When I first embarked on the mission of interviewing Jiu Jitsu practitioners who had experienced strokes from strangulation in our beloved sport back in 2017, my goal was to raise awareness and provide a blueprint for addressing and treating this risk through the power of storytelling. Little did I know that the journey would continue to unfold with the discovery of more and more cases of strokes resulting from chokes in our community. Over the years, survivors have reached out to me, eager to share their stories and shed light on the symptoms, treatment protocols, and often, the mismanagement of these incidents by medical professionals.
Driven by the desire to educate and equip medical practitioners with firsthand knowledge, I tirelessly worked towards publishing a peer-reviewed medical article in the esteemed American Journal of Emergency Medicine titled “Cervical Artery Dissections and Ischemic Strokes Associated with Vascular Neck Compression Techniques (Sportive Chokes)”. By amplifying the stories and experiences of these survivors, I hoped to ensure that the medical community would gain deeper insights into the complexities surrounding strokes in Jiu Jitsu.
But in addition to prevention and treatment, there exists another crucial aspect that demands attention — the life that unfolds after a stroke. Each survivor’s journey is unique, and understanding what to expect and how to navigate the recovery process is vital. Through sharing our diverse stories and paths of recovery, we can all learn from one another’s experiences.
A few years ago, I received an email from Egor, hailing from Russia, seeking advice on life after stroke. I was more than happy to offer my insights at the time. Fast forward two years later, and I reached out to Egor, asking him to share his own journey through a blog article. His story serves as a beacon of hope, highlighting the resilience, mindset, and recovery efforts that have shaped his post-stroke life. Without further ado, let’s delve into Egor’s remarkable tale.
Egor’s blog written 6/23/2023:
My BJJ-related stroke experience
First of all, let me introduce myself. I am Egor. Thirty-nine years of age right now, and I had a stroke related to Brazilian Jiu-Jitsu practice. I wrote this article to share my knowledge with the worldwide BJJ community. I hope it is going to be helpful for others to prevent such situations in the future, and at least it is going to be beneficial for me to remember my English writing skills which are slightly damaged after the stroke.
Life before stroke
I was a happy 37 years old still young man (at least I felt like that) with a significant devotion to Brazilian Jiu-Jitsu martial art. I was a purple belt with two stripes, even with some wins in local tournaments. I didn’t smoke or do drugs, was occasionally a rare alcohol consumer, and was middleweight at around 180 lbs. I didn’t have any health issues in my life and no blood/stroke issues among relatives. My main work was as a product manager in an IT company. I was satisfied with my job cause I had enough time and energy to practice Jiu Jitsu after it 3–5 times weekly. I am married, and we have quite a warm relationship with my wife. My life before the stroke was stable, calm, and happy.
How everything happened:
In August 2021, I was on vacation near the sea. I didn’t want to pause my BJJ training, so I decided to train with my buddy’s local black belt. That was my second training on holiday. I was in a medium shape, but the temperature outdoors was high, around 96 F. I felt nothing strange or unusual in my physical condition except when I woke up. I felt more tired than usual, but It didn’t affect my goal of doing a training session. I read a lot of other people’s notes who experienced a stroke, and most of them mentioned some pre-stroke symptoms like tunnel vision, severe headache, etc.… I didn’t have any of these.
The gym was without any air conditioning, so training was extremely hot. Drilling went well, and we started to spar at the end of the training session. My buddy weighed around 220 lbs and had more BJJ experience, and he decided to make a “baseball choke” with lapels from the bottom half guard and started to spin under me. I tried to resist and counter him with an armbar attempt but could not. Just before passing out, I taped… I don’t know if I lost consciousness, but after I stood on the mat, the whole gym started spinning. My right arm was raised 90 degrees, and I realized I couldn’t put it down. I told my training partners that something was wrong and it was not the typical situation after choking. I sat down. I Drank some water and tried to be calm. After 5 minutes, I couldn’t pronounce any word and could only moo. I could clearly understand everything and recognize the speech, but I could not pronounce any word. Surprisingly nobody understood that it was a stroke, and neither did I cause before that situation, I had heard about strokes, and it seemed to me that it could only happen to older people after 60. Finally, I tried to write 911 on paper, and my training partners took me to the hospital.
Medical issues:
In the hospital, doctors were quite skeptical about me. I looked slightly weird in the GI; they thought I was under drugs. But at least they recognized it as a stroke and put me in the hospital. After some time passed, they did a CT and CT with contrast and found out that I had brain damage on the left side of the brain. Ischemic stroke with hemorrhagic transformation. They didn’t find any clots from dissection. Finally, I realized that the situation was terrible and it could get worse. Surprisingly I was calm and didn’t have any anxiety at that time. I think ten years of
What BJJ taught me:
In any bad situation, you must be calm and work on escape without any rush and panic. I started to count my losses. First of all, it was apparent that I couldn’t speak at all. The doctor showed me a pen, and I understood it was a pen but couldn’t say so. Then I realized that I had a huge weakness. It was hard for me even to walk to the toilet. But at least I could do it by myself. Only 30% of patients in the neurological department could do that. My right hand was unstable, so I did everything with my left hand. I could read, but after 10 minutes of consuming information, my head hurt. Also, after a few days, I understood I couldn’t write. I didn’t understand which letters words are made.
For the whole week, I just lay on the bed. I focused my sight on different items and tried to spell their names. Also, I tried to walk around the neurological department. I was observing other patients and noticed I was the youngest among 50–60 persons. The neurological department consisted of 45+ years of age males who were heavy smokers, and they even continued to smoke just after the stroke. And on the other part, 65–80 years of age, both males and females could not walk and were only in their beds. One week passed, and finally, I could spell some easy phrases and do everything with my right hand, and doctors decided that’s its time to move to the rehabilitation hospital.
Post-stroke rehabilitation issues:
Another two weeks I spent in the rehabilitation hospital. There I started to recover back my ability to speak and write. I had different medical procedures to make my condition better. My mental state was calm and stable. I received massive support from my family. I had only one inconvenience — an extreme weakness. I can’t compare that state with anything else. You feel tired all the time. You wake up exhausted after 15 minutes of any activity and begin feeling weak again. It was hard to have elementary school lessons in reading and writing, even if they lasted only 30 minutes. But those lessons were quite helpful. After two weeks, I could speak almost as well as before, but sometimes I had mistakes in my speech, and those mistakes made me nervous. I could write some easy words, but I still couldn’t chat over the phone, and writing was something I needed to work on. It is essential to start working on your disabilities right after the stroke cause only that may give you a higher chance for a full recovery. Finally, doctors allowed me to return home. They told me to continue working with a neuropsychologist to improve my writing skills. Also, they told me I must walk 30–60 minutes per day at a slow tempo. And that was the only physical activity I was allowed to do for the term of 6 months.
Return home:
I wasn’t happy to return home cause my physical condition didn’t change. I felt a considerable weakness, couldn’t write, and sometimes I had a neurological deficit, which was expressed in the wrong spelling of complicated words and phrases. After that, I had a minor panic attack which was hard to overcome as I tried to become calm and stable again. Despite my physical condition, life was going on, and I realized that I still had to pay my bills…
First, I decided to work online on my personal computer, and I had success after a couple of tries. I was absent from my work for 21 days and decided to re-organize it. I Had a conversation with shareholders, who showed considerable support for my situation and allowed me to work remotely until I solved all my health issues. My primary responsibilities at work were leading offline meetings in the office and organizing different teams’ work. Thankfully my colleagues took my offline responsibilities into their hands, and I started to work online. It is almost impossible to manage a severe development routine when you don’t have any energy and can hardly write simple words. I decided to work 15 minutes and then took a 45-minute break to recover. Step by step, I started to get used to my situation, and in 1 month, I was a pretty productive member of the company. I used to walk two 30 min sessions daily and even found something interesting in that activity. I started to read many books and attended neuropsychologist 2–3 times per week to improve my writing and speaking skills. Thankfully our brain erases all the bad memories, and now, when I write this article, I don’t remember how rough everything was. Sometimes I had a considerable weakness starting from waking up. Even now, from time to time, it is so bad that I can’t usually have breakfast, and the only thing I dream of is to return to bed to rest some more. Then blinks of neurological deficit occur while spelling easy words, and you have a panic attack and think you are losing speech, which is a second stroke. That was a dive to the pure personal hell that lasted several months. Month after month, you have the hope that you will see progress in your recovery and that your weakness will reduce. Nothing changes, and you dive again into your hell. I can only give you one piece of advice, consider the stroke recovery as a marathon rather than a sprint -and hopefully, You’ll get better in years. Don’t expect to recover in several months. If someone had told me that, truth-everything would become much easier for me and my mental state. I considered that six months would end my rehabilitation process, after which I would return to the BJJ gym and my everyday life. Six months after the stroke passed by, nothing changed…
At that point, I started to feel that my situation was hopeless. I was asking doctors about what was going on. They couldn’t do anything except assign nootropics injections, which didn’t change my situation. I Found out that neither one of the medical drugs could have boosted your rehabilitation process after a stroke. Time and hard work are the only things that can help in such a situation.
My mental state started to get worse. My wife noticed some symptoms of depression, and we agreed to begin psychiatric therapy. It didn’t help a lot cause they didn’t find the right antidepressant without side effects, and they only proposed to find some other passion in my life besides BJJ. That wasn’t a solution for me. By the way, my psychiatrist gave me one good piece of advice — start writing a health/mental diary couple of times per day. Reading that diary helped me to see improvements in my condition, and finally, I noticed that progress was coming.
Yoga saved my life:
Eight months after the stroke, I still didn’t feel better. They still had a huge weakness and couldn’t do anything with it. I had great hope that I would be in a BJJ gym by that time, but unfortunately, minutes long and was unbelievably difficult for me; my wife insisted on starting Yoga sessions. We began to do them together. We Used Ipad as a Yoga teachers. Our first session was only 15 minutes long and wasn’t easy for me. Day after day, we continue to do Yoga. We increased the time of yoga sessions by 15 min. After one month, I could handle 1 hour of yoga sessions. I realized that I was improving my physical and mental condition, and my stretching was significantly enhanced. As for now, I can’t imagine my life without Yoga. I made a 30–50 min yoga session part of my morning routine. I just made a small mistake: I started Yoga only after eight months. I think it could be possible to shorten the recovery terms if I began Yoga 2–3 months after the stroke. Yoga saved my life, and I recommend that great practice to everyone. After one month of Yoga, I decided to try to do a BJJ warmup…
BJJ after stroke:
My main problem with starting physical activity was that exercise stress increased arterial pressure. My head started hurting, and I had panic attacks due to PTSD. I felt like I am having a stroke again. It was hard to work with that issue, but I chose to take at least some tiny steps forward day after day. I started to do solo BJJ drills like shrimps, jumping jacks, rolls, etc..… in my garage. I was ready for the full BJJ practice after a month. I asked my training partner to come, and we did an entire BJJ training session with warmup and drilling, and I even did two 3 minutes rounds of flow rolling. After ten months of post-stroke recovery, which was my substantial personal victory and calm and related training sessions, I decided to show up in my gym and started to train in the group class. All my teammates were happy to see me again on the mats. I didn’t push the pace and did everything calmly and relaxed. I was choosing only buddies who knew about my situation. So I started with 4 minute round of flow rolling. I told everyone not even to try to strangle me. While practicing strangles, I needed a third training partner to come, and we worked together so I could practice it by myself and avoid being one on whom one does practice it. Everyone on the mat was quite attentive to me. Slowly month after month, I increased my physical load and pace. Sometimes after a hard roll, I had mini panic attacks, but I learned how to handle them. The main thing about doing BJJ after a stroke is that you must do it carefully. Better roll with the people you trust with whom you feel comfortable and safe. Don’t ever roll with the young and fit blue belts who want to take your belt with your scalp, or else it might be a fatal mistake.
No-Gi is much safer because it doesn’t have immediate nasty collar chokes like a cross collar, a loop choke, a baseball choke from the bottom, etc. Can do No-Gi rolls more complex cause don’t think about the issue that can be collar choked from any position. I started to protect my neck and didn’t allow anyone to reach it. Rarely and safely do forward head movements like shots single/double. For safety reasons, I prefer to play guard and have most of my body between my opponent and my head. And the main thing — don’t struggle in the chokes. Just tap immediately as the choke started.
Medical reason for my stroke:
It was pretty hard to find a valid reason for my stroke. Thankfully I didn’t have any clots. It was a rare mixed type of ischemic stroke with hemorrhagic transformation. Before the stroke, I had COVID 2 Times. My COVID infection was light, but it increased the lupus anticoagulant mark in my blood. That means that my blood was thick. Such aspects as extreme heat and the gym, increased exercise stress during the hard rolling sessions, and increased arterial pressure after the choke was released let the vessel in my brain explode and provoke a stroke. After COVID, we all see the increment in such cases in different sports. Half a year ago, a black belt head coach from another BJJ gym died on the mat after the rolling. A heart attack that was caused by a clot. Totally healthy sports competitor he was. He had COVID in the past. He was only 35. In the amateur ice hockey league, they have already had three death cases like that. They didn’t have such issues before the COVID BJJ is more dangerous for such cases cause in it the extreme physical activity is combined with strangles and neck pressure. Chokes are the dangerous cause of the immediate increment in blood pressure, and neck pressure is dangerous for artery dissections. In order to make it safer, you can take blood thinners and control blood marks such as coagulogram and lupus anticoagulant. Don’t push the pace, and don’t let anyone choke you.
Life after stroke and conclusions:
Almost two years passed since the stroke already. Bad memories about the whole situation grow dim. As for now, I still don’t have to automate writing. Sometimes to write a complicated word, I need to spell it my syllables. I feel impaired tactility in my right hand, and I don’t feel the temperature of things that I touch by it. This is all my loss regarding the situation with the stroke. Despite that, I have much more gains from this situation. That was a truly life-changing experience. The universe gives us different tests to make us change. Only by passing that test and through many struggles can we become a better person. As for me, I started to enjoy every moment of life. Learned how to experience a present moment. I began to have a lot of healthy habits. Due to Yoga, I changed my mind, health, and body condition, and I improved my concentration and my BJJ guard. Due to BJJ training, I got my brown belt interacting with every person on the mat. Improved my bjj game significantly. I still hope to compete in 3–4 years in No-Gi Master 3 division. I have more energy than before to do my work tasks. I concentrate more on small details and feel calm and relaxed while interacting with colleagues and teams. The stroke changed my life, but it changed it better. I hope you won’t feel desperate in any life situation. Try to find good things in any lousy case. Do not lose hope. And work day after day by the tiny steps to become a better person and make our world a little better…
Osss…Egor from Russia.
Similar to Egor, I too have encountered numerous deficits following my stroke, including fatigue, depression, mental exhaustion, and difficulties with verbal and written communication. However, with the passage of time, healing has taken place. Alongside my consistent yoga practice and continued engagement with Jiu Jitsu over the past two years, I wholeheartedly concur with Egor that this combination has been transformative. The benefits I have derived from yoga resonate deeply with Egor’s experience. In my opinion, exercise plays a paramount role in brain recovery after a stroke. I extend my heartfelt gratitude to Egor for sharing his story with our community, and I join him in emphasizing the importance of exercise in the recovery process after stroke.
Other referneces you might like to check out on the topic of strokes in BJJ:
Chewjitsu Podcast: “Chris Martin BJJ Brown Belt.
The BJJ Mental Coach: “EP 51 — Stroke From Chokes | Nova Gyms Co-Owner Chris Martin”
Kama Vlog: “BJJ MEDICAL PSA: STROKES from CHOKES! — Warnings, Prevention, What to Tell Your Doctor.”
BJJ Eastern Europe: “Vascular Neck Injuries and Strokes in BJJ: Recognizing the Warning Signs”
BJJ Asia: “Doctors Need To Know About Stroke Prevention In Jiu-Jitsu.”
Jiu-Jitsu Times: “Another BJJ Athlete Has Stroke”.
