The upshot of this medical journal entry, which went live today in the Annals of Emergency Medicine, is that a 21-year-old male went to the ER complaining of abdominal pain and blood in his stool after receiving a kick to the midsection during a jujitsu class. The guy completed the class, went home, but almost a day later was in so much pain he had to seek help. Ultimately, he was alright, though there is no mention of whether he ever returned to training. The most interesting point of the article was that it noted how ER visits thanks to martial arts injuries are not that unusual. Blunt force trauma injuries to the midsection, however, are. That might not remain the case as MMA gets ever more mainstream, and the article advises its readers to be on the lookout for ischemic colitis (swelling of the colon; what this patient had) as a possible condition when folks limp in from the workout floor.
Being somebody who trains a lot and who has seen folks get accidentally injured in practice, I read this article with particular interest, both from a personal standpoint, but also from a professional one. We often hear about the cost of health insurance and the frequency with which ER services are used as a particularly troubling cost driver. In a world where obesity, sedentary lifestyles and smoking still causes a huge amount of health problems, you’d think that those of us who seek strenuous exercise would be a welcome development. But not if we all end up going to the ER over it.
The thing is, is MMA really any more or less dangerous than the various other martial arts crazes — kung fu, karate, taekwondo, etc. — that have preceded it? Yes and no. at the moment, I could not find too many reliable statistics on MMA-related injury, though on one message board, injury rates for Muay Thai practitioners were revealing:
Results—A total of 152 people were questioned, 132 men and 20 women. There were 19 beginners, 82 amateurs, and 51 professionals. Injuries to the lower extremities were the most common in all groups. Head injuries were the second most common in professionals and amateurs. Trunk injuries were the next most common in beginners. The difference in injury distribution among the three groups was significant (p<0.01). Soft tissue trauma was the most common type of injury in the three groups. Fractures were the second most common in professionals, and in amateurs and beginners it was sprains and strains (p<0.05). Annual injury rates were: beginners, 13.5/1000 participants; amateurs, 2.43/1000 participants; professionals, 2.79/1000 participants. For beginners, 7% of injuries resulted in seven or more days oV training; for amateurs and professionals, these values were 4% and 5.8% respectively.
Conclusions—The results are similar to those found for karate and taekwondo with regard to injury distribution, type, and rate. The percentage of injuries resulting in time oV training is less.
A separate study seems to bear this out, noting that karate and taekwondo lead the pack when it comes to injuries,and other arts such as kung fu, aikido and tai chi experience significantly lower injury rates. The reasons for that are open to much interpretation, but I would offer, purely as a matter of opinion, that a lot of kung fu and aikido schools don’t seem to stress full-contact sparring and combat as do karate and TKD schools, to say nothing of MMA academies, which are experessly for that purpose. it is also worth noting that in this particular study, MMA and various reality fighting arts such as the Israeli krav maga are not mentioned, so the data is a little old.
Where does this leave MMA as a matter of public health, and as a matter of insurability? probably not in the best spot. The Nevada Athletic Commission currently requires all boxing and MMA bouts in the state to carry a minimum of $50,000 in health coverage for all fighters, the most stringent law of its kind in the country. But after the recent near-fatal injury of boxer Z Gorres, who collapsed after a particularly brutal bout and nearly died from brain swelling, Nevada taxpayers were on the hook for Gorres’ $450,000 in medical bills, prompting the state to push for some kind of boxing/martial arts injury fund. Surely such a thing will drive the cost of professional fighting events up, but the events themselves can accomodate it. Meanwile, MMA events have not yet had a widely publicized fatality in the ring, but it has had its share of gruesome injuries, none of which are for the faint of heart to behold.
I cannot say if the student in the article sent me was a beginner, intermediate or advanced practitioner. Nor can I speak to the conditions that left him injured, save that he was kicked in the gut and bled out as a result. I can tell you that if you are going to train in this kind of thing, injury is inevitable. I saw one of my own instructors – a skilled martial artist by any objective measure – get accidentally gouged in the eye and dropped on his head in two separate events not more than a month apart. Neither stopped him from returning from training, and he kind of shrugged it off. It comes with the territory he said. He had also said that after a while, martial arts isn’t something you do, it is something you are. (Something life insurance agents have also told me about their own trade; it is something you become, not something you merely practice.)
With that being the case, do we have one more risk factor to consider when it comes to tackling the seemingly impossible problem of rising health care costs? I don’t think so. I am biased, sure, but I have seen my fellow students get far more health benefit from their training than injury, and I suspect the same is true of many other schools. The key, like any risk factor in health, is self-awareness, a willingness to pursue health over disability, and an understanding that with every action comes a consequence. now if you’ll excuse me, I need to get ready to go home soon. I’m due to hit the dojo at 6:45 sharp.
All photos used with permission by Kevin Wuchter and Final Round Photography.