Matt Pitt Explores Dementia Pugilistica and Its Relationship to Mixed Martial Arts
by Luke Thomas on Feb 11, 2010 2:29 PM EST
in MMA News
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Dr. Matt Pitt is back on Sherdog.com with his inimitable column "Fistic Medicine". This time he takes a look at Dementia Pugilistica or Punch Drunk Syndrome. He makes several points about what is now known as Chronic Traumatic Encephalopathy (CTE) - the injury applies to rugby and football players as much as boxers, and that this syndrome is not an accelerated form of Alzheimer's as some suggest - before turning his attention to MMA:
It is true that there is compelling evidence that MMA is safer than boxing. But "safer" is not safe. MMA fighters are starting younger, are enticed by the money involved to fight longer and eventually MMA will have a cohort of neurologically impaired veterans of its own. With the overwhelming medical, scientific and epidemiologic evidence that a career worth of head blows leads to CTE in one out of five fighters, the moral imperative for some meaningful change is inarguable. The sport is too good not to be better.
Unfortunately, even if the need for greater safety is clear, what actually can be done to lessen the danger of CTE in combat sports is less certain. Football or rugby can adapt new equipment or rules to lessen the danger; fight sport has less clear options. In general, most of a fighter's head blows -- if not the most severe -- will occur during training, out of reach of promoters and athletic commissions. Heavily padded gloves may paradoxically worsen the danger. Headgear appears to be of limited use, may even be harmful and, in any event, is unpopular with fighters and fans alike.
Further, it is difficult to stop what cannot be demonstrated to exist in real-time. Pre-autopsy testing for MTBI is effectively unavailable. The commonly used CAT scan -- which does show bleeding -- does not show MTBI. Blood tests for evidence of brain injury are unreliable, and lumbar puncture testing is impractical. The long delay between traumatic insult in a fight and onset of symptoms means that a fighter who shows no quantifiable evidence of injury during his career can still develop CTE at a relatively young age.* * * Almost certainly the greatest barrier to preventing CTE in fight sport will be the tolerance of promoters and fans. Violence sells. A Google search for "Top 10 MMA Knockouts" produces 60,000 hits. A search for "Top 10 MMA well-fought three-round decisions" is strangely silent. The violence is promoted and well compensated, the harm it causes de-emphasized and well hidden.
But there is reason for hope: The Nevada State Athletic Commission vice chairman mentioned in this article who was so disturbed by Terry Norris' fight-related brain damage is a familiar figure to fight fans: Mr. Lorenzo Fertitta. I understand he has some pull in the world of MMA. We shall see how he uses it.
We shall see indeed. While present changes to protocol to improve safety at this juncture seem unclear, being vigilant about medical developments or proposed rules adjustments could pay dividends in protecting the fighters who make this business move. The quest to improve safety should be a defining principle of this sport's regulation, one which never expires. It should be part and parcel of the culture of MMA, particularly as the methods of delivering punishment and damage by increasingly capable athletes continues to expand.
And for those who may have missed it, I interviewed Dr. Pitt about the nature and extent of the injuries that sidelined Brock Lesnar for MMA Nation on 106.7 The Fan. It's not to be missed. Quite literally, there is no one within the MMA community who is currently writing that has command of these medical issues like Dr. Pitt. He is an invaluable resource and we are better and more capable of making informed choices or opinions by having his contributions.
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People thought I was nuts
When I said that Velasquez vs. Kongo at UFC 99 should have been stopped. The Parisian took too many blows to the head. It may not be a problem now, but can be part of a bigger problem down the road if he continues to fight and take punishment.
It is not enough to succeed. Others must fail.
We're talking about Kongo's beating at the hands of Cain Velasquez.
See if you can figure out the joke.
Fistic Medicine, my favorite thing to read at Sherdog.
I really commend Matt Pitt for the articles he’s written so far. They’ve all been fascinating studies and explanations of topics within MMA that next to nobody knows about. I hope he continues writing these for some time to come.
As for this topic, its a hard balance to strike between safety and fundamental risks. Really, the only way to completely ward off this form of dementia is to remove head strikes completely. Not something that would help the sport grow, and probably something most fighters would scoff at. At the same time, we have these regulations so undue damage and death do not occur. I think this is one of those necessary risks in MMA, what can be done however is to make all fighters well aware of the details of this risk so they can decide whether they are willing to take it or not. Perhaps regulate more stringent medical requirements prefight, even if that means longer amounts of time between fights if that helps reduce the cumulative buildup of brain damage.
The only thing meaningful thing that can be done is to limit fighters to a maximum of 3 fights per year (or at most 4)… this way in between fights and training camps the body heals itself. The problem arises when the body is not allowed to heal itself for long periods of time.
2 months training camp, fight, 1 month off – no strenuous activity, then 1 month training without blows to the head, repeat.
The injuries rarely develop in the fights… they happen in training camps.
by mmalogic on Feb 11, 2010 1:29 PM EST reply actions 1 recs
We still couldn't...
Force fighter to not train if they wanted, but this is the only step I can think of as well. Limiting the amount of time they can fight AND increasing the amount of time the AC says they can’t have sparring in the gym is the only way to illicit this type of change, imo.
by Chris Barton on Feb 11, 2010 1:34 PM EST up reply actions
You risk severly stunting the growth and progression of prospects on the regional circuit.
More thoughts on this, but I’m on my phone.
Twitter: @Mike_Fagan_13
http://www.sackmikegoldberg.com
by Mike Fagan on Feb 11, 2010 4:41 PM EST via mobile up reply actions
yeah, i agree,,, but that’s the only viable solution i see – other than living with the consequences.
There’s preventative care but fighters would need great discipline.
If fighters didnt drink or do other recreational “activities” then this problem would reduce.
There’s very expensive whole food and herbal remedies and diets that would greatly reduce it… but fighters arent willing to give up mcdonalds or booz.
I personallty dont think this type of rule should be instituted across the board.. in Zuffa most fighters dont fight that often anyway. But if people are crying for institutional fixes then this is as close as it gets.
Otherwise fighters should quit booz, get on a whole food diets, do yoga and train smarter on their own and the problem would decrease that way.
Dr. Pitt
Is the best thing to happen to Sherdog in years, and as you say, probably one of the best contributions to MMA.
I do have some discomfort with the idea of protecting people from themselves, but I certainly empathize with the sentiment. Every time I watch Scott Smith fight, I see his children as well as I see the glaze over his eyes and I fucking worry.
My motto,
As I live and learn,
is:
Dig and Be Dug
In Return.
-Langston Hughes (no relation to Matt)
MMA fighters are starting younger, are enticed by the money involved to fight longer and eventually MMA will have a cohort of neurologically impaired veterans of its own.
I don’t want it to happen to this guy:
How did I end up on this bandwagon and why does everything say property of Chael Sonnen?
What makes a guy like mark coleman or frank trigg dangerous for Zuffa is not only them getting hurt… and not only having guys coming in for a paycheck (which devalues the brand) – but on top of that they could be coordinating bets against themselves to maximize their earnings.
Nobody wants that shit. Mark Coleman is done competing… he wants a paycheck which could lead to even worse things than getting brain damage.
i couldn’t believe when they picked up trigg and coleman again. it seemed to go against everything zuffa and the had claimed they were about.
my theory is that strikeforce scared them enough that they felt the need to lock down some names so that strikeforce couldn’t get them. especially names that they’d spent time and money trying to make into marketable stars.
i think it would have been better to let strikeforce have them and let the world see how crappy and desperate those two fighters are. i think this backfired on the ufc.
Coleman did fine with shogun and bonnar… Trigg was coming off a 3 fight win streak. he beat Riggs.
But a I agree the fighters who walk in to collect a paycheck the fighters who want to pad their records have been migrating to shitfarce… and I suspect some of these guys who are cut will go there as well.
There’s like 3 or so fighters in shitfarce who actually want to compete and test themselves and ironically they all want to fight in the UFC.
What evidence do you have that they were betting against themselves?
I hope you have something, because otherwise this is the worst sort of baseless accusation.
It would be very difficult to get away with any sort of gambling related matchfixing in a high profile fight in this day and age. Not to mention the poor risk/reward of betting against yourself at -500.
Twitter: @Mike_Fagan_13
http://www.sackmikegoldberg.com
by Mike Fagan on Feb 11, 2010 4:49 PM EST via mobile up reply actions
It wouldn’t be a bet on yourself at -500. More like a certain round finish.
How did I end up on this bandwagon and why does everything say property of Chael Sonnen?
I’m not sure Vegas books offer those sorts of lines on MMA. And even then, how are you going to get enough action on it to be worth your while?
Twitter: @Mike_Fagan_13
http://www.sackmikegoldberg.com
coleman has had brain damage since UFC10
by SilverNBlackZach! on Feb 11, 2010 5:19 PM EST up reply actions
These stories are tough. I love MMA. I love knockouts, but the body of evidence that the very think I find so exciting does permanent, irreversible damage over time is impossible to ignore. I have no idea what should, or even can be done about it though.
At some point athletic commissions may have to put a hard and low cap on how many KOs a fighter is permitted to suffer and still compete.
Tatum: I think he's a good man. I like him. I got nothing against him, but I'm definitely gonna make orphans of his children.
and they may have to punish fighters for blows to an obviously unconscious opponent. granted, most won’t admit it like hendo did against bisping, but there should at least be inquiries and a way to establish the fact that making sure he’s out is acceptable, purposefully hitting a knocked out opponent cause they said some shit in the prefight is not. it shocked me when people came to hendo’s defense. obviously they don’t know, or simply don’t care about stuff like this as long as someone they “hate” is the one that is having a very real part of their life taken away.
Someones still a little butt hurt
1/20/2010- Has been declared BROCK IS BACK BITCHES day B.I.B.B. for short. Im working on making it a national holiday
Smart ass since 1990, wanna fight about it?
by II SMASH II on Feb 11, 2010 2:08 PM EST via mobile up reply actions
yeah, a guy threw his entire body into the face of an unconscious man, admitted he knew he was unconscious and i’m a little bit butt hurt. people like you are the reason mma is still illegal in the state i live in.
Stay classy!
Lolololol me and the 1.6 million people who went crazy when this happened willstay classy
1/20/2010- Has been declared BROCK IS BACK BITCHES day B.I.B.B. for short. Im working on making it a national holiday
Smart ass since 1990, wanna fight about it?
by II SMASH II on Feb 11, 2010 4:47 PM EST via mobile up reply actions
I admit I freaking love that KO , but honestly what Hendo did was unforgiven …so Im torn here . Morality says no no , but my body knows what it likes . It’s kinda like having sex with a drunk chick that has a crush on u and u know you only want her for sex. No ? Ok thats just me then.
let’s be honest, it’s not like screwing a drunk chick, it’s like screwing a passed out chick. screwing a passed out chick is rape, hitting an unconscious person is assault. just because we can all kind of understand the impulse or because it makes ii smash ii and 1.6 million people cheer doesn’t make it ok, it just makes people like ii smash ii and those other 1.6 million people look like emotionally undeveloped, shitty people.
not to mention that hendo did the same damn thing to wandy, and maybe, just maybe, if he’d been punished for it before, he wouldn’t have done it again. instead it just gave the ufc incentive to let him walk. god knows i’d demand extra compensation to fight a guy known for trying to give unconscious opponents brain damage.
dan lost me as a fan there. it made him look weak, childish and sadistic. bisping’s antics may not have given him the psychological edge to beat hendo, but it sure helped us all learn what dan henderson really is.
I think you're grossly overestimating the amount of thought that goes on
in the split second between the knock down and the follow up blow. You’re in a fight. Your thoughts are not entirely rational. I doubt he was like “Hmmm, he seems out….hmmmm…I hate this guy….lets hit him anyways.” and then struck. He’s a fighter. He knocks a guy down, he follows up. Simple as that. The way he tried to play it off after the fight doesn’t mean anything. He wasn’t thinking about it in that moment. He was just trying to win his fight.
Look he admitted it himself right after …he can say he was “only kidding” all he wants , come on lets get real . It wasn’t a “split second” , he probably felt the force of his punch connecting into Bisping and when he was in the air he had time to see Bisping lying helpless . If he said it was an honest mistake – then I’d give him the benefit of the doubt . But he said what he said.
And I won’t deny it – violence is a huge part of why most fans like this sport . It is what it is , humans are fucked up people . Would u still like mma as much if it was with head gear and 10 seconds counts for knock downs?
Who gives a shit, the Ref is the one whos to blame for that
When you have your adrenaline going and its the heat of the moment, sometimes animal instincts take over. If it was prison Hendo probably would have beat Bisping to death, so I guess he lucked out that he had that happen to him in the Octagon and not the streets.
If the ref wasnt 25 feet away when the KO punch landed, Dan might not have landed that second shot as clean, or at all.
by SilverNBlackZach! on Feb 11, 2010 5:25 PM EST up reply actions
Yeah!
He’s lucky that he consciously chose to train and sign up for a sporting competition instead of getting beaten senseless in jail. Luck.
"Someone is WRONG on the internet. What do you want me to do? LEAVE? Then they'll keep being wrong!"
-Randall Munroe
Problem is if Bisping had, perchance, woken up and got back in the game, everyone would be castigating Hendo for not pulling the trigger. I’ve seen plenty of fights where one guy shows a bit of mercy and gets screwed by it. The rule in MMA is you keep going till the ref stops it. Unless you want to introduce, say, a 5 count for each knockdown to give the ref time or something, that’s pretty much the way its gotta be.
"an excellent example of why most MMA "journalism" is a joke. Pseudonyms like "toxic" and shitty writing like that dopey article"--- Joe Rogan.
this has worried me for years. as a former professional wrestling fan i’ve seen far to often how accumulated brain damage can destroy careers and lives. i mean we all go on and on about how it’s none of our right to tell a fighter he should stop fighting. i can’t disagree with that, but should someone have told chris benoit to stop performing? would the world be a better place if Ali could still be a more engaged part of it? i guess the only hope is to find ways to diagnose the symptoms earlier and force brain damaged fighters to cease fighting. big nog, chuck, scott smith etc. i truly worry about these guys. and when someone goes on a rant about how we have no right to tell them to stop fighting i agree, but i get the feeling they’re not really seeing the big picture.
add wandy to the list… Dear lord he has been in so many wars
Ricky Hatton came closer to beating Manny Pacquiao than Marquez did to beating Floyd.
-SC
by The Lethal Haze on Feb 11, 2010 2:14 PM EST up reply actions
WWE =/= MMA
WWE performers do close to 200 shows a year, with their heads hitting the canvas hard each night. MMA fighters spar with headgear, and compete a half-dozen times a year at most. No comparison. Boxing is closer, but amount of head strikes per competition in boxing is a multiple of MMA.
Not saying it won’t happen in MMA, but the odds are certainly lower.
"The moment you stop thinking you're the best, it's time for you to get out the game." -'King' Mo Lawal
i see what you’re saying, but the general belief is that even with headgear the majority of the damage comes from sparring. if this is the case then i’m willing to bet fighters train more than 200 days a year and for more than the 20-30 minutes even long wrestling matches last. plus, from what i understand house matches (non-televised matches) are usually not nearly as strenuous or dangerous as the matches shown on television and pay per view. i bet it balances out more than you think, but i could be wrong.
That is a real good point and I am glad this article brought that up. The place that is really dangerous for MMA fighters is training camp, just look at all the injuries we have seen lately. This particularly goes for brain trauma, some guys may not take any serious shots to the head over multiple fights but you know that they all spar during training camps.
Want to
see a tragedy? Watch Gary Goodrigdes last 5 fights. Someone needs to save him from himself.
Matt Pitt >>>> Johnny Benjamin
I mean, he hasn’t written that women aren’t capable of fighting 5, 5 minute rounds yet, so he is an improvement.
by KyleAskine on Feb 11, 2010 1:55 PM EST reply actions 1 recs
Any with some links about data regarding glove size and head gear(which from what I have read does not do much) and how much of an effect they have. For example how about using 7 oz sparring type gloves in MMA instead of those 4oz gloves, would they make a diff?
he said “Heavily padded gloves may paradoxically worsen the danger” in the column, and it comes from 2 things: 1, gloves are meant to protect the hand, not the head, so bigger gloves may lead to people punching harder, which is not good. It shouldn’t be an issue in sparring, but you might subconsciously punch harder because you can. Then there’s the other part of the Force equation, F=ma, even if you aren’t punching harder, the glove is bigger, that means more force, that means more damage.
Then why does it appear that kos happen more easily in MMA than boxing? I recall an episode of fight science that shown size of glove does effect power, the bigger boxing gloves cause a lower psi number(though as noted in the show not as big a diff as you might think). While the hitting harder things makes sense in sparring and might be worse(though if people are carefull about what there doing it should be safer). The larger gloves should have little effect in MMA, people are already trying to hit 100% as it is. In Shooto they use bigger gloves, whats the KO ratio compared to 4oz gloves(I understand its not all about KO, as lesser impacts over time can do the same thing, but KO are easy to quantify).?
because the actual knock out is not the major problem, especially long term. I’m not saying a knock out isn’t unhealthy, but the force hitting the head is only part of what makes someone go out in one punch. Getting punched in the head repeatedly with bigger gloves is much worse than getting knocked out.
how many times to people get knocked out on a football field? Look at the problems they are having with brain injuries. The problem with brain injuries is repeated blows to the head, bigger gloves means bigger forces, means more damage overall. It may not cause as many people to go to sleep, but the damage adds up over time.
The more I think about it
The more I like the old Pancrase rules, the ones when Bas used to fight. Open palm to the head and no gloves made for high level grappling, but still decent standup. Even if these rules don’t fly at the professional level, they could be very good at the amature level.
Might not work
Open palm to the head might not decrease the damage to the brain. I read once that the less bone absorbing the impact, the more impact is being absorbed in the brain.
Maybe
But this might lead to more eye poke incidents, too. I don’t know if it would cause any change in brain damage, there’s still a blow to the head that has lots of force to it. The advantage of open palm strikes generally is that it decreases the likelihood of broken hands and wrists.
"I love it when a guy is bleeding on top of me." -- Diego Sanchez, post fight interview about his fight with Clay Guida
No head shots in training
If I were going to be an MMA competitor, I’d simply not do any head shots in training or sparring. But then I value my brain quite a bit.
I’m guessing this will become more common as time goes on.
Not gonna happen.
If you train one way, that’s what you learn. Can’t just change gears and know how to handle it. If you don’t want to get punched in the head, do karate.
"Someone is WRONG on the internet. What do you want me to do? LEAVE? Then they'll keep being wrong!"
-Randall Munroe
There are far too many ‘tough guys’ in MMA for the rules to be changed to protect fighters. Too many people will applaud stuff like what Hendo did to Bisping, will protest every stoppage and will pooh-pooh any and all talk of brain damage. We will one day realise there are ‘Randy The Rams’ in MMA – and quite a few people will take it in their stride, explaining it away by how these people wanted to fight.
by Monday Morning Martial Artist on Feb 11, 2010 2:21 PM EST reply actions
Your point being, sir?
by Monday Morning Martial Artist on Feb 11, 2010 11:47 PM EST up reply actions
A Google search for “Top 10 MMA Knockouts” produces 60,000 hits. A search for “Top 10 MMA well-fought three-round decisions” is strangely silent.
Google searching a 8 word phrase entirely in quotations may not be the best approach at comparison, but the point is still valid.
Not really.
If you search “Best MMA fights” I’ll bet you most are decisions. Shogun vs. Rogerio, Fedor vs. Nog, Fedor vs. Cro Cop, Diego vs. Guida, Miguel Torres vs. Mizugaki, Nog vs. Couture. I don’t feel like doing the search right now, but people love wars to a decision.
"Someone is WRONG on the internet. What do you want me to do? LEAVE? Then they'll keep being wrong!"
-Randall Munroe
i meant that searching an 8-word string all in quotations has to find all of those words in succession.
and i dont know how many web pages are indexed for saying “top 10 mma well-fought three-round decisions” exactly in that way.
but regardless, his point was still valid about there being more web pages for top 10 knockouts than top 10 decisions.
but youre also correct that the top 10 fights would be mostly wars that ended in a decision.
Here....
http://lmgtfy.com/?q=Best+MMA+fights
"The moment you stop thinking you're the best, it's time for you to get out the game." -'King' Mo Lawal
I was on my way out
not unaware of google.
"Someone is WRONG on the internet. What do you want me to do? LEAVE? Then they'll keep being wrong!"
-Randall Munroe
I actually wrote a term paper on this subject
well, more specifically, the relative risks of closed head injury and long-term brain damage between boxers and MMArtists. It concluded that there simply weren’t enough older fighters in MMA to determine with any certainty what the risks are, but it was likely that the incidence of seriously long-term repercussions were less than those of boxers. It was a really boring paper.
Look at Shonie Carter.....
The guy slurs over his words now and when you watch him speak you can see his brain clearly does not function nearly as quick as it use to. There is a drastic difference just from when he was on the TUF comeback series and now. Its sad but true.
www.facebook.com/djpullout
www.twitter.com/djpullout
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www.djpullout.com
AIM = djpullout
info@djpullout.com
“A Google search for “Top 10 MMA Knockouts” produces 60,000 hits. A search for “Top 10 MMA well-fought three-round decisions” is strangely silent. The violence is promoted and well compensated, the harm it causes de-emphasized and well hidden."
I’m sorry, but this is a lousy rhetorical construct here. How many people actually type as specific of a phrase as “Top 10 MMA well-fought three-round decisions” into a google search? Of course “knockouts” is going to have far more results than a phrase as specific as the latter one.
And that doesn’t even get into the fact that this sort of thing carries across all sports. I bet “spectacular slam dunks” get far more google hits than “well-run zone defense” Or “500 foot homers” get more hits than “properly executed hit and runs.” People want to see slam-bang highlights in all sports, it’s not something exclusive to MMA.
When does the knock out of night bonus go away
The fact that fighters are booed if they attempt to take a fight to the ground is a contributing factor.
by KING FEDOR on Feb 11, 2010 5:42 PM EST via mobile reply actions
I’ve never thought about it but that is very interesting. When you think about it, isn’t it a bonus for the most spectacular way of inflicting enough brain trauma to cause it to stop working?
How did I end up on this bandwagon and why does everything say property of Chael Sonnen?
A knock out is definitley spectacular but I always get a little uneasy seeing another man KO’ed. Even a big mouth like Bisping
by KING FEDOR on Feb 11, 2010 5:50 PM EST via mobile up reply actions
Just a thought, but what about the rates of MTBI in football and hockey where head strikes aren’t the main objective and helmets are worn?
"I love it when a guy is bleeding on top of me." -- Diego Sanchez, post fight interview about his fight with Clay Guida
nevermind.
I just read the full article and see it was mentioned. Apologies.
Until recently football apologists argued that their sport was safer than boxing because of the relative paucity of knockouts and the use of helmets. These arguments have been proven to be fatuous. Helmets offer only a fig leaf of protection to acceleration, and sub-knockout concussions — being "dazed" or "dinged" — have been strongly implicated in CTE.
"I love it when a guy is bleeding on top of me." -- Diego Sanchez, post fight interview about his fight with Clay Guida
Only thing is a man running or skating at full speed I would think would be more force on impact
by KING FEDOR on Feb 11, 2010 6:06 PM EST via mobile up reply actions
Too many variables to know
Not only do you have to consider the force, but you have to consider the surface area of the contact points, the space in which it occurs, and how long the impact lasts. And thats not even considering things like torque.
An NFL player being tackled and having his head hit the ground is probably extremely comparable to a MMArtist being superman punched.
The world may never know.
"I love it when a guy is bleeding on top of me." -- Diego Sanchez, post fight interview about his fight with Clay Guida
Funny thing… I remember when CagePotato (?) interviewed Bob O’Reilly about his anti-MMA stance back in early 2009, and this came up…
When you talk about schools and domestic violence and relating that to a professional MMA bout, aren’t you purposely taking it out of context? We wouldn’t want kids in classrooms imitating what they see in boxing or football either, would we?
No, let us take the case of boxing. When I start viewing this now, more recently I’ve seen ads for boxing that really emphasize blows to the head and pictures of the face being pushed to the side, and I think that’s a bad idea to show kids, so I can’t deny that that’s also important. I think if we could change the sorry history of boxing, we as a society would probably do it. But as far as something like football, I don’t see anything wrong like that with a good hard tackle in football. "Interesting food for thought, even as a MMA supporter.
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