteriorating level of consciousness, seizures, and unequal pupil size. Unequal pupil size is a sign of a brain injury that is more serious than just a concussion.
A few tips for prevention:
Students must be taught to fall correctly, and to keep their head and chin tucked while rolling, falling, or being thrown (both left and right side)
- Students must develop confidence in falling, first onto a crash pad and then onto the mats ( tatami)
- Ensure that there is adequate cushioning in the mats. Some gym mats may feel softer but do not have the same density or cushioning effect as real judo mats (tatami). Sprung floors are nice but not always practical. Adding underlay may help, especially on concrete floors.
- When being thrown, breakfalls must become reflexive.
- Keep in mind that as students progress in judo, their throws become faster and harder, so more experienced students must limit their power when training with novices.
- Mat areas should not be over-crowded so it is necessary to adjust class sizes to the size of the mat area
- Some throws and techniques may not be suitable for young children, for example throws in the makikomi family
- Limit the number of partners doing randori at the same time. Split randori sessions by age and size, for example, 6 to 8 year olds and 9 to 12 year olds.
- Keep furniture and hard objects away from the mat area
- Pad walls, support pillars, and any hard edges
- Maintain vigilance and close supervision
- Have a plan for dealing with an injured or concussed student
Any blow to the head should be taken seriously, but successive blows to the head are extremely serious! After any blow to the head or hard fall, the athlete or player should be immediately removed from the activity, immaterial of player protests. They should sit and rest on the side of the mat where they can be closely monitored. In more serious cases they should not be permitted to return to training without a doctor’s clearance.
When parents come to pick-up their children, they should be advised to closely monitor their child and seek professional medical advice if any symptoms persist or worsen.
Finally, keep in mind that you are a judo instructor or sports coach and not a medical professional. Unless you are an MD or Paramedic, you are probably not qualified to render medical assistance beyond the basic Band Aids, first aid, and CPR (if trained and certified). You should not even recommend over the counter (OTC) drugs such as Aspirin or Advil since the individual may be allergic, and Aspirin is a blood thinner. When in doubt, always recommend a professional medical evaluation and follow up.
Warning: This article is not a substitute for professional training in sports concussion management. All coaches are encouraged to do additional reading and research on this subject.