Fight Medicine
Injury prevention for the combat athlete.
From Fitness Trainer November/December
Hitting a punching bag
When Conor McGregor and Floyd Mayweather came face-to-face on August 26 at the T-Mobile arena in Las Vegas, more than 50 million eyes across the country were on that ring (with close to a potential 1 billion homes in 200 different countries streaming the fight).
Behind those ropes, a defining moment rose above the blows—combat sports had clinched the world’s attention like never before.
Just two months earlier on the New York University campus, Laith M. Jazrawi, MD and Guillem Gonzalez-Lomas, MD, were preparing for what was … and is … to come. Co-directing Fight Medicine, a full-day Continuing Medical Education (CME) course that focuses on prevention, diagnosis, and treatment of injuries in combat athletes, such as boxers and mixed martial artists; the physicians are drawing eyes to the types of issues most direct their attention away from once the roar of the crowd fades and the arena seats empty.
Fight Medicine when first presented on May 13, took a multidisciplinary approach to the combat athlete, featuring 25-minute lectures in orthopaedic and primary care sports medicine, neurology, dermatology, nutrition and rehabilitation. As such, athletic trainers, nutritionists, physical therapists, physicians and any others involved in the treatment of combat athletes were present with pen in hand drawing up new plans of action whether for a patient or client.
Dr. Jazrawi, Associate Professor of Orthopaedics at NYU Hospital for Joint Diseases, and Dr. Gonzalez-Lomas,Assistant Professor of Orthopaedics at NYU Hospital for Joint Diseases stacked the course with presentations by leading professionals that included: Avoiding Injuries as an MMA Fighter (Jonathan D. Gelber, MD, MS), Shoulder Injuries in Boxing and MMA (Dr. Gonzalez-Lomas), Hip Injuries in Grappling (Dr. Jazrawi), Hand Injuries in Striking Disciplines: The Boxer’s Fracture and Others (Alton Barron, MD).
I myself presented on “A Fighter and Trainer’s Perspective on MMA Injuries” in the course provided by NYU Post-Graduate Medical School. Fighter Marcus P. Davis, ACE, CAN, FIT “The Irish Hand Grenade” joined me to discuss equipment use during MMA training to promote functional movement patterns while preventing and/ or rehabbing injuries so there is limited down time for the fighter.
Davis and I are big fans on of “hands on” training; Powerpoint is great and all, but I want an audience to smell, taste, and touch my concepts to understand what we are doing. My MMA fitness trainer course is 85 percent hands on. As a trainer and martial artist, I learn best by reading it and then doing it, so our presentation was interactive featuring small sledge hammers, a fitness trampoline, agility ladders, Bosus, and resistance bands.
Speaking of hands on, Dr. Jazrawi holds a black belt in Brazilian jiu jitsu under Gene Dunn who received his black belt from Renzo Gracie. Dr. Jazrawi has been involved with mixed martial arts, kickboxing and grappling for the last 15 years. As for Dr. Gonzalez-Lomas, his background is in boxing and has provided medical coverage at professional boxing and UFC events, most recently George St. Pierre vs. Michael Bisping as the head physician.
Kickboxing
Combat Sports
• Mixed Martial Arts
• Boxing
• Wrestling
• Savate
• Kickboxing
• Muay Thai
• Tae Kwon Do
• Judo
• Brazilian Jiu-jitsu
• Sambo
• Fencing
Ringside Looking In
– What inspired you and Dr. Gonzalez-Lomas to co-direct this course?
The inspiration behind the course was seeing numerous mixed martial artists, boxers, and weekend warriors involved in the sport getting injured. And as it turns out, they were often misdiagnosed or mismanaged by other physicians so we felt the need to educate our community and other individuals to take care of these athletes.
– Why do you feel a course of this nature is beneficial at this time?
The recent rise in popularity of MMA and other combat sports makes this the most appropriate time to educate professionals in the medical community about the injuries unique to these individuals.
Tae Kwon DO
Knee Injuries in Fighters
– Speaking of injuries unique to these individuals, what is it about the knee joint that places it as a concern for fighters?
The knee is prone to injury in fighters for several reasons. First and foremost it’s one of those weapons that are used particularly with low kicks and high kicks or just from striking. The knee is also used to block other kicks and could be injured at this time. Lastly, it serves as a pivot point on which fighters often spin and kick on and during this process ligaments can be torn.
– What are the most common knee injuries seen in fighters?
Meniscus and ACL tears continue to be the main problem,s and this is seen across other sports as well with arthroscopy being the most common knee surgery that was performed on these athletes.
– How are these injuries most commonly incurred?
These injuries occur in two ways. One: during stand up game where the fighter either twists the knee or the knee is struck and knocked out from underneath. Two: during the ground game with grappling where the knee could be twisted when held in the knee bar or hyper flexed causing injury.
– What type of fighter would you say is at most risk for such injuries?
There’s no one specific type of fighter that’s more prone to these injuries as injuries can occur either with striking or during the ground game which makes both people who are stand up fighters, particularly boxers and Muay Thai fighters, prone to some of the standup knee injuries and those that favor the grappling or jiu jitsu type of game changer experience injuries as described above uring the ground game.
– What symptoms should trainers be on the lookout for when it comes to these knee injuries?
Symptoms include a swollen knee, complaints of locking, complaints of instability, and increased movement of the knee during examination in terms of assessing laxity. The trainer should be aware when these complaints are given from their athletes and often times athletic trainers who I train can be versed in a good physical examination to pick up some of these injuries.
– What are the top tips you would give for knee injury prevention in regards to MMA?
Injury prevention, particularly knee injury prevention for MMA, is similar to what we do in some of the other sports; such as focusing on quad strengthening, as well as hamstring strengthening to keep a well-balanced knee. Also instituting some of the ACL injury prevention tips that we know are effective in sports like soccer This is especially important for some of the newer female athletes who are involved in more of a standup game, strictly kickboxing. They may need to be instructed on how to land from jump properly, as we have learned that the ACL’s prone to tearing when landing from a jump with the knee falling into knee valgus position and into hyperextension.
Kevin Kearns
Kevin Kearns is founder and CEO of Burn with Kearns, where he is responsible for the worldwide development and implementation of personal training continuing education courses and group fitness licensing programs. For over 25 years, Kevin Kearns has been professionally involved in the fitness industry. In 2013, he was named an All Star Conference Presenter for IDEA, the worlds largest association for fitness and wellness professionals. Based on his extensive martial arts and fitness backgrounds, Kevin has served as the strength and conditioning coach for professional Mixed Martial Arts (MMA) fighters. He is certified by the NSCA (National Strength and Conditioning Association), is a Functional Movement Screen (FMS) Certified Specialist, a FreeMotion Master Trainer and member of Team Bosu. In the summer of 2013, Kevin released a book, “Always Picked Last,” about how bullying impacted his childhood and the lessons he learned in overcoming it.
