Cervical Spinal Cord Injury in Sumo Wrestling

Abstract

Approximately 80 countries now belong to the International Sumo Federation. Thus, people from many regions of the world have the opportunity to experience the emotionally charged atmosphere of sumo. Women's sumo has also been established, and the first World Women's Sumo Championships were held in Aomori, Japan, in 2001. Thus, sumo is enjoyed and practiced by many people and has recently grown to become a worldwide sport.In recent years, increasing participation in sumo has unfortunately resulted in a higher incidence of injuries in sumo wrestling. In professional sumo wrestling in Japan, one sixth of wrestlers were recently defaulted in a championship because of their injuries. One such injury is spinal cord injury, sometimes catastrophically resulting in quadriplegia or paraplegia. In sumo, dislocations of the spine and spinal cord injuries are rare. We have witnessed, however, a case of dislocation of the lower cervical spine and cervical spinal cord injury in a sumo wrestler. We report this case, including details of how the injury occurred and the implications in relation to the rules provided by the Japan Sumo Association. CASE REPORTA 19-year-old collegiate sumo wrestler, 166 cm tall and weighing 78 kg, had been practicing sumo for 10 years. During an intercollegiate sumo championship on October 31, 1999, he competed with an opponent whose weight was 120 kg. Therefore, the sumo wrestlers in this match had a discrepancy in weight. It was his third fight of the day. From the initial charge, his opponent pushed him, and he escaped by going around the dohyo, or sumo ring. Then, they stopped in the center of the dohyo, and he got under the body of his opponent, as shown in Figure 1. Unfortunately, his position was not ideal. The back of his head was situated on the abdomen of his opponent (Figure 1). After that, his opponent forced him to step outside the dohyo by fixing the back of his head. He had fallen down near the corner of the dohyo, thereby forcing the hyperflexion of his cervical spine (Figure 2).One of the authors (YN), who was a medical doctor for the championship, examined him on the dohyo. He was conscious, his respiration was good, and the mobility of his upper extremities was normal, but his lower extremities were paralyzed. We supposed that he had motor loss below Th2. He had sensory loss below Th4. As cervical spinal cord injury was suspected, his cervical spine was fixed, a few collegiate sumo wrestlers immobilized his body, and he was carefully carried off under the dohyo on the instruction of the medical doctor and taken immediately by ambulance to a hospital.

Catastrophic injuries in the Olympic styles of wrestling in Iran

“…Similarly, high school wrestlers were reported to have more direct catastrophic injury rate than collegiate wrestlers (table 4). 9…”

Radiological Changes in the Cervical Spine in Freshman Collegiate Sumo Wrestlers

“…Only 5 cases of cervical spinal cord injury associated with sumo have been previously reported. 7 , 13 , 16 , 20 , 24 The first report involved a 16-year-old recreational sumo wrestler who pushed his opponent with his head on the initial charge and suffered neck hyperextension, which led to a fracture of C2 and cervical cord injury. 7 The second report involved a C1-C2 dislocation and a cervical spinal cord injury in an 18-year-old boy with os odontoideum who was thrown down.…”

“… 13 The fifth report was on a high-level collegiate sumo wrestler who had anterior dislocation of C7 on T1 and a cervical spinal cord injury. 16 He was pushed down near the edge of the dohyo , or sumo ring, while the back of his head was placed on the abdomen of his opponent, resulting in hyperflexion of his cervical spine. These participants did not have any degenerative changes or congenital abnormalities except for the 1 patient with os odontoideum.…”

“…12 Sumo wrestling entails a risk of impact to the cervical spine, and we have previously reported 2 instances of cervical spinal cord injuries in sumo wrestlers. 13 , 16 Sumo wrestlers make contact with their head and upper trunk during an initial charge, which is the same type of contact that occurs in American football, and their cervical spines suffer from an axial load.…”

Indirect Catastrophic Injuries in Olympic Styles of Wrestling in Iran

“…Therefore, data on wrestling catastrophic injuries are scarce and mainly limited to case reports, such as those from the National Center for Catastrophic Sport Injury esearch. 1,6,7,9,13 …”