The Head to Toe of Injury Prevention for Grapplers: Part 1, the ears

Believe it or not, when I asked for requests on what common injuries they would like to avoid, the majority of people wanted to know how best to avoid cauliflower ear. I really had no idea that people felt this strongly about their ears, and I hadn’t originally intended to write at all about this condition, but I am a slave to public opinion so here is everything I know about your ears and how to keep them looking pretty.

Firstly let’s have a look at what cauliflower ear is. Essentially, what we know as cauliflower ear is just a plain old hematoma- a raised lump caused by trauma to the area. The technical term is actually an auricular hematoma; auricular refers to the auricular cartilage that gives your ear it’s shape. Local trauma to the ear causes the skin to lift off the cartilage, and the new space in between fills rapidly with blood. This is now the typical, reddened, sore, fresh cauliflower ear that many grapplers and combat sportsmen will suffer from occasionally. At this stage, it’s really just a swelling in a very prominent and uncomfortable place, however unlike other swellings, the fluid does not drain out of it’s own accord, and if left unattended will harden into a solid mass. This solid mass is fairly much permanent save for surgical intervention.

Now this article will differ from others inasmuch as there really is no particular method of avoiding the hematomas that lead to cauliflower ear. As we begin to move down the body I will be showing strengthening and mobility exercises for the various body parts we will deal with, but there really is no method of conditioning your ears, and while some people will say to avoid training with guys who excessively squeeze your head, that’s not always practical and it really can happen at any time, regardless of who your sparring partner is. But let’s deal quickly with prevention anyway.

If you are extremely concerned by cauliflower ear, you can decide to use ear guards. These are simple devices that cover both ears and strap to your head like a bike helmet. By using these you are almost 100% guaranteed to not develop cauliflower ear. This will please those of you who model earrings for a living, or more particularly girls who grapple. Lumps on your ears make for good conversation starters for guys, but are probably not as good a look for girls. This is total avoidance, but it has it’s disadvantages. Even the most well designed ear guards are quite bulky and sometimes extremely uncomfortable to wear. Escaping your head from some positions can be more difficult, and you can also cause your training partners some discomfort too as they have to deal with the plastic or webbing when grappling with you. In addition, you now have another piece of equipment to keep hygienically clean and a lot of brands can’t just be shoved in the washing machine like a gi or tee shirt. In fact, once a problem ear has healed, most people stop wearing theirs until the next time their ear becomes sore or swollen. In other words, most people use ear guards to prevent the condition from exacerbating as opposed to preventing it in the first place.

I own these exact earguards

Prevention of hardening is different. This is where we’ve already suffered the hematoma and associated fluid gathering, but the area has not yet hardened. A note here is that it takes about 7-10 days for the fluid to harden permanently, but that doesn’t mean it isn’t already starting to harden from day 1, or that your ear won’t harden sooner. Getting your ear drained is best done as soon as possible. For this, you need a doctor, but let’s face it, most of you won’t use one. If you insist on doing this yourself you will need a sterile syringe and needle, alcohol wipes, a sterile environment (ie. not sitting in the gym toilets or on the end of the mat), compression bandage, and gauze for packing. Draining your ear is completely useless unless you compress the area straight away afterwards since it will just fill with fluid as the space between skin and cartilage will still be there. That’s what the gauze is for. Once your “doctor” has drained the ear, “he” should pack it with gauze, and pack behind the ear too, then wrap the compression bandage around your head to prevent the ear from filling again. Ideally, you will keep the compression bandage in place for at least 1 week to allow the reattachment of skin to cartilage. Yes I said a week, and that’s being conservative. If you think of how long it takes for a common or garden cut on your hand to heal fully, it seems silly to expect any less of your ear. So it’s best to get cauliflower ear in and around the same time as you’re taking time off anyway and can afford to wear the bandage all day for a week or two. For example, if you were getting married and going on honeymoon, that would be perfect. I can’t think of anything wrong with that plan.

While I know every gym probably has an “ear guy”, I would caution against going to anyone who isn’t an expert in these matters. These are your ears, and aside fro whether your guy will be any good at the job, any time we open the skin there is a risk of infection too. Be smart and don’t just trust the first guy to hold up a syringe.

My right ear which has had some caulifowering over the years. My left ear is absolutely perfect and hasn’t had it even once!

But let’s be realistic. Unless the ear is extremely bad, draining and compression for as long as is possible in tandem with ear guards when in training is probably the best and most manageable method of controlling cauliflower ear to a level where you don’t end up looking like Nosferatu and can still train. It should be pointed out that not everyone gets cauliflower. I know people who have been training 20 years who have never once had one, and equally I know people who have developed one after a few training sessions. I rarely suffer from them, and when I do they tend to be quite minor and I don’t particularly bother with drainage, though I have had one that developed quite close to my ear canal which I was keen to deal with since I was concerned about loss of hearing and, well to be honest, I like wearing in-ear headphones.

So there we have a 1000 word start to this little series. May your ears be safe!