Participation in Competition & Competitive Dan Gradings with Stoma Bags

To ensure the safe and inclusive participation of Judoka with stoma bags in British Judo competitions, a formal application and approval process has been established.

This process outlines the necessary steps for competition entry, medical verification, equipment authorisation, and communication with event organisers and officials. It is designed to support the Judoka’s inclusion while maintaining safety and fairness across all competitive levels, ensuring that all stakeholders—Judoka, coaches, referees, and medical teams—are fully informed and prepared.

Process of application and approval

1. Judoka identifies a competition they wish enter (Requires clarification on competition level Judoka can enter, i.e. based grading of the Judoka)
2. Competition entry form requires indication that a Judoka is wearing a stoma and description of what type of stoma- for events team, regional event organiser and or Area Director of Examiners.

Proposed Process for Judoka Registration: First-Time Registration: Judoka with a stoma or prosthetic should complete a registration process with Head Office before competing in any event. This will ensure they are known, queries are resolved, and proper authorisation is given and recorded. Where event organisers are contacted directly, they refer this to the head office contact.

• Authorisations: Judoka should receive instructions and an authorisation letter (PDF), including guidance on how to enter competitions and what to expect. In time, it may be possible to include relevant details on their membership record accessible to officials.

It will be clear what has been authorised, both in terms of the actual devices themselves and any protective covers that must be worn. The Judoka authorisation form will be signed declaration by the judoka or their representatives that they will only wear authorised devices and protective covers and will not wear anything unauthorised. This is because it isn’t going to be appropriate for officials (or at least the referees) to be verifying these comply.

• Competition Entry: Event organisers may not consistently update entry forms to capture the information sought (even against best practice), so proactive communication is needed by the entrant to alert the organisers that a judoka with a stoma is entering so correct arrangements can be put in place to accommodate them.

3. Judoka to confirm they will bring & wear appropriate safety equipment, i.e.  hernia belt, rash guard with Judoka taking additional hernia belt & rash guard
4. Information supplied the by Judoka, as part of their competition entry along with supporting medical report from Judoka stoma medical support person, i.e. stoma nurse (see BJA Doctor guidance below re what this should include)
5. BJA Events Team and/or club/region forward the entry to; 1. Head of Safeguarding, Inclusion & Wellbeing (HISW) for confirmation that Judoka can enter.
6. HISW signs off entry confirmation and issue letter of authorisation (based on information provided, as suggested by BJA Doctor below)
7. Judoka informed that they could enter with written confirmation from HISW
8. Judoka would present written confirm at point of registration on competition day
9. Registration desk will inform officials & referees of Judoka specific stoma needs before competition on the mat
10. Clear guidance agreed by officials & referees at competitions, including cleaning protocols

Guidance needs to send medical teams’ who will be present pre-tournament (with assurances they can deal adequately with a stoma). Including Event Organisers need to ensure this has been discussed and agreed.

The following conditions re Judoka with a stoma will be considered at competitions:

• Stoma Leakage or issue mid-contest: If a stoma bag leaks, the referee’s role is to hand over the situation to medical staff. The same applies if the judoka informs the referee of an issue with their stoma bag. The referee will not seek to confirm the issue is genuine or not.
• Mat cleaning: If the mat requires cleaning, the referee will request this of the medical or the event team before the contest resumes. The judoka should not be asked to handle cleaning.
• Soiled judogi – The referee will ask that it is changed in the shortest possible time, in line with the approach for a rip or tear.
• Medical and Cleaning Pre-Clearance: Procedures for medical intervention and cleaning must be agreed in advance of the event and prior to agreeing to the judoka’s participation. Planning must not assume that the judoka should be responsible for cleaning the mat in case of leakage – as 1) it may be embarrassing, and 2) refusal to do so would then result no one being willing to clean the mat.

Specific Medical Considerations:

BJA Medical Officer guidance is (see Appendix 1):

Some types of stomas could be fine, but others not. So, agreement to participate must be on an individual case by case basis. Stomas are also frequently damaged / revised, so further surgery may be needed. Therefore, medical clearance should not be forever. Judokas need to get permission from their treating surgical team (not the GP), as they are the ones who will be revising the stoma if it gets damaged. This needs to be in the form of a letter which their specialist signs, outlying the risks of trauma very clearly. We had to do one last year for a fighter who wanted to compete following a detached retina. For example, it needs to say something like:

“Judo is a full contact combat sport. Competitors frequently sustain direct blows to the abdominal area, and are thrown onto mats, which may involve them landing on their stoma with their body weight and that of their opponent on top. Judo is a support which heavily engages core strength and both eccentric and concentric contraction of the abdominal wall muscles. I confirm I am the hospital specialist looking after …name… And am happy for them to engage in competitive Judo with this knowledge of the sport.”

In addition, the National Referees Commission (NRC) has stated:

• Referee and Medical Roles: Referee Responsibilities: Referees are not expected to inspect nor make judgments on the fitness of judoka’s stoma bags. Instead, they should intervene only if an issue arises and refer the judoka to medical staff for resolution.

• Medical Judgments: Referees will not assess the fitness of judoka either before the contest or after returning from medical care. They will, however, ensure that soiled judogis (based on visual observation, not inspection) are replaced.
• Medical withdrawal – It should be clear that if medical advice is that it is inappropriate for the judoka to continue – we would act on that advice, even if the judoka (or their parents/coach) wishes to continue.

Creation of clear guidance for officials & referees at competitions

1. Registration desk will inform officials & referees of Judoka specific stoma needs before competition on the mat
2. Referees & officials will brief opponents coach, medical team (ensuring they have the confidence, skills & knowledge in supporting Judoka with support if required) at the event on registration and evidence of risk assessment completed
3. Referee will complete final observation that agreed Judoka measurers are in place (as outlined in risk assessment) before entry onto mat area and agree on any process for any leakage (including cleaning mat & added time)
4. Time to be considered if stoma off leaks in competition. To be agreed, who will clean mat in event of leakage (this should not be the Judoka in order to ensure there is no embarrassment to them). It is recommended that mild detergent in water and then a mild antibacterial disinfectant is used and allowed to dry.
5. In addition to any spillages on the mat consideration must be taken regarding contamination of Gi worn by his and other Judoka. Minor blood spots would not warrant a change of Gi as this could be sponged down if necessary. With any spillage in addition to the bacterial risk there would be the need to prevent odour impacting on those in the mat area. The easiest option would be to prevent potential spillages in the first place. The Judoka should wear appropriate suitable clothing an ensure the pouch is empty before each contest
6. In this case Referee will complete final observation of Judoka agreed measurers in place (as outlined in risk assessment) before return entry onto mat area
7. Post event, Judoka to be invited to feedback their experiences and learning for future events.

UPDATES TO BE MADE TO THE BJA AMENDED CONTEST RULES TO SUPPORT WEARING OF STOMA:

The wearing of stoma bags (with the correct authorised device being confirmed by BJA Doctor) is permitted, subject to prior authorisation of the devices on application to BJA Head Office. This ensures the safety and suitability of each device worn in competition. Referees must be informed where these devices are to be worn in advance of each contest by technical officials. Wearing an unauthorised device is prohibited.

Stoma bags

If the athlete experiences an issue or discomfort with their stoma or stoma bag, they should inform the referee. The referee will immediately stop the contest and refer the athlete to the medical team.

If it becomes apparent to the referee that there is an issue due to the stoma or stoma bag, the referee must stop the contest immediately, even if this is mid-action, and refer the athlete to the medical team.

Referee Responsibilities

Referees are not responsible for inspecting or determining the fitness of stoma bags. Their role is to intervene only if an issue arises and refer the athlete to medical staff.

If medical advice is given that it is inappropriate for the athlete to continue, the referee will end the contest by kiken-gachi.

If the tatami requires cleaning, referees will request cleaning by the medical or event team before resuming the contest. Similarly, if a judogi is soiled, the referee will require the athlete to change it promptly, in line with procedures for rips or bleeds.

Refusal to compete

An opponent refusing to compete against an athlete wearing an authorised device will forfeit the contest by fusen-gachi or kiken-gachi, depending on the timing of the refusal.

Click here to read: Appendix 1: BJA Medical Officer Guidance on Stomas