Mixed martial arts (MMA), also known as cage fighting, is a rapidly growing, albeit relatively young, sport. Popularized in the U.S. in 1993 with the formation of the Ultimate Fighting Championship (UFC), the sport existed previously in an underground and unregulated form.
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July 2012Naturally, we would expect to see an increase in the number of MMA-related injuries in our clinics, some through accident and emergency department referrals.
Otolaryngologists on the Front Line
The first medical officer to attend to such a patient is often an ENT practitioner. In fact, over the past two months, there has been an increase in the number of MMA-induced injuries seen here in the ENT department at Luton and Dunstable Hospital in London. More specifically, we have seen three septal hematomas, four pinna hematomas and several fractured nasal bones, all caused by MMA fighting. In two of the cases of pinna hematomas, the patients returned several times—four times in a month in one case—requiring repeated draining due to persistent fighting. This occurred even though they had been advised that if they continued to fight without adequate protection, they were likely to suffer similar injuries.
A study done at Johns Hopkins University School of Medicine showed that the overall injury rate from competitive MMA fighting was 28.6 percent, of which 47.9 percent were facial lacerations, 10.6 percent nasal injuries and 1 percent ear injuries (J Sports Sci Med. 2006:136-142). Another study showed that combatants with more years of experience were more likely to sustain injuries than those who were inexperienced (Br J Sports Med. 2005;39(1):29-33).
Contrary to popular belief, the sport does have a number of rules that fighters must adhere to in the octagon (the fighting arena). The rules allow for both stance and floor fighting, due to the number of different fighting styles used in MMA, including karate, muay Thai, boxing, jiu-jitsu and judo. To name just a few of the 31 fouls, contestants are not allowed to strike to the back of the head or spine, strike or grab the throat, or gouge lacerations or orifices. For protection, fighters must wear a mouth guard and gloves that must weigh between four and six pounds. A groin protector is optional.
MMA has often been criticized for its brutality. In fact, in a 2008 position paper posted on its website, the British Medical Association (BMA) called for a “complete ban” on MMA fights because the fighters are “open to a myriad of injuries.” However, strong voices against the BMA’s position argue that banning MMA would deny freedom of choice (BMJ. 2011;343:d6937). It has also been argued that MMA, like many other martial arts, encourages meaningful exercise and can be used as a treatment modality for youths who are at risk for violence (WMJ. 2009;108(1):40-43).