Common grappling submissions: A descriptive, illustrative and literature review of anatomic structures at risk and pathophysiology

Grappling disciplines have immensely grown in popularity. These martial arts and sports, such as Judo, Brazilian Jiu Jitsu, Sambo, and Mixed Martial Arts, utilize techniques and movements to maintain control, subdue, or submit an opponent. Grappling submissions introduce risk of injury through a variety of specific moves, positions, and mechanisms. Yet grappling disciplines remain relatively niche, shrouded with confusing, non-descriptive terminology and jargon. This often results in a poor understanding of injury mechanisms, anatomic regions injured, and pathophysiologic cause of injury. The lack of basic anatomic and physiologic understanding is a potential barrier to optimal care and future research endeavors by clinicians in a burgeoning patient population. As such, this study aims to provide a concise guide to common grappling submissions, with illustrative examples and pathophysiologic mechanisms, description of anatomic structures at risk, and a literature review of injuries, with intention of improving care, and facilitating future investigative efforts by clinicians.