Dr. Steve Mora on the ease of hiding an injury from the commission

Image courtesy of Dr. Steve Mora

Renowned Southern California orthopedic surgeon, Dr. Steve Mora discusses the ease with which fighters can hide injuries from the commission, the worst injuries and possible methods of injury prevention.

I recently read something on one of the forums that said Matt Brown fought his last two fights with a cracked sternum. I've heard several fighters come forward and state that they went into a fight with an injury or illness. That begs the question, how are they getting past their medicals to compete?

My co-host, Iain Kidd, and I decided to conduct a research style interview with one of Southern California's top orthopedic surgeons who also happens to specialize in sports injury. Dr. Steve Mora has treated some of the top stars in MMA, as well as other sports, and has a long list of credentials that speaks of his expertise in the field.

We bombarded Dr. Mora with as many questions as we could fit in the 40 minute time frame we had available. Topics range from hiding injuries from medicals to the worst injuries that require the longest recovery times. Hopefully, our readers will find the information he gave us to be useful when pondering the injury status of some of your fight favorites. Here's what he had to say:

Credentials

I went to medical school at UC Irvine College of Medicine, then after that I did my orthopaedic residency at the University of Southern California, LA County. After that, I did an extra year, my fellowship in sports medicine; shoulder and knee surgery.

I practice in the city of Orange, very close to St Joseph's Hospital, which is where I do inpatient surgery. I mainly take care of patients that have sports related problems, as well as other general orthopaedic issues.

I became a doctor in 1996, but as far as sports medicine private practice, it's been eleven years now. It just feels like yesterday, though.


Charity Work in Peru

I had a great experience in Peru. I go there every year and do volunteer work. We do a medical mission there, and I enjoy going to Peru because I used to live there as a child. I actually grew up there, so I have a strong bond towards the country and the people.

When I go there, it's very different to my practice here in southern California. It's obviously directed at an impoverished group of people who don't have access to specialists, so it's a very special experience, being able to help people who otherwise would probably never be able to see a specialist.

On this occasion, we were able to do a couple of things. We brought an arthroscopic system, and I was able to teach a couple of orthopaedic surgeons at the hospital there how to do a very simple, basic knee arthroscopy. We were able to establish the first knee arthroscopy in the state, which was my goal.

We saw a lot of patients, and took care of one patient specifically who had an amputation of his leg. I was able to give him a prosthetic that I had brought over from the United States, and everything went really well.


Peruvian Hospitals vs. US Hospitals

Peru has up to date medical technology and equipment in certain areas. The area that I visited is a city that's in a very poor area, so the hospital is like a very basic county hospital. It has a structure and it has doctors and they take care of very poor people, but it is like going back in time.

It's actually very interesting, because the folks who live there continue to live in a traditional way. It's just like a picture you would see in national geographic, as far as how they're dressed. They don't have a lot of medical access there, but that's exactly why we go there.

The organisation that I go with is called ‘Peruvian American Medical Society'. If anyone is interested in doing a mission they can look that up.


How Easy it is For a Fighter to Hide an Injury From a Commission

What I tend to see, is that fighters will get injured during their training camp in preparation for their fight. They might be healthy going into camp, and then at some point they get hurt sparring or something. At that point, what I've seen is they won't see a doctor for it. They have a pain somewhere, like the knee, or the hand and they know it's hurt, but they haven't seen a physician so there isn't anything documented. They haven't sought official medical care, so there isn't anything in the records saying they have a problem.

As far as getting through the basic medical exam, it's very hard to identify an injury on a patient if they aren't saying that it hurts. If there aren't any gross signs of a problem, like swelling or a cut or something, it's not too difficult to disguise.

A lot of these guys, they want to fight. They want to do what they've signed up for, and they want to please the fans. They want to be able to do well. They have good intentions, and sometimes they don't realize that an injury that may seem trivial, actually does end up slowing them down. There's no ill intent; they've got heart and just want to do what's right. Unfortunately sometimes that's maybe not the best decision.


Fighters Training Through Injuries

If you have a simple pain, let's say you have shin pain, from getting kicked over and over or you're overtraining by running too much. Well, that shin pain might actually be a stress injury to the bone. A very simple stress injury that would heal if you just rest. That stress injury to the bone can lead to a stress fracture, where the bone actually cracks, if you continue to work through the pain.

Once it cracks, you're out for a much longer time, and you might even require surgery to treat the stress fracture. Before, all you needed to do was rest it for 3-4 weeks and then it would be healed. Those situations do happen, that's just one example of an injury becoming something worse that could have been treated very simply, initially.


The Effects of a Pinched Nerve, Like Michael Bisping Has

It depends on the degree to which it's injured. If a nerve is being pinched, or it's inflamed, it starts to malfunction and doesn't send signals to the muscles appropriately. The muscles will begin to atrophy, or get weak.

Sometimes [a pinched nerve] it can recover, but as far as how it affects you at the moment that you're fighting? It can profoundly affect you. You lose your reflex, you can lose your power, you lose the snap and you could lose the ability to guard yourself or block a punch, because it just doesn't respond the way you want it to.


Extreme Training Regimens

I think it's okay to be creative with certain training techniques. I think that creativity has helped to develop certain programs. It's no longer just about doing squats or deadlifts, but you have to be smart about your training. Their health is their livelihood. They have to be smart about how they train, or they should be smart about how they train. You don't have to be extreme to get similar results in a safe way by using good training techniques in a reasonable manner.

Once something breaks, it's very often difficult to bounce back. I think the more seasoned guys, the more experienced guys, know that, and they're more aware of potential injury, so they'll back down a little bit due to that experience.


Most Common Causes of Injury

Most of the injuries that I see happen during grappling or sparring; during full contact activities, or during the actual fight. I've seen some cumulative trauma type injuries that happen from overtraining, but not as many. Most of the injuries that I see in MMA athletes happen to be from blows or from a sparring partner that was not looking out well for their partner, and hit them in the wrong place, or hit them too hard.

Maybe two guys stumble onto the mat and one of them puts their arm out and dislocates their shoulder. The injuries that I see in the octagon or in the ring are usually from kicks, or from armbar defense, resulting in a snapped pectoralis tendon or biceps tendon, or they dislocate their shoulder or elbow.


Potential Solutions

I think fighters should talk to the guys they're sparring with, and be more careful about where they're being kicked, if possible. You don't want your sparring partner taking out your knees before a fight. I've seen that a few times actually, where people will get kicked on the outside of their knee, and will suffer an MCL strain on the inside when the knee buckles inward.

I don't have the solution for it, to be honest. I know these guys want to be 110%. That means during training they want to match what they're going to be experiencing in the ring. Maybe for that reason they expose themselves to that level of training. It's easy for me to say, ‘Tell your partner not to kick you', but I don't know if it's possible.

When it comes to cumulative trauma injuries, like using bad technique or not listening to your body, there are things you can do. For example, if you're doing flys with dumbbells that are heavy, and you've been doing them routinely, but they start to hurt your shoulder. Well, when you feel that type of pain, it's a different pain from muscle strains that are part of the workout process. When you feel that pain, it's better to lay off that type of exercise and cross-train a little bit. Switch it up. Try a different method. Do something different to train your shoulder. That way you don't strain the tissue to the point that it fails. You have to listen to your body when you start feeling that pain.

You can follow Dr. Mora via his Twitter account, @myorthodoc

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