Archive for December, 2013

Ever wonder where the most MMA events take place?  Data was recently compiled addressing the volume of sanctioned amateur and professional events in the US and Canada from 2009-2012.

California wins by a landslide with 154 sanctioned events in 2012 alone.  Texas comes in second with 83 and Nevada ranked fifth overall in volume in 2012 events.

The Canadian winner is Alberta with the various local commissions overseeing more than 20 events in 2012 with Quebec coming in second at 10.  Below is the full list:

ABC MMA Sanctioned Events By Commission from 2009 – 2012

ABC Gender Image

Few topics generate more debate when it comes to MMA regulation than licencing of transgender athletes.   Ultimately this is a debate that is best addressed through science as the most valid criticisms focus on the health and safety of participants.  To this end, the Association of Boxing Commissions Medical Committee (comprised of some 40 physicians) has released a suggested policy dealing with this.  Below are their recommendations which are noted to be “a starting point” with revision on an as needed basis as more medical evidence becomes available.

___________________________________________

ABC MEDICAL COMMITTEE SUGGESTED TRANSGENDER POLICY

The purpose of developing this policy was to allow combat sports
athletes the opportunity to participate in competition in accordance
with their gender identity while maintaining the relative balance of
competitive equity among competitors.

This document is based on review of current medical literature, review
of NCAA and IOC policy, and has been co-authored by one of the world’s
leading authorities on this topic, Dr. Eric Villain, M.D., PhD., chair of

Medical Genetics Clinic
Director, Center for Gender-Based Biology
Professor, Pediatrics
Urology
Human Genetics
at UCLA.

This document is a starting point. It will need to be revised as greater
bodies of evidence based medicine become available.

MALE TO FEMALE (MTF)

• Individuals undergoing sex reassignment PRIOR to puberty
should be regarded as females.
• Individuals undergoing sex reassignment AFTER puberty should
be eligible for participation in female competition under the
following conditions:
o Surgical anatomical changes have been completed
including gonadectomy and external genitalia
o Hormone therapy appropriate for the assigned sex
(female) administered by a board certified
endocrinologist or any specialist in good standing
with his/her licensing jurisdiction known to have
significant knowledge and experience with
transsexual and transgender individuals for a
MINIMUM of TWO years AFTER gonadectomy.
o A letter from a board certified physician responsible
for the care of the athlete should be submitted to the
athletic commission being petitioned for licensure
and to the ABC Medical Review Board.
o TUEs will not be granted for hormone replacement
therapy (HRT).
o The transsexual competitor (as with all competitors)
should be subject to random drug testing

FEMALE TO MALE (FTM)
• Individuals undergoing sex re-assigment from female to male
AFTER puberty should be eligible I male competitions under the
following conditions:
o Hormone therapy for the assigned sex (male) has
been administered by a board certified
endocrinologist or any specialist in good standing
with his/her licensing jurisdiction known to have
significant knowledge and experience with
transsexual and transgender individuals.
o A letter from a board certified physician responsible
for the care of the patient will need to be submitted to
the medical review panel of the athletic commission
being petitioned for licensure and to the ABC Medical
Review Board
o TUEs WILL be granted for FTM.
o The athlete maybe subject to drug testing before,
during and/or after competitions.

TRANS MALES (FTM)
• A trans male (FTM) athlete who is on testosterone replacement
therapy may compete ONLY AS A MALE.
• TUEs WILL be granted at the discretion of the licensing
commission provided appropriate documentation has been
submitted
• Athletes will be subject to random drug testing

TRANS FEMALES (MTF)
• TUEs need NOT be granted for HRT. A full disclosure of
prescribed medications is required for each applicant
• Athletes maybe subject to random drug testing

RECOMMENDED MINIMUM PAPERWORK FOR SUBMISSION TO THE
LICENSING JURISDICTION

• History, physical examination, baseline blood work (CBC, thyroid
function tests, blood chemistries, clotting times, lipid profile),
EKG, ophthalmologic examination CT or MRI/MRA of the head
(These guidelines can be found in the ABC Medical Handbook
edition 1)
• A declaration letter from the treating physician.

The physician must be board certified in his/her specialty
and in good standing with his/her jurisdiction. The
physician must have extensive experience with
transgender patients and the administration of related
medications, if required.

The physician should:
State the length of time the athlete has been in
his/her care
Submit a complete history and physical
examination
Include mandated blood work, as required by
the licensing jurisdiction
Include mandated tests, as required by the
licensing jurisdiction
Include the medications prescribed
Document therapeutic hormone levels, and the
intervals between testing of levels
Submit an appropriate request for TUE, if
applicable

Earlier this year I canvassed the possibility of obtaining Therapeutic Use Exemptions for medical marijuana users licensed to compete in combat sports.

The Association of Boxing Commissions Medical Committee has now addressed this issue, noting that “there are no good data at present to suggest that marijuana acts directly as a performance-enhancing drug” and confirmed that, provided that the underlying medical condition does not bar the combatant from being licensed, Athletic Commissions should be open to granting marijuana TUE’s.  Below is the Medical Committee’s consensus statement which ought to be referenced for any user seeking a TUE for medical marijuana:

ABC MEDICAL COMMITTEE CONSENSUS STATEMENT REGARDING
MARIJUANA
The ABC Medical Committee Consensus Statement regarding MEDICAL
MARIJUANA is as follows:
Based on current standards of care, the current diagnoses for which medical
marijuana could be indicated as treatment would most probably preclude a
combatant from participation in combat sports. Nevertheless, the committee
recommends that each request be reviewed on a case-by-case basis.
Should the athlete be deemed healthy enough for participation, an explanation from
the treating board certified physician, who must be in good standing in his/her
states) of licensure, should be submitted to the jurisdiction sanctioning the bout. It
is recommended that the letter include the following:
1. The length of time the contestant has been under the physician’s care
2. The complete work-up and diagnosis of the patient
3. A clear explanation as to why other treatment modalities deemed acceptable in
competition have not been suggested to the contestant.
4. Follow-up plan for the contestant including the means for objective assessment of
improvement with this treatment modality.

 

C.T.E. (chronic traumatic encephalopathy) is a progressive degenerative disease which is linked to combat and other contact sports such as hockey and football.  When an athlete experiences too many concussive or sub concussive shots over the course of a career they are at risk of developing CTE which can have profound consequences later in life.

So how much contact is too much?  This is the vital yet presently unanswerable question.  The troubling aspect is that symptoms of CTE often don’t set in for decades making it difficult for an athlete to gauge whether they are exposing their brain to too much trauma.  There is no known cure for CTE so it is problematic to only learn of the damage after the point of no return.  Presently the only known way of diagnosing the condition is by studying brain tissue after death.

There appears to be some medical progress, however, giving hope that earlier diagnosis may be possible.  Earlier this year The American Journal of Geriatric Psychiatry published findings indicating that through PET Scans it may be possible to diagnose CTE prior to death.  The New York Times recently published a thorough article addressing this study which is worth reading for better understanding of this topic.

If you want the Cliff’s Notes version the bottom line is further research is needed but there is some promise of earlier diagnosis of CTE.   It will take years before there is any certainty to the possibility of earlier diagnosis and there is no indication whether the condition will be able to be diagnosed before the point of no return.  All combat athletes should know that there is no good guage on when you have exposed yourself to one hit too many.  If you choose to compete in combat sports it is vital to take precautions minimizing how much head trauma you expose yourself to over a career.

For more on participant safety you can click here to access this site’s archived posts discussing other safety studies related to MMA and other combat sports.

I’ve previously discussed some of the biggest legal threats to MMA with PED abuse and inadequate policies addressing this being one of them.  I’ll confess that when a lawyer talks about the law, especially in a hypothetical situation, it can be a little dry.  Enter Ben Miller.  Last week Ben authored an article at the Wrestling Observer discussing what the PED lawsuit will look like in MMA.  It’s a hypothetical first person account and Ben paints a compelling picture which, unfortunately, is all to easy to see playing out.  It starts as follows:

Welcome to my lawsuit. 
 For years I played your game.  I made a lot of money.  I had a lot of fun.  It was my choice.
 But you told me that you were keeping your game safer than you really were.  Other players used drugs.  They used drugs that made them stronger.  More aggressive.  Gave them better vision and focus to hit me.  You put my health at risk.  I knew the game was dangerous.  But that was something different.  That was like handing my opponent a crowbar before he walked into the cage.
 
Now I’m screwed.  I get angrier than I used to.  I forget things that I’ve known for years.  People have to tell me their names three or four times.  It’s hard to keep a job that way.  Or a wife or a family.  And you’re still fine.  You dissed the rank and file fighters.  Now my fight is going to court.

 

You can click here for the full article which I encourage you to read.  The bottom line is PED abuse exists and the inadequate policies addressing this creates a genuine threat to the combat sports industry.  This is a fixable problem and reforms can be put into place.  Absent these, however, it is likely only a matter of time before a retired athlete will tell the same tale as Ben and when that plays out in Court the damage to the sport will not easily be undone.

Adding to this site’s archives addressing combat sports prosecutions in Canada, useful reasons for judgement were recently shared with me addressing charges under the Ontario Athletics Control Act dealing with an amateur kickboxing event.

In the unreported 2010 case (Her Majesty the Queen v. McNamara) the Defendants held two kickboxing bouts and were charged with “holding a professional contest or exhibition of boxing without the authority of a licence” under the Ontario Athletics Control Act.     The Court heard from Ken Hayashi, the Ontario Athletic Commissioner, who testified that he did not licence the event but also confirmed that he has no responsibilities in overseeing amateur events.  The Court also heard from the President of the Kickboxing Ontario Association (a voluntary Provincial Sport Organization) who testified that their organization did not sanction this event.

The Court found there was no evidence that the event was “professional” as defined in the statute and absent such evidence the jurisdiction of the Ontario Athletic Commissioner was not triggered.  Implicit in the judgement is that Kickboxing Ontario’s oversight was also not needed to be in compliance with the Athletics Control Act.  In granting a motion for non suit and dismissing the charges the Court provided the following reasons:

Well, it’s clear from the act that professionals are individuals who compete for a stake bet or public money.  The court heard nothing by way of evidence from the prosecution that the kickboxers, who were present for the two events from June 19, 2008 and September 28, 2008 were professional, licenced fighters.  There’s no evidence to conclude that.  And in order for the court to have this matter continue, it would’ve had to have heard that.  And that is an essential element to the charge.  So the motion for non-suit is grated.  The Court is going to dismiss the charges.

You can find a full copy of the reasons for judgement here – Her Majesty the Queen v. McNamara

Prosecutions under section 83 of the Criminal Code are few and far between and published reasons for judgement addressing such prosecutions are even more scarce.  Recently unpublished reasons for judgement were shared with me addressing proceedings on a guilty plea during a section 83 prosecution in Ontario in 2003.  I highlight these here for the sake of public access to information regarding such prosecutions.

In the 2003 case (R v. 1156579 Ontario Ltd.) the Defendant corporation along with two of its shareholders were charged with holding an unlawful prizefight contrary to section 83(1)(b) of the Criminal Code.   A plea bargain was apparently struck with the corporation alone pleading guilty to the charge and the charges against the individuals were withdrawn.  The Court went on to accept a proposed fine of $2,000.  Following the guilty plea little analysis is done addressing appropriate sentences for these charges with the Court’s primary concern being the timelines needed to pay the fine.

You can find a full copy of the transcript of proceedings here: HMTQ v. 1156579 Ontario Ltd

Welcome UFC Central Listeners!

Posted: December 13, 2013 in Uncategorized

FN 590 photo

Yesterday I had the pleasure of appearing on UFC Central Radio to discuss some of the legal topics addressing combat sports in Canada.   You can listen to the interview here.

I’d like to thank Showdown Joe Ferraro for having me as a guest once again.  If you are visiting here for the first time after listening welcome!  If you are looking for more information on the topics we covered here are some quick links to the articles addressing these issues:
Ontario Slow to Legalize Amateur MMA and Non Olympic Combat Sports

Why Amateur MMA is Illegal in Ontario

BC’s Position on Pro Kickboxing and What Can Be Done to Address This

PEI Shuts Down Kickboxing Event

The Three Biggest Legal Threats to MMA

As previously discussed intense and frequent sparring can have more negative effects on brain function than the frequency of knockouts in competition.  A further study addressing the effects of cumulative subconcussive hits was recently published in the journal Neurology.  You can find an abstract of the study here.

The author compared a group of NCAA hockey and football players to a group of non contact sport NCAA athletes.  The contact athletes wore instrumented helmets which recorded the acceleration-time history of the head following impact.  The athletes undertook cognitive tests before and after the season.   A higher percentage of the contact sport athletes performed more poorly than predicted during the post season tests.  New learning was effected.  There was a relationship between the poorer scores and “higher scores on several head impact exposure metrics.“.

In a further study published this week it is reported that a season of hard hits comes with measurable changes in the brain’s white matter with the Concussion Policy and the Law Blog reporting thatthe degree of white matter change in the contact sport athletes was greater in those who performed more poorly than expected on tests of memory and learning, suggesting a possible link in some athletes between how hard/often they are hit, white matter changes, and cognition, or memory and thinking abilities.

The bottom line is that hard sparring takes its toll.  The brain can only take a finite number of jostles before negative repercussions take place.  Combat athletes would do well to not only be aware of this but to spar smart and not expose themselves to unneeded damage while training.

Since their creation earlier this year the BC Athletic Commission has been one of the busiest in the Country overseeing a host of amateur and professional combat sports events with perhaps the most high profile being the recent World Series of Fighting event this past weekend in Vancouver.

With all of these events how many Therapeutic Use Exemptions have been granted for otherwise prohibited substances?  Surprisingly the answer is none as the Commission has yet to be asked to grant a single TUE.

I reached out to BC’s Athletic Commissioner to find out what policies are in place for TUE’s.  So far there are none.  Mr. Maedel responded as follows to my question asking if a TUE policy is in force yet:

Not at this time.

 It has not come up as an issue yet and, as such, it has not risen to the top of the very high pile of things to do. Should we need to deal with a request for a TUE I anticipate we would be able to put something together based on industry practices.

For what it’s worth the framework is in place for a sensible TUE policy.  Section 21(2) of the BC Regulation reads as follows:

For the purpose of this regulation, the World Anti-Doping Agency’s list of prohibited substances and methods applies as amended from time to time

WADA has set standards for obtaining TUE’s and the path of least resistance would be for BC to formally adopt the WADA standards if they are not already absorbed by the language of Section 21.  The WADA TUE standards are as follows:

The four criteria that must be fulfilled before a TUE is granted are set forth 
in the International Standard for TUEs: 
1. “The Athlete would experience a significant impairment to health if 
the Prohibited Substance or Prohibited Method were to be withheld in 
the course of treating an acute or chronic medical condition.” (Article 
4.1 a. of the International Standard for TUEs.)

2. “The Therapeutic Use of the Prohibited Substance or Prohibited 
Method would produce no additional enhancement of performance 
other than that which might be anticipated by a return to a state of 
normal health following the treatment of a legitimate medical 
condition. 

3. “There is no reasonable Therapeutic alternative to the Use of the 
otherwise Prohibited Substance or Prohibited Method.” (Article 4.1 
c of the International Standard for TUEs.)

4. “The necessity for the Use of the otherwise Prohibited Substance or 
Prohibited Method cannot be a consequence, wholly or in part, of 
prior non-Therapeutic Use of any Substance from the Prohibited 
List.” (Article 4.1 d. of the International Standard for TUEs.)