Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points - A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes.

The study aimed to evaluate the immediate effects of a dry needling (DN) therapy session on biomechanical properties, muscle power, perfusion, and pressure pain threshold of the gastrocnemius muscle with latent trigger points. Twenty mixed martial arts athletes (MMA) were randomly divided into two groups: experimental (eDN, n = 10) and sham (qDN, n = 10) to undergo one session of DN either with a real or a qazi needle. The measurements were taken at rest, 1-5 minutes after the DN (Post1-5min) and 24h after the DN (Post24h). DN significantly increased the muscle perfusion (Post1-5min and Post24h, p < 0.001), reduced its tone (Post1-5min and Post24h, p < 0.001) and stiffness (Post1-5min, p < 0.05; Post24 h, p < 0.001), and improved its elasticity (Post1-5min and Post24h, p < 0.001). DN also caused a significant increase in pressure pain threshold (Post1-5min, p < 0.001; Post24h, p < 0.05) and in muscle power (Post24h, p < 0.01). The DN session increased the blood perfusion and improved the biomechanical properties of the gastrocnemius muscle, which led to improved muscle power. The DN also had an analgesic effect. These effects were maintained at 24 h, which suggests that DN could facilitate muscle recovery in a post-exercise period of MMA athletes.

Facial width-to-height ratio predicts fighting success: A direct replication and extension of Zilioli et al. (2014).

Zilioli et al. (2014) were the first to show an association between male facial width-to-height ratio (fWHR) and physical aggression and fighting ability in professional mixed-martial-arts fighters. Here, we re-examined this relationship by replicating (using all original measures) and extending (using 23 new variables related to fighting performance) Zilioli et al. (2014) in a statistically well-powered sample of 520 fighters using automatic and manual measures of the fWHR involving both eyelid and eyebrow landmarks, used interchangeably in previous reports (Studies 1-2). Most importantly, we successfully replicated Zilioli et al.'s (2014) central finding that fighters' fWHR, when manually calculated using the eyebrow landmark, predicted their fighting success (p = .004, controlling for body mass index and total fights). Consistent with past criticisms of using fight rather than fighter data to examine fighting success, which have argued that individual fights can be suddenly and unexpectedly determined and do not capture an individual's overall ability to succeed, Study 3 (N = 1367 fights) found no association between fWHR and singular victories. Studies 1-3 showed continual evidence that larger fWHRs were associated with grappling abilities, even after controlling for demographic and allometric factors. Strikingly, Study 3 discovered associations between all fWHR measures and grappling skill that remained robust before and after controlling for 17 different control variables. We discuss that grappling, or the act of taking down an opponent, involves a more aggressive, close-combat approach than does striking. Combined, these results offer additional support for the argument that fWHR may have been shaped by sexual selection.

Assessment of the Relevance and Reliability of Reaction Time Tests Performed in Immersive Virtual Reality by Mixed Martial Arts Fighters.

Immersive virtual reality (VR) is increasingly applied in various areas of life. The potential of this technology has also been noticed in recreational physical activity and sports. It appears that a virtual environment can also be used in diagnosing certain psychomotor abilities. The main aim of this study consisted of assessing the relevance and reliability of VR-implemented tests of simple and complex reaction time (RT) performed by mixed martial arts (MMA) fighters. Thirty-two professional MMA fighters were tested. The original test developed in the virtual environment was applied for RT assessment. The fighters' task consisted of reacting to the lighting up of a virtual disc situated in front of them by pushing a controller button. The relevance of the test task was estimated by juxtaposing the obtained results with the classic computer test used for measuring simple and complex reactions, while its reliability was assessed with the intraclass correlation procedure. Significant relationships found between the results of VR-implemented tests and computer-based tests confirmed the relevance of the new tool for the assessment of simple and complex RT. In the context of their reliability, RT tests in VR do not differ from tests conducted with the use of standard computer-based tools. VR technology enables the creation of tools that are useful in diagnosing psychomotor abilities. Reaction time tests performed by MMA fighters with the use of VR can be considered relevant, and their reliability is similar to the reliability obtained in computer-based tests.

Punch Trackers: Correct Recognition Depends on Punch Type and Training Experience.

To determine the ability of different punch trackers (PT) (Corner (CPT), Everlast (EPT), and Hykso (HPT)) to recognize specific punch types (lead and rear straight punches, lead and rear hooks, and lead and rear uppercuts) thrown by trained (TR, n = 10) and untrained punchers (UNTR, n = 11), subjects performed different punch combinations, and PT data were compared to data from video recordings to determine how well each PT recognized the punches that were actually thrown. Descriptive statistics and multilevel modelling were used to analyze the data. The CPT, EPT and HPT detected punches more accurately in TR than UNTR, evidenced by a lower percentage error in TR (p = 0.007). The CPT, EPT, and HPT detected straight punches better than uppercuts and hooks, with a lower percentage error for straight punches (p < 0.001). The recognition of punches with CPT and HPT depended on punch order, with earlier punches in a sequence recognized better. The same may or may not have occurred with EPT, but EPT does not allow for data to be exported, meaning the order of individual punches could not be analyzed. The CPT and HPT both seem to be viable options for tracking punch count and punch type in TR and UNTR.

Perceived and actual fighting ability: determinants of success by decision, knockout or submission in human combat sports.

Animal contest theory assumes individuals to possess accurate information about their own fighting ability or resource-holding potential (RHP) and, under some models, that of their opponent. However, owing to the difficulty of disentangling perceived and actual RHP in animals, how accurately individuals are able to assess RHP remains relatively unknown. Furthermore, it is not just individuals within a fight that evaluate RHP. Third-party observers evaluate the fight performance of conspecifics in order to make behavioural decisions. In human combat sports, when fights remain unresolved at the end of the allotted time, bystanders take a more active role, with judges assigning victory based on their assessment of each fighter's performance. Here, we use fight data from mixed martial arts in order to investigate whether perceived fighting performance (judges' decisions) and actual fighting success (fights ending in knockout or submission) are based on the same performance traits, specifically striking skill and vigour. Our results indicate that both performance traits are important for victory, but that vigour is more important for fights resolved via decision, even though the effect of vigour is enhanced by skill. These results suggest that while similar traits are important for fighting success across the board, vigour is overvalued in judges' perceptions of RHP.

Rapid Facial Cryotherapy for Combat Sports: A Comparison of Materials and Methods for Cooling Facial Tissues in 60 Seconds or Less.

CONTEXT: Athletes in combat sports who have sustained facial hematomas during competition have traditionally been treated with an enswell. These treatments take place between rounds of the competition and generally last less than 60 seconds. The efficacy of this modality has not been studied. Other modalities may provide a more effective cryotherapy treatment in this timeframe. OBJECTIVE: To compare the efficacy of different forms of rapid cryotherapy to cause surface temperature changes of the face within 60 seconds of application. DESIGN: Crossover study. SETTING: Laboratory. PARTICIPANTS: Eleven healthy men (age 21.73 [1.42] y, mass 82.1 [5.6] kg, height 177.2 [7.0] cm). INTERVENTIONS: A 60-second treatment using chilled surgical steel enswell, copper, commercial cold pack, aluminum, brass, ice cube, ice pack, and saltwater pack. MAIN OUTCOME MEASURES: Preintervention and postintervention surface facial temperatures. RESULTS: The ice bag, cold pack, ice cube, saltwater pack, and stainless-steel enswell caused statistically different temperatures preintervention to postintervention. The ice bag and saltwater pack cause statistically greater cooling than the other materials tested. CONCLUSIONS: This study does not support the clinical use of an enswell to provide short-duration cryotherapy treatments to facial tissue, as ice packs are more effective.

The King-Devick test in mixed martial arts: the immediate consequences of knock-outs, technical knock-outs, and chokes on brain functions.

The aim of this prospective cohort study was to determine the effect of an 'event,' defined as a knock-out (KO), technical knock-out (TKO), choke, or submission, on King-Devick (K-D) test times in mixed martial arts (MMA) athletes. MMA athletes (28.3 ± 6.6 years, n = 92) underwent K-D testing prior to and following a workout or match. Comparison of baseline and post-workout/match K-D times to assess any significant change. K-D tests worsened (longer) in a majority of athletes following an 'event' (N = 21) (49.6 ± 7.8 s vs 46.6 ± 7.8 s, p = 0.0156, Wilcoxon signed-rank test). K-D tests improved (shorter) following a standard workout or match in which no 'event' occurred in a majority of cases (n = 69) (44.2 ± 7.2 s vs 49.2 ± 10.9 s, p = <0.0001, Wilcoxon signed-rank test). Longer duration (worsening) of post-match K-D tests occurred in most athletes sustaining an 'event'; K-D tests shortened (improved) in a majority of athletes not sustaining an 'event'. Our study suggests MMA athletes suffering an 'event' may have sustained a brain injury similar to a concussion.

Noninvasive Interactive Neurostimulation Therapy for the Treatment of Low-Grade Lateral Ankle Sprain in the Professional Contact Sport Athlete Improves the Short-Term Recovery and Return to Sport: A Randomized Controlled Trial.

Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, randomized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflammatory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.

Brazilian Jiu Jitsu, Judo, and Mixed Martial Arts Injuries Presenting to United States Emergency Departments, 2008-2015.

Limited research has systematically examined injuries resulting from Brazilian Jiu Jitsu (BJJ), Judo, and mixed martial arts (MMA), especially when compared to more well-known or -established martial arts. These three combative sports differ substantially regarding their rules and techniques. BJJ emphasizes ground positioning and submission, Judo rewards throwing an opponent on their back with submission ending the match, and MMA emphasizes knocking out or forcing the submission of one's opponent. We examined injuries, among people of any age, experienced from participation in BJJ, Judo, and MMA. We analyzed data from the United States (U.S.) Consumer Product Safety Commission National Electronic Injury Surveillance System to create estimates of injuries presenting to U.S. emergency departments (EDs). We compared injury profiles between sports, including estimated numbers of injuries, their site, type, and mechanism. Participation in BJJ, Judo, and MMA resulted in an estimated 39,181 injuries presenting to U.S. EDs from 2008 through 2015. Strains and sprains were the most common diagnoses for BJJ and Judo participants, whereas abrasions/contusions were the most commonly diagnosed MMA injury. Being struck resulted in the majority of injuries for all three sports. The head was the most injured body region for BJJ and MMA, whereas the leg was the most injured body region for Judo. Finally, the majority of BJJ and Judo injuries occurred during noncompetitive grappling, whereas most MMA injuries occurred during competition. Our study adds to the limited literature examining injuries from BJJ, Judo, and MMA using data from a probability sample and is an initial step towards understanding the national burden of injury from participation in these sports. Given the quantity and severity of injuries sustained by participants, additional research is needed to assess the riskiness of participation and the effectiveness of interventions, such as improved personal protective gear and mats, as a means to prevent commonly occurring injuries.

Analysis of injury types for mixed martial arts athletes.

[Purpose] The purpose of the present study was to examine the types of injuries associated with mixed martial arts and their location in order to provide substantial information to help reduce the risk of these injuries during mixed martial arts. [Subjects and Methods] Data were collected from 455 mixed martial arts athletes who practiced mixed martial arts or who participated in mixed martial arts competitions in the Seoul Metropolitan City and Gyeongnam Province of Korea between June 3, 2015, and November 6, 2015. Questionnaires were used to collect the data. The convenience sampling method was used, based on the non-probability sampling extraction method. [Results] The arm, neck, and head were the most frequent locations of the injuries; and lacerations, concussions, and contusions were the most frequently diagnosed types of injuries in the mixed martial arts athletes in this study. [Conclusion] Reducing the risk of injury by establishing an alert system and preventing critical injuries by incorporating safety measures are important.

Urinary myoglobin quantification by high-performance liquid chromatography: An alternative measurement for exercise-induced muscle damage.

This study investigated a means of quantifying urinary myoglobin using a novel reverse-phase high-performance liquid chromatography (RP-HPLC) method that is an alternative measure of exercise-induced muscle damage. It also investigated the effect of storage and alkalization on urinary myoglobin stability issues. An RP-HPLC method was validated by precision and repeatability experiments. Myoglobin stability was determined through spiked urine samples stored at various temperatures over an 8-week period using alkalization and dilution in a pH 7.0 buffer. The method was validated with urine collected from mixed martial arts fighters during a competition and training session. The method produced linearity from 5 to 1000 µg/ml (R(2) = 0.997), intra- and inter-assay coefficients of variation from 0.32 to 2.94%, and a lower detection limit of 0.2 µg/ml in the final dilution and 2 µg/ml in the original urine sample. Recovery ranged from 96.4 to 102.5%, myoglobin remained stable at 4 °C when diluted in a pH 7.0 buffer after 20 h, and a significant increase (P < 0.01) and an identifiable peak were observed following a mixed martial arts contest and training session. Storage length and conditions had significant effects (P < 0.05) on stability. The method's simplicity and noninvasive nature means it can be used as an alternative muscle damage assay following exercise and trauma.

Acute Anterior Thigh Compartment Syndrome in a Young Mixed Martial Arts Fighter.

Acute compartment syndrome (ACS) of the thigh is an uncommon injury, and diagnosis of such cases can be easily delayed or even missed due to the rare nature of this condition.  We present a case of ACS of the thigh in a young, healthy mixed martial arts (MMA) semi-professional athlete with no history of previous medical illnesses and normal coagulation.  This MMA fighter sustained a direct blow to the anterolateral aspect of his left thigh with a strong kick during a sparring match with his opponent.  After early surgical fasciotomy, this athlete returned to his pre-injury state and athletic performance within six to eight months postoperatively. Our literature review asserts that young athletic males with high muscle mass, engaging in contact sports, are at a higher risk of developing ACS of the thigh.

Distal rupture of the biceps brachii tendon in a female mixed martial arts athlete: a case report.

The distal rupture of the biceps brachii muscle tendon (DBT) accounts for 3% of biceps ruptures. Diagnosis typically relies on high clinical suspicion and complementary imaging studies, with >90% of cases documented in males between the fourth and sixth decades of life. Reports of DBT ruptures in females are scarce, mostly involving partial and degenerative injuries. Here, we present an unprecedented case of a 28-year-old female professional mixed martial arts athlete with a total traumatic DBT rupture. The athlete underwent surgical repair using anchor reattachment technique. No complications were observed, and the athlete showed satisfactory outcomes, being cleared for physiotherapy after 2 weeks and returning to sports after a 3-month postoperative period.

Professional fighters brain health study: rationale and methods.

Repetitive head trauma is a risk factor for Alzheimer's disease and is the primary cause of chronic traumatic encephalopathy. However, little is known about the natural history of, and risk factors for, chronic traumatic encephalopathy or about means of early detection and intervention. The Professional Fighters Brain Health Study is a longitudinal study of active professional fighters (boxers and mixed martial artists), retired professional fighters, and controls matched for age and level of education. The main objective of the Professional Fighters Brain Health Study is to determine the relationships between measures of head trauma exposure and other potential modifiers and changes in brain imaging and neurological and behavioral function over time. The study is designed to extend over 5 years, and we anticipate enrollment of more than 400 boxers and mixed martial artists. Participants will undergo annual evaluations that include 3-tesla magnetic resonance imaging scanning, computerized cognitive assessments, speech analysis, surveys of mood and impulsivity, and blood sampling for genotyping and exploratory biomarker studies. Statistical models will be developed and validated to predict early and progressive changes in brain structure and function. A composite fight exposure index, developed as a summary measure of cumulative traumatic exposure, shows promise as a predictor of brain volumes and cognitive function.

Perceived aggressiveness predicts fighting performance in mixed-martial-arts fighters.

Accurate assessment of competitive ability is a critical component of contest behavior in animals, and it could be just as important in human competition, particularly in human ancestral populations. Here, we tested the role that facial perception plays in this assessment by investigating the association between both perceived aggressiveness and perceived fighting ability in fighters' faces and their actual fighting success. Perceived aggressiveness was positively associated with the proportion of fights won, after we controlled for the effect of weight, which also independently predicted perceived aggression. In contrast, perception of fighting ability was confounded by weight, and an association between perceived fighting ability and actual fighting success was restricted to heavyweight fighters. Shape regressions revealed that aggressive-looking faces are generally wider and have a broader chin, more prominent eyebrows, and a larger nose than less aggressive-looking faces. Our results indicate that perception of aggressiveness and fighting ability might cue different aspects of success in male-male physical confrontation.

Rapid Weight Gain and Weight Differential Predict Competitive Success in 2100 Professional Combat-Sport Athletes.

PURPOSE: Combat-sport athletes commonly undergo rapid weight loss prior to prebout weigh-in and subsequently rapid weight gain (RWG) prior to competition. This investigation aimed to evaluate the effect of RWG and weight differential (WD) between opponents on competitive success. METHODS: A retrospective cohort study was performed using data from professional mixed martial arts (MMA) and boxing events held between 2015 and 2019. The primary outcome was RWG (relative and absolute) between weigh-in and competition stratified by bout winners and losers. Binary logistic regression was used to explore the relationships among bout outcome, RWG, and WD between competitors on the day of their bout. RESULTS: Among 708 MMA athletes included, winners regained more relative body mass (8.7% [3.7%] vs 7.9% [3.8%], P < .01) than losers. In 1392 included male boxers, winners regained significantly more relative body mass (8.0% [3.0%] vs 6.9% [3.2%], P < .01) than losers. Each percentage body mass increase resulted in a 7% increased likelihood of victory in MMA and a 13% increase in boxing. The relationship between RWG and competitive success remained significant in regional and male international MMA athletes, as well as boxers. WD predicted victory in international mixed martial artists and boxers. WD predicted victory by knockout or technical knockout in international MMA athletes and regional boxers. CONCLUSION: This analysis of combat-sport athletes indicates that RWG and WD influence competitive success. These findings raise fair-play and safety concerns in these popular sports and may help guide risk-mitigating regulation strategies.

Neuroimaging in professional combat sports: consensus statement from the association of ringside physicians.

Professional boxing, kickboxing, and mixed martial arts (MMA) are popular sports with substantial risk for both acute and chronic traumatic brain injury (TBI). Although rare, combat sports athletes have died in the ring or soon after the completion of a bout. Deaths in these instances are usually the result of an acute catastrophic neurological event such as an acute subdural hematoma (SDH). Other causes may include acute epidural hematoma (EDH), subarachnoid hemorrhage (SAH), intraparenchymal hemorrhage (IPH), or a controversial, rare, and still disputed clinical entity called second-impact syndrome (SIS). Neuroimaging or brain imaging is currently included in the process of registering for a license to compete in combat sports in some jurisdictions of the United States of America and around the world. However, the required imaging specifics and frequency vary with no consensus guidelines. The Association of Ringside Physicians (an international, nonprofit organization dedicated to the health and safety of the combat sports athlete) sets forth this consensus statement to establish neuroimaging guidelines in combat sports. Commissions, ringside physicians, combat sports athletes, trainers, promoters, sanctioning bodies, and other healthcare professionals can use this statement for risk stratification of a professional combat sports athlete prior to licensure, identifying high-risk athletes and for prognostication of the brain health of these athletes over the course of their career. Guidelines are also put forth regarding neuroimaging requirements in the immediate aftermath of a bout.

Examining the occurrence and outcomes of concussion and mTBI in mixed martial arts athletes: a systematic review.

INTRODUCTION: Mixed martial arts (MMA) is a sport growing in popularity around the world. However, many individuals participate in the sport with little understanding of the potential short- and long-term consequences of injuries sustained while participating. Specifically, individuals are placed at a high risk of minor traumatic brain injury (mTBI) and concussive episodes as a result of head injuries incurred during training and competition. AIMS: The current review aimed to examine the literature surrounding the occurrence and outcomes of mTBI in MMA athletes to gain a better understanding of these consequences. METHODS: Twenty-five studies were identified within the current review, of which 14 examined occurrence of mTBI within the sport setting, and elevenidentified outcomes of injury. RESULTS: Overall, studies found that MMA athletes experienced mTBI and concussion to a greater extent than athletes in other sports. Deficits in memory, reaction time and processing speed were identified following occurrence of mTBI; however, several gaps in outcome measurement were identified within the current literature, including a lack of focus on speech and language outcomes. CONCLUSION: Future research should examine a wider variety of outcomes to provide a clearer understanding of the consequences of participating in the sport.

Weight cutting in female UFC fighters.

BACKGROUND: It is common practice for fight sport athletes to use a variety of weight manipulation strategies to compete in desired weight classes. Although numerous studies have highlighted rapid weight loss (RWL) strategies and the magnitude of weight loss, few have focused specifically on weight loss in female fighters. The purpose of this study was to provide descriptive information on professional UFC female fighters engaging in RWL in all women's UFC weight divisions: strawweight (52.2 kg): flyweight (56.7 kg); bantamweight (61.2 kg); featherweight (65.8 kg). METHODS: All fighter's weights were obtained at five separate time points: 72 hrs. pre-weigh-in, 48 hrs. pre-weigh-in, 24hrs. pre-weigh-in, official weigh-in, and 24 hrs. post-weigh-in (competition weight). Mixed effects models and random effects analysis were used to assess changes in weight and differences between weight divisions. All statistics were analyzed, and significance was set at p ≤0.05. Significant changes in weight between all time points were reported. RESULTS: No statistical differences between weight divisions were observed. Female fighters lost 4.5-6.6% of their weight prior to the official weigh-in. CONCLUSION: Females engaged in RWL practices lose weight in a similar fashion irrespective of weight class.

Boxing as an Intervention in Mental Health: A Scoping Review.

Introduction: Physical activity has been shown to have a multitude of mental health benefits. However, there is limited evidence on the specific mental health benefits of boxing. We conducted a scoping review of academic and grey literature to map research of boxing exercises as an intervention in mental health and to identify gaps in knowledge. Methods: The authors utilized the PRISMA-ScR methodological approach and guidelines from the Joanna Briggs Institute and a structured search was completed from inception until August 08, 2022. Results: We identified 16 documents that used non-contact boxing as an exercise intervention that improved various mental health difficulties. Non-contact boxing exercises, usually in a high-intensity-interval training group setting, provided significant reduction in symptoms of anxiety, depression, PTSD and negative symptoms of schizophrenia. Non-contact boxing provided a cathartic release of anger and stress, with evidence of improved mood, self-esteem, confidence, concentration, metabolic burden, strength and coordination. Conclusions: Preliminary evidence indicates that non-contact boxing exercises are a promising intervention to improve mental health burden. Further well designed randomized controlled trials using group, non-contact boxing exercises as an intervention for common mental disorders are warranted to confirm its benefits for mental health.