Study – KO / TKO Rate Due to Head Trauma Lower in Female MMA Compared to Boxing

Adding to this site’s archived combat sports safety studies, an article was recently published in the Journal of Medicine & Science in Sports & Exercise looking at the rate of finishes in Mixed Martial Arts where a bout was stopped due to Knockout or Technical Knockout involving head trauma.  The data revealed that the combined incidence of KOs and TKOs from head trauma was 103.4 per 1000 athlete exposures and that this rate was lower than the rates seen in female professional boxing and men’s MMA.

The study’s full abstract reads as follows:

Mixed martial arts (MMA) is a full-contact combat sport, which in recent years has experienced an increase in participation of female athletes. Previous research has indicated knockouts (KO) and technical knockouts (TKO), which are typically associated with head trauma, are frequent occurrences (46.2% of match outcomes are determined by KO and TKO) in male MMA competitions. However, the occurrences and context of KOs and TKOs have not been investigated in female MMA competitions.

PURPOSE: To characterize the occurrences and context of KOs and TKOs in female professional MMA competition.

METHODS: Publicly available score card and video data of female Ultimate Fighting Championship (UFC) competitions that occurred between November 2014 (UFC 180) and July 2016 (UFC 200) were analyzed. Score card information from and was used to determine the occurrences of KOs and TKOs of female UFC fights. The MMA Knockout Tool was used to analyze video of the female UFC fights that ended in KO or TKO. The MMA Knockout Tool allows for coding of the context of a KO and TKO as well as coding the number of head and body strikes sustained by the loser in the 30 s prior to the KO or TKO.

RESULTS: Two out of a total 29 matches ended in KO while 4 ended in TKO due to repetitive strikes. One other TKO was due to a musculoskeletal injury and was not included in the analysis. The combined incidence of KOs and TKOs from head trauma was 103.4 per 1000 athlete exposures (AEs). Video analysis of the KOs and TKOs revealed that in 5 of the 6 KO/TKOs the loser was standing and not clinched with the winner, and in 1 fight the loser was on the ground. In the 30 s prior to TKO the loser sustained a mean of 15.5 ± 7.6 impacts to the head with a mean 8.0 ± 3.6 strikes to the head occurring in the final 10 s. The head regions that sustained the greatest number of strikes within the 30 s prior to KO or TKO were the mandibular and temporal regions, which received 34.7 and 30.7 % of all head strikes, respectively.

CONCLUSIONS: KO and TKO events may represent a conservative estimate of concussive events in MMA competition. The incidence of 103.4 TKO/KOs per 1000 AEs is less than that observed for professional female boxing and male MMA competitions. Furthermore, our data suggest that engaging in a standup versus ground fight is associated with greater incidences of KO/TKOs.

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