Cauliflower Ear – The Grappling Badge of Honor

Cauliflower Ear – The Grappling Badge of Honor

If you’ve been grappling or doing MMA for a while, it’s likely you know someone with massive cauliflower ear issues or have them yourself. If you’re an avid fan of the sport, you probably know a fighter or two with these same issues. Even Mixed Martial Arts legends like Randy Couture, Dan Henderson, and Wanderlei Silva all have these massive bunions growing on the side of their heads! It’s probably one of the first things you might see as they make their way inside the Octagon! 

But why is that? Why do even the most grappling elites have cauliflower ears? In this article, we take a look at one of the most common injuries in grappling and MMA alike. We look at Cauliflower Ear – the grappling badge of honor! 

What is Cauliflower Ear and What Causes It

Cauliflower Ear is a common condition in the grappling arts. As it is most commonly known in wrestling, it is sometimes referred to as “wrestler’s ears.” It was nicknamed Cauliflower Ear because the condition makes your ears look like bundled up skin tissue resembling a Cauliflower. But what exactly is it? What causes Cauliflower Ear?

The medical terminology for the condition is called Auricular Hematoma. The condition happens when a collection blood underneath the perichondrium (the elastic cartilage of the ear) which occurs secondary to trauma. The exact epidemiology is unknown, but it mostly happens in martial arts which involve a lot of grappling and clinch fighting.  

Cauliflower ear occurs as the consequence of untreated or improperly treated auricular hematoma. It is a medical condition where the cartilage inside of a fighter’s ear breaks. It leads to disrupted blood supply from the skin. A fluid build-up occurs.   

As cartilage heals, it shrivels up and folds in. As you continue to damage it throughout the years of training, plastic deformation starts to occur, and your ears permanently gets deformed! 

Since grapplers are notorious for not wanting to take breaks away from the mat, these damages build up over time. In a grappling session, you can put pressure against your opponent face to maintain proper head control. This pressure against the ear leaves microtrauma, stopping blood flow to the peripheral parts of your ear.  

Usually the skin is capable of healing itself overtime. But the ears are different. They are much thinner compared to other parts of your body. The healing process isn’t as prevalent. Think of it like a piece of paper. If you crumple it over and over it becomes near impossible to remove the creases! The continuous impact from clinching, striking, or pressure grappling on the ears eventually develops Cauliflower Ear.   

Risks of Cauliflower Ear

Cauliflower Ear in general can be hassle. People that have it mention that they can be very painful and sensitive to the touch. If left untreated for too long, the condition does become much worse and can be prone to infection. A painful inflammation to the cartilage can form and make the swelling much larger 

Some severe cases can even cause the ear canal to be blocked. This can really affect your hearing if the swelling gets out of control! 

The pain of untreated cauliflower ear can get so bad that you might be tossing and turning at night. Some fighters report that the pain can get so bad that they even have trouble sleeping. If this happens, make sure to consult your doctor to relieve the pressure on your ears.  

Another risk factor is that there can be massive fluid build up in your ear. One blow to the side of your head can cause it to pop! A bit gruesome to watch but here’s a clip of Leslie Smith’s ear exploding at UFC 180. (Viewer’s discretion is advised).  

The Grappling Badge of Honor

One common question often comes to mind when starting grappling is will I get Cauliflower Ear if I try any grappling sport? Will it happen to everybody? Not necessarily.  

When you look at BJJ grapplers that have been doing this a while, your results may vary even if they have a similar game. For example, Andre Galvao, a very top-heavy pressure passer look like his ears been through some times, while Xande Ribeiro’s look unscathed. Both have similar styles but both don’t have the same ear issues. Your fighting style or your genetics might come to play. Some fighters are just prone to it and some aren’t – it really depends 

The reason these concerns might come up is the bad rep that Cauliflower Ears get. For one they aren’t the most pleasing to look at. They look like shriveled up skin! It can get pretty nasty. Take a look at Alexander Gustafsson’s ears – they’re massive! 

Alexander Gustafsson Cauliflower Ear

But Cauliflower ears aren’t all that bad. They’re more common than you think. There are even ancient Greek statues that have these conditions. Back then probably only bare-knuckle boxing and maybe Greco Roman Wrestling existed. Yet fighters were portrayed having suffered minor ear damages. So you know these conditions existed for ages! 

You might get some stares and sideways looks but that’s perfectly fine. Its normal and it simply comes with the territory. Some fighters consider their cauliflower ears as a grappling badge of honor, and they’d never change it. Take Randy Couture, for example, even said in an interview he was very proud of his ears.  

Cauliflower Ear Treatment

There are a few ways you can treat Cauliflower Ear depending on the level of damage. Some of the main treatment for the damage include:  

  • Ice Therapy 
  • Draining Fluid
  • First Aid 
  • Plastic Surgery

Ice Therapy

It might be unpleasant, but ice prevents swelling. Keep in mind that you can do this even if your ears aren’t swollen. Even if you have slight pain, some ice might do you some good! Here are the steps required:

Here are the steps required:

  • Put ice on the critical area and use a hand wrap to compress it down 
  • Don't wrap too tight otherwise it might cause damage
  • If you aren't able to sleep at night, go see a doctor to prescribe you meds 

Draining Fluid

This is probably the most common practice for Cauliflower Ear Treatment. Apply this process as often as possible at home to prevent permanent damage. It is easy, but you do need a lot of patience. If you have steady surgeon hands, go for it! However, it’s probably best if you have a friend or a doctor do the draining for you.  

Note: Only do this yourself if and only if your hands are steady! Don’t panic, you’re helping yourself! 

Here are the steps:

  • Please put a pair of gloves on. First, disinfect the area you’d like to work on. Using a sterile cotton ball is a great choice for this process.
  • Soak it in the alcohol and put it on the swollen area to kill all the bacteria (water will not prevent the area from the infection).
  • Prepare a syringe and a needle. If you have no medical experience or fear of the needles, we advise you to ask for the help here. But those who want to do it themselves should purchase 1-inch needle with at least 3 milliliters syringe attached to it. It’s time to treat the Hematoma.
  • Slowly pierce the swollen area deep enough. The tip of the needle should be able to get in. Try to push it to the mid of your ear, not deeper, to stay away from more damage. Move it very gently and slowly.
  • Draw the blood and other fluid out of your ear very slowly.  In the most extreme cases, there is a chance you’ll have to press the swollen area for a successful draining process.
  • Disinfect the area one more time. Repeat the sterile cotton ball and alcohol or hard drink routine.
  • Press the injured area to prevent or stop bleeding. If your cauliflower ears are not damaged, this step is unnecessary.

First Aid

If your ears are heavily damaged, you may need to use proper first aid to start the healing process. If your ears are so damaged that even a direct blow to the ear can cause your ears to get cut or bleed out, start some first aid.

Here are the steps:

  • (Optional: you can apply hard liquor like whiskey or vodka if you don't have regular rubbing alcohol. Even more optional: drink a few swigs of that liquor (if you are 21 and over of course) because it's probably going to hurt - it can help numb the pain!)
  • Use a bandage or a sticking plaster, depending on the level of damage
  • If the bleeding is heavy and continues to bleed profusely, consult your doctor! 

Plastic Surgery

In serious extreme cases when the ear injury is too serious, you might have to resort to plastic surgery. If it gets to the point that you aren’t able to hear due to the swelling or if the pain is just too severe that none of the treatments are working, it might be time for plastic surgery.

If you leave your ears untreated too long, this might be what you might resort to. Rafael Dos Anjos had to undergo plastic surgery when his ear nearly fell off! You don’t want to get to this point. Make sure to treat your Cauliflower Ears! Consult your doctor and surgeon to see if plastic surgery is right for you.  

Cauliflower Ear Prevention

Probably still the best treatment for Cauliflower ear is its prevention in the first place. You can do so by taking the proper safety precautions when it comes down to training.

Don’t ignore the signs. If your ears hurt, take care of those ears! Make sure you ice them even if they might not be swelling yet. Make sure you get a lot of rest!

And for those BJJ players that can’t seem to stay away from the mats, make sure you make the proper adjustment to your game play. If you are a heavy pressure passer or a half-guard player, maybe switch it up a little. These positions require a lot of close body contact that might rub against the side of your head. These types of movements can easily reinjure your ears and risk developing Cauliflower Ear. Maybe play a little more open guard De La Riva or Spider to keep your distance!

However sometime head contact isn’t avoidable. Your opponent might be able to pass your guard go for choke hold. In this case, if you get caught in a really deep guillotine or triangle, don’t forcefully pull your head out! Every choke attempt carries a heavy risk of ear contact and can easily re-damage your ears if you force yourself. If you don’t have a clear way to get out, just tap. Remember, it’s just training. Permanently damaging your ears just isn’t worth it!

Lastly, the easiest way to protect your ears during a rolling session is to get yourself some proper wrestling head gear. There are some excellent choices out there and they aren’t all that expensive either! Check out some of our picks from Amazon:


Grappling is an excellent sport. But just like anything else, it does come with plenty of risks if you aren’t careful. If you don’t take the proper risk implications, you can develop some major Cauliflower Ear condition.

Remember, your ears are extremely fragile. It doesn’t take a whole lot to damage them. As you grapple more often, you risk re-damaging your ears, and eventually become permanent. And these damages can be painful!

Take the necessary safety precautions to avoid injuring your ears. The pain and hassle that comes with Cauliflower Ear simply isn’t worth it! 

However, if you do have it, keep in mind that they are very common in grappling. It comes with the territory. Wear them proud, you've earned them! Wear them like a badge of honor!