MIXED MARTAL ARTS HUMAN COCK FIGHTING I THINK NOT!
The sport of mixed martial arts lives in an underground world in the United States that is filled with misconceptions and ignorant stereotypes thanks in part to Arizona Senator John McCain. It was McCain who in 1995 began to sling damning propaganda at the sport by proclaim that mixed martial arts, and the UFC in particular, was akin to “human cockfighting,” thereby unfairly implying that mixed martial arts fights exhibited the same blood and gore as actual cockfights, which are fights to the death.
Limited rules, no gloves, the absence of weight classes, and, in some instances, the absence of time limits all contributed to McCain’s smear campaign, and in 1997 major fight states such as New York, California and Nevada began instituting bans on mixed martial arts competitions. Shortly thereafter, cable providers banned the sport from their pay per view airwaves. Everybody reasoned that mixed martial arts was too dangerous. It was certainly much more dangerous than boxing. After all, it was human cockfighting. Simply put, mixed martial arts was put on life support due to misinformed and uneducated opinions of its danger levels.
Fast-forward to today. The UFC is back, but with a new look. Gone are the days of no time limits, no weight classes and no gloves. Today’s fighters fight with 6 ounce vale tudo gloves, weight classes jump in 15 and 20 pound increments starting at 155 pounds, and matches are comprised of 5 minute rounds – 3 rounds for non-title fights and 5 rounds for title fights.
With it’s new set of rules, and owners making the claims that the sport was now much safer, both Nevada and iNDemand pay per view lifted their ban on the sport in 2001, and it once again began to grow. In fact, UFC 40 featuring established star Tito Ortiz facing off against living legend Ken Shamrock sold 130,000 pay per view buys, which is astonishing considering that the previous post-ban era pay per views averaged around 35,000 buys. And with this past Friday’s epic unification battle between Ortiz and Randy Couture, which was featured on Friday afternoon on ESPN News, MMA is once again creeping into the mainstream consciousness ever so slowly. As that happens the whispers of “human cockfighting” and “excessively dangerous” begin to creep back into water cooler discussions around the country.
We’re here to drown out those whispers with a cold hard medical fact: MMA is no more dangerous than boxing when it comes to death or permanent brain injuries. Yes, you read that correctly. But just in case you missed it, let’s do it one more time: MMA is NO MORE dangerous than BOXING in terms of serious long term health risks.
The focus of this article is on death and permanent debilitating injury. We do not care about broken bones or cuts because they heal. We do not care about torn ligaments because they can be repaired. What we care about is the potential for a competitor to die in the ring or Octagon or to suffer permanent injury to the brain caused by repeated head trauma – a medical condition called “dementia pugilistica.”
Since 1990, 12 boxers have died worldwide from injuries suffered during a professional prizefight. Such fallen fighters include Bradley Rhone who died in the ring after being knocked out on July 18, 2003. Since its inception, not a single competitor has died from injuries suffered in a UFC, Pride FC or any other U.S. or Japanese mixed martial arts competition. There is an unsubstantiated rumor that a man died in a vale tudo (Portugese for “no rules”) match in Russia where there were no rules, no time limits and no weight classes. But we have not been able to confirm that rumor. Nevertheless, even if you assume that the Soviet incident actually occurred, the occurrence of death following a boxing match greatly exceeds the occurrence of death following a mixed martial arts match. To think otherwise is simply uneducated.
Notwithstanding the fact that death has yet to rear its ugly head in a MMA match, antagonists of the sport point to the use of submission holds in the form of chokes as another factor elevating the risks associated with MMA beyond those of boxing. Again, that simply is not the case.
“Fighters actually attempt to occlude the carotid arteries of their opponent [in order to gain a submission],” explained Thomas E. Higgins, M.D., FCAP, who is the Chief of Pathology at Northern Westchester Hospital Center in New York. “Even if released at the point of unconsciousness, a transient ischemic attack has occurred and the brain may sustain permanent damage that may be subtle but still consequential in the long-term. One does not have to sustain an overt stroke to cause brain damage. Certainly, if the circulation is interrupted for too long (and that time frame varies individually) a major stroke or even death can occur. There is no safe time or buffer zone before which you can be confident of no deleterious effects.”
Nevertheless, how often is a fighter actually choked into unconsciousness during a fight? Most often, a fighter will “tap out” thereby signaling that he has lost the mat the minute his opponent sinks the choke hold. “There’s no shame in tapping out. That’s what separates us from boxing where you can’t quit. If you get put into a situation where there is no hope of winning, you simply tap out and live to fight another day,” said UFC light heavyweight champion Tito Ortiz.
Granted, boxers do not get their blood flow to the brain blocked during a boxing match, so that event is unique to MMA. But the resulting brain injury associated with occluding the carotid artery is not unique to MMA. “An accumulation of small ischemic attacks can have similar effects to the blunt head trauma induced by boxing,” Dr. Higgins reasoned. Thus, the potential resulting injury from getting choked out is similar to the effects of repeated blows to the head in boxing, and so we are back focusing on blunt head trauma. Of course, that raises the question of whether the smaller 6 ounce vale tudo gloves used in MMA lead to an increased risk of brain trauma when compared to the 10 ounce gloves most typically used in boxing (weight classes under 154 pounds actually use 8 ounce gloves).
“One cannot define, clinically or statistically, an expected amount of or threshold for damage to the brain related to size of gloves or amount of punches. There are too many variables involved that can't be controlled. I can't imagine how one could design a controlled study to derive any meaningful statistical data to make a conclusion one way or another. Each blow causes an unspecified amount of damage. The effects are both immediate and cumulative.” And such effects manifest themselves in a medical condition called “dementia pugilistica.”
So what actually causes dementia pugilistica? “Acute head injuries as well as repetitive chronic head injuries cause sudden rotational acceleration of the brain in a closed system (the cranium with meninges and cerebrospinal fluid) with stretching of nerve axons and supporting cerebral vessels. The brain injuries sustained are diffuse and these tissues do not repair themselves well. Any reparative process will likely destroy neurons and the supporting neuropil with replacement by scar and denatured proteins. These do not function as neural tissue and the accumulation of these substances in the brain alters or prevents the subtle neurophysiological processes necessary for higher cerebral functions as well as more basic support functions of the brain,” Dr. Higgins explained.
All of that manifests itself in a variety of ways in dementia pugilistica sufferers. Such individuals will likely exhibit slurred speech, slowed reflexes, a loss of coordination, lowered inhibition and impaired mental processes. We’ve all heard the expression “punch drunk.” Well, that is the common vernacular for dementia pugilistica. If you’ve ever seen former world champion boxers Meldrick Taylor or Riddick Bowe walk or heard them talk in the past few years, you understand fully what dementia pugilistica can do to a man. And there is no known effective treatment for that medical condition.
“Dementia pugilistica is neuropathologically similar to Alzheimer's Disease,” explained Dr. Higgins. “The clinical findings also overlap significantly with each other. The main treatment would have to be considered prevention because the drugs currently being tried for Alzheimer's are not curative and often ineffective. When initiated early enough, they may only prolong the time to dementia and not prevent it. One cannot predict who will respond [to treatment] and who will not.” Therefore, if a fighter receives enough concussive blows to bring about dementia pugilistica, it is very likely to be a permanent condition.
So which sport runs a greater risk of its athletes suffering from dementia pugilistica? The nature of boxing, including the 10-12 round fights where a combatant receives upwards of 100 blows to the head during a fight, must increase the risk for permanent brain injury statistically speaking. Remember, the effects of blunt head trauma are both “immediate and cumulative,” thus it reasons that one taking more blows to the head would, on average, increase the odds, statistically speaking, of experiencing a permanent brain injury, whether immediate or cumulative.
Moreover, the “10 count rule” in boxing further differentiates the sport from MMA. “In boxing, you get knocked down and have no idea where you are. You have 10 seconds to get up and shake out the cobwebs and you continue fighting. In MMA, if you screw up and get knocked down, the fight is typically stopped almost immediately. Hey, you screwed up and got caught. Live to fight another day,” explained Ortiz. And it is the rule in MMA that stops a fight upon a fighter receiving a concussive blow that really separates itself from boxing and makes it clear that MMA is no more dangerous than boxing.
“If someone sustains a concussion, then any additional insult would enhance the likelihood of serious immediate injury,” explained Dr. Higgins. “The cumulative effects are also operative here but may not be manifest until later. Regaining consciousness does not ensure that there will be no long-term effects from that particular injury. I believe that, in general, the less opportunity for injury provided, the better off a fighter will be. So, of course, stopping a fight with any evidence of injury is preferable to allowing it to continue insofar as the individual fighter is concerned.”
In other words, boxers are put at an increased risk after experiencing a legitimate knockdown. In football, players are removed from the game the minute that the athlete receives a concussion (if known to the coaching staff). In MMA, a fight is stopped the minute a fighter receives a concussion because he stops defending himself at that point. Yet, in boxing, a fight is allowed to continue after the occurrence of a concussion provided he can stand-up and demonstrate that he is alert and aware. Nevertheless, that individual is now at a greater risk of experiencing a permanent head injury than before the concussive blow. In fact, the fighter may be knocked down twice in every round of the fight and still be allowed to continue provided he can stand-up and demonstrate that he is alert and somewhat aware within 10 seconds. Again, I fail to see how MMA is more dangerous than boxing.
In summary, “[i]t would appear that statistically boxing incurs more long-term risks but maybe martial arts involves more immediate risks [depending on the outcome of the match – ie, knockout versus tapping out versus getting choked out],” Dr. Higgins reasoned. “However, both types of injury will occur in both activities and since it is individual participants at risk, you cannot make any blanket statement about risks. The data is not compelling and it is derived statistically. Statistics apply to populations not to individuals so you can't advise any individual based upon that data and guarantee anything for him. You take your chances when you engage in these activities and, therefore, everyone should expect to be hurt. Maybe they will be lucky and avoid it; maybe they won't. It's a gamble they have to be willing to take.”
Accordingly, the world can stop referring to MMA as “human cockfighting.” It is not any more dangerous than boxing in terms of the risk of death or receiving a permanent brain injury. I am not here to tell you that any combat sport is safe because they are not. But, alas, football and hockey are not safe either. Similarly, having a bottle of wine with your wife, girlfriend or date and then driving home in your automobile certainly is not safe. Injury, and even permanent injury, is a known and acceptable risk that fighters take each time they engage in a fight.
Nevertheless, those who say that MMA is more dangerous than boxing are simply misinformed and uneducated on one of America’s most competitive and exciting sports. Human cockfighting? Absolutely not, Senator John McCain!
