COMMON MIXED MARTIAL ARTS INJURIES AND PHYSIOTHERAPEUTIC APPROACH TO PREVENT AND RETURN TO THE PRACTICE. 

MMA or Mixed Martial Arts is the fusion of different styles of traditional martial arts. The best aspects of disciplines such as kickboxing, boxing, wrestling, muay thai, Brazilian jiu jitsu, karate and judo, mixed all in one to form an effective and complete fighting style, where two mixed martial arts professional athletes face each other in a cage under right rules that protect them from severe damage, but at the same time allow so much action that they have made MMA the fastest growing unarmed combat sport worldwide. Radio Salil et la (2013) pointed out that “90% of injuries are yield by training itself, which is one of the prime conclusions of the study carried out on sports injuries, their prevention and recovery. According to this study, the most affected zones by lesions are the knee, thigh and ankle.”

IS THERE ANY DIFFERENCE BETWEEN UFC and MMA? 

UFC is the abbreviation of Ultimate Fighting Championship, the main organization of MMA in the world, created in the United States. The popularity of this organization is what has made people relate directly to the sport.

“A study of 9 weight divisions of UFC was made, in which it there were 291 injuries over 285 fights i.e. the injury average of athletic exposure was 51 per 100 fighters/ athletes. Males fighters (fifty-four injuries per one- hundred athletic exposures) had a higher average of suffering an injury than female ones” Stated out by Joseph A. Abboud et al (2018).

WHY IS SO VITAL PHYSICAL THERAPY DURING PRE AND POST TRAINING/COMPETITION?

The risks of not following preventive protocols can lead to problems such as muscle inflammation or rupture, delayed muscle damage, or fibrillar micro tears. For this reason, the work performed by the physiotherapist / physical therapy specialist in Manchester city in the pre and post training phase allows the prevention of muscle injuries and optimal muscle recovery. As part of these prevention assignments, MY SPORTS INJURY CLINIC PHYSIOS recommend applying a topical anti-inflammatory before and after sports activity, because thanks to its heat effect, it helps to prepare the muscles and joints. 

WHAT ARE THE MOST COMMON INJURIES IN MARTIAL ARTS? 

Martial arts can lead to a wide variety of injuries. The type of injury often depends on the particular martial art form of being performed. Many forms of martial arts are non-contact and are characterised by overuse injuries. Contact martial arts vary widely in their techniques, standards, and protective equipment and these factors affect the type and rates of injury.

“A figure of 55 martial arts practitioners with an age average (18-39 years) was included in the research that showed 207 injuries, in which high belt ranks had significantly fewer injuries compared to low belt ranks and Amateur fighters showed fewer severe injuries than Professional fighters. Most frequent parts of the body impaired were face, neck and head obtaining 38, 2% of prevalence, in second place was found the lower limbs 30, 4 % of recurrence, upper limbs 22, 7% of incidence, trunk region 8, 2 per cent and groin area presented 0, 5 per cent.  Injuries in specific areas such as toe, nose and shoulder displayed to be the most common with 6, 3% all of them. Contusions with 29, 4% continued by strains with 16, 2% of prevalence, next, sprains with 14, 9% of frequency and finally abrasions 10, 1%, they were the most frequent injuries found in the study” Lt. Charles E. Rainey (2009).

THE MOST FREQUENT INJURIES IN CONTACT MARTIAL ARTS.

• Concussion; common symptoms of concussion include headache, dizziness, nausea, balance problems, concentration difficulties, and memory problems. Martial arts that use kicks and blows to the head are more prone to causing concussions.

• Face / eyes / ear / nose; kicking or punching can result in minor injuries such as cuts, bruises and lacerations. These types of injuries can be minimized by selecting the martial arts style, coupled with proper training and the correct use of protective equipment.

• Neck; minor neck injuries, such as bruises and abrasions, are the most common. However, some forms of martial arts, such as jiu-jitsu, judo, and mixed martial arts, do allow the choking techniques that can result in loss of consciousness. It is important to understand the risks of different forms of martial arts and always train under proper supervision.

• Extremities; limb injuries include cuts, bruises, sprains, and strains. Joint fractures and dislocations are less common, but can occur, particularly in styles that use joint locking techniques.

“The injuries mainly occurred in MMA are muscle contusions. In Judo, Karate, Taekwondo, Aikido, Fight, muscle contusion is the main sports injury. After monitoring more than 5000 competitors, 65% of them have suffered a muscle contusion. Being this the cause that is repeated the most times regardless of the category or gender of the competitors.”

“Throughout the course of 2008 and 2012 Olympic Games within judo/ martial arts matches, it was observed that the average number of sports injuries due to the practice of martial arts was about 11% i.e. musculoskeletal contusions, tears, cramps and sprains represented the most frequent injuries usually affecting shoulders, fingers and the knee” Gerhard Ruedl et al (2013).

“Throughout the course of 2008 and 2012 Olympic Games within judo/ martial arts matches, it was observed that the average number of sports injuries due to the practice of martial arts was about 11% i.e. musculoskeletal contusions, tears, cramps and sprains represented the most frequent injuries usually affecting shoulders, fingers and the knee” Gerhard Ruedl et al (2013).

Muscle injuries can be classified according to many factors: mechanism of production, time of evolution, location of the injury.

LET’S CLASSIFY THEM ACCORDING TO THE PRODUCTION MECHANISM:

• Extrinsic (factors outside our body): muscle contusion.
• Intrinsic (factors related to our own movement): muscle tear, elongation, strain, muscle cramps.

To know the extent of a muscle injury it is necessary to use diagnostic tests such as ultrasound or magnetic resonance imaging. Only through this type of test we can get to know how the tissue is. The recovery time will depend on the amount of muscle tissue that is affected, the place of production, age of the subject and the assistance of your health care provider in this case musculoskeletal clinicians / physical therapy practitioners. 

“Magnetic resonance imaging has been widely used to accurately assess and diagnose musculoskeletal injuries. MRI has been well received and accepted as a diagnostic method by trauma physicians and specialist physiotherapists due to its accuracy, emphasizing its use in conditions caused by accidents and sports-related injuries” Conveyed by A L Deutsch, J H Mink (1989). 

A term widely used in rehabilitation and one of the most frequent injuries in sports, we refer directly to the musculoskeletal system, since this is where these common injuries occur. Within sports we are subjected to a lot of impact, jumps, changes of direction, over efforts, which together can cause the muscle to begin to damage, generating adhesions at the muscular level. But when the intensity exceeds the limits of resistance at the muscular level, inflammation or muscle contusion occurs, generating a lot of inability to execute certain types of movements and in turn a lot of pain when pressing the damaged muscle, thus confirming a muscle contusion. 

HOW CAN PHYSIOTHERAPEUTIC MANAGEMENT ASSIST TO TREAT MUSCLE CONTUSION?

The treatment is conservative since the athlete is asked to continue executing movement during the treatment as well as therapeutic isometric work; physical agents are applied to the injured area. Within this type of pathologies, the use of invasive techniques such as dry needling is recommended. Some of strategies and treatment choices during a physiotherapeutic / soft tissue therapy session to return to the prior level of proficiency are: 

• Ice.
• Anti-inflammatory drugs.
• Interferential electrotherapy.
• Laser therapy.
• Isometric exercise.
• Proprioceptive exercise.
• Dry puncture.

“A huge variety of non-surgical strategies to treat acute and severe injuries and musculoskeletal disorders are utilised i.e. the main focus is to minimize and avoid future damage to the injured area, decrease edema and haemorrhage, ease spasm and pain, and encourage healing. Moreover, muscle injuries due to its nature demand a functional approach from acute stage until the aim of returning to sport, conservative management is highly effective for these muscle contusion injuries  and one of its immediately treatment options is RICE which means rest, ice, compression and elevation” Research made by  L. Baoge et al (2012). 

Rest after activity is an extremely important component of any treatment program once an anatomical structure is injured, the healing process begins immediately. If the injured structure is not allowed to rest and it receives external pressure and stress, the healing process has no chance to start.

Rest does not mean that the athlete does nothing, the term rest concerns the part of the body injured during this period, the athlete must continue to work on their cardiovascular capacity and perform strengthening and flexibility exercises in other parts of the body that have not been affected.

REFERENCES

• Woodward TW. A review of the effects of martial arts practice on health. Wisconsin Medical Journal. 2009;108(1):40–3.

• Bahr R, Holme I. Risk factors for sports injuries – a methodological approach. British Journal of Sports Medicine. 2003;37:384–392.

• Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–7.

• Surgeon General's report on physical activity and health. From the Centers of Disease Control and Prevention. JAMA. 1996;276:22.

• Border WA, Noble NA. Transforming growth factor β in tissue fibrosis. The New England Journal of Medicine. 1994;331(19):1286–1292. 

• Järvinen TAH, Järvinen TLN, Kääriäinen M, Kalimo H, Järvinen M. Muscle injuries: biology and treatment. American Journal of Sports Medicine. 2005;33(5):745–764. 

• Arrington ED, Miller MD. Skeletal muscle injuries. Orthopedic Clinics of North America. 1995;26(3):411–422. 

• Buse GJ. No holds barred sport fighting: A 10 year review of mixed martial arts competition. British Journal of Sports Medicine. 2006;40:169–172.

• Poliakoff MB. Combat sports in the ancient world: Competition, violence, and culture. New Haven, CT: Yale University, 1995:54–7.