Concussion in Judo Athletes: A Structured Return-To-Competition Protocol

To design a structured Return-to-Competition (RTC) protocol for judo athletes by adapting the 2023 Amsterdam International Consensus Statement on Concussion in Sport to judo-specific biomechanics and training demands.

We searched PubMed for English-language publications from January 1, 2010, to January 1, 2025 (search conducted February 1, 2025). Keywords included brain concussion, return to sport, martial arts, and judo. We identified additional sources by screening reference lists and retrieving consensus statements and federation protocols.

We integrated evidence on concussion recognition, acute assessment, and graded exertion with judo-specific technical demands to construct a staged RTC pathway. The protocol adapts general return-to-sport principles by introducing judo-specific substages progressing from symptom-limited activity and graded aerobic exercise to noncontact technical drills (tandoku-renshu) and structured reacquisition of key judo competencies, including breakfall skills (ukemi). Controlled partner drills (uchikomi) and sparring (randori) are reintroduced only after clinical recovery and symptom stability within defined progression and regression criteria (including symptom "flare" thresholds), with medical clearance required before full-contact training. The protocol was refined through consultation with a sports medicine physician experienced in judo.

This judo-specific RTC protocol translates international consensus recommendations into tatami-relevant stages with explicit progression criteria. Implementation provides clinicians and coaches with a structured framework that may reduce premature return-to-competition and recurrent injury risk in judo athletes. Prospective validation in judo settings is warranted.