Treatments for BJJ Knee Injuries

From heel hooks to knee bars—get the assessment and treatment protocols that have helped 500+ grappling athletes recover fully and return to training stronger.

From heel hooks to knee barsget the assessment and treatment protocols that have helped 500+ grappling athletes recover fully and return to training stronger.

The Problem

You felt your knee twist. Maybe it was a heel hook. Maybe a knee bar. Maybe just an awkward scramble or bad takedown attempt.

Now your knee hurts. It might be swollen. You can't squat fully. Going up and down stairs is painful. You're worried about training—and maybe even walking normally.


Here's what you've probably tried: Rest and ice for a few weeks Knee sleeve or brace for support Anti-inflammatory medication Hoping it goes away on its own Maybe some generic PT exercises that didn't help much


Here's what usually happens: The pain decreases slightly. You think you're healing. You return to training. Within days or weeks, it flares up again—sometimes worse. Now you're stuck in a cycle of partial recovery and re-injury, and you're starting to wonder if you'll ever train normally again.


There's a better way.

At Grapplers PerformX, we've treated hundreds of BJJ knee injuries. We understand the specific mechanisms that cause them, the structures that get damaged, and the progressive protocols that ensure full recovery—not just temporary symptom management.

The Problem

You felt your knee twist. Maybe it was a heel hook. Maybe a knee bar. Maybe just an awkward scramble or bad takedown attempt.

Now your knee hurts. It might be swollen. You can't squat fully. Going up and down stairs is painful. You're worried about training—and maybe even walking normally.


Here's what you've probably tried: Rest and ice for a few weeks Knee sleeve or brace for support Anti-inflammatory medication Hoping it goes away on its own Maybe some generic PT exercises that didn't help much


Here's what usually happens: The pain decreases slightly. You think you're healing. You return to training. Within days or weeks, it flares up again—sometimes worse. Now you're stuck in a cycle of partial recovery and re-injury, and you're starting to wonder if you'll ever train normally again.


There's a better way.

At Grapplers PerformX, we've treated hundreds of BJJ knee injuries. We understand the specific mechanisms that cause them, the structures that get damaged, and the progressive protocols that ensure full recovery—not just temporary symptom management.

The Problem

You felt your knee twist. Maybe it was a heel hook. Maybe a knee bar. Maybe just an awkward scramble or bad takedown attempt.

Now your knee hurts. It might be swollen. You can't squat fully. Going up and down stairs is painful. You're worried about training—and maybe even walking normally.


Here's what you've probably tried: Rest and ice for a few weeks Knee sleeve or brace for support Anti-inflammatory medication Hoping it goes away on its own Maybe some generic PT exercises that didn't help much


Here's what usually happens: The pain decreases slightly. You think you're healing. You return to training. Within days or weeks, it flares up again—sometimes worse. Now you're stuck in a cycle of partial recovery and re-injury, and you're starting to wonder if you'll ever train normally again.


There's a better way.

At Grapplers PerformX, we've treated hundreds of BJJ knee injuries. We understand the specific mechanisms that cause them, the structures that get damaged, and the progressive protocols that ensure full recovery—not just temporary symptom management.

Why BJJ

Is Hard On Your Knees

Our knees face challenges in BJJ that most other sports don't create:

Rotational Forces Under Load: Heel hooks and knee bars create rotational torque while your knee is bearing weight. This combination stresses ligaments in ways they weren't designed for.

Extreme Range of Motion: Positions like z-guard, knee slice defense, and leg locks require knees to move through ranges most people never experience in daily life.

Sudden Direction Changes: Scrambles, takedowns, and sweeps create unpredictable forces. Your knee has milliseconds to respond to loads coming from unexpected angles.

Sustained Positional Stress: Holding positions like combat base, combat stance, or deep half guard for extended periods creates chronic stress on knee structures.

Impact Loading: Takedowns, guard pulls, and explosive movements create sudden compressive forces that can overwhelm the knee joint.

The rise of leg lock systems has changed the injury landscape:

  • More heel hooks at all belt levels

  • Athletes attacking legs more aggressively

  • Higher torque submissions being applied

  • Faster pace of leg entanglements

  • Less understanding of safe leg lock defense

If you train in a gym with active leg lock games, knee injuries are significantly more likely. Understanding proper defense mechanics and tapping earlier becomes critical.

Why BJJ

Is Hard On Your Knees

Our knees face challenges in BJJ that most other sports don't create:

Rotational Forces Under Load: Heel hooks and knee bars create rotational torque while your knee is bearing weight. This combination stresses ligaments in ways they weren't designed for.

Extreme Range of Motion: Positions like z-guard, knee slice defense, and leg locks require knees to move through ranges most people never experience in daily life.

Sudden Direction Changes: Scrambles, takedowns, and sweeps create unpredictable forces. Your knee has milliseconds to respond to loads coming from unexpected angles.

Sustained Positional Stress: Holding positions like combat base, combat stance, or deep half guard for extended periods creates chronic stress on knee structures.

Impact Loading: Takedowns, guard pulls, and explosive movements create sudden compressive forces that can overwhelm the knee joint.

The rise of leg lock systems has changed the injury landscape:

  • More heel hooks at all belt levels

  • Athletes attacking legs more aggressively

  • Higher torque submissions being applied

  • Faster pace of leg entanglements

  • Less understanding of safe leg lock defense

If you train in a gym with active leg lock games, knee injuries are significantly more likely. Understanding proper defense mechanics and tapping earlier becomes critical.

Why BJJ

Is Hard On Your Knees

Our knees face challenges in BJJ that most other sports don't create:

Rotational Forces Under Load: Heel hooks and knee bars create rotational torque while your knee is bearing weight. This combination stresses ligaments in ways they weren't designed for.

Extreme Range of Motion: Positions like z-guard, knee slice defense, and leg locks require knees to move through ranges most people never experience in daily life.

Sudden Direction Changes: Scrambles, takedowns, and sweeps create unpredictable forces. Your knee has milliseconds to respond to loads coming from unexpected angles.

Sustained Positional Stress: Holding positions like combat base, combat stance, or deep half guard for extended periods creates chronic stress on knee structures.

Impact Loading: Takedowns, guard pulls, and explosive movements create sudden compressive forces that can overwhelm the knee joint.

The rise of leg lock systems has changed the injury landscape:

  • More heel hooks at all belt levels

  • Athletes attacking legs more aggressively

  • Higher torque submissions being applied

  • Faster pace of leg entanglements

  • Less understanding of safe leg lock defense

If you train in a gym with active leg lock games, knee injuries are significantly more likely. Understanding proper defense mechanics and tapping earlier becomes critical.

Common BJJ Knee Injuries:

MCL (Medial Collateral Ligament) Sprain

What it is: Damage to the ligament on the inner side of your knee from heel hooks with internal rotation, knee forced inward during takedowns, or lateral pressure during passing

Meniscus Tears

What it is: Tears in the C-shaped cartilage cushions between your thigh bone and shin bone from rotational force with foot planted, deep squatting with rotation, or compression during knee slice passes

LCL (Lateral Collateral Ligament) Sprain

What it is: Damage to the ligament on the outer side of your knee from heel hooks with external rotation component or force pushing knee outward

Patellar Tendinopathy (Jumper's Knee)

What it is: Inflammation and degeneration of the patellar tendon connecting your kneecap to shin bone from repetitive explosive movements like takedowns, sprawls, and shooting

Patellofemoral Pain Syndrome (PFPS)

What it is: Pain around or behind the kneecap caused by abnormal tracking or increased pressure between kneecap and thigh bone, often from weak hip muscles

ACL (Anterior Cruciate Ligament) Tear

What it is: Tear of the ligament in the center of the knee that prevents the shin bone from sliding forward, typically from sudden deceleration, pivoting, or awkward landing from throws

PCL (Posterior Cruciate Ligament) Injury

What it is: Injury to the ligament that prevents the shin bone from sliding backward, less common in BJJ but can occur from direct blow to front of shin with knee bent

Common BJJ Knee Injuries:

MCL (Medial Collateral Ligament) Sprain

What it is: Damage to the ligament on the inner side of your knee from heel hooks with internal rotation, knee forced inward during takedowns, or lateral pressure during passing

Meniscus Tears

What it is: Tears in the C-shaped cartilage cushions between your thigh bone and shin bone from rotational force with foot planted, deep squatting with rotation, or compression during knee slice passes

LCL (Lateral Collateral Ligament) Sprain

What it is: Damage to the ligament on the outer side of your knee from heel hooks with external rotation component or force pushing knee outward

Patellar Tendinopathy (Jumper's Knee)

What it is: Inflammation and degeneration of the patellar tendon connecting your kneecap to shin bone from repetitive explosive movements like takedowns, sprawls, and shooting

Patellofemoral Pain Syndrome (PFPS)

What it is: Pain around or behind the kneecap caused by abnormal tracking or increased pressure between kneecap and thigh bone, often from weak hip muscles

ACL (Anterior Cruciate Ligament) Tear

What it is: Tear of the ligament in the center of the knee that prevents the shin bone from sliding forward, typically from sudden deceleration, pivoting, or awkward landing from throws

PCL (Posterior Cruciate Ligament) Injury

What it is: Injury to the ligament that prevents the shin bone from sliding backward, less common in BJJ but can occur from direct blow to front of shin with knee bent

Common BJJ Knee Injuries:

MCL (Medial Collateral Ligament) Sprain

What it is: Damage to the ligament on the inner side of your knee from heel hooks with internal rotation, knee forced inward during takedowns, or lateral pressure during passing

Meniscus Tears

What it is: Tears in the C-shaped cartilage cushions between your thigh bone and shin bone from rotational force with foot planted, deep squatting with rotation, or compression during knee slice passes

LCL (Lateral Collateral Ligament) Sprain

What it is: Damage to the ligament on the outer side of your knee from heel hooks with external rotation component or force pushing knee outward

Patellar Tendinopathy (Jumper's Knee)

What it is: Inflammation and degeneration of the patellar tendon connecting your kneecap to shin bone from repetitive explosive movements like takedowns, sprawls, and shooting

Patellofemoral Pain Syndrome (PFPS)

What it is: Pain around or behind the kneecap caused by abnormal tracking or increased pressure between kneecap and thigh bone, often from weak hip muscles

ACL (Anterior Cruciate Ligament) Tear

What it is: Tear of the ligament in the center of the knee that prevents the shin bone from sliding forward, typically from sudden deceleration, pivoting, or awkward landing from throws

PCL (Posterior Cruciate Ligament) Injury

What it is: Injury to the ligament that prevents the shin bone from sliding backward, less common in BJJ but can occur from direct blow to front of shin with knee bent

Results

Results

Results

Join 500+ Grapplers

Who Chose Expertise Over Generic Healthcare

90% of our patients avoid surgery

95% patient satisfaction rate

5.0★
average rating

5.0★
average rating

5.0★ average rating

8-12 sessions average plan of care

  • "I thought my career was over—four weeks later I was sparring like normal.”

    Joss Ayres

    Purple Belt

  • "I wish I contacted Dalton much much earlier!! Thank you so much for keeping on the mats and training whilst helping me recover."

    Virtual Patient | Nils Hirani

    BJJ Purple Belt

  • "Great to have a physio that had specific grappling knowledge so immediately understood the positions which caused the injury."

    Virtual Patient | Owen Lewis

    BJJ Athlete & Weightlifter

  • "Being able to speak to an experienced grappler who understood the more specific movements that it entails helped me communicate my pains more effectively."

    Virtual Patient | Chiu Dat

    BJJ Purple Belt

  • "I thought my career was over—four weeks later I was sparring like normal.”

    Joss Ayres

    Purple Belt

  • "I wish I contacted Dalton much much earlier!! Thank you so much for keeping on the mats and training whilst helping me recover."

    Virtual Patient | Nils Hirani

    BJJ Purple Belt

  • "Great to have a physio that had specific grappling knowledge so immediately understood the positions which caused the injury."

    Virtual Patient | Owen Lewis

    BJJ Athlete & Weightlifter

  • "Being able to speak to an experienced grappler who understood the more specific movements that it entails helped me communicate my pains more effectively."

    Virtual Patient | Chiu Dat

    BJJ Purple Belt

Your Path

Back To The Mats

Step 1: Free 15-Min Discovery Call

See if we're the right fit for your specific situation—no pressure, just honest advice.

Step 2: Virtual Assessment (90 Minutes)
Step 3: Custom Plan (10-15 Sessions)

Most athletes see noticeable improvement within their first 1-3 sessions!

Your Path

Back To The Mats

Step 1: Free 15-Min Discovery Call

See if we're the right fit for your specific situation—no pressure, just honest advice.

Step 2: Virtual Assessment (90 Minutes)
Step 3: Custom Plan (10-15 Sessions)

Most athletes see noticeable improvement within their first 1-3 sessions!

Your Path

Back To The Mats

Step 1: Free 15-Min Discovery Call

See if we're the right fit for your specific situation—no pressure, just honest advice.

Step 2: Virtual Assessment (90 Minutes)
Step 3: Custom Plan (10-15 Sessions)

Most athletes see noticeable improvement within their first 1-3 sessions!

About Us

Built by a Grappler, For Grapplers.

We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

The Problem: 6 Months of Going Nowhere

Founder Dalton Urrutia couldn't find a single PT who understood grappling injuries. Traditional physical therapy failed him for 6 months straight.

The Solution: If It Doesn't Exist, Build It

When nobody could help him get back on the mats, Dalton went to PT school to solve it himself—and for every grappler facing the same frustration.

The Result: 15 Years, 500+ Athletes

Today, Grapplers Performance is the specialized virtual clinic Dalton wished existed when he was injured. We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

Dalton Urrutia

Founder, CEO & Performance Physical Therapist

Dalton founded Performx to help athletes better understand their movement, injuries, and body, in order to keep them doing what they love. Dalton has expertise in movement, strength & conditioning and exercise science and believes that education and understanding injury/the body combined with exercise-based rehab is the key to effective rehab.

Having opened a clinic in London and launched a successful virtual physical therapy business, he's excited to be back supporting his local community in the Willamette Valley.

Outside of the clinic Dalton loves rolling on the mats, flying leisure airplanes and exploring the local area with his wife, Sydney, their 2 boys, and dog, Ipa.

Dr. Tom Hanson, DPT

Virtual Performance Physical Therapist

Tom believes that long-term performance and resilience start with understanding how the whole body works together. 

Tom started training in Brazilian Jiu-Jitsu in 2012 and earned his black belt in 2024. He continues to train and teach regularly and has a deep passion for working with grapplers and combat athletes.

Tom holds a Doctorate of Physical Therapy and has been practicing since 2018. He’s worked extensively with both everyday athletes and high-level competitors, always with the same goal: helping people move with confidence and purpose.

At home, Tom is a proud dad to three young boys and two rescue dogs. When he’s not in the clinic or on the mats, you’ll find him fixing up guitars, exploring outdoors with his family, or homeschooling alongside his wife.

About Us

Built by a Grappler, For Grapplers.

We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

The Problem: 6 Months of Going Nowhere

Founder Dalton Urrutia couldn't find a single PT who understood grappling injuries. Traditional physical therapy failed him for 6 months straight.

The Solution: If It Doesn't Exist, Build It

When nobody could help him get back on the mats, Dalton went to PT school to solve it himself—and for every grappler facing the same frustration.

The Result: 15 Years, 500+ Athletes

Today, Grapplers Performance is the specialized virtual clinic Dalton wished existed when he was injured. We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

Dalton Urrutia

Founder, CEO & Performance Physical Therapist

Dalton founded Performx to help athletes better understand their movement, injuries, and body, in order to keep them doing what they love. Dalton has expertise in movement, strength & conditioning and exercise science and believes that education and understanding injury/the body combined with exercise-based rehab is the key to effective rehab.

Having opened a clinic in London and launched a successful virtual physical therapy business, he's excited to be back supporting his local community in the Willamette Valley.

Outside of the clinic Dalton loves rolling on the mats, flying leisure airplanes and exploring the local area with his wife, Sydney, their 2 boys, and dog, Ipa.

Dr. Tom Hanson, DPT

Virtual Performance Physical Therapist

Tom believes that long-term performance and resilience start with understanding how the whole body works together. 

Tom started training in Brazilian Jiu-Jitsu in 2012 and earned his black belt in 2024. He continues to train and teach regularly and has a deep passion for working with grapplers and combat athletes.

Tom holds a Doctorate of Physical Therapy and has been practicing since 2018. He’s worked extensively with both everyday athletes and high-level competitors, always with the same goal: helping people move with confidence and purpose.

At home, Tom is a proud dad to three young boys and two rescue dogs. When he’s not in the clinic or on the mats, you’ll find him fixing up guitars, exploring outdoors with his family, or homeschooling alongside his wife.

About Us

Built by a Grappler, For Grapplers.

We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

The Problem: 6 Months of Going Nowhere

Founder Dalton Urrutia couldn't find a single PT who understood grappling injuries. Traditional physical therapy failed him for 6 months straight.

The Solution: If It Doesn't Exist, Build It

When nobody could help him get back on the mats, Dalton went to PT school to solve it himself—and for every grappler facing the same frustration.

The Result: 15 Years, 500+ Athletes

Today, Grapplers Performance is the specialized virtual clinic Dalton wished existed when he was injured. We're grapplers who became PTs specifically to fill the gap in grappling healthcare.

Dalton Urrutia

Founder, CEO & Performance Physical Therapist

Dalton founded Performx to help athletes better understand their movement, injuries, and body, in order to keep them doing what they love. Dalton has expertise in movement, strength & conditioning and exercise science and believes that education and understanding injury/the body combined with exercise-based rehab is the key to effective rehab.

Having opened a clinic in London and launched a successful virtual physical therapy business, he's excited to be back supporting his local community in the Willamette Valley.

Outside of the clinic Dalton loves rolling on the mats, flying leisure airplanes and exploring the local area with his wife, Sydney, their 2 boys, and dog, Ipa.

Dr. Tom Hanson, DPT

Virtual Performance Physical Therapist

Tom believes that long-term performance and resilience start with understanding how the whole body works together. 

Tom started training in Brazilian Jiu-Jitsu in 2012 and earned his black belt in 2024. He continues to train and teach regularly and has a deep passion for working with grapplers and combat athletes.

Tom holds a Doctorate of Physical Therapy and has been practicing since 2018. He’s worked extensively with both everyday athletes and high-level competitors, always with the same goal: helping people move with confidence and purpose.

At home, Tom is a proud dad to three young boys and two rescue dogs. When he’s not in the clinic or on the mats, you’ll find him fixing up guitars, exploring outdoors with his family, or homeschooling alongside his wife.

Serving grapplers worldwide. Virtual sessions. Real results.

Ready to Train Without Pain?

Book your free call today. If your initial evaluation doesn't deliver value, you don't pay. That's our 100% satisfaction guarantee.

Serving grapplers worldwide. Virtual sessions. Real results.

Ready to Train Without Pain?

Book your free call today. If your initial evaluation doesn't deliver value, you don't pay. That's our 100% satisfaction guarantee.

Serving grapplers worldwide. Virtual sessions. Real results.

Ready to Train Without Pain?

Book your free call today. If your initial evaluation doesn't deliver value, you don't pay. That's our 100% satisfaction guarantee.