Is Brazilian Jiu-Jitsu a Traumatic Sport? Survey on Italian Athletes' Rehabilitation and Return to Sport

Background: Brazilian Jiu-Jitsu (BJJ) is a physically demanding sport associated with a notable risk of musculoskeletal injuries. Understanding injury patterns, rehabilitation approaches, and psychological readiness to return to sport (RTS) is essential for prevention and management strategies. This study aimed to investigate injury characteristics among Italian BJJ athletes, assess their rehabilitation processes and psychological recovery, and identify key risk factors such as belt level, body mass index (BMI), and training load. Methods: A cross-sectional survey was conducted among members of the Italian BJJ community, including amateur and competitive athletes. A total of 360 participants completed a 36-item online questionnaire. Data collected included injury history, rehabilitation strategies, RTS timelines, and responses to the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale. A Random Forest machine learning algorithm was used to identify and rank potential injury risk factors. Results: Of the 360 respondents, 331 (92%) reported at least one injury, predominantly occurring during training sessions. The knee was the most frequently injured joint, and the action "attempting to pass guard" was the most reported mechanism. Most athletes (65%) returned to training within one month. BMI and age emerged as the most significant predictors of injury risk. Psychological readiness scores indicated moderate confidence, with the lowest levels associated with playing without pain. Conclusions: Injuries in BJJ are common, particularly affecting the knee. Psychological readiness, especially confidence in training without pain, plays a critical role in RTS outcomes. Machine learning models may aid in identifying individual risk factors and guiding injury prevention strategies.