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Cauliflower Ear in Grappling and MMA

Hematoma auris. Perichondriall hematoma. Traumatic articulate hematoma. These are the medical names for what we know as Cauliflower ear. Besides boxing, wrestling, BJJ, and MMA, it’s also common among rugby players.

What is cauliflower ear?

Repetitive trauma can create a blood clot between the cartilage and the skin of the upper ear. The plastic surgeon who worked on my ear compared the ear to an Oreo cookie. The cartilage is like the cream of the Oreo and the skin is like the cookie part. When fluid gets between the cartilage and skin, nutrients can’t get delivered to the cartilage via the skin and it subsequently dies. Fibrous tissue is then formed in the outer lying skin leaving the ear looking swollen and deformed.

Is Cauliflower ear in grappling and MMA a badge of honor?

For some wrestlers and fighters, cauliflower ear is actually considered a badge of honor or experience. While it may be a rite of passage for some, I’d like to present the other side of the coin with some reasons to avoid and/or treat cauliflower ear.
  • Appearance- Although you may think cauliflower looks cool now, it’s usually permanent (barring extensive surgery) and your opinion of it may change as you get older. Your appearance will be important for little things like getting a job!
  • Loss of hearing- In extreme cases the eardrum can rupture and permanent hearing loss can occur.
  • No more earphones- Whether it’s listening to your ipod or using your blue tooth in the car, you’ll have to figure something else out. Being unable to wear earphones may be just a minor annoyance to you, but I thought it was worth mentioning in hopes that you’ll avoid future ear deformities.
Be proactive in regards to preventing/treating cauliflower ear

I trained for over 10 years before developing anything more than a minor irritation. I used to always wear ear guards but got a bit lazy over time. The better I got at grappling the less my ears got irritated. This was because less guys were controlling my head.

Then I began doing more boxing and MMA sparring. Since a lot of this training was new my ears became more susceptible again. It seemed to happen quickly in my case. I went from not noticing anything to my ear blowing up.

Although some guys at your gym will crack jokes and they are somewhat annoying to train with, I think it’s worth it for you to invest in a pair of ear guards. Wearing them every time you train is your best bet. This will help to make it a habit. If not every session, at least put them on when you feel your ears are red and/or inflamed. Remember, “An ounce of prevention is worth a pound of cure.”

If you do get cauliflower ear, don’t make the mistake of thinking it’s too late to do anything. The longer it goes untreated, the harder it is to fix. So go to a doctor who knows how to drain and sew the ear properly.

Some doctors drain the ear without sewing the skin to the cartilage using a button or small sponge on the outside of the ear. If you just drain it, there will be a higher chance the ear will blow back up again. This is because even though the fluid is drawn out, there is still some space left between the skin and cartilage for it to fill back up.

DIY Cauliflower Treatment

Depending on insurance and doctors this can be a costly procedure. Although you can find information online about how to drain your ear yourself, it’s important to use caution when going this route. The main advantage I see to doing it yourself is affordability. But with that I believe comes a higher risk of infection and a higher chance of the ear re-filling.

Check out this video of Dr. Allan Freedman removing sutures from my ear after one week.


Dr. Alan Freedman Treating Cauliflower Ear

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