Short summary

Mixed martial arts (MMA) is a competitive, full-contact sport that have experienced a rapid worldwide increase in popularity within the last decades, and is mostly utilizing elements drawn from boxing, wrestling, judo Brazilian jujitsu, Muay Thai and kickboxing. 

The purpose of this study is aimed to identify prevalence and assessing the severity, location, and type of injuries in Danish Mixed Martial Arts (MMA) athletes in Denmark, sustained during training, over a twelve-month period prior to the survey. Secondary we want to see if there is any difference in the injury outcome when looking at variables such as age, sex, primary martial art style, years of experience, hours of training per week, protective equipment and current fighter status. 

Rationale

Mixed martial arts (MMA) is a competitive, full-contact sport that have experienced a rapid worldwide increase in popularity within the last decades. The international development of combat sports in general, and MMA in particular, have been described over the past century, including the many myths and misunderstandings.

The term MMA is used to describe the contact competition and training, mostly utilizing elements drawn from boxing, wrestling, judo Brazilian jujitsu, Muay Thai and kickboxing. 

Professional and amateur MMA competition has experienced an increase in number of events held world-wide and has over the years become more popular than boxing, despite of concerns regarding potential risk of serious injuries, raised by media and several national medical associations, who consider MMA to be violent and dangerous. In Denmark the sport has acquired similar attention.

MMA involves intensive sparring and learning techniques, practice, and participation in competition and research have repeatedly confirmed that the majority of combat sport injuries occur during training. 

Most research concerning injuries and concomitant prevention in MMA have explored the injury risks associated with competition, primarily considered injuries sustained during professional or amateur fights, and not during training.

The purpose of this study is aimed to identify prevalence and assessing the severity, location, and type of injuries in MMA athletes in Denmark, sustained during MMA training, over a twelve-month period prior to the survey. 

Secondary we want to see if there is any difference in the injury outcome when looking at variables such as age, sex, primary martial art style, years of experience, hours of training per week, protective equipment and current fighter status. 

Method

A questionnaire survey will be sent out to all members of the Danish MMA federation (DMMAF) using the members registration platform (MyFightbook®). The survey will be sent to all registered MMA members in Denmark, via their registered email, prior to confirmation to participate in the study.

The questionnaire will be divided in two parts:

Part 1: Age, sex, primary martial art style, years of experience, hours of training per week, protective equipment, current fighter status (amateurs vs professional)

Part 2: Body region injured, types of injury, repeated injuries, required time off from training, medical attention, injury setting, old injuries.

Injuries will be divided into the following body sites, as described in appendix 1: head, back, neck, or trunk; shoulder or upper arm; elbow or forearm; wrist or hand; hip or groin; knee or leg; ankle or foot; and uncategorized. 

Participants reporting injuries will be asked for injury severity, in terms of the following; 

Definition of severity (if injured)

1. Total removal from MMA training and other outside routine physical activities for >1 week 

2. Modification of normal training activities in duration, intensity, or mode for >2 weeks 

3. Any physical complaint severe enough to warrant a visit to a health professional

Study data will be collected from august 2019 to october 2019 via an electronic survey. Data will be collected and managed using REDCap electronic data capture tools hosted by OPEN at the University of southern Denmark. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies. 

When data is collected, appropriate statistical analysis will be used to calculate outcomes in terms of injury prevalence, severity and anatomical location.

Description of the cohort

All members of the Danish Mixed Martial Arts Federation (DMMAF), who have been active (training) within the last year. All participants must be +18 years, and have trained MMA for at least 1 year. 

Collaborating researchers and departments

Department of Orthopedics and Traumatology, Lillebælt Hospital, Kolding. 

• Medical student Kaya B. Elkington
• Medical student Lena Dietze
• Associate Professor PhD Carsten Jensen

Orthopaedic research Unit, Department of Orthopedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark. MD, PhD fellow 

• Bo Bregenhof