Longtime NJ Commission Doc Explains How Current State of MMA Regulation Hurts Fighter Safety

Lost in Translation – Fighter Safety

– Guest editorial by Sheryl Wulkan, M.D.
(Dr. Wulkan is one of the most experienced ringside physicians in combat sports. She has served as part of the New York and New Jersey athletic commissions, has chaired the Association of Boxing Commissions Combat Sports Medical Committee, and is a member of the New Jersey Martial Arts Hall of Fame, among other distinctions. This article represents Dr. Wulkan’s opinion only. It in no way expresses the views of the New York Athletic Commission or the New Jersey State Athletic Control Board or MMAWeekly.com.)

The Association of Boxing Commissions is Fragmented

There are a few not so insidious threats to fighter safety, and perhaps, the future of MMA. These include the fragmentation of the ABC (Association of Boxing Commissions) alliance, the lack of unified rules and arbitrary decisions about which suspensions to honor, and the tweeting of inflammatory,  pseudo-factual information. None have a place when dealing with fighters’ lives.  All highlight the need for federal guidelines that mandate standardized minimum medical requirements, standardized rules, a national databank, and the honoring of suspensions from one jurisdiction (national/international drug testing program) to another to prevent an at risk athlete from “crossing the border” to compete before it is appropriate for him/her to do so. 

Mr. Mazzulli, who holds positions as the current ABC President, Mohegan Tribe Department of Athletic Regulation President, and the promotional regulator for Bellator, has taken a bold step by deciding not to uphold USADA’s twoyear PED suspension of Mirko CroCop. Whether intentionally or not, in so doing, he has undermined one of the ABC’s greatest abilities to function effectively. If each jurisdiction is free to choose what suspensions it desires to uphold, there are no longer consequences to actions, no stop-gaps for cheating, and most importantly, no group consistently acting on behalf of equity in competition, and the health and safety of participants. Furthermore, this precedent could lead to a Commission removing an athlete from suspension for a big money fight prematurely in exchange for the guarantee of future events.  These tenets run against the very reason for the creation of the ABC: to share, recognize and honor suspensions and medical concerns among all member jurisdictions.

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New MMA Rules Adopted by Some, but Not by All

Currently, each jurisdiction/Commission remains sole arbiter of the requirements for licensure/pre- participation medical examinations and rules governing professional combative sports participants. (Some jurisdictions regulate amateur combative sports, but not all.) From April 2001 until July 2016, most, if not all, ABC participating members honored one rule set for MMA. Under the new ABC leadership, proposed rule changes were bundled during a vote, and were passed “en masse.” Two of the multiple proposed rule changes were opposed by both a group of distinguished ringside physicians, and esteemed coaches and fighters including Renzo Gracie, Ray Longo, John Rallo, Ricardo Almeida and Aljamain Sterling. In addition, it was stated that the ARP (Association of Ringside Physicians) supported all the rule changes, which has since been proven fallacious. It was also stated that all jurisdictions adopted the new rules, but to date, 16 out of 21 jurisdictions that host the greatest number of events annually have not adopted the new rules. The reason: concerns for fighter safety raised by their respective medical experts.

Breaking Down Controversial MMA Rules and Enforcement

From a doctor’s perspective, the adoption of the rule that redefined a downed opponent was the most disconcerting.

When the head is down and the neck flexed, as may occur while placing both palms on the ground, the back of the head and the neck may potentially be predisposed to a greater number of unintentional strikes from knees, elbows and kicks. Strikes to this area, whether intentional or not, can be lethal.

Eddie Alvarez vs Dustin Poirier UFC 211Full weight bearing on both hands places the neck in a hyper-extended position causing it to be at greater risk from strikes when a grounded opponent attempts to stand. In addition, if both palms must be weight bearing for a competitor to be grounded, it makes it virtually impossible to bring one or both hands to defensive position to prevent head strikes, especially when the opponent yanks the formerly grounded athlete’s hands from the mat. It is also rare to see combative sports competitors post from the weight bearing palm position. Most post to fingertips. Because an athlete in this position is no longer considered a downed opponent, the other competitor has another second or so to attack an unprotected head with strikes. The risks of skull and orbital fractures, brain contusions and brain bleeds increase with the implementation of this policy. In an era where knowledge is being accumulated and disseminated about the short and long term effects of concussion, mild traumatic brain injury (mTBI) and chronic traumatic encephalopathy (CTE)in athletes, it seems, at best, cavalier, and at worst, irresponsible, for jurisdictions to endorse such a rule. The odds are usually in favor that nothing catastrophic will occur during an event, but are we really willing to play those odds with someone’s life?  The MMA community has had several close calls since the implementation of the new rule, as is evidenced by the Chris Weidman vs. Yoel Romero fight, the Jeremy Stephens vs. Josh Emmett bout, the first Tim Means vs. Alex Oliveira match, and the Eddie Alvarez vs. Dustin Poirier competition. Rule changes that could adversely affect a fighter’s career and long term health should only be changed when, and if, solid research studies, objective medical data and clinical evaluations sufficiently prove that a fighter will not be placed at increased risk due to policy change.

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It is not clear why the proposal to change the rule was made in the first place. There was no overt clamor from promoters. Nor, to my knowledge, were coaches or athletes lobbying for this change.  However, some referees argued that utilization of the new regulation would make the sport more exciting for fans, would make it easier to define a downed opponent, and would mitigate the “gaming” of the system that occurred under the original definition. To my mind, the rules should always be, first and foremost, about fighter health and safety.  Referees always have the option to warn an athlete, to issue point deductions or to disqualify a competitor.

Holly Holm UFC 208 ScrumThe enforcement of the dictum that the bell acts as a signal to the referee, not the fighters, that the round has ended, has also led to confusion. Under the present system, athletes may continue to fight unless the referee steps in and fully extends his/her arms.  It was recently stated that one referee did things 90% correctly.  How can an athlete be responsible for determining whether the referee has met the requirements for stopping a round 85 or 90 or 100 percent? Doesn’t it make more sense to just condition athletes to protect themselves at all times but to break at the sound of the bell? The referee should step between the fighters as a secondary precaution. Holly Holm took a dangerous strike to the back of the head because of the confusion about this regulation.  There was no disqualification in that bout. How then, is a disqualification justifiable in the Hector Lombard bout? Overcomplicating what should be a simple signal to the athlete can potentially result in unnecessary injuries. Why take that risk?

Confusion Reigns in MMA Regulation

So, yes, the current rule system is a debacle. No other professional sport functions with rule changes from jurisdiction to jurisdiction. Can you imagine an NFL game where the rules in Chicago were different from N.Y.?  To an extent, Commissions now bear the burden of dealing with the confusion. Unfortunately, what has been lost in translation by sound bites, tweets of 280 characters, and the dis-unification of the ABC, is fighter safety.  However, had there not been the unnecessarily rapid adoption of poorly scientifically supported rule changes, and capricious decisions to choose what suspensions to honor, the current divisiveness would not likely exist.

DISCLAIMER:  THIS ARTICLE REPRESENTS MY OPINION only, and in no way expresses the views of the NYAC or the NJSACB.

– Sheryl Wulkan, M.D.