BJJ Cauliflower Ear: Causes, Prevention, and Treatment

19.10.2021 by

BJJ cauliflower ear is a condition that affects the ears of some grapplers as a result of damage that occurs during exchanges in training and/or competition. As a result, one or both ears can get deformed, reminiscent of a cauliflower. While unpleasant, cauliflower ear is easily preventable and treatable, and doesn’t affect everyone who trains. 

This article will teach you what cauliflower is, what causes it, how to prevent it, and what treatment options are available if you get it!

Definition: What is a cauliflower ear?

Cauliflower ear forms when the cartilage in the ear bends and breaks as a result of external trauma. These bends and breaks cause internal bleeding, and the blood gathers in the area between the cartilage and the skin of the ear. This pooled blood is called a hematoma.

BJJ Cauliflower Ear: Causes, Prevention, and Treatment 1 BJJ Cauliflower Ear: Causes, Prevention, and Treatment cauliflower ear
The bronze statue Boxer of Quirinal (100-50BCE) shows us that cauliflower ear and its treatment is nothing new. – Photo credit Carole Raddato (CC BY-SA 2.0)

If left untreated, this will result in the buildup of scar tissue. Repeated injury can result in an accumulation of scar tissue that changes the way an ear appears from the outside, giving it a cauliflower-like appearance. 

What are the symptoms of cauliflower ear?

At first, the part of the ear that is nearest to the trauma will be swollen, red, and tender to the touch. This happens in the early stages when blood pools in the newly formed pocket, forming a hematoma.

An image of bjj cauliflower ear.
Minor case of BJJ Cauliflower ear caused by escaping a tight triangle choke.

Without treatment, the swelling will gradually subside as the blood is reabsorbed, but hardened scar tissue will be left behind, causing deformity to the ear. The more scar tissue, the more the ears will resemble cauliflower. 

Rarely, severe cases of BJJ cauliflower ear can result in hearing difficulties, ringing in the ears, headaches, or even bleeding from the ear. 

How long does it take to get BJJ cauliflower ear?

The occurrence of cauliflower ear is highly variable and not every grappler will get it. After ear trauma resulting in a hematoma, scar tissue will start to form after 7 – 10 days. It will keep on hardening for the following 20 days or so, and is completely set after about a month. 

Does cauliflower ear hurt?

During the initial stages when there is a soft swelling and the ear is bruised, it is extremely painful to the touch. The pain subsides as the scar tissue forms, and a fully formed cauliflower ear is not painful at all. 

Causes: What causes cauliflower ear?

In cases caused by BJJ, cauliflower ear is the result of grappling exchanges that result in trauma which bends or breaks the ear’s cartilage. For grapplers, trauma is mostly in the form of friction during headlocks and similar positions. The BJJ gi is also notorious for causing damage to the ears of those predisposed to forming cauliflower ears.

What activities can cause cauliflower ear?

Whenever the ear is on the receiving end of shearing force, trauma to the cartilage is a possibility. Positions in Jiu Jitsu including headlocks, cross-face control, triangles, and chokes are the main culprits behind BJJ cauliflower ear formation. 

However, any sort of trauma, like receiving a blow to the ear, can cause the condition.
Certain types of ear infection can also sometimes result in the formation of cauliflower ear. 

Who is at risk of cauliflower ear?

While anyone can get cauliflower ear if the trauma is severe enough, some people seem to get it extremely easily, while others seem immune to the condition. 

There is likely a genetic factor that plays a role in predisposition to the development of the condition. Some people have stronger cartilage and are therefore much more resilient to the development of the condition. 

At the end of the day, whether or not someone is at risk of developing BJJ cauliflower ear from Jiu Jitsu is a highly individual thing that is hard to predict. 

Prevention: Can cauliflower ear be prevented?

Is it possible to prevent cauliflower ear?

Yes, BJJ cauliflower ear is a preventable condition. To prevent it you need to determine if you are susceptible to the condition in the first place. That will then lead you to the methods at your disposal for preventing the formation of cauliflower ears at different stages.

How do you prevent cauliflower ear?

When you’ve just started training you won’t know if you are susceptible to cauliflower ear or not. The first signs of cauliflower ear will be redness and tenderness on the ear after training. If you act quickly you’ll be able to prevent this from getting worse.

You may be able to limit the swelling by holding an ice pack against the ear for several successive 15-minute periods, as soon as possible after you feel the formation of swelling. Do not apply the ice directly to your ear – use a clean cloth as a barrier.

If you find yourself having to ice regularly then you are likely to develop cauliflower ear. The most effective prevention is using an ear guard whenever you are training. They are designed to offer ear protection and come in different styles, depending on how much protection you are looking for.

Treatment: What is the treatment for cauliflower ear?

Cauliflower ear treatment involves several different methods, depending on which stage of the condition you are in. In each and every case, you will need to visit a medical professional for the treatment and take a break from the mats if you truly want to resolve the situation. 

The Healing Process

The body’s healing process of the effects of trauma is actually what forms BJJ cauliflower ear in the first place. Just like with scars from wounds of the skin, the body can repair most things, but it can never get them to the state they were in originally. 

In order to treat cauliflower ears as best as possible, medical intervention is mandatory, preferably during the early stages of the condition. 

How are cauliflower ears treated?

The treatment depends on how far along the condition is. During the early stages, treatment can be fairly quick, with a focus on draining the fluid from the swelling. Later on, as the scar tissue forms and hardens, treatment is more complicated and may require surgery. 

Early Treatment

Early treatment takes place before the formation of scar tissue, i.e. any treatment within the first few days of trauma to the ear. This usually involves drainage of the fluid in the swelling, also known as aspiration. It is a fairly simple procedure that is somewhat painful, given that the condition is still in its early stages.

While some people tend to do this in the gym, after training, I strongly advise that you go to a medical professional for the aspiration procedure. Resting for at least a week with no training after the procedure is a must to stop the swelling from reappearing.

Drainage & Compression

The issue with BJJ cauliflower ear formation is that the trauma to the cartilage often means the swelling can return on its own after aspiration, even from the slightest provocation. That is why aspiration is usually followed by the advice of compression, to prevent the “pocket” from refilling with blood. It is usually done with bandages, magnets, or silicone compression molds

It is also something that medical professionals know how to set up correctly, hence the need to visit one rather than let your sparring partner take a syringe to your ear in the dressing room. 

In some cases, the blood clots in the region form quite quickly, especially when it is not the first occurrence of BJJ cauliflower ear. This usually requires surgical drainage of the ear which means more time off the mats to allow for sufficient recovery.  

Surgical Treatment

Sometimes, in cases of truly advanced cauliflower ear that have been left untreated for long, it takes a surgical procedure to correct the damage done to the cartilage. If done within 30 days of the injury, it is a fairly straightforward procedure and won’t require more than 10-15 days off the mats for recovery purposes. 

However, if it is done later or gets complicated by infections or the cartilage dying, a more complicated cartilage repair procedure is required, which takes significantly longer to recover from. 

Prognosis and Effects: Does BJJ Cauliflower Ear Go Away?

Cauliflower ear won’t go away on its own. If you are one of those unlucky individuals that are prone to the condition, you’ll have to treat it with one of the options laid out above and focus on preventing it from occurring again. 

What are the effects?

The most common effect of cauliflower ear is cosmetic – they look unappealing. From a practical standpoint, you may not be able to wear earbuds depending on the severity of the cauliflower ear. Also, as the ear tends to protrude as a result of the scar tissue, it is more prone to future injuries. 

One study suggests that people with cauliflower ears have a greater risk of suffering from hearing loss. Also, people with cauliflower ears tend to be more prone to ear infections, given the extra creases that are perfect breeding grounds for germs. 

Anecdotally, some people wear their cauliflower ears as a badge of honor and even do their best to develop BJJ cauliflower ears as a way to “prove how tough” they are. Keep in mind, however, that some employers might see cauliflower ears as a reason not to hire people.

What happens if you don’t drain your cauliflower ear?

If you do not take the steps to prevent or treat cauliflower ear, the hematoma will heal on its own resulting in the buildup of scar tissue, disfiguration, and the associated risks outlined above.

What is the prognosis for cauliflower ear?

With treatment, cauliflower ear is completely curable. Depending on how far along the condition is, and how many times it has happened without adequate treatment, options may range from simple aspiration to plastic surgery. 

FAQ about BJJ Cauliflower Ear

  • Do all grapplers get cauliflower ear?

No, the condition is individual and based on both predisposing factors (like genetics) and the type of grappling game you play. 

  • Can you get a cauliflower ear from BJJ?

Yes, as the name suggests, BJJ cauliflower ear is a common thing, especially when people that are predisposed to the condition train heavily with the gi. 

  • Is it possible to train in BJJ and not have cauliflower ears?

Yes, it is. If you have a tendency to develop the condition, wearing protective headgear guarantees safety, and if you are not, you have nothing to worry about. 

  • Is cauliflower ear harmful?

Depending on how long you leave it untreated, it can lead to hearing loss or a tendency to develop ear infections. 

  • Will headgear prevent a cauliflower ear in BJJ?

Yes, most types of ear guards offer nearly 100% protection. Moreover, there are different types to choose from, depending on your preferences and needs. 

  • Is it safe to drain my cauliflower ear with a needle and syringe?

The risks in draining a BJJ cauliflower ear at home include severe infection.  While you or a teammate could do it, it is highly recommended to seek the help of a qualified medical professional. 

  • Do you actually want a cauliflower ear when training in BJJ as a badge of honor?

No! They are definitely not a badge of honor and will interfere with your training when left untreated. 

  • How do I get cauliflower ear?

If you are prone to getting the condition, any type of blunt trauma, whether in the form of ablow or friction will cause damage to the cartilage in the ear, resulting in the formation of a cauliflower ear. 

Final Thoughts

BJJ cauliflower ear is a medical condition affecting some people that train which has to be taken seriously. There is no reason to leave it untreated or avoid using preventative measures if you are predisposed to the condition. While walking around with cauliflower ears is not dangerous to your overall health it can leave you vulnerable to infections or other injuries.