Editorial by Rami Genauer for MMAWeekly.com

Myth-ed Martial Arts:

The first installment of this series discussed the assertion that a cage
is safer than a ring. As a quick follow-up, the main point of the column –
that the very idea of a “cage” hurts MMA’s image – would seem to be
confirmed by all the recent nonsense comparing MMA to dogfighting. Naysayers
see mixed martial artists as caged animals, bred for mayhem. It will be an important
battle in the coming years to challenge that notion.

This column is devoted to
analysis of the claim made most frequently in defending the safety of MMA. For
years, supporters have claimed that mixed martial arts is actually safer than
boxing. With the recent hoopla surrounding the Mayweather-De La Hoya fight and
constant comparisons between the two sports, this claim has been made even more
often. Not limited to web forums or trade media, “MMA is safer than boxing” is
the official position taken by the UFC brass in conversation with the
mainstream press. As Dana White says, “MMA, where fights often end without
punches being thrown, is safer than boxing, where head trauma is guaranteed in
every fight” (Toronto Star, 12/13/06) and “There has never been a serious
injury or death in the UFC, and I
know boxing can’t say the same” (Las Vegas Review-Journal, 07/02/06).

While these two quotes
would seem to make the same point, they actually present two very different
arguments. The first quote is a qualitative statement about the nature of the
two sports: MMA involves less head trauma than boxing, making it safer. The
second quote presents a quantitative statistical measure of safety: MMA has
caused fewer serious injuries and deaths than boxing, proving it is safer.

Therein lies the problem
with evaluating which sport is safer. A definitive answer will be hard to come
by since no one can agree on what “safe” means. Does it only mean a lower risk
of dying or does risk of injury matter too? And if injury is a factor, how
serious must the injury be to qualify an activity as unsafe? In addition, an
inherent challenge in answering this question is looking beyond the dangers of
one individual fight in trying to view the safety of the sport as a whole. How
do we weigh immediate injuries that are temporary (like a broken arm) against
cumulative, permanent conditions (like dementia pugilistica
, or punch drunk syndrome)?

There are no objectively
correct answers to these questions; individuals will have to ask themselves
what constitutes a safe activity. There are several criteria, however, that are
most frequently used to judge the safety of sporting activities.

The first
criteria, the one most frequently used by proponents of MMA, is the risk of
death. On the surface, it would seem clear that MMA is the safer of the two
sports. The statistics don’t lie: In the 13 or so years since the first UFC,
there has never been a death resulting from a sanctioned MMA match, whereas
several boxers die every year.


Sadly, this
clear-cut distinction won’t remain true forever. This is not because MMA is
particularly deadly, but because there is some measure of danger inherent in
any contact sport, let alone combat sport. People die playing professional
football and baseball; teenage girls are killed doing cheerleading routines.


Most deaths
in boxing are caused by acute subdural hematoma, which is basically bleeding on
the brain caused by sudden head trauma. Any activity that involves blows to the
head, MMA included, presents this risk. The fact that there have been no deaths
in MMA is likely due to the fact that participation is still low compared to
other sports. Safety stats are often calculated using the indicator “deaths per
100,000 participants.” As MMA participation increases past the 100,000
threshold and beyond, especially among amateurs with less skill and
conditioning, a fatality is unfortunately inevitable.


based on what we’ve seen so far, the mortality rate for MMA is not likely to
match that of boxing. The data over the last 10 years shows an average of eight
boxer deaths per year. Even though there are certainly more boxing matches held
annually than MMA matches, there are not more boxing bouts held per year than
MMA bouts held in the last 13 years combined. Even using 13 years of
professional MMA as a sample size equivalent to a year of boxing matches, there
still seems to be an eightfold increase in incidences of death in boxing
compared to MMA (eight boxer deaths per year versus one death in MMA). Chalk it
up to less frequent head trauma as Dana White did or to no standing eight count
reducing the risk of Second Impact Syndrome as some have suggested, but if risk
of fatality is your only criteria, you can count one for MMA in the safety


While MMA
fans would probably love to concentrate on the reduced mortality rate (at least
until MMA catches up), most rational observers consider the potential for
injury an integral component of judging safety. While people are quick to point
out that there has never been a serious injury (presumably, things like
paralysis, blindness, or anything else that results in permanent impairment) in
a sanctioned MMA match, a serious injury in MMA is also unavoidable.


addition, the people that need the most convincing regarding MMA’s safety are
likely not concerned with just serious injury or death. To most non-combat
sports fans, safety means low risk of bodily harm, including temporary injuries
like broken bones, torn ligaments, or facial lacerations. Using this as a measure,
MMA is undoubtedly more dangerous than boxing. Traditional boxing injuries –
facial cuts, broken noses, ribs, hands, and orbital bones – are present
in MMA as well. But the increased kinetic movement necessary in MMA (takedown
attempts, guard passes, grappling) and the musculoskeletal stress of
submissions both increase the risk of injury past what one would expect of the
simple stand-up techniques of boxing. Indeed, a 2006 study in the Journal of
Sports Science and Medicine found that MMA produced 28.6 injuries per 100 fight
participants compared to 17.1 injuries per 100 fight participants in boxing.


There is
still one injury criterion to explore, and it is an important, but perplexing
one. Medical science is still grappling with the issue of concussions and their
long-term effects. In the case of boxing, repeated head trauma and concussion
has been linked to a neurological condition called dementia pugilistica
, or punch drunk syndrome. The
damage sustained in a career in boxing combined with the additional head trauma
endured in a lifetime of training leaves many retired prizefighters with
permanent impairment.


long-term effects of MMA have yet to be studied in depth, due to the youth of
the sport. No one really knows what the long-term effects are. For instance,
medical literature suggests that the onset of dementia pugilistica
comes approximately 16 years after
the sufferer began participation in the sport. The UFC is only 13 years old and
most of the sports’ elder statesmen came from backgrounds other than pure mixed
martial arts (a background in a different combat sport would cast doubt that
the negative effect was because of MMA). It will be some time before we can
observe athletes who have trained exclusively in mixed martial arts for 16
years. Until then, it would be difficult for anyone to conclusively determine
the long-term effects of professional MMA.


The current
literature on concussion statistics in MMA is unpersuasive, but still serves as
fodder for opponents of the sport. Fox News host Bill O’Reilly proved this
point during his interview of Dana White and Rich Franklin (June 21, 2006).
Using data from a 2006 study in the British Journal of Sports Medicine, O’Reilly
made the claim that MMA is more dangerous because the study claims concussion
rates are nearly three times higher than in boxing. The truth is, O’Reilly used
incorrect data (he used kickboxing’s numbers in place of boxing stats) and the
study has severe methodology problems (among other issues, head trauma
statistics for boxing are garnered from amateur boxing competitions that use
head gear and larger gloves and have shorter fights).


What is
clear is that the simple “no deaths or serious injuries” argument is not
persuasive enough to settle the debate. The key in making a persuasive case is
in separating the thought of an individual fight from consideration of the
sport as a whole. With the increased injury rate and existent (though reduced)
threat of death or serious injury, it is hard to argue that a single MMA bout
is safer than a single boxing match. This is the notion that feeds critics of
the sport. But considered over the course of a career, with head trauma
accumulated both in the ring and in practice, combined with what seems to be a
greater risk of death or serious injury, it is hard to conclude that boxing is
the safer of the two sports.


So MMA is
the safer sport in toto
. But so what? As mentioned before, opinions on safety are personal and
subjective, and as sports go, boxing is a pretty poor benchmark for safety.
Asserting that MMA is safer than boxing may gain you some traction among sports
fans that are familiar with the sport and are accustomed to the idea that two
people beating each other up can be (relatively) safe. But let’s not get
carried away with the boxing comparisons. The fact is, boxing is only tolerated
by the masses because it has a long and storied history. Deep down, most
non-fans would probably like to see boxing banned just the same.


One tack
might be to challenge people’s perceptions of what is a safe activity. Using
fatality, injury, and concussion numbers, MMA is far safer than football,
hockey, or even gymnastics. In addition, much of the opposition to MMA
indicates a clear Western bias in considering violent behavior. Is a kick, elbow,
or knee more violent than a punch? Only Westerners would think so. Attitudes in
the Far East, where martial arts have a longer history than boxing does in the
West, see these in a more equal light. If anything, punching is the most
violent of all the strikes. It is telling that professional Muay Thai requires
padding for punches but no such cushioning for elbows, knees, or kicks.

One final
tack that might be useful is one that will hopefully become even more so as the
sport grows. As of now, 22 states plus the District of Columbia sanction MMA
events (45 states, plus DC sanction boxing). As more states regulate MMA
competition, the sport will gain legitimacy and traction. With government on
board, MMA should be positioned as safe on a level par with the air we breathe,
water we drink, and food we eat – all things regulated by the government
as well.


The battle
for the legitimacy of the sport will have its ups and downs. Eventually and
tragically, someone will lose his or her life participating in MMA in America.
And though it will almost undoubtedly happen in a small show, possibly even one
unregulated by state authorities, it will be the UFC that bears the greatest
burden and has the most to lose. One would hope that the UFC (and their PR
team) have a strategy in place for placing the message that MMA is safe once
something tragic occurs. The message of “only happened a few times” carries far
less weight than “never.” It may not be their fault, but as the reigning
hegemon of the MMA world, this is certainly the UFC’s problem. They must know
by now, with great power comes great responsibility.