Concussions and MMA

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I have a female MMA fighter who has gotten two concussions in the ring. Not knocked right out either time, but the second one was bad enough that she's still having headaches and dizziness and whatever a month or two afterward.

I want a devil character to be pushing her back into the ring, and an angel character trying to persuade her to take more time or quit entirely.

Perfect scenario, plot-wise, would be if there could be something physical (an MRI image?) or otherwise concrete that two different doctors could look at and come to different conclusions about. One, working for the devil side, would say she was okay to fight. The other, on the angel side, would point at something and say no, that's still there, it's a problem, you're not safe in the ring.

Any chance of this actually working? Or is post-concussion treatment a bit more nebulous?

What would a fighter in this situation actually need to show in order to be medically cleared to compete? (I'm working with a fictionalized UFC organization).
 

MDSchafer

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There's a couple of considerations. I'm not sure what the MMA requires, but Indycar and other concussion prone sports are starting to mandate baseline concussion testing. That makes it fairly straight forward whether or not a competitor can compete. If the MMA doesn't require baseline testing it's a bit gray.

Typically you don't look at an MRI until three days after a concussion, and basically what they're used for is to check for intracranial bleeding. A CT scan is the tool of choice for suspected serious concussions, and typically they're fairly conclusive.

Where doctors can have differing opinion is on the recovery time needed after a concussion. There's Second Impact Syndrome which is a condition where you injure your brain before it has time to fully recover from the first one. Obviously the damage would be worse the second time, and you're setting yourself up for chronic traumatic encephalopathy. Also once you've had one or two concussions the amount of energy required for you to have a third one drops, and it can drop significantly.

Indycar champion Dario Franchitti suffered a concussion last year. It was his third documented concussion and he decided hang up his helmet. I would seriously question the judgement of anyone who had two concussions attempting to fight.
 

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Thanks, this is a great start!

What's involved in baseline concussion testing? What would that look like?
 

debirlfan

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I'm not sure exactly what the baseline testing involves, but I've gotten the impression that some of the drivers make it a point during initial testing to not quite perform at their best, so there's a bit of "fudge factor" in the results. If they do baseline testing on your fighter and she passes, she might know she only passed because of intentionally under performing on the initial test.
 

suchan

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Different fight organizations have different medical standards but since you mentioned that you're basing this on the UFC, we'll go with UFC rules.

The UFC is notoriously stringent in their medical standards because they like to market themselves as the safest sport organization ever.
"Here's the reality. This is the most regulated sport in the world," UFC president Dana White told the UFC 128 pre-fight news conference.
There are 3 medical tests a fighter must undergo to fight in the UFC:

Medical test 1:
MMA combatants must undergo annual tests to maintain their licence to fight.

Medical test 2 (prefight):
They also have a medical test when fighters are chosen for the card (this can happen 3-5 months before). The medical test includes: a check up by doctors sanctioned by the State Athletic Commission (which state/country depends on where the UFC show will be held. A San Jose show would mean the California State), CT scans, X-rays and MRIs if they spot major anomalies.

Medical test 3 (right before weigh ins):
Then another test happens right before the weighs-ins to make sure a fighter did not injure themselves during fight camp but this test isn't as stringent as the one before. It usually just involves a doctor.

Medical test 4 (post fight):
Then after the fight, the State Athletic Commission imposes post-fight medical suspensions, varying on the degree of damage taken. "If they take any damage to the head, they're put on a three-month suspension," said White. "These guys are on a three-month medical suspension and cannot return until they're seen by a doctor.

Here are some examples of medical suspensions from UFC on FOX 12 "Lawler vs Brown":

Matt Brown: Suspended 180 days for possible fracture to open nasal area, Additional suspension 60 days for laceration to nasal area, unless cleared by physician. Minimum suspension 45 days (30 days no contact).

Robbie Lawler: Suspended seven days (precautionary reasons).

Antonio Rogerio Nogueira: Suspended 60 days for laceration to right eyebrow, unless cleared by physician. Minimum suspension 45 days (30 days no contact).

Anthony Johnson: Suspended seven days (precautionary reasons).

Clay Guida: Suspended 60 days for facial laceration, unless cleared by physician. Minimum suspension 45 days (30 days no contact).

Fighters often return to action much quicker once doctors give them the green light. The lengthy suspensions are just a precaution in most cases. In addition, not all injuries are recorded during the post-fight examination and often times surface in follow-up tests.


In your above scenario, it is very unlikely that a concussion that causes headaches and dizziness and whatever a month or two afterward will not be caught by a CT scan during the prefight testing. So in the above scenario, unless her fight camp decided to 'fake' her CT scan by switching out her CT scan with another healthy person's scan (i've heard of this happening before in other fight organization just not in the UFC), her concussion will likely be caught.

If she also sustained the injury during a fight, the post fight examination may catch it depending on how bad it is, this would also put her on the 'watch' list meaning that doctors would be on the lookout for it knowing she had sustained a concussion in her previous fights. Dana White says in his keynote address Jan 2013:
""Concussion is a huge dilemma right now for the NFL. Here's the difference between the UFC and the NFL as far as concussions are concerned. First of all, if you get a concussion, if you get knocked out or you get hurt whatsoever in the UFC, three months suspension. You are on suspension for three months and you cannot come back until you are cleared by a doctor. You can't have any contact whatsoever."

The UFC is really stringent with injury, they've cancelled fights before for the smallest things esp if the fighters are headlining the card. Given that female MMA is the new hottest thing, the females are under a lot more scrutiny then the males and hence the medical tests will be a lot more stringent I'm guessing.

Hope this helps!
 

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That's GREAT information, Suchan - thanks very much!

(It's annoying for my plot, but - better to work it out now than regret it later!)
 

suchan

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No worries, hope it helps. If you have any questions about MMA or training I'll try my best to answer them :)

Although I don't do MMA myself, I train Brazilian Jiu Jitsu at a MMA gym. Been doing it for 5 years and my coach is a MMA fighter too with Shooto Brazil and OneFC.
 

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You might find this book useful, though it's a few years old now:

Head Games: Football's Concussion Crisis from the NFL to Youth Leagues


This was when the issue of concussions was starting to gain more and more momentum in the sports world, and if nothing else, it's a good (and scary) read on some of the long term ramifications and potential effects of multiple concussions.

Long-term symptoms for your character if they are suffering from post-concussion syndrome can vary. Speaking from personal experience with a loved one who suffered a severe concussion in an accident, coupled with concussions in years before and after, you can have "fuzzy" or off days. Short term memory problems that may extend for some time are common if it's more severe. Mood problems. Depression. Etc.

Though your character seems to be currently concerned about the short term effects, as Head Case and other materials will attest, there are some scary long term implications to think about as well (i.e. suggested links to early Alzheimer's, Parkinson's...it's not pretty). Just another item to chew on for your book.