CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES Case Report Presented to The Faculty of the College of Health Professions and Social Work Florida Gulf Coast University In Partial Fulfillment Of the Requirement for the Degree of Doctorate of Physical Therapy By Jason L. Burns 2015 CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES APPROVAL SHEET This case report is submitted in partial fulfillment of the requirements for the degree of Doctorate of Physical Therapy ______________________________________ Jason L. Burns Approved: May 2015 ______________________________________ Dr. Stephen Black, DSc, PT, ATC, CSCS Committee Chair ______________________________________ Dr. Russell Hogg, PhD. Committee Member The final copy of this case report has been examined by the signatories, and we find that both the content and the form meet acceptable presentation standards of scholarly work in the above mentioned discipline. CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES Acknowledgements I would like to express sincere gratitude to the following individuals who assisted in the completion of this independent study: Dr. Steven Black who served as my committee chair and provided guidance and support along the way; Dr. Russell Hogg who was my committee member, a mentor, and a consummate professional. This study would not have been completed without their wisdom, direction, and insight. I would also like to thank my fellow classmates and most of all my family for their endless support CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 2 Table of Contents Abstract ..................................................................................................................................... 4 Introduction ........................................................................................................................... 6 Injuries .................................................................................................................................. 7 Wrestling ............................................................................................................................... 9 Traditional Martial Arts ...................................................................................................... 10 Informal Search of MMA Injuries ...................................................................................... 12 The Case Study ....................................................................................................................... 14 Introduction ......................................................................................................................... 14 Literature Review: Identification ........................................................................................ 20 Literature Review: Management ......................................................................................... 25 Literature Review: Physical Activity Tolerance ................................................................. 27 Literature Review: Return to play....................................................................................... 29 Literature Review: Dual Task Activities ............................................................................ 30 Literature Review: Long-term Consequences .................................................................... 31 Future Research .................................................................................................................. 31 Case Description: ................................................................................................................ 32 The Examination: ............................................................................................................ 34 The Assessment: ............................................................................................................. 35 The Plan of Care ............................................................................................................. 36 Outcomes: ....................................................................................................................... 42 Future Recommendations: Team Approach to Management ............................................. 44 CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 3 References ............................................................................................................................... 45 Appendix: Tables .................................................................................................................... 49 CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 4 List of Tables Table 1 .....................................................................................................................................46 Table 2 .................................................................................................................................... 48 Table 3 .................................................................................................................................... 49 Table 4 .................................................................................................................................... 50 Table 5 .................................................................................................................................... 51 Table 6 .................................................................................................................................... 52 CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 5 Abstract Mixed Martial Arts is in its relative infancy as an official sport, however, the various components of the MMA athletic competition have been in use throughout human history. Mixed Marital Arts is a conglomerate of virtually every form of unarmed combat sport utilizing: punches, kicks, knees, elbows, throws, takedowns, spinning, jumping, and other movements. The competitors will utilize a combination of strength, power, speed, and endurance throughout their matches. The early results of recorded injuries during these sporting events indicate that any physical therapist interested in working with mixed martial arts athletes or clients who prefer to exercise in a similar fashion will need to be well versed in several different areas such as; concussions, neck and back injuries, as well as upper and lower limb disorders. Therefore they will best serve their patients through an evidence-based “best practices” approach to treating these injuries CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 6 Introduction On November 12, 1993 eight-men entered an arena in Denver, Colorado to participate in an event that would change the world of sports dramatically over the next two decades. This was the first Ultimate Fighting Championship. While hand-to hand combat has been around essentially since man’s beginnings here on earth, it first became a sport in 648 B.C. during the Greek Olympiad games. Fighters of that time participated in the Pankratian combat style which was essentially a mixture of boxing and wrestling. Over the centuries styles have branched out and evolved according to regional traditions and teachings. However, with the introduction of Mixed Martial Arts, those fighting styles have once again been brought back together and blended into a conglomeration of techniques which build a more rounded athlete. In a mixed martial arts competition, the contestants obtain victory by: concussing the opposing fighter until he or she is defenselessness through blunt head trauma; or disabling an opponent through joint subluxation, dislocation, or soft tissue trauma. The opponent at that point may choose to either forfeit the fight by “tapping out” or suffer injury (Buse, 2006). Over the years, numerous studies have shed light on the varying types of injuries common to each specific style of martial arts. These injuries are the result of a combination of techniques coming from styles such as; boxing, wrestling, Judo, Karate, and Jiu-jitsu. With Mixed Martial Arts (MMA) being so new to the scene, the science specifically targeting the discovery of MMA injuries is in the early stages. There are approximately 18 million people in the United States who practice some form of martial arts. While this is merely an estimate that is currently unverifiable, it does provide an idea of how wide spread the field of combat sports is. CONCUSSIONS AND OTHER MIXED MARTIAL ARTS INJURIES 7 Additionally, professional mixed martial arts have become an industry that generates hundreds of millions of dollars of revenue each year. Owners, fighters, trainers, and even fans have a vested interest in the health of the athletes. With this in mind, it seems prudent to research the training for and injuries resulting from such a physical sport, and to determine where physical therapists will find their place in this emerging market. With a deeper grasp of the types of incidents of injuries and a full understanding of the training regimen of these athletes, physical therapists will be better equipped to implement preventative measures and best-practice therapy techniques for those athletes and solidify the importance of their practice in this field of sports rehabilitation. Injuries With Mixed Martial arts being a relatively new sport, there is a shortage of recorded data regarding the prevalence of injuries occurring during mixed martial arts bouts. More research needs to be conducted on the types of injuries and the long term