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UFC Performance Institute releases concussion protocol in athlete study

Esther Lin, MMA Fighting

The UFC Performance Institute on Tuesday released a 484-page athlete study that includes a first-ever concussion protocol for fighters.

The protocol outlines a step-by-step procedure for a return to training and fighting in the event of a concussion, including activity levels, nutrition and other lifestyle recommendations to speed recovery.

“There are various types of concussions that athletes can experience, and treatment should be individualized depending on symptoms that they are experiencing,” the study states. “With a thorough evaluation and the proper classification of the concussion type, the fighter’s management and rehabilitation can be much improved.”

The second part of “A Cross-Sectional Performance Analysis and Projection of the UFC Athlete,” the study is based on data culled from the PI, a 30,000 square-foot facility in Las Vegas that provides training support to UFC fighters. Every facet of the sport, from training to fighting, from injuries to recovery, from weight-cutting to a fighter’s mindset, is covered in abundant detail.

Fighters are not bound to follow the concussion protocol, as they are considered independent contractors who are in charge of their own training regimens. The UFC, however, hopes to make the protocol standard procedure for all fighters, according to

The PI offers a variety of free services, from physical therapy to gym space to performance testing, to current contractees. Its staff previously have conducted seminars for MMA coaches on best practices for sparring and recovery. Several UFC veterans have called the PI a godsend when they used the facility to prepare for fights. Some have moved across the country to have access.

The concussion protocol, which mirrors that of other contact sports leagues like the NFL and NHL, follows a five-stage process that covers the point of initial injury to a return to full contact. If an athlete begins to experience any concussions symptoms during the process, they are advised to rest for 24 hours and repeat the previous stage.

First and foremost, the study recommends rest of between 24 and 48 hours for a fighter who has just suffered a concussion, including rest from “screen time” of phones or computers. Sleep is allowed, but monitoring is also advised for “red flag” symptoms that include nausea, double vision and severe or increasing headache.

From there, athletes are advised to check their daily symptoms using the SCAT5 concussion assessment tool and begin a gradually increasing exercise regimen, moving from a two-stage no-contact phase emphasizing cardiovascular exercise to technique-only MMA drills and strength training before attempting moderate contact. =

At the final stage, a single weekly sparring session with no more than three, five-minute rounds is the starting point for a return to full contact. The protocol advises a physician’s clearance to sign off before resuming normal training.

At all stages of the process, fighters are advised to check their daily symptom score from the concussion assessment and monitor for additional symptoms. The protocol should be managed by a “licensed health care provider,” the study states in bold letters.

“For brain injuries like concussion, even if you are feeling symptom-free, a fighter should go through all stages of a return-to-sport protocol to ensure a full brain recovery,” the study states. “Resuming activity too quickly, especially in contact sports like MMA, not only increases the risk of subsequent musculoskeletal injuries and longer recovery times but also further concussions (e.g., second-impact syndrome) which can lead to chronic neurological conditions, permanent disability and death.”

The study also categorizes different types of concussions based on how they affect the body and brain. It does not include any guidance on subconcussive impacts, which are inherent to the sport and believed to be a contributor to long-term brain injuries that are suffered by some fighters.

According to scores from a standardized assessment of concussion (SAC) tool, male UFC fighters “symptom severity score” were six times higher than average males, while female UFC fighters’ scores were more than seven times worse than average females, the study said. Males and females also performed more poorly on balance tests, though they were markedly better than the average in tests that measure processing exercises and processing speed.

In addition to funding the PI, the UFC has also partnered with the Mayo Clinic on research into brain trauma. The promotion recently renewed a five-year financial commitment – amounting to $200,000 yearly – for a longitudinal study into head trauma and long-term brain health of fighters and other contact sport athletes at the Luo Ruvo Center for Brain Health in Las Vegas. The promotion has recruited 100 current and former UFC fighters as participants since the study began in 2011.

More former UFC fighters have come forward to reveal struggles with health issues related to brain trauma. Former UFC lightweight Spencer Fisher enrolled in the study three years after a scan revealed lesions on his brain and ended his professional MMA career. Former UFC lightweight Mac Danzig also detailed ongoing symptoms after his retirement. The Ultimate Fighter 1 winner Diego Sanchez said he underwent treatment to deal with speech and memory problems; he was recently ruled out of his UFC Vegas 26 fight against Donald Cerrone when he failed to certify he wasn’t suffering from any short- and long-term issues related to his brain health.

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