Let's Talk Bare Knuckle MMA and Brain Damage

[ErikMagraken]

Here's a piece I put together a year ago noting the KO rates from punches in the early days of bare knuckle MMA compared to the modern era. Given brain trauma is perhaps the most serious side effect of a career in MMA I'd be interested in this community's views of the subject -
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Although the mandatory use of gloves in Mixed Martial Arts was one step which helped bring the sport from its ‘human-cockfighting‘ stigma into greater mainstream acceptance, this requirement likely increased the incidence of brain trauma for the sport’s participants.

Gloves protect fighters’ fists from injuries and reduce superficial cuts to opponents but do little to protect an opponent from brain injury. Given the greater understanding of the long term harm that accompanies head trauma, I decided to look at objective evidence of the greater rate of knockouts from punches in MMA with the addition of gloves. In short, the knockout rate from punches increased from 1% to 10% after gloves became mandatory for the sport. While I appreciate that correlation does not always prove causation this is, at the very least, a compelling statistic.

Methodology –

I reviewed the results from the numbered UFC events from UFC 1 to UFC 50. Where only a KO was noted with no accompanying information as to the cause of the KO, I reviewed the bouts to determine if the KO was from punches or other strikes. In the early tournament format UFC’s I excluded any alternate bouts as video footage was not readily accessible to review any ambiguously reported knockouts. TKO stoppages were not included in this study.

Results –

Gloves became a required part of the sport at UFC 14. For this reason the study broke these events down into two categories, the events from 1-13, and 14-50. In the first 13 events a total of 101 bouts occurred. Of these only 4 knockouts by punches were noted. However, 3 of these occurred with the winner wearing gloves. The only bout with a knockout stoppage noted from punches with the winner not wearing gloves occurred at UFC 3 with Harold Howard defeating Roland Payne with a KO at the 0:46 mark.

This leaves a margin of one glove-less knockout via punches out of 98 bouts, a frequency of about 1%.

Moving on to UFC 14 – UFC 50 the data reveals a total of 279 bouts. Of these 27 ended via knockout noted by punches. This is a total of approximately 10%, a tenfold increase in the rate of KO by punches.

Removing gloves from MMA will increase the rate of fractured hands and superficial lacerations to competitors. “Bare knuckle” fighting is also likely to be met with resistance by government regulators so the likelihood of the removal of gloves from the sport is slim. That said, the above shows that the removal of gloves from the sport can reduce head trauma. If government and MMA stakeholders review the rules of the sport with brain injury in mind the data is fairly clear that gloves protect the hands, not the brain.

Original article - Knockouts By Punch Increased Tenfold After Gloves Introduced to MMA | Combat Sports Law

 

[Splinty]

Removing gloves from MMA will increase the rate of fractured hands and superficial lacerations to competitors. “Bare knuckle” fighting is also likely to be met with resistance by government regulators so the likelihood of the removal of gloves from the sport is slim. That said, the above shows that the removal of gloves from the sport can reduce head trauma. If government and MMA stakeholders review the rules of the sport with brain injury in mind the data is fairly clear that gloves protect the hands, not the brain.

Now this will be an interesting regulatory argument to watch unfold.

From a fans perspective, will fights get stopped more from injured hands?
Brain damage is the subtle hidden cost we don't want to explore. But will the immediacy of fight ending hand injuries prevent such a conversation at a large level? People like knockouts. They don't like quitting.

 

[ErikMagraken]

Now this will be an interesting regulatory argument to watch unfold.

From a fans perspective, will fights get stopped more from injured hands?
Brain damage is the subtle hidden cost we don't want to explore. But will the immediacy of fight ending hand injuries prevent such a conversation at a large level? People like knockouts. They don't like quitting.

I'd be surprised if regulators seriously looked at this issue. I think the stigma of 'bare knuckle fighting' makes regulators look away from the topic without analysis. That said I noticed a brief discussion about bare knuckle boxing was on the agenda of this year's ABC annual convention so thought this is a good time to bring the topic up.

 

[Leigh]

I fought bare knuckle NHB a number of times before it became MMA. I preferred it significantly and didn't feel any more vulnerable

 

[ErikMagraken]

The Daily Beast just wrote this article on this topic (good timing for this conversation!)

Hey UFC, Bring Back Bare-knuckle Fights to Stop Brain Trauma - The Daily Beast

 

[Splinty]

I'd be surprised if regulators seriously looked at this issue. I think the stigma of 'bare knuckle fighting' makes regulators look away from the topic without analysis. That said I noticed a brief discussion about bare knuckle boxing was on the agenda of this year's ABC annual convention so thought this is a good time to bring the topic up.

We've (our site) have been in some talks with Bobby Gunn's people and their push to make it more mainstream. Well have to get him and others over here to share their view.

There is a contingent pushing this more in the mainstream. But agreed on stigma challenges.

 

[Zeph]

Striking wasn't exactly at a high standard for the first few UFC's, or even that successful. From around the 10s onwards sprawl and brawl started to become more prevalent.

 

[ErikMagraken]

Striking wasn't exactly at a high standard for the first few UFC's, or even that successful.

True. But modern striking would not be possible without gloves (you won't throw a wild overhand or hard hooks hoping to catch a piece of your opponents skull bare knuckled unless you don't mind profound hand fractures).

Seeing as how 85% of recorded KO/TKO stoppages come from punches to the head I think there is merit to the argument that removing gloves would reduce TBI in the sport

The American Journal of Sports Medicine

 

[SC MMA MD]

In to comment later; at an event right now. In short- the summary statement "Gloves protect hands- not brains" is exactly correct

 

[ErikMagraken]

In to comment later; at an event right now. In short- the summary statement "Gloves protect hands- not brains" is exactly correct

Looking forward to your views Doctor

 

[BJTT-Rizzo]

True. But modern striking would not be possible without gloves (you won't throw a wild overhand or hard hooks hoping to catch a piece of your opponents skull bare knuckled unless you don't mind profound hand fractures).

Seeing as how 85% of recorded KO/TKO stoppages come from punches to the head I think there is merit to the argument that removing gloves would reduce TBI in the sport

The American Journal of Sports Medicine

Good post. I just wanted to point out the hand wraps under the glove too. Solid wrists and padding is big game changer for when and how to punch opposed to bare knuckles.

 

[ErikMagraken]

Here's the full daily beast article -

In a truly tragic irony, a measure introduced to quell concerns about the brutality of MMA fighting has become the source of serious brain trauma.
On July 11, 2015, UFC welterweight champion Robbie Lawler and challenger Rory McDonald were slinging furious punches at each other’s skulls, slick to the elbows with blood. When the bell rang, Lawler, who has tattoos of a gladiator and the Roman Coliseum on his bicep, flung down the gauntlet. He lowered his brows at his rival and huffed a geyser of blood toward MacDonald’s feet. MacDonald moved to center cage in acceptance of the challenge, and the two men locked eyes as the referee and cornermen pushed them apart.

After twenty minutes of skillfully frenetic violence, Macdonald’s face was a red ruin, with dark sheets of blood flowing steadily from his slit brows and rubbled nose. For his part, Lawler was ripped and swollen around the eyes, with his grotesquely split upper lip spread open like curtains. In the fifth and final round, the champion Lawler, who was behind on every scorecard, stormed back to drop MacDonald with a straight left, and then finished him on a mat that was as red and slippery as a butcher’s floor. After the fight, the twenty-five year old Rory MacDonald couldn’t tell the doctor what year it was, and both men were rushed to the hospital for stitches and scans. At the post-fight press conference, UFC president Dana White was elated. Lawler-MacDonald wasn’t the fight of the night or even of the year, White said. With its display of skill and gore and unholy courage, it was more like the “fight of the ever.”

I love MMA. I’ve loved it as a fan for twenty years, and I loved it for the three years that I trained myself, eventually taking part in a fight, as research for a book on the subject. But, for me, MMA has always been a distinctly guilty pleasure.

Fighting sports mainly come down to brain damage contests. A great fighter must have the skill to inflict blunt force trauma on his opponent’s brain and the “good chin” to take it. Fight fans feel trapped in a Devil’s Bargain. We love the drama of combat sport, and revere the skill and bravery of the athletes. But the pleasure lies heavy on the conscience because we know it costs them too much.

But while a certain savagery and danger is intrinsic to fighting sport and cannot be removed without ruining it, the current level of brain trauma is not intrinsic nor inevitable. On the contrary, it is the result of a single, simple mistake: In an honest attempt to make fighting safer, authorities introduced a single rule that made it enormously more perilous. This is a mistake that can, and should, be undone.

The Ultimate Fighting Championship (UFC) introduced “no-holds-barred” fighting to the US market in 1993. Quickly condemned as “human cockfighting,” the sport consisted of two men entering a chain-link cage and scrapping—bare-fisted—until one of them couldn’t. By the mid-1990s the UFC had begun a process of reform intended to make the sport safer and more palatable both to mainstream sports fans and to the politicians seeking to ban it. They added rounds, they added weight classes, and they banned many of the most dangerous techniques. The UFC also ended the practice of bare knuckle fighting, which was the primary symbol, in the public eye, of cage fighting’s irredeemable brutality. After all, when we say “the gloves are coming off”—as members of the U.S. government did after the terror attacks of 9-11—we mean that we are through playing nice, and we are reverting to a ruthless style of aggression. Strapping gloves on fighters was the UFC’s most visible indication that they were changing cage fighting from a red-toothed Darwinian struggle into a civilized, rule-bound sport which would henceforth be rebranded as Mixed Martial Arts (MMA).

In PR terms, adding padded gloves was a wise move, but as a safety measure it was a tragic mistake. In the 19th century, boxing made the same mistake. Exactly like the early UFC, bareknuckle boxing was under constant threat from authorities who hoped to—and often did—shut the fights down. In 1867, The Queensbury Rules introduced many reforms intended to make boxing safer, including the mandatory use of padded gloves. The rule seemed logical. After all, if you were going to be punched by a strong, scary man wouldn’t you prefer that he first strap a pillow to his knuckles?

Think twice. The bones of the skull are thick, heavy, and hard; the bones of the fist are small, fine, and fragile. When you punch a man’s skull bare-fisted, the skull punches back. But if you cast a man’s hand and wrist stiffly in tape, and then encase it in foam and leather, you turn the fragile fist into a brutal cudgel. A padded glove allows a fist to attack a brain without having to reckon with its formidable defenses. Gloved-up, fighters can attack the skull savagely and recklessly, with no fear of crippling themselves. If a bare-knuckle fighter threw punches like a gloved fighter, he’d reduce his hands to sleeves of broken bone.

Here’s the bottom line: padded gloves do make fighting sports safer—for the hands. But the consequence of making fighting safer for the hands is making it exponentially more dangerous to the brain. And how would you rather walk away from a fighting career: with gnarled, arthritic hands or with a brain ravaged by CTE?

It’s not that boxing in the bare knuckle era was safe. On the contrary, bare-knuckle fighting was extraordinarily dangerous for a number of reasons. For example, referees didn’t stop fights no matter how lopsided, and there were no time limits—fights could stretch on for many hours in the heat of the day, with both fighters swilling down brandy like Gatorade, and with cornermen repeatedly rousing unconscious fighters and dragging them back into the fray (methods of waking an unconscious pugilist included blowing mouthfuls of brandy up his nose or biting through his ears). Of course, in the bareknuckle era, guys got knocked out. But it was usually because—after hours of scrapping and bleeding--they were too exhausted to rise for the bell, not because they sustained a sudden “lights-out” concussion.

In short, there was exactly one safe thing about fighting in the bare knuckle era, and that was the bareness of the knuckles. Padded gloves instantly turned boxing from a contest of grit and stamina (what the old-timers called “bottom”) into a test of a man’s ability to inflict and absorb brain damage. (It’s worth noting that a similar story has played out in America’s most beloved combat sport, football. Increasingly robust football helmets were introduced in an honest effort to civilize play. But because they encourage players to treat their heads like rams, helmets have been a neurological catastrophe for athletes. Stripped of heavy armor, the brutal smash-up derby of American football would quickly revert to a saner, rugby-like level of mayhem).

Of course, stripping off the gloves would come with costs as well as benefits. The costs might include more injuries to the eyes (ungloved knuckles tuck too nicely into eye sockets) and the hands. But when it comes to hand injuries, I think fighters would quickly learn which punches are more likely to K.O. the barefisted puncher than the punchee (a windmilling overhand right, for example). Bare-knuckle fighting requires a different arsenal of offensive and defensive techniques (for instance, in the bare knuckle era fighters threw hooks sparingly, and threw more punches to the padded torso). Stripped of their gloves, modern fighters would quickly rediscover the lost wisdom of bareknuckle fighting, and they would learn to treat their hands as their most fragile and important tools.

But, in MMA, wouldn’t taking off the gloves backfire by putting more emphasis on powerful techniques like kicks and knees to the head? I doubt it. A shin has a long way to travel before it can intersect with a skull. And such kicks might actually be harder to set up if fighters didn’t have to be so wary of their opponents’ dangerously gloved hands. In fact, the danger of all of a fighter’s weapons might be limited—kicks, knees, elbows—by reducing the potency of the fists. And there is no question that the gloved fist is, far and away, the most dangerous weapon in the fighting cage. A recent article in The American Journal of Sports Medicineexamined every UFC fight from 2006-2012 and determined that 85% of KO’s and TKO’s resulted from punches to the head.

So the biggest advantage to stripping off the gloves is that fighting would instantly become much safer for the brain. But, sadly, that’s probably also the main obstacle: fans and promoters might not want that. When I attended my first UFC event in 2011, the fights were a little flat, and the crowd was listless. When the main event came around, a fan at my side screamed down at UFC president Dana White, whose gleaming dome made him conspicuous at cage side, “Dana White, give us our money back! We paid all this money and not one K.O.?” The fan felt defrauded. He had paid good money to see brain trauma, and there’d been too little. But then Frank Mir landed a blow (a knee in fact) that put Mirko Crocop instantly to sleep, and the crowd went native.

Gloves weren’t added to make boxing or MMA more exciting; they were added in a misguided effort to make them safer. But the gloves probably have made fighting more exciting by allowing athletes like Robbie Lawler and Rory MacDonald to put on the kind of reckless slobber-knockers that lift crowds to their feet. Reverting to bareknuckle would make fighting safer, but it would also slow it down. Fighters would throw their hands more sparingly and carefully, and MMA fighters would spend more time hugging on the mats (both because grappling is safer for the hands and because gloves significantly handicap grappling specialists). For this reason, the UFC, which shapes their roster and their performance incentives to encourage rollicking kick-boxing wars will not be keen on a return to bare knuckle (lawsuits from brain damaged fighters, which are surely coming down the pike, may eventually lead them to reconsider). But the UFC has succeeded so well as a business—rising in less than twenty years from a small-time carny sideshow to a mainstream international sport—because they have constantly adjusted their product in hopes of giving fight fans what they want. So what do we want?

Here’s one fight fan’s vote for bare knuckle. Fighting gloves turned what could have been reasonably sane and safe sports into morally compromising spectacles in which gladiators are armed with de facto weapons and encouraged to do their utmost to wound each other’s brains. We can make fighting sports substantially safer and more ethical if we simply strip off the gloves. Without gloves, combat sports would still be raw, dramatic, and supremely demanding tests, but they’d also revert to a more acceptable level of neurological risk.

 

[Wild]

Curious to hear @SC MMA MD's take. In my opinion, bare knuckle is much safer in terms of potential brain damage because bones in the hands will give way before the skull & brain do.

 

[ErikMagraken]

The one and only El Guapo weighs in


View: https://twitter.com/BasRuttenMMA/status/625512077013049345

 

[ErikMagraken]

I am not necessarily suggesting gloves be banned, I suppose my direct question is should regulators be open to gloveless MMA to live side by side with the sport we have come to know?

 

[Zeph]

But it was usually because—after hours of scrapping and bleeding--they were too exhausted to rise for the bell, not because they sustained a sudden “lights-out” concussion.

A recent article in The American Journal of Sports Medicineexamined every UFC fight from 2006-2012 and determined that 85% of KO’s and TKO’s resulted from punches to the head.

That article seems to pick and choose it's information to make it's point. The first quote seems to imply that TKO's aren't the problem, yet they are included in the 85% number which the writer uses to make his point. What % of actual straight KO's came from punches to kicks, knees, elbows, etc? That would be interesting to see.

However, isn't this all missing the point, that it is the repeated stress which is more likely to cause TBI, which happens in training more than it does in a fight. As the article points out, hands are fragile, how many fighters are going to still train with gloves even if they are removed from the fight itself? I would hazard a guess at many. Even now they don't use 4 oz gloves in practice often, but big 16 oz to protect from hand injuries as much as anything else.

MMA is still an evolving sport and looking back at the beginnings of it, when many fighters couldn't defend a takedown or get back to their feet - or if they could had never trained striking a day in their life - to compare the ratios of KO's and TKO's to fighters fighting today, without mentioning or taking into account the increase in skill, doesn't portray all the information at best, or is intentionally misleading at worst.

It would be interesting to see the differences in KO's/TKO's in % of fights from 2006 and 2012, rather than lumping all those years in together, as if they are somehow equal just because they all had gloves. 2006 also seems like an arbitrary starting point, gloves had been in use since 1997. A comparison from 1993-2001 would be a much fairer analysis, but even then the level of skill of Wanderlei Silva in 2001, to the first UFC and NHB fights was night and day.

 

[Zeph]

Another point which just came to me, regarding the 85% of KO's and TKO's were with punches, the rules disallow kicks and knees to a grounded opponent. How many finishes started with a kick or a knee, but were finished on the ground with punches? How many fights wouldn't have been finished with punches if a fighter could kick or knee a downed opponent? While there is data to find out the former, the later is subjective and would be at best a guess, even if you watched every fight, yet it is a valid question if comparing NHB and Vale Tudo to post unified rules MMA.

 

[ErikMagraken]

Another point which just came to me, regarding the 85% of KO's and TKO's were with punches, the rules disallow kicks and knees to a grounded opponent. How many finishes started with a kick or a knee, but were finished on the ground with punches? How many fights wouldn't have been finished with punches if a fight could kick or knee a downed opponent? While there is data to find out the former, the later is subjective and would be at best a guess, even if you watched every fight, yet it is a valid question if comparing NHB and Vale Tudo to post unified rules MMA.

Good questions.

 

[Sweets]

What about gloves and no wraps? I think it could be a best of both solution... Less cuts than bare knuckle and fighters would have to adjust there style to avoid breaking hands wrists etc meaning not winging wild shit around...

 

[SC MMA MD]

So my take on this issue is pretty much the same as the general consensus above. In my opinion, there are a few conventions in fight sports that were likely put in place with the intent of making the sport safer- without adequate research of the actual effect of the measure. Gloves and wraps are one of these, banning 12-6 elbows, rounds with breaks in between, standing 8 counts in boxing, and headgear for amatures and in training are a few others. From a head trauma standpoint, gloves and wraps do two things- 1) they cushion the blow a little bit which makes it more likely a fighter will sustain more blows overall in a fight; and 2) they greatly protect the hand so a fighter can throw much harder and frequently without as much concern that they will break their hand. To make fighting safer from a brain standpoint, I would argue that a very thinly padded glove without underlying hand wraps would be far safer than the gloves currently used. I doubt that we will ever see a significant change along those lines in the unified rules (the danger of the standing 8 count in boxing is well known and that seems here to stay), but I think that athletic commissions should be open to sanctioning bare knuckle fights. It seems that the public is more interesting in the appearance of safety as opposed to actually making fighters safer if it involves changing the rules

 

[Wild]

So my take on this issue is pretty much the same as the general consensus above. In my opinion, there are a few conventions in fight sports that were likely put in place with the intent of making the sport safer- without adequate research of the actual effect of the measure. Gloves and wraps are one of these, banning 12-6 elbows, rounds with breaks in between, standing 8 counts in boxing, and headgear for amatures and in training are a few others. From a head trauma standpoint, gloves and wraps do two things- 1) they cushion the blow a little bit which makes it more likely a fighter will sustain more blows overall in a fight; and 2) they greatly protect the hand so a fighter can throw much harder and frequently without as much concern that they will break their hand. To make fighting safer from a brain standpoint, I would argue that a very thinly padded glove without underlying hand wraps would be far safer than the gloves currently used. I doubt that we will ever see a significant change along those lines in the unified rules (the danger of the standing 8 count in boxing is well known and that seems here to stay), but I think that athletic commissions should be open to sanctioning bare knuckle fights. It seems that the public is more interesting in the appearance of safety as opposed to actually making fighters safer if it involves changing the rules

Well said. Thanks for sharing your expert opinion sir!

 

[ErikMagraken]

So my take on this issue is pretty much the same as the general consensus above. In my opinion, there are a few conventions in fight sports that were likely put in place with the intent of making the sport safer- without adequate research of the actual effect of the measure. Gloves and wraps are one of these, banning 12-6 elbows, rounds with breaks in between, standing 8 counts in boxing, and headgear for amatures and in training are a few others. From a head trauma standpoint, gloves and wraps do two things- 1) they cushion the blow a little bit which makes it more likely a fighter will sustain more blows overall in a fight; and 2) they greatly protect the hand so a fighter can throw much harder and frequently without as much concern that they will break their hand. To make fighting safer from a brain standpoint, I would argue that a very thinly padded glove without underlying hand wraps would be far safer than the gloves currently used. I doubt that we will ever see a significant change along those lines in the unified rules (the danger of the standing 8 count in boxing is well known and that seems here to stay), but I think that athletic commissions should be open to sanctioning bare knuckle fights. It seems that the public is more interesting in the appearance of safety as opposed to actually making fighters safer if it involves changing the rules

Well said Doctor.