170. Brazilian Jiu Jitsu (BJJ) injuries with Dr Lachlan Giles
Release Date: 04/08/2025
Physio Edge podcast
Patellofemoral pain (PFP) rehabilitation doesn’t end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice’s journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals,...
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Strengthening exercises are a key part of successful patellofemoral pain (PFP) rehabilitation. Squats, lunges and single leg squats are often painful early on and can aggravate your patients pain, but on the flip side, we want to build up their tolerance and confidence with these movements. If you introduce an exercise your patient isn’t ready for, progress too quickly, or overload the knee too early, you’ll often flare your patients pain and set their rehabilitation back. In this episode, Tom Goom (Running Physio) and David Pope explore the third pillar of successful PFP treatment:...
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Patellofemoral pain (PFP) is one of the most common running injuries, and the high recurrence rate can make it a frustrating injury for patients to experience and clinicians to treat. In this episode, Tom Goom (Running Physio) and David Pope break down why PFP has such a high recurrence rate, and what most rehab plans miss. You’ll also discover: The "Four pillars" framework Tom uses to treat PFP and other running injuries How and when to keep patients running or exercising when it is essential for their mental health and social life How to find a manageable starting point when a...
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When is your patient's shoulder pain from their neck? Are you missing a cervical spine component in your shoulder patients? After a day in clinic reviewing patients with years of unresolved shoulder pain, Shoulder Specialist Physiotherapist Jo Gibson breaks down the five most common mistakes clinicians make when ruling in — or out — the neck. In this podcast, Jo covers: Why you don't need neck pain to have neck-driven shoulder pain (and which pain locations are most pathognomonic) Why referred symptoms below the elbow don't automatically point to the cervical spine Why active range of...
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Should you prescribe isometric or isotonic exercises for your patient's lower limb tendinopathy? When is it safe to add plyometric loading, and how do you progress running or jumping without flaring your patients tendon pain? Why do some "tricky tendons" refuse to respond to your best loading programs? Dr Ebonie Rio (Post-Doctoral Senior Research Fellow, La Trobe University) reveals the evidence-based answers as she guides you through the clinical reasoning and practical strategies for managing patellar, achilles, and other lower limb tendinopathies. In this conversation, you'll follow...
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Have any of your shoulder patients improved and then plateaued, unable to regain their full range of movement, or get rid of their painful arc? Sometimes it’s not the cuff, capsule, nerves or neck—it’s the acromioclavicular joint (ACJ) holding things back. In this episode, Jo Gibson sheds light on this often-overlooked contributor to persistent shoulder pain. From real patient case studies to the latest research and simple clinic-ready symptom modification tests, Jo shares practical strategies you can use immediately. Learn how to identify ACJ involvement, and use targeted rehab...
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Anterior hip pain is often blamed on the hip flexors, but in runners, that’s rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You’ll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies...
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Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple,...
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Your patient is running, playing sport, or jumping or lunging forward - an activity with fast eccentric or concentric activity in dorsiflexion,and suddenly they feel like they’ve been kicked in the back of the leg. They might hear a snap and have difficulty weightbearing, walking and pushing off. What’s your likely diagnosis? You picked it - an Achilles tendon (AT) rupture. AT ruptures are a devastating injury that can drastically impact a patient’s ability to walk, run, or return to sport. Despite their frequency, there’s a lot of uncertainty among clinicians, patients, and even...
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Brazilian Jiu-Jitsu (BJJ) is a popular grappling-based martial art that uses joint locks and chokes to subdue or submit opponents. It’s an intense, physically demanding sport with complex movements and submission techniques that involve a risk of injury, particularly to the knees, shoulders, elbows, neck, and lower back. It’s important for Physiotherapists and health professionals who treat BJJ athletes to understand the different mechanisms of injury, movements and positions athletes need to be able to perform, so they can develop successful rehabilitation programs, and safely and successfully return athletes to training. In this podcast, David Pope (APA Titled Musculoskeletal and Sports and Exercise Physio) explores BJJ injuries with Dr. Lachlan Giles—a BJJ black belt and world-class BJJ competitor, including 1st Place IBJJF Pan-Pacific Championship 2016 & 2017, 3rd place ADCC 2019 Open weight division and many more accomplishments. Lachlan is also a BJJ coach to top level competitors, including Levi Jones-Leary, Craig Jones before he moved to DDS, and a Physiotherapist with a PhD in knee pain and rehab. Lachlan shares his extensive experience treating and managing BJJ injuries, drawing from the research, as well as his clinical knowledge and personal experience as an elite grappler and BJJ coach. In this podcast, we discuss:
- The challenges physiotherapists face when treating BJJ athletes and how to adapt rehab programs for them.
- Common areas injured in BJJ.
- What commonly causes knee injuries, including LCL and ACL sprains, in BJJ.
- Different positions athletes need to get into in BJJ, why it’s important to understand these positions, and how you can use this to guide your rehab and return to sport.
- Strength vs flexibility vs conditioning? Which factors are critical in injury recovery, prevention and performance?
- Practical strategies for modifying training and load to allow injured athletes to continue training safely.
- The role of neck strengthening in protecting against neck injuries from chokes and takedowns.
- How to structure a safe return-to-play progression for knee, back, and rib injuries.
- Key factors that impact athlete recovery. When athletes can continue training, when and how to modify training and when to recommend complete rest. The impact of training style, intensity, and mindset on injury risk and longevity in the sport. How older athletes can adjust their game to have fewer injuries while continuing to train and compete. Listen to this podcast now to have a better understanding of BJJ injuries, rehabilitation, and strategies to help athletes successfully get back to or continue training and competing in BJJ.
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Links
- Improve your musculoskeletal and sports injury assessment & treatment results with a free trial Clinical Edge membership
- Click here to register and receive immediate access to the Tricky tendons infographic series
- Free Achilles tendinopathy video series with Tom Goom
- David Pope at Clinical Edge
- Download and subscribe to the podcast on iTunes
- Download the podcast in Overcast
- Listen to the podcast on Spotify
- Dr Lachlan Giles
- David Pope on Twitter
- David Pope & why I started Clinical Edge
- Review the podcast on iTunes
- Infographics by Clinical Edge
Chapters:
- 04:40 - Lachlan's PhD
- 10:06 - Can VMO be targeted with rehab?
- 14:06 - What challenges do Physios face when treating BJJ athletes?
- 17:03 - When to allow patients to continue training
- 19:35 - Different types of training
- 21:36 - Lachlan's training with an LCL injury
- 26:53 - Common injuries in BJJ
- 29:18 - Other areas injured in BJJ, and why low back pain occurs
- 33:39 - How BJJ athletes can train to stay healthy and avoid injury
- 37:05 - Getting back to training and rolling
- 42:23 - Tests before patients "invert" with their legs over their head
- 48:11 - Leg entanglement, 50/50 and leg locks
- 52:09 - Positions to use when coming back from an injury
- 53:08 - Rib and costochondral injuries
- 59:44 - Forearm periostitis



