Combat Sports Law

Fighting is objectively violent. In many ways athletes participating in full contact sports know what they are getting into. But in many other ways they do not as research has recently demonstrated.

Some injuries, like concussions and the neurodegenerative disease CTE which is linked to repeated concussive and subconcussive blows, are subtle but could have profound impact on quality of life. These are some of the most important injuries to be familiar with for participants in sports were full contact strikes to the head are allowed. And even more so for coaches training athletes in these sports.

A recent study was published diving into just how well combat sports participants and coaches actually understand concussion. The answer was not very. In fact the study found that “Merely 5.7% of coaches properly recognized the level of traumatic brain injury a concussion represents”.

In the study titled “Understanding concussion knowledge and behavior among mixed martial arts, boxing, kickboxing, and Muay Thai athletes and coaches” the authors polled athletes and coaches from across various full contact combat sports disciplines including MMA, Boxing, Kickboxing and Muay Thai. All sports where full contact strikes to the head are allowed and thus making concussion a central part of the sport.

The study showed that not only did fewer than 6% of polled coaches have adequate knowledge of what a concussion truly was, almost 70% “were unfamiliar with any sideline assessment tools” and only 14.3% of the coaches were often seeking out concussion knowledge.

Athletes themselves were largely at the mercy of their coaches knowledge (or lack thereof) with many of them noting they relied on coaches assessment (or self assessment) to determine if they suffered a concussion.

The data also revealed that knowledge is power. Athletes who were aware of the level of brain injury a concussion represents “performed fewer sparring sessions per week and had a greater likelihood of reporting concussive episodes.”

In short the study shows there is much room for improvement in increasing brain injury knowledge for combat sports participants and that many fighters do not actually “know what they are getting into“. Coaches are the gatekeepers for many fighters when it comes to concussion knowledge. The industry must do better than 6%.

The full abstract reads as follows:

Abstract

Objectives: In combat sports, strikes to the head are not just incidental but a deliberate and clear determinant of success. Concussion is a complex injury that is poorly understood and inappropriate practices are often observed among athletes and coaches. The purpose of this study was to investigate concussion knowledge and behavior as well as address recommendations for combat sports athletes and coaches. 

Methods: 70 athletes and 35 coaches from combat sports disciplines completed an online-validated survey and a personal questionnaire about concussion knowledge, training experience, and knowledge translation. Athletes were divided into subgroups for analysis according to sex (male n = 55, female n = 15), skill level (amateur n = 52, professional n = 18), and weight classes (<66.2 kg: n = 25, 66.6 to 77.5 kg: n = 30, and >78 kg: n = 15). 

Results: The likely absence of health-care professionals during training was confirmed by 68.5% of coaches, and athletes declared that self-diagnosis (79%) and coaches’ diagnosis (43.3%) were the most used method of suspected concussion assessment. Merely 5.7% of coaches properly recognized the level of traumatic brain injury a concussion represents, 68.8% were unfamiliar with any sideline assessment tools, and only 14.3% often seek out concussion knowledge. Athletes who were aware of the level of brain injury a concussion represents performed fewer sparring sessions per week (mild: 1.27 ± 1.1; severe: 3.17 ± 2.81; p = .05, d = .89) and had a greater likelihood of reporting concussive episodes. Most professional (55.5%), female (54.5%), and under 66.2 kg (50%) athletes returned to full practice within 1 week following a concussion diagnosis. 

Conclusions: Relevant key gaps of knowledge and behavior were verified in combat sports athletes and coaches. The awareness of basic concepts may improve injury reporting and safer behavior in athletes. Knowledge translation strategies with accessible language are recommended for coaches, in particular on how to identify acute symptoms and perform basic assessment.