Concussions in combat

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Adil Sajjad reports on the issues surrounding serious injuries in contact sports.

“The UFC, listen, we don’t hide from it, it’s a contact sport and that’s what these guys do…In the 20-year history of the UFC, it will be 20 years in November, there has never been a death or a serious injury.”

These were the words of Dana White in January 2013. The UFC president explicitly made clear that while concussions were an ever-present problem in combat sports, it wasn’t necessarily their problem because they ‘actively look to minimise and treat’ concussions. It’s true that the UFC sanctions a mandatory three-month medical suspension for any fighter suspected to have suffered general mental trauma, though the question is how much can the threat of such trauma in a combat sport really be prevented, and is treatment really even relevant once someone has already developed a degenerative brain disorder, such as Muhammad Ali/Gary Goodridge?

It should be of no surprise to anyone that the realm of combat sports is riddled with broken bones and crushed limbs. Yet it’s often been called the purest form of competition; from modern day boxers and mixed martial-artists to the wrestlers of ancient Greece. I’m not ashamed to say I agree with that sentiment. In some sense, the supposed barbarity may be what draws the audience to it. Maybe the sight of two evenly matched individuals in an act of physical aggression against one other for the sole objective of glory quenches a primordial bloodlust that can be attributed to human evolution. That’s okay then, right?

Perhaps we relate to the poetry of someone literally fighting for every pay-check in the same way the average Joe feels he has to ‘fight’ to put food on the table. Maybe.

However, what neither of these theories explains is why we react so differently to physical and mental trauma in general. What merits a loud ‘ooh’ or ‘ouch’ sound when it comes to fractures causes a pained and uneasy silence when it comes to brain damage. Don’t believe it? There’s a way to test this kneejerk reaction: show any boxing fan from the 60s and 70s one of Muhammad Ali’s recent interviews and it’ll become painfully clear that the subject is still a taboo.

Before we go any further, it should be explained that the reason there is such a focus on the UFC when talking about MMA is because it is undoubtedly the largest, busiest, most profitable and the most prominent organisation. It is essentially the face of the entire sport in the same way that when one mentions basketball, the NBA immediately comes to mind.

Until recently there wasn’t exactly a wealth of research on the topic of concussions in MMA, but the University of Toronto have just finished carrying out an investigation over the span of seven years from 2006 to 2013 in a bid to illustrate the average number of concussions (via KO for MMA and boxing) in the UFC in comparison with other contact sports. They found that for every 100 athletes 6.4 will suffer a concussion, which is trumped only by American football which had an average of 8.4 athletes injured (as published in the American Journal of Sports Medicine).

This statistic is made all the more concerning when you take into account the level of mental trauma suffered by mixed martial artists who lose a fight by technical knockout (TKO). In this scenario the majority of TKOs take place when the referee decides that a fighter is in a disadvantageous position and is showing no signs of ‘intelligent defence’. For the layman, this means that the referee may decide to stop the fight if one fighter is perched on top of the other pinned-down fighter, and is repeatedly raining down haymakers. From this the referee will look to see if the defending fighter is actively looking to improve his position and isn’t just at the mercy of his opponent. Sometimes the defender will manage to wriggle out of harm’s way and sometimes they won’t. What matters is the massive amount of damage a fighter can take if the referee is slow to act. It’s possible that the losing fighter could take up to 10 unanswered shots to the head. When including the number of fights that end in a TKO, the number of average concussions soars to 15.9, dwarfing every other mainstream sport on the planet.

In the history of mixed-martial arts as a modern sport, there have been ten recorded fatalities from both sanctioned and unsanctioned ‘amateur’ bouts. Of these fatalities, nine can be attributed to blunt force trauma to the head. It’s truly worrying for the competitors.

It’s for this reason that fighter safety is so important, and doubly so for MMA, so the task therefore is to find ways to minimise the risk of brain damage without overly transforming the sport. For example, some of the more obvious-sounding solutions such as protective headwear wouldn’t be advisable in MMA as they would minimise a fighter’s ability to perform any submissions to the head area altogether if there is an obstructive helmet-shaped pad that reaches under the chin. Should the fighters be asked to sacrifice a large, maybe crucial, portion of their game for the sake of minimising the risk of one particular type of injury?

This becomes uncomfortable territory as the immediate question that follows is: what’s more important, fighter safety or the sport itself? Ethics or entertainment? It seems a simple question to answer; of course an athlete’s wellbeing should be held above all other factors but the hard truth is this: most fighters need the money. If interest in the sport depreciates then so does the size of their pay-checks. At UFC 157, a pay-per-view event, Liz Carmouche fought in the main event for the bantamweight title and made only $12,000 (according to CSAC disclosed salaries via mmajunkie.com). While this isn’t entirely consistent with every event, it should illustrate the type of money you can look to earn even as a main-eventer if you’re not a fan favourite (or willing to swing haphazardly in every fight). While it might make everyone feel good to say that the sport must be changed, doing so may put hundreds of athletes out of work altogether.

Poetry, or barbarity? Perhaps it’s a bit of both.

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