Cauliflower Ear: A BJJ Ailment or a Badge of Honor?

We’ve all seen it. That crumpled, malformed mass of various shapes and sizes hanging off the heads of fighters of all types. The dreaded – or beloved, depending on your personal stance – cauliflower ear.

In the grappling worlds of Brazilian Jiu-Jitsu, wrestling, and MMA, cauliflower ear is as ubiquitous as Craig Jones’ trolling of Gordon Ryan. It’s everywhere. Some love it and some hate it. Some athletes wear it as a badge of honor (some weirdos even actively seek it), while others dread it and do everything they can to avoid it.

But what exactly is cauliflower ear, and why does it happen? We’ve got answers:  

What Exactly is Cauliflower Ear? 

Cauliflower ear, medically known as “auricular hematoma” or a “subperichondrial hematoma”, is a condition that occurs when the outer part of the ear is injured repeatedly, leading to the pooling and clotting of blood and fluid between the cartilage and the perichondrium (a layer of connective tissue) of the ear. Basically, whether from blunt force trauma or friction, the tissue separates from the cartilage, creating a kind of pocket where blood and serous drainage (that clear-ish fluid) accumulates, creating a squishy, painful bubble. If left untreated, fibrous tissue develops, resulting in a hard, permanent lump, resembling – very, very loosely – a cauliflower. Just like no two snowflakes are alike, no two cauliflower ears are alike.

Why and How Does it Happen?

As mentioned earlier, this injury typically results from direct trauma or friction to the ear, which is common in contact sports such as wrestling, BJJ and MMA, where the ears are often subjected to constant rubbing, pressure, or impact.

Techniques that involve grabbing and compression around the head – such as headlocks and guillotine chokes – are common culprits. My own cauliflower ear originated from a sloppy, hail-Mary escape out of a triangle choke, in which my ear was folded forcefully against my head as I tried to extract myself. Repeated trauma – through continued training even as the ear is trying to heal – can disrupt blood flow to the cartilage, leading to the formation of clots, necrosis of the tissue, and subsequent scarring. 

I must mention that cauliflower ear doesn’t happen to everyone. I know plenty of people who have been training decades and have perfectly formed ears. I also know plenty of people who have trained a month and already have angry, swollen blobs for ears. In my experience, typically those with more flexible ear cartilage (the kind of ears you can roll into a joint) tend to avoid it, while those with stiffer ear cartilage are more susceptible.

The Culture Surrounding Cauliflower Ear

This is a weird one. But, well… it is what it is. Cauliflower ear has undoubtedly developed a unique cultural significance within the grappling community.

For some, it's a badge of honor; a visible mark of dedication and experience in the sport. To them, it symbolizes resilience, toughness, and commitment to training. Athletes with cauliflower ear are regarded with respect, as their appearance suggests they've endured the rigors of intense training and competition. This kind of view has infiltrated the general public, as many MMA fans might see cauliflower ear and instantly fanboy. Of course, as I mentioned before, the lowliest single-stripe white belt in the room can have massive cauliflower ear, while the baddest black belt in the country does not.

On the flip side, cauliflower ear has its disadvantages. When it’s fresh, it HURTS. It hurts to sleep, it hurts to train, and if you do want to train, you end up having to wear silly, wrestling headgear that leaves you vulnerable to guillotines and other chokes. It can also affect your hearing, depending on where it’s located. If it’s toward the inner part of the ear, it can block sound waves from entering the ear canal. Even cauliflower ear that’s on the outer shell of the ear can affect the natural acoustic properties of the shape of the ear. Then there are aesthetic concerns. Not everyone will see it as a result of hard martial arts training. For some, they see an unfortunate deformity.

Treatment and Prevention

If you train long enough, and the stiffness of your ear cartilage lends you to be more susceptible to cauliflower ear, it’s near impossible to prevent. If you’re ultra conscious about tapping whenever your ears are in a compromising position, and you don’t forcibly escape a choke, you may avoid it for a long time. Those are good rules in general. Tapping and using technique over strength, especially in escapes, will facilitate your longevity on the mat. 

Treating cauliflower ear is possible. When it’s fresh, you can drain it – either yourself, or by having a friend do it for you. Make sure you use a clean, disinfected needle. Depending on how viscous the fluid is, you might be able to use a small gauge needle, which hurts far less going in. I speak from experience here. Once you drain it, you’ll want to compress area for a good while, to help – hopefully – the tissue adhere back to the cartilage. You may have to repeat this several times. Staying off the mat helps, but of course, it’s your life and your ears. If it really bothers you, you can also get it surgically repaired. Either way, know that your ears will never look or feel the same again. 

Whether you consider cauliflower ear to be a terrifying BJJ ailment, or a badge of honor, what you should always remember is that it doesn’t make the grappler, or the person. Train hard, respect everyone, take care of yourself as best as you can, and live your best jiu-jitsu journey.