Tap early and tap often. That’s not specific to heel hooks, that’s a good general rule you want to avoid injuries and tame your ego to keep the ability and desire to train alive. Tapping often is one of the first things that is taught to white belts in a healthy BJJ gym. Humble yourself, tap early, and learn from it so you can be healthy enough to train another day. Simple concept, right? Well, sometimes it takes a while for that to sink in. A while can be years and there are plenty of examples of high-level matches when the ego creeps in and SNAP.
What is a Heel Hook?
Before we jump into the details of the break, let’s make sure we have a good understanding of what a heel hook is.
The heel hook is a grappling technique that is primarily used in Brazilian Jiu-Jitsu, Submission Wrestling, and Mixed Martial Arts (MMA) to attack the knee joint. It is called a “heel hook” because the attacker uses their own heel to apply pressure to the heel of the defender’s foot, which in turn puts stress on the knee joint.
The origin of heel hook is not clear but it is known to be used in early catch wrestling, sambo, and judo and it’s probably that these disciplines have an older tradition of this submission. It became popularized in the 1980s and 1990s with the rise of Brazilian Jiu-Jitsu and MMA, and it is now considered to be one of the most dangerous submissions in grappling due to the potential for serious knee injuries.
Anatomy of the Knee
Let’s get a brief understanding of the knee, which is the typical joint under stress when proper heel hooks are applied.
The knee is a complex joint that is made up of several different anatomical structures, including:
- Bones: The knee joint is formed by the thigh bone (femur), the shin bone (tibia), and the kneecap (patella).
- Ligaments: The knee has four main ligaments that provide stability to the joint. These include the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).
- Cartilage: The knee joint has two types of cartilage, the articular cartilage, and the meniscus.
The articular cartilage covers the surfaces of the femur and tibia where they meet and allows for smooth movement of the joint. The meniscus is a rubbery cushion between the femur and tibia that helps absorb shock and distribute weight evenly.
- Bursae: The knee has several small, fluid-filled sacs called bursae that help reduce friction between bones and tendons.
- Tendons: The knee joint has several tendons that connect muscles to bones and provide movement to the joint. The quadriceps tendon connects the quadriceps muscle to the patella, while the patellar tendon connects the patella to the tibia.
- Muscles: The knee is surrounded by several muscles, including the quadriceps, hamstrings, and calf muscles, which work together to provide stability and control to the joint.
All these structures work together to allow for movement, stability, and support of the knee joint. Injuries to any of these structures can cause pain and limit the function of the knee.
What Happens if You Don’t Tap Heel Hooks?
If a person does not “tap out” when caught in a heel hook, there is a risk of suffering an injury to the ankle or knee. Heel hooks apply significant pressure to these joints and can cause damage such as sprains, strains, dislocations, or fractures if the hold is not released in a timely manner. It is important to understand and respect the potential for injury in any grappling or martial arts training, and to tap out when necessary to avoid serious harm.
Depending on the specific heel hook applied and pressure, knee injuries can vary from mild to extreme depending on when the submission it let go.
Mikey Musumeci showcased his skills in a grappling match with combat sambo champion Gantumur Bayanduure ONE Fight Night 6. During the match, Mikey engaged in a very deep inside heel hook on his opponent, resulting in his opponent’s knee twisting in an unnatural way for almost the entire match. Despite the gruesome display Gantumur managed to last the match without tapping.
After the match, it was revealed that Gantumur Bayadurren tore his ACL, MCL, and meniscus and broke his ankle.
Returning competitively to sport after ACL reconstruction is determined both by the physiology of tissue healing and physical capacity.
Typical Minimum Return to Sport Criteria after ACL reconstruction:
•9+months post-op (12+ for cadaver grafts)
•>90% Quad strength symmetry
•>90% on all hop tests
•Biological healing time for a graft can be up to 2 years post-op.
•Return to sport reported a 7x increased risk of new ACL tear when returning before 9 months.
•51% reduction of reinjury rate for each month delayed to return up to 9 months.
The outcomes of [multiligament knee injuries] might be negatively influenced by the bi-cruciate ligament, meniscal, and cartilage injuries. While surgical treatment provides good overall function, ROM, and stability, it rarely results in a ‘normal’ knee and the chances of complications and reoperations are high (Alentorn-Geli 2019).
Depending on the extent of the injury, you could expect to be out for six months or even up to two years if multi-ligament damage is present.
Why you Should Tap to Heel Hooks
If you didn’t get the picture thus far, we may not be able to help out.
You should tap to heel hooks because failing to do so can result in serious injury to your knee and lower leg. Tapping to a heel hook is a way to signal to your opponent that you concede the match and do not wish to risk injury. It is important to tap early and tap often in training and competition to ensure your safety and avoid long-term damage to your body. Remember, while training and competing in martial arts can be challenging and rewarding, safety should always be the top priority. By tapping to heel hooks and other submissions, you can minimize the risk of injury and enjoy the sport for years to come.
How to Keep Your Knees Healthy
Here are some steps to help keep your knees healthy:
- Maintain a healthy weight: Excess weight places additional stress on your knees, leading to pain and long-term damage.
- Exercise regularly: Strengthening the muscles surrounding your knees can help improve stability and support.
- Warm up before exercising: A proper warm-up can help prevent knee injuries.
- Avoid high-impact activities: High-impact activities like running or jumping can put a lot of stress on your knees. Consider low-impact alternatives like cycling or swimming.
- Wear proper footwear: Wearing shoes with good support and cushioning can help reduce the stress on your knees.
- Stretch regularly: Stretching can help improve flexibility and reduce the risk of knee injuries.
- Seek treatment for pain or injury: If you experience knee pain, seek treatment from a doctor or physical therapist as soon as possible. Ignoring the problem can lead to long-term damage.
- Avoid overuse: Overusing your knees can lead to injury and pain. Listen to your body and take breaks as needed.
Yes, tapping may equal defeat, for a moment. But to lose and be out of competition for potentially two years sounds far worse.