Poll: Brazilian Jiu-Jitsu (BJJ)

Despite the poll having a tie between TKD and BJJ, I decided to go ahead and cover BJJ first. I'd like to thank the people who voted on the poll and I hope you all keep visiting this site to enlighten yourselves about the science of mixed martial arts.

Any fighter of MMA is mostly likely to be familiar with BJJ. It's basically Japanese Jiu-Jitsu but modified so the practitioner will use less power and strength but more leverage instead. Black belts of this system are practically kinesiologists, knowing how their opponents' body functions and moves to locate their weak spots. This method is especially efficient when it comes to neutralizing an attacker without the use of strikes. This form of martial arts is a bit out of the ordinary because you can be on your back and still have an advantage over your opponent.

One of the most basic submission moves practiced is the armbar. Your arms are significantly weaker than your leg muscles so this is much easier to achieve than the knee bar. The weakest point on your arm is the elbow itself since it is not a structure consisting of solid hard tissue (bone). Although the elbow joint allows movement, increased movement means decreased stability. When the technique is executed correctly and the arm becomes hyperextended, the elbow becomes vulnerable to biceps tendon strain/rupture, ligament damage and possible bone fractures as well as other soft tissue damage. There are several ways to achieve the armbar, whether it's on your back, on top of your opponent, or even standing. The first position in which you learn to perform this technique during BJJ, is when you're on the ground, and to make things simpler we'll begin with the practitioner laying down with legs over the neck/chest and the hip under and between the elbow and shoulder (Fig 1) of the opponent.

ᵝ Fig 1. The black square is where your hip should be under the arm.


As a BJJ practitioner, you would use the opponents own arm as a second-class lever. For those of you not familiar with physics, a lever itself is used to help move mass with less effort. A lever can be a stick, a rod, or in this case, a forearm. A fulcrum helps pivot the lever, which will be the elbow of the opponent. A second-class lever has the load between the effort and the fulcrum. The load will be the forearm again but with the opponent's arm muscles pulling it towards his own body. The effort will be the force of your pulling that forearm so it can straighten out. In physics, the effort always travel a greater distance and is less than the load so very little work from you is needed just to extend your opponents arm. However, you don't want your opponents arm to stay perfectly straight. Instead, you want to hyperextend it by popping up your hips from the ground, creating more room for the effort to travel more with the forearm. This will cause the opponent's elbow to moving more than 180 degrees, causing hyperextension and making your opponent give up.

This submission is an example of many others that Brazilian Jiu-Jitsu has to offer without the use of strikes. The lack of strength and power needed to execute these techniques are especially useful against opponents who are much bigger and/or stronger. During the first UFC event, Royce Gracie, a BJJ practitioner, went up against significantly larger fighters like Golden-Glove winner Art Jimmerson who was 20 pounds heavier. He was able to defeat all three of his opponents during that event without needing to strike. That has also shown that since this combat system does not require the need of strength and power, it would help prevent the user from gassing out during competitions. Brazilian Jiu-Jitsu is a clever system that has essentially been created so that less energy is needed, and its reasons to be viewed respectfully has been shown time and time again.


ᵝ Edited picture of a cadaver's left arm (1)

1)Elliott,Darryl."Clinical Kinesiology: Elbow & Forearm"[Power Point Slide].Kinesiology.Northeastern University.pg23.27 March 2007.

Q&A: knuckle protection from punching bags

Q: Knuckle protection for a punching bag?
what is a good type of protection for hitting a punching bag other than bag gloves?

A: Whenever you practice on a punching bag, it's best to use both a hand wrap and gloves (16 ounces preferably). Hand wraps (eg. brand: Everlast) can be found in most sport stores, but the longer wraps can give more support. There are many different ways to wrap your hands but you must remember that the purpose of doing this is to prevent any immediate (acute) or long-term (chronic) injuries to your wrist and hands.

For prevention of more acute injuries, you must wrap on and behind the wrist. You won't always make a perfect connection and eventually you'll make a connection that will push your wrist back. Also, as make a pass around the pinky, you need to make sure to that pull your hand wrap towards the side of your thumb. This will decrease the risk of breaking the bone behind the pinky (aka: Boxer's Fracture). That bone usually breaks when it is pushed away from the rest of the hand when a weak connection to a heavy object occurs. Although the Boxer's fracture is the most common in this type of sport, another fracture that is not uncommon is of the bone behind the thumb, especially when MMA gloves are used exposing the thumb knuckle or allowing the thumb itself to tuck under the fingers upon impact. To help prevent this, make sure you wrap your thumb with the wrap going on the other side of the hand (usually this happens after wrapping your wrists).

One of the most common used hand wrapping technique is the basic American hand wrap. Unfortunately, this technique is only efficient for pure punching but no grappling. Many fighters will tape up their hands, following this technique and then cut out the tape wrapped over the palms. Unfortunately, this decreases the structural integrity with the tape moving laterally to be only supported by any tape that was laid to and from your knuckles and wrist. A modified Muay Thai wrap or a Mexican-style boxing wrap may be better since there's more support on the wrists and due to the fact that they both leave the palms open already, they allow a better grip for grappling, harder strikes and more padding over the knuckles to prevent arthritis.

It's a good habit to always roll up your wraps after use so that they do not wrinkle and cause a hassle while putting them on again. Also, if you do have any previous injuries with your hands (eg:a fracture), you might want to pass that spot more than once for security. If it's too much of a hassle, there are also hand gel wraps that slip on like a glove and cover your wrists as well. They usually have a small length of wrap at the base to secure it around your wrists. Unfortunately these are sometimes not allowed during competitions so it may be better to keep yourself or your cornerman/cutman familiar with a wrapping technique.

Q&A: Pulled arm muscle treatment

Question:
Ace bandage on pulled arm muscle?
will it help? im using a heating pad and ice.

Answer:
Provided that the injury is a simple strain, don't apply heat just yet. Applying heat now will only increase inflammation. Just remember P.R.I.C.E. (protect, rest, ice, compress, elevate).

Get a damp bandage (ACE wrap) and wrap it around your shoulder. Mold a loose ice bag around your shoulder for 15-25 minutes or until you feel numbness, pain or uncomfortable from the cold. Do this 3-5 times a day with 2+ hours in between within 72 hours of injury. The use of ibuprofen or any other non-steroidal anti-inflammatory drug(NSAID)can help the symptoms (eg: increased temperature, redness, pain, swelling).

When you're completely healed, then you usually apply heat before exercise. You may also use the ace bandage to support the arm with the injured muscle.

CALL FOR RESEARCH ON THE STUDY OF INJURY IN THE SPORT OF MIXED MARTIAL ARTS

ᵝFig 1. Untreated auricular hematoma after rupturing

Mixed Martial Arts (MMA) competitions were introduced in the United States with the first Ultimate Fighting Championship (UFC) in 1993. It was a syncretic sport, showing off hundreds of different types of martial arts and its practitioners performing against each other to see which form was superior. In 2001, individual states sanctioned MMA events after a new series of rules have been established. Despite it being 15 years old in the United States, it is still a fairly young sport and because of this, very little knowledge has been recorded on the level of injuries that occur and what can be done to prevent them. The purpose of this article is to determine, from major studies pertaining to MMA, if more research on the incidence of injury in the sports’ fighters is needed. If possible cause of injury is researched, then health professionals such as neurologists, orthopedics, physical therapists, and athletic trainers can establish injury prevention and treatment techniques.

In the study, “Incidence of Injury in Professional Mixed Martial Arts Competitions” by Bledsoe, Hsu, Grabowski, Brill, and Li, data from all professional MMA events that took place between September 2001 and December 2004 in the state of Nevada were obtained from the Nevada Athletic Commission. The study included 220 fighters participating in 171 1-on-1 matches. The overall injury rate was 28.6 injuries per 100 fight participations or 12.5 injuries per 100 competitor rounds. Facial laceration was the most common injury accounting for 47.9% of all injuries, followed by hand injury (13.5%), nose injury (10.4%), and eye injury (8.3%) (2 pg 1). A second study, “No holds barred sport fighting: a 10 year review of mixed martial arts competition”, has also taken some data from 1284 men competing in 642 consecutive televised matches in the United States and Japan from November 1993 to November 2003. 182 (28.3+/-3.4%) were stopped because of head impact, 106 (16.5+/-2.9%) because of musculoskeletal stress, 91 (14.1+/-2.7%) because of neck choke, and 83 (12.9+/-2.6%) because of miscellaneous trauma (3 pg 1). In a third study titled “Injury trends in sanctioned mixed martial arts competition: a 5-year from 2002 to 2007”, data from all regulated MMA competitions during the study period from March 2002 to September 2007 (1270 fight exposures) was obtained in the state of Nevada. 300 of the 1270 athletes sustained documented injuries with an injury rate of 23.6 per 100 fight participations (1 pg 1). The result of all 3 studies states that 21.49% out of the 3838 fights had an injury with the conclusion to an MMA fight due to head impact. The injury assessments performed, during each study, occurred immediately after each individual match by the present doctor only. This did not include radiological examination or any other examinations that may have occurred when the injured athlete left their competitions. The sport does have similarities in mechanisms of injury but its statistical difference is much more significant.


ᶲFig 2. Complete fractured metacarpal of the index finger

The mechanisms of injury (MOI) from MMA are quite different from other sports. The reasons for this are due to the fact that inefficient protective equipment is worn during competition. For example, football players are categorized in what is called a collision sport but since it has been well established, there has been an advance in the safety equipment used by each player. The player will wear enough equipment to protect his back, neck and head in case of a collision occurs (eg: tackle). The football helmet designed with a breakaway face mask has been created by James T. Hayden. After noticing that studies pertaining to specific angles of impact upon a player, the mask were to respond to a force “which impinges on [it] in a direction toward the wearer's face, but permit the mask to break away from the helmet in response to excessive forces in other directions, as when the mask is pulled forward or twisted sideways” (5 pg1). This is an example of research that has observed mechanisms of injury, specifically to the head and neck, in the sport of football. The MMA athlete does not wear any equipment pertaining to his/her spine nor has it been properly noticed by health communities and have a created category labeling its increased physical intensity compared to other collision sports. The standard MMA gloves only cover partial wrist support and knuckles and there is no sport specific cup that can be worn. Even though the gloves are meant to protect the hands of the athlete, the athlete is still prone to a Boxer’s fracture and articular fractures around the thumb. The glove’s lack of sufficient design may also contribute to other types of fractures (Fig 2). Not only the decreased padding in MMA gloves causes more damage to the opponent, it can also increase the chance of injury of the hands that are wearing them. The hand wraps that are placed under the gloves may also be poorly designed since the wraps cannot run over the fighter’s palms, decreasing the ability to grapple, a crucial strategy in MMA. Many athletes apply the boxer’s wrapping technique which has evolved enough to provide a strong support of the hand. However, MMA cutmen (the people who wrap the athlete’s hands) also cut out the tape covering the palms after applying the boxer’s technique, causing the structural integrity be compromised. In this case, research needs to be done on the anatomy of the hand and its strong point, weak points, the areas of most to least impact, and the breaking point of the average hands soft tissue. If further data is collected on the sport and its impact on the upper extremity, then constructing more successful protective hand wrap techniques (eg: how much tape should be used) can be pursued.


ǂFig 3.

The journal article, “Incidence of Injury in Professional Mixed Martial Arts Competitions”, showed that the first round of competitions had the highest frequency of concluding with a winner. However, the matches that did not stop during the first round usually ended during the 3rd-5th rounds as opposed to the second. Due to the fact that different leagues establish that fights last for 3 to 5 rounds before making a decision shows the possibility those fights lasting the last round. With the possibility of overly cautious (lack of offensive strategy) opponents aside, fatigue in the competitors may have played a factor in the inability to finish the fight earlier. Also if the fighters were fatigued, then they’re likely to have lacked strength & conditioning which may be the cause of a significant number of injuries recorded (from muscle strain to facial laceration) as well.


‡Fig 4. 250 lbs of force to the head is the general limit for a concussion to occur

However, because of its syncretism, there are possibly hundreds or even thousands of combat systems involved with the sport, all with different striking and submission techniques which make the mechanism of injury vary greatly. For example, National Geographic’s “Fight Science” produced an episode in which it determined the amount of force created by several martial arts’ most powerful punches. The results varied with a Kung Fu punch producing 612 pounds of force, which would at most break facial bones, whereas the boxer’s punch produced almost a thousand pounds of force, causing a severe concussion. This episode showed the variety of punches performed by different techniques but they also displayed how more research is needed to cover many other strikes that may potentially be an MOI. “Incidence of Injury in Professional Mixed Martial Arts Competitions” does however show how different forms of martial arts can change the frequency and severity of injuries in Figure 3, but the study did not go over what technique caused each individual injury. It showed that the knockout rates of MMA are significantly lower than boxing. This shows that further use of health researchers may be needed to establish which form of martial arts is more damaging to certain parts of the body whether it be Brazilian Jiu-Jitsu, boxing, wrestling, or any other form that collaborates with the sport of MMA. However, before going into more specific fight systems, establishing what could be the baseline of how much impact the human body can both generate and receive before injury occurs can help label the level of harm that offensive moves can cause. For example, in the Fight Science episode, an MMA fighter demonstrated a basic elbow strike against a dummy’s head (Fig 4). The dummy contained instruments that measured the amount of force from the strike. The technicians recording the dummy’s readings declared that the strike happened to generate just enough force to cause a concussion to the receiver. More baseline research, such as this, needs to take place in order to properly understand the injuries that take place in MMA. In conclusion, the results from the research have shown that more professionals need to be involved, who have their expertise in neurology as well as orthopedics, physical therapy and strength & conditioning. This sport needs the help of health professionals, but in order for that to occur, further research needs to be conducted. Before a mixed martial arts athlete walks you’re your office, prepare yourself with more information on the sport. Ask your colleagues or the health organization that you’re associated with and ask if they can help conduct further studies on the sport. If you’re a neurologist, ask for studies of body slams. If you’re a physical therapist, call for research on overuse syndrome associated with a certain type of kick. MMA may be 15 years old, but the number of participants is still growing significantly. Remember, although this increases the chances of you treating one, if you understand the sports’ MOI and how to treat/prevent them, then you’ll have more costumers feeding your wallet.



ᵝ Cropped Sherdog.com picture from fiveouncesofpain.com (7)
ᶲ Thales Leites’ x-ray (6)
‡ Tito Ortiz in National Geographic’s Fight Science (4)
ǂ Table1 from “Incidence of Injury in Professional Mixed Martial Arts” (1 pg 137)

1) Ngai, KM Levy, F Hsu, EB.“Injury trends in sanctioned mixed martial arts competition: a 5-year from 2002 to 2007”. Br J Sports Med.Vol 42, Ed 8.2008 Aug.pg686-689.< http://0-search.ebscohost.com.ilsprod.lib.neu.edu/login.aspx?direct=true&db=aph&AN=34258002&site=ehost-live>2008 28 Sept.
2) Bledsoe, GH Hsu, EB Grabowski, JG Brill, JD Li, G.“Incidence of injury in professional mixed martial arts competitions”.Journal of Sports Science and Medicine. 2006 01 July.pg136-142. .2008 28 Sept.
3) Buse, GJ.“No holds barred sport fighting: a 10 year review of mixed martial arts competition”.Br J Sports Med.Vol40(2).2006 Feb.pg169-72. .2008 28 Sept.
4) Brenkus, John(Director/Producer).“Fight Science”.National Geographic. 2008 27 Jan.
5) Hayden, James T.“Football Helmet with Breakaway Mask”.United States Patent.14 Aug 1990..28 Oct 2008.
6) “Leites’ X-Ray”.MMAWeekly.08 Jan 2008..27 Oct 2008.
7) Jardine, Keith.“James Thompson’s Cauliflower Ear”.Five Ounces of Pain.6 June 2008..27 Oct 2008.