Cauliflower Ear and Grappling: Prevention, Treatment, and Potential Pitfalls

 Cauliflower ear, a common yet often misunderstood condition in the world of grappling and Brazilian Jiu-Jitsu (BJJ), is a deformity that occurs due to repetitive trauma to the external ear. Wrestlers, BJJ practitioners, and other combat sports athletes are particularly susceptible to developing cauliflower ear. In this article, we'll explore the options available for prevention and treatment when cauliflower ear strikes, as well as the potential pitfalls that can arise when it goes untreated.

Understanding Cauliflower Ear:

Cauliflower ear, scientifically known as auricular hematoma, is caused by blood and other fluids pooling between the skin and cartilage of the ear following trauma. This occurs when the ear sustains repeated impacts or friction, leading to inflammation and separation of the connective tissue. If not managed properly, the ear can harden and take on a cauliflower-like appearance, hence the name.

Prevention Measures:

Preventing cauliflower ear starts with taking preventive measures during training and competition:

1. Ear Protection: Wearing ear protection, such as wrestling headgear or BJJ ear guards, can significantly reduce the risk of cauliflower ear. These protective gear options can help disperse the impact and friction, safeguarding the ears from trauma.

2. Proper Technique: Learning and practicing proper technique in grappling and BJJ can reduce unnecessary ear injuries. Being mindful of how you engage with your opponents can prevent unnecessary pressure on the ears.

3. Immediate Care: If you experience ear trauma during training or competition, seeking immediate care and attention can help prevent or minimize the severity of cauliflower ear. Applying ice and compression to the affected area can be beneficial until professional medical care is obtained.

Treatment Options:

In the unfortunate event that cauliflower ear does occur, seeking proper medical treatment is essential. There are several treatment options available:

1. Aspiration and Compression: In the early stages of cauliflower ear, a medical professional can drain the accumulated fluids through aspiration. They may also use compression to prevent further fluid buildup. Early intervention can help restore the ear to its normal shape and prevent permanent deformity.

2. Surgical Drainage: For more advanced cases of cauliflower ear, surgical drainage may be necessary. A healthcare professional will make an incision to remove the accumulated fluids and then apply compression to prevent further complications.

3. Aftercare: Following treatment, proper aftercare is crucial to ensure a successful recovery. This may include wearing compression dressings, taking prescribed medications, and adhering to follow-up appointments.

Potential Pitfalls:

When cauliflower ear goes untreated or is improperly managed, several complications may arise:

1. Permanent Deformity: Untreated cauliflower ear can harden and become permanent, leading to irreversible deformity. This can affect an athlete's self-esteem and may require corrective surgery.

2. Infection: If the condition is left untreated, the fluid buildup can become infected, leading to severe complications and requiring more aggressive medical intervention.

3. Hearing Loss: In rare cases, untreated cauliflower ear can result in hearing impairment if the ear canal becomes blocked or damaged.

Conclusion:

Cauliflower ear is a common occurrence in grappling and BJJ, but it is not an inevitable consequence. Preventive measures, such as wearing ear protection and practicing proper technique, can significantly reduce the risk. If cauliflower ear does occur, seeking immediate medical treatment and adhering to proper aftercare can help prevent complications and promote successful recovery.

Awareness of the condition and the available options for prevention and treatment are essential for the grappling and BJJ community. By prioritizing preventive measures and promptly addressing any ear injuries, practitioners can protect themselves from the potential pitfalls of cauliflower ear and continue to enjoy their martial arts journey without unnecessary hindrances.

Joe Rogan talks about the cauliflower ear

Some guys think this is cool but most of us rather not have it. Take a look at the link below to learn more about a very typical injury that happens to guys that do wrestling, judo, bjj, rugby and boxing.

Click Here To Find Out More About Cauliflower Ear

By the way, for those who don't know, Joe Rogan is the guy that leads the commentary for the UFC and I think he does a good job doing it too. The guy is really cool and is very good at what he does. His knowledge of jiu jitsu is excellent and he does really well explaining what is going on.

I'm not sure whether he is on the Ultimate Fighter show, he should be and I think he could add a lot of value there to the production. I've seen the first season online and wanted to get the rest of the shows on DVD so I am waiting but I've not seen him there.

Treating Cauliflower Ear

So how do you treat cauliflower ear? What needs to be done is you have to drain blood from the formed hematoma as soon as possible. Any infection must be prevented and therefore you should definitely go to the doctor for this. (you need a syringe if you really want to do it yourself and you may not be able to prevent infection so better go to the doctor) It is also not that easy to do this yourself due to the angle, visibility etc.

Draining the hematoma will re-establish the connection of the skin to the underlying cartilage and hopefully allow the ear to heal and look normal again.

The draining normally involves an incision in the ear and a syringe (in my experience) is used to suck the blood out. If there is no blood to drain then it is likely too long has passed or no hematoma has formed and therefore the ear should really heal by itself.

It is definitely worth wearing an earguard right after you have done this. What may happen if you dont wear the earguard is that the area where the hematoma formed may get filled with blood again in which case the blood has to be drained once again. In practice in judo or bjj this may happen especially if you are sparring with someone and he gets you in kesa gatame or headlock.

Now the other method I've seen instead of using an earguard is tape. Tape is tied right around the head to secure the injured ear. In Russia I've seen this done a few times but it seems to me as an ineffective (and cheaper) way to deal with the problem. You will still get contact with the injured ear after all during training.

Cauliflower ear in bjj and judo

I never even heard of cauliflower ear, until i got a bit more serious with my training. For those that don't know what it is:

"Cauliflower ear (also hematoma auris or perichondrial hematoma) is a condition most common among amateur wrestlers, rugby players, mixed martial artists, and grapplers. If the external portion of the ear suffers a blow, a blood clot or other fluid may collect under the perichondrium. This separates the cartilage from the overlying perichondrium that is its source of nutrients, causing the cartilage to die. This leads to a formation of fibrous tissue in the overlying skin. When this happens, the outer ear becomes permanently swollen and deformed, resembling a cauliflower." - Wikipedia

This kind of crap happens to pretty much everyone involved in bjj and judo at some point but these are not the only sports where people get them. Boxing, rugby and a bunch of other activities where there is physical contact typically have to deal with cauliflower ear.

Headlocks and pretty much any kind of rough contact with the ear can cause this. Randy Couture, a famous wrestler and MMA fighter who you can see above has a bad case of cauliflower ear. The picture basically shows what can happen when it is untreated. The only thing that really can be done to help prevent it is using an ear guard.

First lets look at the reasons to avoid cauliflower ear:

1. IT SCARES PEOPLE AND LOOKS UGLY

I think this really is the #1 reason not to have it. Some say that guys look tough with cauliflower ear and some women are in fact attracted to this. For some its like a "badge of honor"! I would however not recommend it. At the end of the day, its way better to keep your ears the way they are. Your new girlfriend may not appreciate it as much as the old one.

For girls of course it is far worse. Certainly no guy in my opinion would ever appreciate cauliflower ear. Something to look into though. I wonder what do all the top female bjj players do about this. Do they really wear headgear all the time? Of course competitions in bjj do not allow ear guards which means many will still get it.

If you've got a really bad case of cauliflower ear that is easily noticeable, then this will certainly be a problem with the employer. Imagine going to an interview with huge swollen ears! It just makes you look nasty and why would your company want a nasty looking guy working with its clients. This just makes you less desirable.

2. HEARING LOSS

If you didn’t care much about the first one, the second one is a reason to wear an ear guard. The swelling can occur in different parts of the ear, and if it does occur near your ear hole and swells heavily, you may struggle to hear (not only from your bjj instructor but everywhere else! :)
If untreated, the ear will deform, then swell, then deform again and this will go on and on. In addition to that you may also run the risk of ear infection. The swollen skin may be less resistant to germs. The ear being continuously hit will also cause pain - putting a hat on, washing your head.. pretty much anything.

And yes, if you go to the doctor quick enough, he may drain most of the blood out. If you wait, you can do cosmetic surgery which is going to be very expensive. In any case, I think i have just mentioned another couple of reasons why cauliflower ear sucks.

3. NO MUSIC

Cant really enjoy listening to music with your ipod! Well. I think that’s small but also not great.
The other thing, don’t do it yourself. You really run the risk of screwing your ear up even worse. Infection is one reason not to do it. If you didn’t go to the doctor right away, just buy yourself an ear guard or head guard for wrestling and use it all the time.

Personal Experience: this is a really nasty thing to have guys... and does not look good at all! You walk around with screwed-up ears. You feel pain when somebody grabs your head or if its really bad when just somebody hugs you and makes contact with your ear.

I drained once each of my ears and wear the ear guard every time I train now with no exceptions. Once you get cauliflower ear, you seem to keep getting it more and more. Draining also did not do much for the second time I did it because I think too much time went before the ear got drained. It dried up and so there wasn’t much blood to drain.

The annoying thing is also that the ear fills up back with blood afterwards so if you haven’t got time to go to the doctor and keep draining ears all the time then just wear the head guard.

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The only way to prevent cauliflower ear is to use protective head gear. Please see my post about head gear and ear guards here.