Brazilian Jiu Jitsu Chokes & Strokes— The Dwane Stover Story.
Part 8 of this series.
For over nine years, Dwane Stover has been training in Jiu Jitsu, even after suffering from a stroke while on the mat during a triangle escape drill. A triangle escape drill teaches individuals how to properly escape a triangle choke. On May 2, 2018, this choke caused Dwane to have a stroke.
According to an article on BJJ, Dwane “felt a little more tired than normal. He didn’t think much of it, but his training partners noticed that he was looking at them oddly and was slurring his speech.” Fortunately for Dwane, his teammates knew something was wrong. They called 911 after noticing these symptoms, which, in turn, saved his life.
If his friends weren’t so observant, Dwane Stover would not have survived his stroke. An article on Vail Daily about stroke awareness offers a detailed look at Dwane’s experience:
“Having a stroke is a frightening experience, but Edwards resident Dwane Stover realizes how lucky he was to be surrounded by observant, prepared friends when he had a stroke on May 2, 2018. Stover, 53, was working out at Inyodo, the jiu-jitsu gym in Edwards, when he said that he felt tired and was planning on going home. However, his teammates at the gym noticed that his speech was a bit slurred and he was looking at them oddly. Instead of letting him go home, his teammates called 911. On arrival at Vail Health, doctors determined that Stover was experiencing an Ischemic stroke — a total blockage. He was then airlifted to Swedish Hospital in Denver. Less than five months later, after physical and occupational therapy, Stover is back working, teaching, and training. His recovery was fairly quick, which Stover said is due to a combination of his teammates recognizing the situation quickly, getting help and his overall physical health. Though he was timid at first, not wanting to upset anything, he was soon back on his bicycle and in the jiu-jitsu gym. ‘I can’t say enough about those guys recognizing the signs and not letting me go home — I was tired and just wanted to sleep,’ Stover said. ‘I owe a lot to them and their awareness. That was definitely a key factor. If I had gone home, it could have gone the other way’”
Recently, I interviewed with Dwane and he told me how lucky he was to have his teammates by his side. If they hadn’t noticed the early signs of stroke, Dwane would not have had the help he needed to survive.
His story isn’t the only one. I have heard other stories where someone suffered from a stroke after a triangle choke. Check out this clip from an interview I did on Jiu Jitsu Radio, where I shared my own stroke experience while training in jiu jitsu.
During my interview with Jiu Jitsu Radio, Sean also told me a story about a blue belt trainee at the American Top Team (ATT) in Florida, who also suffered from a stroke. One day, the man training got caught in a triangle choke and soon tapped out. Once he tried to get up from the mat, he fell back down due to a stroke, which is the same thing that happened to Dwane. However, unlike Dwane, this man never went back onto the mats after suffering from his stroke.
While speaking to Dwane, he told me that his doctors were very unfamiliar with BJJ and had not heard of any cases like his. Also, both of his parents had strokes, so he believed it was likely going to happen to him anyway. His doctors agreed with him.
However, as I spoke with Dwane and updated him on stories that I have heard from other BJJ practitioners, many of these strokes seemed to have been caused by a dissection before the stroke.
In my interview, I told Dwane that “there were a couple of times prior where I was looking in the mirror prior to jiu jitsu practice and I noticed that my right eye was droopy. And I just brushed it off.”
According to my doctors, prior to the day of my stroke I had a significantly-sized clot on my carotid artery. This clot was most likely the result of a dissection that was already on my carotid artery before I had my massive stroke. I believe that it was there and torn for quite some time. Looking back on my own signs, I feel that I might have had two mini strokes the month before my massive stroke.
As I mentioned with Dwane, over the past couple of years since my stroke in August 2017, I was forced to remember what my training was like before I had my stroke, as well as listen to other people’s stories, learning about their signs and strokes. This made me realize that I could have had a few mini strokes before my massive one, which was most likely due to my prior dissection.
My own research, months after my stroke, made me recognize the symptoms that I missed. I said to Dwane, “as I continue to do my research and now I’m starting to do speeches on this, putting all the puzzles together, it brings more awareness to my stories. And, Dwane, I’m embarrassed to say this, but I may have had a bunch of mini strokes before my massive stroke because I was so young.”
Looking back, I realized that I had blurry vision in my right eye after practice one night. This was months prior to the stroke. I did mention this to a teammate once, but I brushed it off as a small concussion. I can’t remember how long before the stroke these symptoms started to occur, but I do remember that just days before the stroke, I had a sore throat and flu-like symptoms. Almost like a little bug. Either way, the clot on my carotid artery was there before the North/South choke I was stuck in while training with my teammate, Rob Smith, from Milwaukee. I did not tap out because I was breathing, and I thought that I could have gotten out of the choke if he adjusted his body and gave me some room to move. I will say, though, during the months prior to the stroke, I practiced a significant amount of back-take drills and choke transitions from the back-take.
Now, I think it is very likely that the amount of chokes and choke escape transitions during the month before my stroke caused the damage to develop. It, most likely, never fully healed because of ongoing damage and manipulation.
My doctors did not know how long the clot was on my carotid artery. There was no way to tell. However, the clot was very large, which could have meant that the clot was there for a while.
The doctors told me that “the big clot had been sitting on the carotid for some time before the accident. It was so large, the doctor said it was still there, even in post-surgery photos. Since the clot was still present after my surgery, they decided to put a stent in to prevent the clot from going back to the brain.”
According to my doctor, the clot was so large that even after my surgery, they had to put a stent in my carotid artery because there was still a large part of it there.
In an article released by the Journal of Cerebrovascular and Endovascular Neurosurgery, “only 2% of all strokes are from carotid artery dissection. However, dissection is the leading cause of stroke patients under the age of 45.”
As I explain in my article on the Medium, I am now very cautious when I practice jiu jitsu and I also train differently. “I treat my partners differently and make sure we are practicing our art while mitigating damage to the neck as best as we can, especially with kids!”
Also, two years after my stroke on the BJJ mat, I am almost fully recovered. I’m a healthy, 40-year-old athlete with no pre-existing condition, but I want to bring awareness about the dangers of the sport to the BJJ community.
At the end of my interview with Dwane, he started to reflect on his own symptoms, such as numbness in his shoulder and mouth. All of these signs that he had mentioned should have been checked before his stroke. If they were, the stroke could have been prevented. Additionally, Dwane also agrees that there should be more awareness brought to BJJ gyms, so that coaches and teammates know the signs and symptoms of a stroke.
In conclusion, after finishing my interview with Dwane, I realized that:
- It is absolutely imperative that everyone on the mat needs to know the signs of a stroke. This is happening more often, and it could happen to someone in your own gym. If we are going to continue these choking drills, we need to have more awareness. A number of BJJ coaches and athletes have NO idea that this can happen to BJJ athletes all over the world.
- As I have mentioned in my other podcasts and interviews, many of these stories I hear from other jiu jitsu practitioners have them brushing off some of the signs of the strokes (like forgetting their partner’s name, dehydrated, fatigued, and feeling over-trained). Most of these athletes thought that these signs would just go away if the went home and “slept it off”. But this is also one of the worst things you could do during a stroke, mini or large. Dwane’s teammates did the right thing by calling 911 once they recognized the symptoms.
- Dissections in young adults are also hard to detect, even with modern imaging technology. In fact, many times, a dissection is misdiagnosed and not treated properly by doctors and hospitals.
This year, a number of BJJ stroke survivors created a Facebook support group for other members of the BJJ community, who want to connect for support and advice.
On April 18, 2019, a member of the group who wished to be anonymous asked the other members:
“It’s interesting, none of my instructors, including the ones who have been training for over 20 years, had heard of an arterial dissection and/or stroke from BJJ prior to my incident this past December. I wonder if (or do you think) there are more arterial dissections that go undiagnosed or if it’s under reported. My stroke happened a month after my initial vertebral artery dissection. By the time they caught my dissection (because it was misdiagnosed at the ER initially), I had already had a stroke but the artery was healing itself enough that they did not need to stent it. I was in a lot of pain for over a month which is why they did the MRI, otherwise who knows when/if I would have figured out that I had the dissection. Our human anatomy hasn’t changed since the advent of BJJ, many dissections are attributed to neck manipulation from chiropractics and “sports,” but it seems like the reported BJJ dissections is a newer phenomenon. What do you think?”
Josh Vera, a black belt in BJJ, answered him in the comments:
“I’m pretty sure they are extremely under-diagnosed. I have worked in emergency medicine for 9 yrs and have only caught 1 and then mine. Problem is they get misdiagnosed as a sore throat or neck strain. They are mostly only picked up in major trauma or after stroke. We suck at picking them up. Vertebral artery dissections are said to be 1 in 100,000 and carotid 2.3 in 100,000 but I bet it’s worse than 1 in 20,000 but they heal before people stroke out. Or people stroke and they don’t look at the neck.”
After reading what Josh said, and looking online at other contributors in other BJJ forums that discuss BJJ dissections, it seemed that many of these dissections are largely misdiagnosed.
According to Josh, dissections are only picked up when they are “scanned with contrast but even then they have something like 80% reliability. Without this imaging it is something like 10% along with MRI. Most sensitive is angio but that can cause dissections and strokes too.”
Another user, Jouni, also replied with:
“Hi, excuse my late reply but I’m pretty new to the group. It was the same for me, none of my coaches had heard of the connection between Bjj and stroke. And what I know i’m the only one in Sweden that has suffered from it in connection with Bjj. I really hope that it gets noticed and taken seriously. Sometimes I can feel that people do not really want to see the connection or think it can happen.”
This brings us to our next discussion: Does BJJ increase the risk of strokes?
There are a number of online forums that do a great job with bringing this discussion to the forefront. However, there are still a lot of people who do not see this as a threat and think that there isn’t enough evidence to link strokes with chokes from BJJ.
Although, it’s also a bit early to know for sure. One user, alpaca raisin, from the forum posted a reply to those naysayers, who believe that these accidents in BJJ are highly unusual or just the result of pre-existing conditions:
“You say ‘highly unusual and other posters here suggest that it’s ‘incredibly rare,’ but are these stroke events really so rare? By my count, there are three people who have commented in this thread alone that claim to have personally suffered a transient ischemic attack (TIA) or stroke from grappling and others who claim to know someone.
“Again, we don’t know the specifics of causation in these cases. Perhaps, it had nothing to do with BJJ. That’s the answer we’re all hoping is true. I’m merely suggesting that we not delude ourselves into thinking that these events are just an act of god or the result of PEDs, and thus deny ourselves the chance to consider that being choked or cranked (repeatedly) could be a contributory cause of some of these injuries/conditions. If there’s a risk, and one that could be mitigated, wouldn’t you want to know?
“In short, we should ask more questions before reaching a conclusion. If we are seeking the truth and health, why would we emphatically rule out a potential cause without good reason to do so? Absence of evidence is not the same as evidence of absence, and I’m not so sure we can even concede that there’s an absence of evidence.”
Let’s leave this article on that question. Unfortunately, there is a lack of evidence at this time. But, as I continue to investigate stories about practitioners who have gotten a stroke from BJJ, I see that the amount of stories in my inbox only continue to increase every month.
That said, I believe we are making progress and we are spreading awareness to something that could easily be brushed under the rug. Hopefully, these interviews will continue to help save lives in the future, as jiu jitsu continues to grow.
Part 7 of this series — https://medium.com/@bizjitsu/the-loop-choke-bjj-stroke-part-vii-shanes-story-9ca162c85af2
Part 6 of this series — https://medium.com/@bizjitsu/a-jiu-jitsu-choke-that-caused-a-stroke-82f8c8136d
Part 5 of this series — https://medium.com/@bizjitsu/a-stroke-from-carotid-artery-dissection-from-jiu-jitsu-32db9bcf1b47
Part 4 of this series — https://medium.com/@bizjitsu/bjj-after-stroke-aarons-story-da3dff7fe0b8
Part 3 of this series — https://medium.com/@bizjitsu/another-stroke-from-bjj-part-iii-another-story-b6916f2890d3
Part 2 of this series — https://medium.com/@bizjitsu/my-brazilian-jiu-jitsu-stroke-part-ii-what-you-need-to-know-about-dangerous-practices-fae9fa136f5b
Part 1 of this series — https://medium.com/@bizjitsu/my-stroke-my-story-ff01f4924d68