Fistic Medicine: Reader Questions, Feedback

By Matt Pitt Dec 24, 2010
My thanks for your e-mails and questions, as they have made this column more fun and satisfying than I had hoped or expected it could be.

If building up the neck muscles is so important to enduring a punch to the head, how do you work those muscles out?
Flexion bridge maneuvers and flexion curls. Any exercise that involves bending the neck forward against resistance. Heavy weights should not be used. This is a good, simple Web site:

That article about Dementia Pugilistica was really disturbing. Is there anything new about the disease?
In terms of basic science, there has been no watershed development, but evidence of the dangers of CTE is mounting. The autopsy results of NFL player Chris Henry are concerning: Chronic Traumatic Encephalopathy present in a 28-year-old wide receiver. UFC heavyweight and former NFL lineman Matt Mitrione says, “I guarantee you I have brain damage.” He would know. An Ivy League footballer commits suicide and shows extensive brain damage at autopsy. Eventually, the evidence will be impossible to ignore.

I train in MMA and boxing. What are the risks for me ending up with severe brain injury?
No one knows but presumably much lower than a professional fighter. Risk of CTE is a function by the number and severity of brain injuries. We assume the timing of repetitive injuries, the parts of the brain affected and an athlete’s genetics play a big role, as well, but no one knows how to quantify these risks for a population or individual. I wouldn’t give up a sport I loved, but I would keep my eyes open. And my chin down.

Wait, wait, wait -- there really is such a thing as glass jaw syndrome, and it can be cured?
An October 2009 article in “Dental Traumatology” suggests so. It was a small study, but it came out of a well-reputed university. I’m not entirely sure the proposed mechanism is legitimate, but that is the beauty of science: hypotheses can be supported or debunked in time.

Why don’t you answer any questions?
I do. The articles on Staph Aureus, Women’s MMA, Mouthguards and Cauliflower Ear were prompted by readers’ questions. A few others were “prompted” by my editor.

So why didn’t you answer my question?
Either because I haven’t gotten to it yet, or, just as likely, because I’m wholly ignorant. I make a point of basing my articles on published research and established science. If I can’t find research to answer a question, I’m hesitant to add just another opinion to the blogosphere.

What makes liver shots so devastating?
I have some thoughts on the matter, and there’s a tremendous amount of information about liver injuries in the medical literature. However, to date, I haven’t found articles that address liver trauma from hand-to-hand combat trauma, pain associated with liver trauma or how a liver blow debilitates an opponent so effectively. When I find it, I’ll publish it. In the meantime, I think you’ll appreciate this:

You’re ignorant and an alarmist. Modern steroid regimens are totally different from what the GDR did in the 1960s. Modern steroid use is safe, is it not?
You may be right, possibly on all counts, but I doubt you have the evidence to prove it. The German sport system compiled detailed data on every aspect of athletes’ performance but virtually none regarding their health. We know there are risks to steroid use, but we don’t know -- quantitatively -- what those risks are. If we know there are rocks beneath the surface of the lake, how much more do we need to know before choosing to jump in? A lot of the people jumping are kids.

What techniques can I use to maximize my adrenaline response for a fight?
Stepping into a closed cage with a man willing and able to badly hurt you should evoke a robust sympathetic response. More difficult is controlling it: mental discipline, yoga, visualization, training and experience.

Explain to me again how marijuana can be a performance-enhancing drug?
There are canaboid receptors in the brain. During times of stress, the brain releases chemicals that stimulate a sense of calm and well-being, which is vital for an animal whose intelligence is arguably its best hope for survival. Marijuana -- specifically delta-9-tetrahydrocannabinol -- exogenously stimulates these same receptors.

Your article didn’t make it clear. In your opinion, can women do MMA?
Can they fight professional MMA? Yes, clearly. Can they do so safely? This is not a safe sport for anyone who participates in it. As long as promoters match fighters of roughly equal ability, my read of the literature does not suggest women are in greater danger. Can they fight at an “acceptable” level? De gustibus non est disputandum.

What can I do to limit my risk of getting MRSA?
As far as you’re concerned, don’t shave immediately before training; shower immediately after; don’t share personal equipment; wear a rash guard; avoid opponents with visible red patches of skin or large red pimples; and avoid opponents with long nails and coarse 5 o’clock shadow that will open microscopic skin wounds. As far as your gym is concerned, clean the mats and gear religiously, and promote a culture of caution that encourages self-policing.

Jared Hess’ knee blew out on the first takedown of the fight against Alexander Shlemenko at Bellator 20? How is it possible he fought the whole fight on a bad knee?
Forrest Griffin is adamant that there is a difference between fighters (like him) and mixed martial artists (like a whole lot of us). Hess is a fighter.

Do Chuck Liddell, Antonio Rodrigo Nogueira and (insert fighter’s name here) have CTE? Is that why their games are slipping?
I’m not their doctor. I’m not their friend or family member. I have an opinion, but it’s a fundamentally ignorant opinion -- it doesn’t belong in print.

I think Cauliflower ear is sexy!
So do a whole lot of commenters on the Facebook page. This seems like a great opportunity for Sherdog to set up a dating Web site. Contact Jordan Breen if interested.

More Fistic Medicine »
Staph Infection
Examining a Knee Injury
The Importance of Mouthguards
The Benefit & Cost of Steroids
The Biophysics of Taking a Punch
Dementia Pugilistica & MMA
Brock Lesnar’s Illness & Recovery
Becoming Superhuman
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