Ask the Fight Doc: Should the Canadian Medical Association support the MMA ban?

The Canadian Medical Association recommends a ban on MMA.

However, MMAjunkie.com medical columnist and consultant Dr. Johnny Benjamin believes the organization’s stance has gone a step too far.

While there’s no doubt MMA has inherent risks, current medical literature doesn’t justify that it’s any more dangerous than many of Canada’s other popular sports.

* * * *

Doc, what do you make of the Canadian Medical Association’s position on Bill S-209, which addresses the legalization of MMA in Canada? – Concerned Mom

Dr. Anna Reid, president of the Canadian Medical Association (CMA), has voiced the safety concerns of the organization, which supports a legal ban of MMA. Dr. Reid suggests that MMA is an unacceptably dangerous sport that promotes serious head injuries.

Dr. Reid admits the lack of medical literature related to the long-term safety of MMA, but she appears to draw many of her conclusions from the medical experience of boxing.

“Cage fighting, like boxing, is distinct from many other sports, in that the basic intent of the fighter is to cause harm in order to incapacitate his or her opponent,” she stated in a press release. “An activity in which the overriding goal is to pummel one’s opponent into submission does not promote good health.

“For parliamentarians, and for society, the question of whether to legalize MMA under the Criminal Code therefore comes down to a choice: a choice between money and health. For me, as a physician, it is about putting health first. I cannot condone punches to the head.”

I share many of the concerns of my Canadian colleagues but strongly disagree with their position.

Their opposition of MMA from a fighter safety perspective simply lacks scientific basis. At the current time, there is not a significant body of medical literature that suggests MMA has an incidence of major injury – and specifically traumatic brain injury (TBI) – that exceeds that of other permitted contact sports.

To extrapolate the incidence of traumatic brain injuries associated with boxing to properly regulated, modern MMA as practiced under the Unified Rules is fraught with inconsistencies. I do not suggest that MMA should not learn from the collective medical experience of all contact sports, especially boxing, but boxing and MMA differ in some very important ways that may significantly lower the serious risk profile of MMA:

• Boxing commonly utilizes gloves that are two to three times the weight of standard 4-ounce MMA gloves, which allows the striker to impart greater force to the recipient due to the increased weight and better protection of the hand.
• Punch-stat numbers counting head blows during elite professional boxing contests uniformly range in the hundreds (200-500) as compared to MMA, which rarely exceed 75.
• Championship professional boxing contests can last as long as 36 minutes vs. 25 minutes for MMA.
• Professional boxing allows for an athlete to be knocked down to the ground by a blow to the head (potentially concussed), regain his or her composure within 10 seconds, follow a few basic commands and continue. The process potentially can be repeated multiple times. In MMA, a similar singular episode will result in the referee stopping the contest and limiting further potential trauma.
• Holding/grappling as a legitimate technique to stop an onslaught of strikes is not allowed in boxing, but in MMA, it is a considered a highly valuable and respected method of defense.

There is no current medical literature that suggests modern, properly regulated MMA as governed by the Unified Rules has an incidence of major injury, including TBI, that approaches or exceeds that of many sports routinely enjoyed in Canada. Hockey, football, rodeo, cheerleading, soccer, snowmobile riding, downhill skiing, baseball and many others have significant incidents of concussion and more serious TBI but continue be enjoyed. Practicing medicine and/or creating public health policy by anecdotal experience or casual observation, rather than evidence-based medicine supported by peer-reviewed science, is dubious at best.

Dr. Reid, I share many of the concerns that most physicians have related to some of the activities of our patients both current and future. I also understand the official position of the CMA, as well as the American Medical Association, cannot condone MMA participation. But medical literature does not support the condemnation of the sport as worthy of a ban or consideration as an illegal activity.

If, as physicians, we desire to significantly improve the health and well-being of our communities, wouldn’t we better serve our friends and neighbors if we shared information related to evidence-based medicine supported by quality science?

As physicians, would we better serve our communities by promoting a ban on tobacco smoking?

Dr. Johnny Benjamin is MMAjunkie.com’s medical columnist and consultant and a noted combat-sports specialist. He is also a member of the Association of Boxing Commissions’ MMA Medical Subcommittee. Dr. Benjamin writes an “Ask the Doc” column approximately every two weeks for MMAjunkie.com. To submit a question for a future column, email him at askthedoc [AT] mmajunkie.com, or share your questions and thoughts in the comments section below. You can find Dr. Benjamin online at www.drjohnnybenjamin.com, and you can read his other sports-related articles at blog.drjohnnybenjamin.com.