Campaign for NSK Injury Protocols

Campaign for NSK Injury Protocols

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Graham Densham started this petition to Nippon Sumo Kyokai (NSK) and


Sumo is a sport enjoyed by fans around the world, evidenced by the many international Sumo fan groups that exist with memberships in the thousands. While the handling of injury to rikishi has always been a topic of discussion on these groups, there has been widespread outrage at the handling of injuries sustained by rikishi on the dohyo in recent basho. The Campaign for NSK Injury Protocols has been formed to highlight the strength of feeling among Sumo fans to the Nippon Sumo Kyokai (NSK) and The Ministry of Education, Culture, Sports, Science and Technology (MEXT) in order that urgent changes to injury protocols be made.

Sumo Injuries

Sumo is a combat sport with a long and proud tradition, and this history is respected by fans the world over. Rikishi dedicate their lives to training and fighting, the risk of injury is accepted and ever-present. However, rikishi are NSK employees and their ongoing safety is the responsibility of the NSK. Recent high-profile injuries have shown that the NSK is falling short in protecting rikishi.

To highlight these concerns, the Campaign for NSK Injury Protocols had a Doctor review the injury handling of two of the most recent high-profile injuries:

Shonannoumi – Asagyokusei, Hatsu 2021


·       Momentary unconsciousness observed.

·       Obvious immediate poor coordination indicative of significant concussion.

·       Slow to regain coordination.

Recommended treatment:

·       Assessment for any neurological signs including Glasgow Coma Scale, eye reflexes, speech disturbance and amnesia.

·       Assess for any cervical spine injury.

·       Monitor for a sensible period of time for any post-concussion syndrome.

·       If none of the above observed, clear to compete following day.

Hibikiryu – Imafuku, Haru 2021


·       High velocity injury to neck at dangerous angle.

·       Concerning lack of movement with signs of loss of consciousness.

Recommended treatment:

·       Check airway.

·       If airway clear, then DO NOT MOVE as high clinical suspicion of significant spinal injury.

·       If concerns about airway, shift into supine position then immobilise neck.

·       Immediate emergency medical assessment.

·       Immediately call an ambulance and state adult trauma with suspicion of spinal cord injury.

·       Under no circumstances should this individual compete until fully assessed at hospital.

In short, the lack of trained medical professionals in these instances led to outcomes which may have worsened the injuries sustained by each rikishi, especially in the case of Hibikiryu where the handling of his injuries may have contributed directly to his death. The handling of these two injuries are only the most recent examples and there are countless others which cause concern among Sumo fans. Although statistics on injuries in Sumo are hard to find, Matsumoto Tsuchiya MD, PhD (Department of Orthopaedic Surgery, Arthroscopy and Sports Medicine Centre, The Fraternity Memorial Hospital, Tokyo) published a review of rikishi injured between 1982 and 2007. This review investigated 4849 rikishi injuries over a 25-year period and found that 348 (7.2%) rikishi had suffered neck and head injuries. Injuries in Sumo are to be expected, and they have the potential to be life-threatening or life-altering, and appropriate preparations should be made. This is recognised by other sumo associations, for instance the International Sumo Federation (IFS) require that trained medical staff are present for all matches, that an ambulance is on standby and that an Automated External Defibrillator (AED) is available at the Sumo World Championships venue.

The Impact of Injuries in Sumo

The impact on an individual rikishi cannot be overstated. In the best-case scenario, a rikishi who suffers a serious injury will take the time to recover before working his way back up the banzuke. If the rikishi fails to recover fully then it will end with the rikishi being demoted or retiring from the sport entirely. In the worst-case scenario the impact of an injury on the dohyo could end up altering, shortening or even claiming the life of a rikishi. And, unfortunately, this is exactly what we have witnessed with the sad passing of Hibikiryu.

The long-term survival of Sumo relies on the recruitment of new rikishi. The recent report published on the tradition and future of sumo wrestling calls for a review of safety consideration for rikishi specifically because the current protocols are dissuading parents from allowing their children to pursue sumo. These experts, as well as the Campaign for NSK Injury Protocols, are pushing for the modernisation of injury protocols to ensure a future for sumo where rikishi feel their wellbeing is looked after.

Our Proposal

The Campaign for NSK Injury Protocols calls on the Nippon Sumo Kyokai (NSK) and The Ministry of Education, Culture, Sports, Science and Technology (MEXT) to urgently review the suitability of, but not limited to:

·       The provision of trained medical staff at all matches during a basho,

·       The medical equipment provided to ensure inured rikishi can be moved in the safest way possible,

·       The first aid training provided to all NSK employees, and

·       The training on safe use of medical equipment to aid in moving rikishi provided to all NSK employees.


You can contact the Campaign for NSK Injury Protocols at:




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