When it comes to brain trauma and certain facial lacerations there is much consensus as to when a combat sport should be stopped. When it comes to other physical injuries there is no universal consensus for when ringside physicians should bring a contest to an end.
In the latest issue of the Journal of Combat Sports Medicine, published by the Association of Ringside Physicians, two experienced doctors propose standardizing medical stoppage decisions in boxing and MMA with clearly defined NO-GO orthopaedic criteria. In the article, titled “Making Boxing and MMA Safer: The Case for Establishing a NO-GO Orthopaedic Criteria in Combat Sports” the authors propose the following list of injuries leading to consensus stoppages and come to the below conclusion:
There is an urgent need to make combat sports safer and it is far better to stop a fight early rather than too late. It is recommended that the above proposed “NO-GO” orthopedic criteria and best-practice guidelines be debated by ringside physicians and the wider combat sports medical community. Evidence-based guidelines on these medical stoppages need to be developed in conjunction with the professional boxing and MMA governing bodies. Many of these “NO-GO” criteria are well established in other professional sports. If an ACL tear is suspected in a professional football player, that player will be removed from the game without question. However, this has not been the case in MMA or boxing. The warrior mentality these athletes possess will drive them to continue. In some respects, physicians caring for these athletes are swayed by this mindset and fights at times are allowed to continue despite some of the above injuries. Physicians taking care of combat sports athletes (ringside physicians) come from various disciplines of medicine such as neurology, sports medicine, emergency medicine, ophthalmology, and family medicine. Establishing strict “NO-GO” orthopedic criteria in combat sports, as has been done for traumatic brain injury, will take some of the emotions out of the medical decision making for the physician, referee, governing bodies, and the combatant. This shall also help to standardize medical stoppages in these sports by non-orthopedic physicians. We will not only better protect these athletes and lengthen their careers but minimize the long-term disabilities many may live with even after they retire.