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Dear Editor:
A recent article in The American Journal of Sports Medicine entitled Head Trauma in Mixed Martial Arts, written by Michael G. Hutchison, David W. Lawrence, Michael
D. Cusimano, and Tom A. Schweizer,5 is about a critically
important topic that deserves our undivided attention.
Mixed martial arts (MMA) shows a recent increase in popularity and is a full combative sport with a high rate of
injuries, particularly head injuries.5 This sport is growing
tremendously in amateur and youth categories. There is
limited research on head trauma in MMA. I feel that it is
very important to research the mechanism and seriousness
of injuries related to the sport of MMA, particularly when
youth are involved. I think that it is more important to
begin taking greater measures to protect MMA competitors
from traumatic head injuries. Hutchison et al5 discuss the
incidence, risk factors, and characteristics of knockouts
(KOs) and technical knockouts (TKOs) due to repetitive
strikes in MMA. A KO is defined as occurring when a competitor is knocked down unconscious or disoriented, and
a TKO is defined when a referee stops the contest when
a competitor is disoriented to the point where he or she
is unable to defend himself or herself.5 What I am most
interested in is what is being done to prevent head trauma
in MMA. Mixed martial arts includes techniques from
a variety of sports including boxing, wrestling, karate,
taekwondo, jujitsu, Muay Thai, judo, and kickboxing. The
American Medical Association (AMA) describes MMA as
violent and dangerous and expresses its concerns about
the aggressiveness of the sport and it causing physical
harm, specifically brain injuries.5 A comparison was
made between match scorecards and digital video recordings of matches. Conclusions showed that rates of head
injuries in MMA are higher than those reported in boxing.
This is shocking to me! In a video analysis of 65 KOs, the
head was the part of the body struck in all 65 events.5(p3)
Of the 65 competitors who lost by a KO, 41 (63.1%) sustained a secondary head impact with the fighting environment (ie, the floor, cage, or post).5(p4) Of these 41, 37
competitors (90.2%) struck the arena floor, most frequently
(n = 30, 73.2%) impacting the occipital region of the
head.5(p4) The specific region of the head that was struck
was the mandible (35 events [53.9%]), followed by the
maxillary (13 events [20.0%]) and temporal (13 events
[20.0%]) regions.5(p3) Public health officials and physicians
should be educating participants and patients appropriately about the risk of brain injuries associated with KOs
and TKOs from repetitive blows to the head.5 Physicians
and/or athletic trainers should be present especially at
NP43
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REFERENCES
1. American College of Sports Medicine. Injuries in emerging sports calls
for improved medical understanding [news release]. August 1, 2011.
Available at: http://www.acsm.org/about-acsm/media-room/acsm-inthe-news/2011/08/01/injuries-in-emerging-sports-calls-for-improvedmedical-understanding. Accessed April 6, 2014.
2. Galetta KM, Barrett J, Allen M, et al. The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters.
Neurology. 2011;76(17):1456-1462.
3. Gutierrez M. After injury leaves him paralyzed, an MMA fighter battles
still. The Sacramento Bee. March 31, 2013. Available at: http://
www.sacbee.com/2013/03/31/5305129/after-injury-leaves-him-para
lyzed.html#storylink=cpy. Accessed April 6, 2014.
4. Harris S. A sense of urgency: MMA races to learn more about brain
injuries. Bleacher Report. May 8, 2013. Available at: http://bleacherre
port.com/articles/1633111-a-sense-of-urgency-mma-races-to-learnmore-about-fighter-brain-injury. Accessed April 6, 2014.
5. Hutchison MG, Lawrence DW, Cusimano MD, Schweizer TA. Head
trauma in mixed martial arts. Am J Sports Med. 2014;42(6):1352-1358.
6. Welsh T. Whats wrong with American health care? The Seeker Books.
2011. Available at: http://www.theseekerbooks.com/articles/Whats
Wrong.html. Accessed April 6, 2014.
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