Abstract
Concussions represent one of the most prevalent and disabling injuries in combat sports, where rapid accelerations, rotational forces, and repetitive sub-concussive impacts expose athletes to significant neurological risk. Among the systems most vulnerable to such trauma is the vestibular apparatus, which plays a critical role in balance, gaze stabilization, and spatial orientation. Vestibular dysfunction—manifesting as dizziness, visual disturbances, postural instability, and impaired motor coordination is increasingly recognized as a key predictor of prolonged recovery, reduced athletic performance, and long-term neurological sequelae. Combat sports such as judo, despite their non-striking nature, impose substantial biomechanical stresses on the head and cervical spine through high-velocity throws, uncontrolled falls, and rotational accelerations. These mechanisms can disrupt both peripheral and central vestibular structures, with cumulative effects that may remain undetected without targeted assessment. Tools such as the Vestibular/Ocular Motor Screening (VOMS) and balance testing have emerged as essential components of concussion evaluation, while early vestibular and neurovisual rehabilitation has shown superiority over passive rest in promoting recovery. In judo specifically, deficiencies in falling technique (ukemi), inadequate symptom reporting, and underuse of vestibular screening contribute to underdiagnosis and delayed management. Emerging technologies including wearable sensors, biomechanical modeling, and AI-driven risk stratification offer promising avenues for monitoring head impacts and guiding individualized prevention strategies. Overall, integrating vestibular assessment, safe falling instruction, evidencebased return-to-play protocols, and technological innovations is critical to mitigating concussion risk and enhancing athlete safety in judo and other combat sports.