The Assortment of Injuries Associated with Mixed Martial Arts Activities

By Griffin Stephens

Mixed martial arts is a full contact sport in which the main objective is for athletes to inflict enough damage to incapacitate opponents, primarily with the use of techniques from various other martial arts disciplines. Mixed martial arts has a common ancestor in an ancient sport called Pankration. Pankration involved all forms of hand to hand combat and was often performed during the Olympic games. Not until the 1990s did mixed martial arts become internationally recognized for brutal televised showcases in organizations such as Pride Fighting Championship, Strikeforce Mixed Martial Arts, and The Ultimate Fighting Championship. Professional mixed martial arts bouts are typically three to five rounds, with each round lasting five minutes. Bouts can be stopped by knockout, technical knockout, submission, or time expiration. Due to the violent nature of the sport, organizations such as The Ultimate Fighting Championship have faced social backlash, with some even going so far as to question the legality of the sport. Athletes can sustain injury in a variety of ways when engaging in mixed martial arts, including miscellaneous trauma, rapid weight loss, and brain trauma injuries.   

Miscellaneous trauma injuries commonly occur in the form of soft-tissue and hard-tissue injuries. Injuries to soft-tissue are a common occurrence when partaking in mixed martial arts activities. The rate at which soft tissue injuries occur in mixed martial arts can be examined with the help of a 2009 study conducted by the San Diego Naval Medical Center’s Physical Therapy Department: “The most common type of injury reported by participants was contusions (29.4%), followed by strains (16.2%), sprains (14.9%), and abrasions (10.1%)” (Rainey 193). In most professional organizations, ringside physicians are present to tend competitors’ injuries. Additionally, ringside physicians have the authority to medically disqualify competitors based on injury severity and other predetermined medical protocols. A common injury suffered by a mixed martial arts athlete is a facial laceration, which is the tearing of the soft tissue. One study cites facial laceration as the most common injury recorded in the viewing of 171 separate matches (Bledsoe 138). Mixed martial arts are unique in the fact that they allow ground-based techniques such as Olympic and Freestyle Wrestling, Brazilian Jiu Jitsu, and Russian Sambo. Ground-based techniques employ submission grappling to incapacitate opponents. Submissions render opponents unable or unwilling to continue by applying pressure during chokeholds or joint-lock submissions. Joint-lock submissions, such as an armbar submission, hyperextend the joint into an unnatural and painful position, potentially causing structural damage. A study assessing injuries while participating in Brazilian Jiu Jitsu found that “orthopedic injuries were found to be the most common injury type in BJJ competitions, accounting for 78.3% of all injuries…. Most were hyperextension injuries to the elbow” (Scoggin 2-6). The correlation between hard-tissue injuries and submission grappling is significant, one study referencing that the more often an athlete is involved in submission grappling, the more likely it is for an injury to occur (Usuki 153). Submission grappling, such as Brazilian Jiu Jitsu, is only one of many martial arts techniques utilized by professional mixed martial arts athletes.

Performance-based rapid weight loss can lead to a myriad of inimical side effects. Performance-based weight loss is when an athlete undergoes the process of shedding body weight with the desired result of meeting a designated weight limit. Mixed martial arts athletes commonly push the limits of rapid weight loss. Frequently mixed martial arts athletes “compete in weight categories 5% to 10% below their normal body weight… reducing food and fluid intake and pursuing active sweating through increased exercise or other forms of voluntary dehydration” (Pettersson 99). Performance-based weight loss remains one of mixed martial arts most controversial aspects. Due to limited oversight by trained medical professionals, many professional mixed martial arts athletes question the necessity of the practice. A remarkable number of mixed martial arts athletes are not successful in their rehydration efforts before competition, often competing while dehydrated (Jetton 1322). Dehydration is a significant risk factor for heat-illnesses such as heat rash, heat exhaustion, and heat stroke. Heat stroke is potentially life-threatening illness. Heat stroke is recognized in the clinical setting as a core body temperature above forty degrees Celsius, one hundred and four degrees Fahrenheit, coupled with altered mental status, seizures, and coma. Heat stroke is associated with multi-organ inflammatory response that leads to multi-organ dysfunction (Bouchama 1978). Performance-based rapid weight loss can put an athlete’s body in an incredibly weakened and vulnerable state. One study suggests that rapid weight loss from dehydration and reduced water intake can cause kidney disease (Rasouli 61). Chronic kidney disease is the presence of kidney damage as a result of decreased kidney function, often accompanied by anemia. Anemia is defined as a reduction of one or more blood cell measurements. Anemia associated with chronic kidney disease increases morbidity and mortality from cardiovascular issues. The cardiovascular issues help facilitate further renal failure and may eventually lead to cardiorenal anemia syndrome (Thomas 3-4). Professional mixed martial arts athlete Dhafir Harris, better known as Dada 5000, details his near-death experience at the hands of a failed weight loss that resulted in kidney failure: “So when the kidneys shut down and I’m still pushing, the next thing to go was the heart…I had two heart attacks and I [flat-lined] twice” (Al-Shatti). Harris goes on to attribute his nearly forty-pound, pre-fight weight loss as a significant factor in the ordeal. Harris remained on dialysis for nearly two months after the incident.

Injuries resulting from brain trauma are particularly severe due to the grave consequences associated with them. Match-ending head trauma in mixed martial arts can be delivered in the form of a knockout (K.O.) or a technical knockout (T.K.O). Increased risk factors for knockout and technical knockout include previous knockout and match significance. Brain trauma resulting from a knockout is often exacerbated by repetitive strikes to a downed opponent: “Average time between the KO-strike and match stoppage was 3.5 seconds (range, 0-20 seconds), with losers sustaining an average of 2.6 additional strikes (range, 0-20 strikes) to the head” (Hutchison 1352). Unlike boxing, mixed martial arts competitions do not have a ten-second count that allows referees to determine whether or not the athlete is able to continue. The gloves used in mixed martial arts competition are significantly less padded: “Mandatory ‘grappling’ gloves now used in MMA events weigh between 4 to 8 ounces, thinner than the 8 to 10-ounce gloves worn by professional boxers” (Bledsoe 139). The severity of injuries to the brain cannot be understated due to the brain’s limited capacity to repair itself. The damage from mild traumatic brain injuries, such as concussions, disrupts healthy vascular blood flow preventing cerebral vessels from maintaining homeostatic blood pressure within the brain. The abnormal vasoconstriction resulting from a concussion prevents the reuptake of vital chemicals such as glucose, lasting anywhere from one to nine months. Misidentification of a concussion could potentially lead to the development of second concussion syndrome, the pooling of blood within the brain resulting in hemorrhage. Second concussion syndrome results from a secondary concussion suffered before the effects of the initial concussion could be rectified. The severity of second concussion syndrome should not be overlooked; some studies have shown the resulting mortality rate as high as 50% (Burns 15-7). Repetitive brain trauma has a positive correlation with a host of chronic and delayed neurological issues. One study examined the compounding effects of multiple concussions and found that repeated concussions likely lead to a delayed form posttraumatic brain degeneration (Tator 975). The term Chronic Traumatic Encephalopathy is often used when referencing a chronic brain syndrome caused by repetitive damage to the brain. Chronic Traumatic Encephalopathy is a chronic brain syndrome caused by repetitive brain trauma, often presenting symptoms similar to Parkinson’s disease. The onset of neurodegenerative disorders such as Chronic Traumatic Encephalopathy can be delayed for years after training and competing in mixed martial arts (Blennow 886-7). The negative impact of repetitive brain trauma has also been linked to an increased risk for suicide, one study finding long-term suicide risk as high as three times that of the regular population (Fralick 501). Whether physical or psychological, the effects of traumatic brain injury are truly devastating.

Injury is a constant risk for athletes of all sports; however, the damages associated with mixed martial arts activities are unique in their severity and variation. The exponential growth of mixed martial arts has led to the implementation of ring-side physicians and other government-sanctioned safeguards. Ultimately, institutions such as the Nevada State Athletic Commission and other governing bodies should not solely be the deciding factor on whether or not athletes should compete. Future mixed martial arts athletes must consider potential injuries before engaging in competition. Additionally, future comprehensive safety measures must be emplaced to ensure an athlete’s health and safety continues to be the primary focus of mixed martial arts promotions. With the improvement of health science and technology, one may remain hopeful that the negative health effects related to mixed martial arts may be mitigated.


Works Cited

Al-Shatti, Shaun. “Dada 5000 on Bellator Scare: ‘I Was Pronounced Dead’.” MMA Fighting, MMA Fighting, 13 Apr. 2016,

Bledsoe, Gregory H., et al. “Incidence of Injury in Professional Mixed Martial Arts Competitions.” Journal of Sports Science & Medicine, vol. 5, no. 1, 1 Jul. 2006, pp. 136-42. NCBI,

Blennow, Kaj, John Hardy, and Henrik Zetterberg. “The Neuropathology and Neurobiology of Traumatic Brain Injury.” Neuron, vol. 76, no. 5, 2012, pp. 886-99. ProQuest,, doi:

Bouchama, Abderrezak and James P. Knochel. “Heat Stroke.” The New England Journal of Medicine, vol. 346, no. 25, 2002, pp. 1978-88. ProQuest,

Burns, Jason L. “Concussions and Other Mixed Martial Arts Injuries,” ProQuest Dissertations and Theses, Florida Gulf Coast University, Ann Arbor, 2015, pp. 1-54, ProQuest,

Fralick, Michael, et al. “Risk of Suicide After a Concussion.” Canadian Medical Association Journal, vol. 188, no. 7, 2016, pp. 497-504. NCBI,

Hutchison, Michael G., et al. “Head Trauma in Mixed Martial Arts.” The American Journal of Sports Medicine, vol. 42, no. 6, 2014, pp. 1352-8. NCBI, doi: 10.1177/0363546514526151.

Jetton, Adam M., et al. “Dehydration and Acute Weight Gain in Mixed Martial Arts Fighters before Competition.” Journal of Strength and Conditioning Research, vol. 27, no. 5, 2013, pp. 1322. NCBI, doi: 10.1519/JSC.0b013e31828a1e91.

Pettersson, Stefan, Marianne P. Ekström, and Berg, M. Christina, “Practices of Weight Regulation among Elite Athletes in Combat Sports: A Matter of Mental Advantage?”, Journal of Athletic Training, vol. 48, no. 1, 2013, pp. 99-108. ProQuest,

Rainey, Charles E., “Determining the Prevalence and Assessing the Severity of Injuries in Mixed Martial Arts Athletes.” North American Journal of Sports Physical Therapy, vol. 4, no. 4, 2009, pp.190-9. NCBI,

Rasouli, Haji M., and Rohani, A., “101 the Effect of Dehydration on the Athlete’s Kidney Function.” Journal of Science and Medicine in Sport, vol. 8, 2005, pp. 61. ProQuest,, doi:

Scoggin, James F., et al. “Assessment of Injuries During Brazilian Jiu-Jitsu Competition” Orthopaedic Journal of Sports Medicine, vol. 2, no. 2, 21 Feb. 2014, pp. 1-7. NCBI, doi:10.1177/2325967114522184.

Tator, Charles H., “Concussions and Their Consequences: Current Diagnosis, Management and Prevention.” Canadian Medical Association. Journal, vol. 185, no. 11, 2013, pp. 975-9. ProQuest,

Thomas, Robert, et al. “Chronic Kidney Disease and Its Complications.” Primary Care, vol. 35, no. 2, 2008, pp. 329-44, vii. NCBI, doi: 10.1016/j.pop.2008.01.008.

Usuki, H., et al. “Injury History, Severity, and Medical Care for Athletes Participating in Brazilian Jiu-Jitsu.” Journal of Athletic Training, vol. 52, no. 6, 2017, pp. 1 ProQuest,