Cauliflower Ears in Brazilian jiu-jitsu

Stephan’s Note: the material in this article comes from a number of sources. The photo and the first perspective were contributed by The Fightworks Podcast

Baret Yoshida Cauliflower earTheFightworkPodcast says: Chances are that if you practice Brazilian jiu-jitsu, you know someone whose ears look like Baret Yoshida’s. Cauliflower ear is caused when the ear receives a blow that shears away the ear’s cartilage from its overlying perichondrium. Liquid fills the new space between the two layers, and will harden into a hard fibrous lump if not drained.

I was speaking with six-time world champion Robson Moura last week, who said that his issue with cauliflower ear did not begin until 2002, years after he had received his black belt. Today both ears are severely affected. He commented that it can only take one incident for an ear to go from normal to cauliflowered.

What are the reasons to avoid cauliflower ears? Here’s a brief list.

Reason 1:

You may scare away a potential girlfriend, boyfriend, or employer. I think guys have a little less to worry about here as having the appearance of a “tough guy” may be attractive to some women. I don’t think any guy ever would appreciate his girlfriend having cauliflower ears though as most would agree that cauliflower ears never qualify as “pretty”. In very few cases will having cauliflower ears help you get a job, especially in a white collar setting.

Reason 2:

It may be harder to hear! I am no audiologist, but I think we can safely say that your ear hole’s original diameter is intentional and probably optimized for good hearing. Making it smaller or obstructed is likely to negatively impact one of your five precious senses.

Reason 3:

There is no way to put your ipod earphones in your ears! This is the scariest of all outcomes as it may prevent you from being able to listen to your favorite BJJ podcasts. Robson told the story of when he was warming up at a tournament once he borrowed his friend’s ipod. When the earbuds immediately fell out of his ears he originally thought it was because there was something wrong with the earbuds. After they fell out the third time he realized his own banged up ears were causing him to not be able to listen to the ipod, not the earbuds.

Where does that leave us? Well the best way to prevent cauliflower ears is to wear protective headgear. Honestly these are not the most comfortable things in the world, nor are they a recipe for high fashion. However as I have a friend who trains with me who is a doctor and wears headgear I feel empowered to make the statement “prevention is the best medicine”.

If your ear just filled up with liquid after getting scrunched like origami during BJJ training, you may have some luck if you drain the liquid. Doctors can do this for you and there are plenty of postings on forums showing where people drain their ears on their own. Ouch.

If you have had cauliflower ear for a long time and it’s become marble-hard, you can get plastic surgery to repair the damage. That’s expensive. If you’re on a budget and want to negate undesirable cosmetic effects of cauliflower ear, you can grow your hair long so it hangs over your ears, or buy a funny hat that draws attention away from your ears.


Stephan Kesting’s story

I’ve had my ears swell up several times, but the first time it happened was the most interesting. My ear was sore from a previous sparring session, and the next time I got on the mat (without headgear) my ear got mauled again and it decided to swell up. Now whenever my ears are sore I ALWAYS wear headgear until they feel completely normal again.

Everyone says “go to your doctor to get your ear drained”, so I dutifully trundled off to see my local GP who looked very confused when I asked him to drain my ear, saying that he’d have to refer me to a specialist. I asked why, and described the procedure to him, saying that all my rugby friends do it themselves. He looked at me, said “I can do that” and got the hypodermic needle out.

He cleaned and drained the ear, and it looked normal again. The next day, however, it swelled up again and I went back to my doctor’s office and found out that my doctor was on holiday. The replacement doctor didn’t want to touch the ear, recommending that I apply ice to it instead. I left, went to a walk-in clinic, and was now told to apply pressure to it. My internet research on the topic suggested that ice and pressure might stop additional swelling, but might not get rid of the fluid already present.

Tired of getting three different pieces of advice from three different doctors I decided to drain the ear myself. I bought some insulin needles (getting a very dirty look from the pharmacist who was sure I was going to inject drugs or something) and some polysporin. I cleaned the ear with soap and water, then I cleaned the ear with rubbing alcohol, and then I applied polysporin to the ear. I really, really didn’t want any sort of infection to occur so close to my brain.

Draining the ear was relatively simple, although it was somewhat weird to be augering around inside your own body with a needle. The fluid that came out was a red coloured pus.

If you decide to do it yourself here are some quick pointers. I am NOT a doctor, so caveat emptor!

  • Get larger bore needles if you can – insulin needles are a bit small
  • Really wash your ear well before trying this, then coat the whole ear with polysporin b4 sticking yourself
  • Draining the ear once a day is probably plenty. If you do it too often you will cause a lot of damage, which will cause more bleeding, which will cause more swelling.
  • Try to initiate draining asap after injury. The fluid coagulates after 2 or 3 days, and this thicker fluid doesn’t come out very well at all. It also starts necrotizing the surrounding cartilege.
  • Try to keep pressure applied to the ear throughout the day. I have used a headband (which didn’t work very well) and a really bizarre paperclip and shaped cardboard contraption which worked well.
  • It seems that some people are more susceptible to cauliflowering than others. I never had a problem with my ears until my third or fourth year of BJJ (and that was after years of Judo), but then something changed and I had to start being a lot more careful.
  • Of course it is better to have a professional do this, but not every doctor knows what he is doing here. If you can find a doctor who specializes in wrestlers or rugby players you are in luck!

Felicia Oh’s comment

(Stephan’s note: Felicia Oh is a BJJ black belt and multiple time BJJ and submission grappling champion)

Felicia Oh on Cauliflower EarsDISCLAIMER!!! I am not a doctor or medical professional of any sort. The following is just an account of my experience in draining my cauliflower ear. This should not be tried by anyone. It is dangerous and can lead to infection.

After I got my big “black bean” cauliflower, my husband drained it with an insulin needle. A day or two later, it needed a second draining and suddenly I had become a pin cushion. He poked at it several times, but he could not get any of the fluid out. Frustrated because I could still feel the fluid that had accumulated gushing around, I went to the bathroom determined to do it myself. By God, if there was fluid in there, I was gonna get it out! I don’t want any crazy Sakuraba “kettle chips” for ears.

I cleaned my left ear again with an alcohol wipe, front and back, and then my fingers. I got a new, clean needle and was ready to go. So, looking in the mirror, I used my left hand to feel where the fluid was. Since it had already been drained once, it wasn’t really tight and full…I could feel there was some looseness and the fluid moved around. I used my left fingers to squeeze and push all the fluid to one side of the “pocket” so that it was tight and filled up. Basically, it’s like a blister. So, knowing how I had to push the fluid to make it tight, I got the needle ready (pull the plunger back) and held it in my right hand. With my left hand, I squeezed the fluid to the one side. I angled the needle to go into the “blister”…from the side…just like any normal blister…NOT straight in.

Once I hit the right spot and it went into the “blister”, all resistance stopped and it just slid in. I adjusted my right hand so I could control the needle and keep it in the blister pocket (it needed a little bit of forward pressure to stay in) AND pull the plunger up at the same time. This was a bit tricky. With my left hand, I kept moving the fluid toward the needle so that it could suck it up. After I finished, I got a clean piece of toilet paper and squeezed any more blood out that I could and put some pressure on it to stop any more bleeding.

To keep the swelling down I then tried using a clothespin to pinch it and then I wrapped my head with gauze (like they do when you go to the doctor for a head injury). This arrangement would drive me crazy when I slept and made me feel claustraphobic. I also didn’t like having to do the gypsy” scarf wrap look. And I don’t like wearing beanies. AND I couldn’t train!!!!

Then my husband told me about this thing called alumafoam that he was familiar with from working at a hospital, but I couldn’t just go in to a hospital and and take it. I tried the aluminum/foam finger splints, but they were too hard. After some searching on the internet, I found a similar thing to what he described in the SAM-E splint and it was easy to get.

From there, it was just trial and error until I created the “earclip” out of the SAM-E splint. I cut curves at the corners so they didn’t poke me, tried different sizes: smaller to be less conspicuous, but then I found out what “too small” was, etc.

The thing is that I have long hair which pretty much keeps the earclip inconspicuous when not training. I would also put a piece of tape over the clip and tape my ear flat to my neck. Then my hair and other things won’t get caught on the ear (which now sticks out a bit more because of the clip). I also think that it will help the ear to heal flat against your head instead of sticking out which I was afraid it would do, but maybe that’s just my own neurosis ;)

The other cool thing is that you can do all of this for about 20-25 bucks. Compare that to the doctor and/or plastic surgeon visit that costs MUCH more AND they tell you that you can’t do anything strenuous for 2 weeks!

A few days later, my ear got reinjured. Okay, actually, this happened a few times over the next few weeks doing stupid things. It would fill back up and then I’d have to drain it again.

The good thing is that each time I had to redrain it, it had healed a bit more…so there was less and less fluid each time. At least progress was being seen. A couple of times that I did it and had trouble getting to the blister, there was resistance the whole time. It hurt, so I stopped, repositioned and tried again. I found that it hurt a lot less when I was controlling the needle instead of not being able to see it done and having no control of it.

I also found that it helped to keep wearing the earclip for an extra week or two after it “seemed” healed. I’d loosen it or take the clip off and it would fill back up again! So, I just kept wearing the earclip until I was REALLY sure it was healed. That was probably a total of 2 1/2 weeks w/out getting re-injured or redraining. I ended up having to draining my ear a total of 6 times.

The nice thing…people who see my ear now can’t tell it was ever messed up. Only I can feel the difference in the cartilage when I compare it to the other ear.


Jimmy Cerra’s Suggestion

(Stephan’s note: Jimmy is currently a purple belt training at Team Balance in Pittsburgh)

Unfortunately, I first got the cauliflower ear from a good throw after almost a year of training. In fact, almost every time I got cauliflower ear it was a sudden impact – only once from a really intense week of training (unless I was slammed and didn’t remember it). I miss my flexible ears and have only met one girl who liked the cauliflowered ears!

Here’s some of my experiences with cauliflower ear. Compression and icing never worked for me, I always had to see a doctor. If the general practitioner won’t touch it, you should request a referral to an ENT – Ear Nose and Throat Doctor aka otolaryngologist. They specialize in the ear and most have experience treating cauliflower ear.

The first time, my GP referred me to a good ENT who had me stitched up shortly. Once I went to the ER to get it fixed quicker (hoping it wouldn’t fill up quickly – it did anyway). The on-call doctors didn’t know anything, and eventually they called an ENT anyway. My ENT just alcohol wipe and maybe some iodine (I forget) to steralize it before draining my ear. There was no pain for me. For anyone with health insurance which covers ENT visits, I highly recommend them.


Here is a ingenious solution by

Kevin “The Resister” Earls

, a reader of the Grapplearts newsletter

I thought I would share a solution to keeping the skin and cartilage together after draining the fluid of an injured ear.

Place two rare earth magnets on opposite sides of the cartilage to keep pressure on the injured cartilage. I used a couple of magnets I recovered from an old computer hard drive. These magnets are very strong and may actually pinch your ear too strongly depending on the size of the magnets. So you may need to use some gauze as a cushion. This solution is more comfortable than clothes pins and other banding types of objects. You just have to put up with the magnetic earring comments for a few days from your friends

Other Cauliflower Ear Draining Resources

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