Head injuries are arguably the most serious injuries in mixed martial arts (MMA). Recurrent head trauma is thought to be associated with an increased risk of the development of neurodegenerative disease, and is the primary cause of chronic traumatic encephalopathy (CTE). As MMA as a sport is still in its relative infancy, research into long-term brain health of athletes is scarce.

This systematic review looked at 30 studies of head injuries in MMA and their relationship to cognitive impairments/brain damage. Head injuries accounted for 58-78% of all injuries, with between 29.1 and 34% of athletes reporting having been KO’d/TKO’d in their career. These rates were higher in older and heavier athletes. 

Cognitive function tests (such as the The King-Devick test) focused on verbal memory, processing speed, psychomotor speed and reaction time. Performance in these areas was shown to be acutely impacted compared to baseline for those athletes who had experienced head trauma. 2 studies also demonstrated long-term decline in retired fighters.

MRI studies revealed a strong correlation between years of fighting and structural brain change, including decreased white matter density, brain volume and cerebral blood flow. 

Vestibulo-ocular reflex (the ability to stabilise gaze during head movement) impairment was also noted in active MMA participants. 

As the degree of head trauma is partially dependent on the time of stoppage, the authors recommend more vigorous training of referees to be able to recognise signs of cognitive impairment and stop matches at the appropriate time, although acknowledged the logistical difficulties associated with this.

Other recommendations included consistent regulations within the sport of MMA (throughout both professional and amateur competitions) regarding fight stoppage, post-fight assessment, and return to play rules, as well as more thorough athlete and coach education.

#thescienceofstriking #ufc #headtrauma #traumaticbraininjury #tbi #concussion #mma #mixedmartialarts #boxing

Schlegel, P., Novotny, M., Valis, M., & Klimova, B. (2021). Head injury in mixed martial arts: A review of epidemiology, affected brain structures and risks of cognitive decline. The Physician and Sportsmedicine.

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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