The Inherent Risks of Combat Sports

UFC fighter Jon Fitch recovers from shoulder surgery. Photo via Jon Fitch.

It should be fairly obvious to anyone with a brain and a pair of functioning eyeballs that MMA is an inherently dangerous undertaking, especially at the UFC level. Yet since it's not as dangerous as the hysterical opponents of the sport claimed, and is arguably less dangerous than comparable sports like boxing, football and hockey, many hardcore fans forget that it's a brutal undertaking that exacts a serious toll on the physical well-being of competitors. 

But last week a succession of stories really drove home the risks of MMA.

First up, Eddie Goldman on the possible impact on MMA of the new research on Chronic traumatic encephalopathy (CTE) in football and boxing and inevitably in MMA (transcribed by Fight Opinion) and how the MMA world will respond:

"The lessons of this really have to be considered by those in combat sports. Boxing isn't going to consider anything, it's a pretty amoral and corrupt culture and it's willing to go to its death as a sport rather than change. I don't see much of a different culture in MMA and since that's been growing and more money has been coming into it, people haven't been considering this. But wait until the effects of MMA, which has a more lot striking now than it used to, start to become public and wait until the issue of CTE and brain trauma starts to be considered by the Internet-savvy people around MMA. Hasn't happened, yet, but I think it's going to happen at some point in the near future.

"I think what's likelier to happen rather than banning with these sports is that those that can change will try to change a little bit and they'll lose viewership, they'll lose sponsors, they'll lose networks along the way and they'll hope to hang on as smaller niche sports. We've seen a lot of sports decline: boxing, baseball, horse racing, and so forth. We've even seen the WWE decline to a certain extent where so many people have died in that, although the mainstream media refuses to honestly really look at how dangerous that type of acting really is."

"What this could mean for MMA is that it's elevator ride to the top may stop, may get stuck somewhere midway. Because the mainstream media gives MMA a pass to a certain degree but not when prominent people start turning out to be vegetables, when top athletes start showing the signs of CTE, of the dementia pugilistica that we see in boxing, and if and when and I think a lot of people believe it's more of a when than an if, some prominent fighter dies live in a nationally or internationally televised Mixed Martial Arts card. Remember, it's only a short period of time that MMA has gotten any legitimacy and that legitimacy is only in most of North America. It's still illegal in New York, it's still illegal in France, it's not accepted in Germany, in Japan it's been tainted of course by the yakuza scandals, and it is growing in many, many different countries but it's far from being a part of the culture, it's far from being entrenched in the economic and political institutions, it's still has a rather tenuous existence including on television in the United States where major networks do not want to show Mixed Martial Arts events."

Goldman is right to raise this as a serious issue going forward for MMA. We're already seeing fighters like Gary Goodridge showing up with obvious brain damage, it's something that MMA fighters, promoters and fans all have to take seriously. Then there's 52 year old Dan Severn, still out there fighting and getting hurt badly. Jonathan Snowden says it's long past time for Dan to retire. I agree.

More in the full entry, we'll talk about paralysis from a take down that went wrong, recovering from torn rotator cuffs and the inherent risks of MMA.

And it's not just the striking aspect of MMA that is dangerous to fighters. Sherdog's series on paralyzed Iowa fighter Zach Kirk reminds us how dangerous wrestling techniques can sometimes be:

Of the immediate reactions to Kirk's injury -- horror, outrage, grief -- there was very little surprise. Iowa has a proud wrestling heritage, and Iowans know cervical spine injuries are not unexpected in grappling sports. As a wrestler, Kirk knew the risks: "I knew injuries could happen in MMA just as easy as in any other sport. I know accidents happen all the time in all sports."

If Kirk's injury had occurred two years earlier, when he was a high school wrestler using identical double-leg takedowns in scholastic competition, his tragedy would be just one more of the almost 60 severe high school wrestling injuries recorded by the National Center for Catastrophic Sports Injury Research in the past 26 years.

The incidence of high school wrestling related catastrophic spinal cord injury and death is approximately one per 100,000 participants. Because the takedowns in MMA are essentially wrestling moves, we assume the MMA risk is similar. Approximately 250,000 boys and an increasing number of girls participate in high school wrestling annually. It is unknown how many young people participate in MMA, but beyond doubt, that number is growing rapidly.

Kirk's story is a painful reminder that MMA is an inherently risky activity and participating can have life changing consequences for athletes. The same is true of getting in the car and driving to work of course, but it serves us well to remember the risks these athletes take every single time they get in the cage. 

Luke Thomas has a piece on UFC heavyweight champ Cain Velasquez and his more shoulder injury that points out that while a torn rotator cuff may seem more prosaic than brain damage or spinal injuries, it involves a very real risk to the champ's career:

Velasquez tore both his rotator cuff and labrum at UFC 121 in his title fight with Brock Lesnar. I'm certainly no professional athlete, but I am familiar with the experience of these injuries. In 2001, I tore the rotator cuff of my right shoulder weight lifting. I was able to use physical therapy without surgery to heal the injury. In 2009, I had my left shoulder surgically repaired for a torn labrum, also from weight lifting. Both injuries have profoundly affected my athletic life.
A year after surgery I went back to my doctor for a check up. My shoulder, he told me, was "completely healed". But how could that be? It still ached, I couldn't even bench press a bar and I noticed I had lost a significant amount of range of motion. My surgeon explained that what I was experiencing was the medical version of "mission accomplished". In other words, given the extent of my injury, having an ache, reduced range of motion (a surgical intention to protect the joint) and a few compromises in the weight room was the best possible outcome. There was no such thing as going back to the old me or having a normal shoulder as I had understood.

Coincidentally, my doctor and I discussed athletes with these types of injuries. He told me labrum repair can significantly affect or end the careers of professional baseball pitchers, boxers and weight lifters. A surgically repaired shoulder, by design, isn't able to handle the same stresses or deliver the same performance as a normal, healthy shoulder because the joint is made "safer". Pitchers loose zip on their fastball. Boxers lose steam on their hooks. There are plenty of documented cases where professional athletes have been able to recover from these surgeries and achieve previous levels of greatness, but it's far more often that some athletic trade off is made in the name of health.

The human body is a fragile thing and MMA puts it at risk of serious, permanent damage. Injuries are part of life and can happen during any activity, but let's not kid ourselves that MMA is "safe" -- it's not and never will be. Promoters, regulators, athletes and fans must work together to make the sport as safe as possible and that entails an open-eyed assessment of the risks involved.

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