The sport of mixed martial arts has a big problem, and it's one that can't really be solved by regulatory bodies or promotions.
Training injuries are an epidemic right now from the regional level all the way up to the UFC and Bellator. The UFC has held 16 events in 2016 and in five of them they had to come up with a new main event on short notice.
That's more than a 30-percent clip -- one of every three. Look at co-main events and the numbers double from there. And just about every main card of the UFC year has been affected by an injury withdrawal. It has become the norm rather than an anomaly.
From a fan's perspective, this is a huge issue because the fights that have been promised -- and sometimes even paid for -- don't go through as expected. That also explains why it's a problem for promotions: Jon Jones vs. Daniel Cormier at UFC 197 stands to sell a lot more tickets and pay-per-views than Jones vs. Ovince Saint Preux.
Most importantly, though, training injuries are detrimental to the fighters above all. If a main event drops out, the UFC event will still go on. The promotion will still find someone to fill-in on short notice and money will still be made. Not so for the fighter who experiences the injury.
Unlike in other sports, an MMA fighter doesn't get paid unless he or she shows up and fights. Injuries in training mean a fighter doesn't get paid. And training camp isn't cheap, either. A net loss is the result and sometimes it's significant.
Rafael dos Anjos had to pull out of his UFC 196 main event with Conor McGregor just 11 days prior to the fight. Dos Anjos stood to make millions. Instead, a broken foot he sustained in training caused him to lose money. The UFC lightweight champion said at a media day in Los Angeles last week that he "invested a lot of time" and "a lot of money" in his camp. All for naught.
"It was tough, because I want to fight," dos Anjos said. "I want to be there, I want to compete, like I said. I put in a lot of work. When you fight and you lose, it's hard because you feel that all the work you put into that camp was for nothing. But that situation was different, because I didn't even fight. It was even worse for me."
I had a fan tweet at me once that a fighter should be punished for getting injured and having to pull out of a fight. That's about as much of a miss as you can get, even for social media. Having an injury, missing out on the fight and not getting paid is punishment enough.
So how can injuries be prevented? Well, they're never going to go away. MMA is fighting and the best way to practice is still to fight, in one form or another. But there are ways to train better, according to Dr. Jonathan Gelber, an orthopedic surgeon in New York and founder of FightMedicine.net.
In Gelber's new book, "The Ultimate Guide to Preventing and Treating MMA Injuries," he attempts to combine a physician's knowledge with experiences from legends of the sport like Randy Couture, Pat Miletich, Renzo Gracie and Bas Rutten.
The idea, Gelber said, comes from the fact that there really are no science-based guidelines for fighters to use with regards to keeping the body from breaking down. MMA is such a young sport that literature, facilities and personnel to prevent injuries just don't exist yet.
"There is no resource for these guys," Gelber told MMA Fighting. "Even in the medical community, even in the sports medicine community, where we all know a lot about baseball, basketball, football, soccer -- the quote-unquote mainstream sports -- even from the medical standpoint a lot of doctors don't understand the demands of the mixed martial artist. These are very unique athletes."
The UFC will be debuting its new campus in Las Vegas next year and within it will be an athlete health and performance center. Inside of that will be an Octagon, a boxing ring, mats, a track, Olympic lifting platforms and a media center. More vital than that, though, there will be consultation and treatment rooms; a physiotherapy and rehab gym; and performance technology and sports science areas.
The center will be a ground-breaking achievement for the promotion and great news for athletes. But there are more than 500 fighters on the UFC's roster and not all of them will be able to frequent Las Vegas. Preventing injuries, at the end of the day, still comes down to the fighters, their coaches and their teammates.
Gelber says injury prevention can be something as seemingly obvious as making sure you have the right equipment and you're wrapping your hands correctly. Trusted training partners and coaches are also important, of course. So is gym space.
"The transition from stand up to the ground game is where a lot of guys get hurt," Gelber said. "Even in gyms, just the simple thing of making sure there's enough space between two guys rolling, guys doing takedowns next to each other. A lot of injures will happen not even from the guy you're training with, but also the guys next to you and they'll roll into you and you'll twist a knee or blow an ACL or MCL."
This kind of thing happens all the time, even at the best gyms in the world. Again, injuries are impossible to totally prevent, but there are steps to be taken. Gelber said that also means placing an emphasis on training smart rather than training the hardest possible. Many injuries, he said, come when fighters are tired. And it's possible that fighters at a high level don't benefit as much from sparring as they think.
"You've gotta treat your body like it is your job," Gelber said. "It really takes a lot of self-control, a lot of talking to the right guys and, most importantly, surrounding yourself with the right team.
"If you're a fighter and you know you're tough enough, you don't have to prove yourself in the gym. You have to train to win. That's a mentality of an MMA fighter that often gets in their way, trying to prove how tough they are."
There is indeed a culture in MMA where fighters feel like they have to go 100 percent at every moment because they believe their opponent is doing the same thing. They don't want to fall behind. These are attributes in a fighter than fans love -- they're incredibly tough and headstrong and willing to fight through injuries. It's one of the reasons why MMA is a popular sport -- the athletes are true warriors. But there are downsides to that as well.
"Unfortunately what makes them great as a fighter sometimes gets in their way as an athlete," Gelber said.
Education is where it starts first and that's why Gelber said he wrote the book. It's very difficult for athletes to change their ways, especially when they're having success. And fighters are even less likely to listen to doctors. If fighters were overly concerned with their health, they probably wouldn't be in MMA in the first place.
Gelber said that's why he sought out the opinions of greats like Couture and Miletich and current stars like Demetrious Johnson and Carlos Condit.
"They really need guys who have been there, guys who are there, guys who have been at the top of the sport to tell them these things," Gelber said.
Last year, I spoke with former fighter and current UFC on FOX analyst Brian Stann about injuries and he brought up the incredible amount of money fighters like Cain Velasquez and Dominick Cruz have lost in their careers due to spending so much time on the shelf. Stann estimates those numbers to be in the millions.
He's right. And every time a big fight drops out, we have to keep in mind that it's the fighter -- not the fans and promotion -- most affected by that loss from a financial perspective. It's incumbent on those fighters to realize that as well.
"That's a big part of what separates MMA from the more mainstream sports is these guys don't have guaranteed contracts," Gelber said. "There's no guaranteed income and the healthier you can stay, the longer your career will be, the more fights you're gonna have, the more money you're gonna make."