How dangerous is MMA ? What MMA doesn’t tell you..

Mixed Martial Arts ( MMA ) is a rapidly growing sports not only in the USA, but also in Asian countries like Thailand, Myanmar and etc. There are significant number of young population involved with this sport. Recently the MMA has passed the boxing and became the most famous fighting sport in the world.

However the health professionals worldwide is not in a place to appreciate what happens in MMA fights as its brutal nature.

There is no doubt that MMA is a very dangerous close contact sport. It’s no need to mention about that there can happen bruising, contusions and lacerations not only in the game, but also while practicing. But the most serious complication associated with MMA is Chronic Traumatic Encephalopathy ( CTE ).

What is Chronic Traumatic Encephalopathy ?

CTE is first noted at 1928 and at that time it was called “punch drunk syndrome”. This is mainly detected in professional boxers as they show behavioural changes. And the later this condition was renamed to “dementia pugilistica“ as there are some other symptoms like memory impairment, loss of executive functions, mood changes and neurological problems.

Scientists have confirmed that all these symptoms are associated with repetitive brain damage occur from boxing fights.

The post mortem studies of the ex boxers brains shows that degenerative changes in cerebral cortex, cerebellum and special areas called substantia nigra which coordinate our body movements.

Later this condition is named as chronic traumatic encephalopathy and scientists have found following symptoms associating with that.

  • Learning and memory impairment
  • Mood changes including depression, apathy, irritability and suicidal feelings
  • Changes in behaviour like increased aggression and poor impulse control
  • Persistent headaches ( this would be the most common symptom they get )
  • Loss of balance while walking
  • Fine tremors
  • Difficult to concentrate
  • Loss of information processing
  • Loss of executive functions like planning, decision making

How the MMA causes CTE ?

MMA itself a close contact sport with minimal protection. The most of the time MMA fighter wear dental guards, groin guards and 4 to 6 oz. weight punching gloves only.

In a MMA fight both striking and grappling are used to control the opponent.

Fighters attained victory mainly by knockout ( KO ) or technical knockout ( TKO ). KO happens by making the opponent defenceless by blunt head trauma, disabling through joint subluxation, dislocation or soft tissue trauma and making the opponent syncope after a neck choke or disabling the opponent with any other submissive method.

The TKO happens when the opponent is unable to safely defence himself.

The Strikes

A meta analysis done on MMA injuries shows the highest distribution of injuries occur in head and neck regions and those are about 67.5% to 79.4%. Although other contact sports like American football, hockey has the risk of head impacts, they don’t have this much of high values.

A video analysis also performed related to UFC MMA fights and it shows the 90% of TKOs occur after repetitive strikes. In further investigating these TKOs revealed that about 30 seconds before a opponent became TKOed he or she get multiple head strikes in increased frequency.

The other factor that MMA become more dangerous compared with other contact sports is it’s head injuries occur within short period of time. An animal study performed related to this shows head injuries happen in short period of time has a potential to do more damage. Because it has a less period of time to recover after damage.

The Grapplings

Some are arguing that MMA and boxing both has the same effect on a fighter. It’s true if we only consider about striking. What MMA is special from boxing is it uses submissions to control the opponent.

The famous one is rear naked neck choke and there are many other neck chokes used in a fight. It causes sudden asphyxiation for a short period of time or causing opponent to pass out.

The danger is there is only a 2 kilograms of force is necessary to compress the jugular vein which is the vein that takes out blood from the brain. The jugular vein compression can cause brain oedema.

And with the 5 kilograms of force can compress the carotid arteries which ultimately lead to hypoxic brain damage and with the 15 kilograms of force can even block the airways causing severe brain injury.

The more severe case is a fighter faces these situations in his fighting career many times as in a fighting match and also while practicing. Therefore these frequent repetitive asphyxiations and strangulations leads the brain into hypoxic ischemic brain injury.

Chokes in MMA can cause hypoxic brain damage
Chokes can cause asphyxiation and hypoxic brain damage

How to prevent serious damages in MMA ?

MMA sport is now in better place compared with its early stage which is much brutal. Now there are several restrictions and regulations in the sport to improve the safety of the fighters.

This includes stopping the match suddenly when a fighter knock down and check him immediately if there are signs of brain damage.

And using well trained referees, so they can identify a defenceless fighters or fighters who loss their consciousness and stop the fight immediately.
There are medical staff on ground who immediately attend when a fighter get KO or TKO to assess the athlete and do the initial medical managements to avoid further damage.

At last for the people who already developed symptoms there are drugs which already in developing stage to low the progression of the condition. Memantine, a NMDA receptor antagonist is currently showing good results on neuroprotection properties.

So as rapidly growing sports MMA need much more attention from health sector, never to underestimate the damage it can cause to a person’s life.


  1. Dangers of Mixed Martial Arts in the Development of Chronic Traumatic Encephalopathy by Lucas J.H. Lim, Roger C.M. Ho, and Cyrus S.H. Ho
  2. Determining the Prevalence and Assessing the Severity of Injuries in Mixed Martial Arts Athletes by Lt. Charles E. Rainey, PT, DPT
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Sapumal Edirisinghe
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