MMA medical clearances after spine surgery...as tough as it gets
I read an article on mmajunkie by John Morgan that happened to mention Tito Ortiz. Among other things Tito seems to have discussed his need for an additional 6-months of rehab on his recently surgically fused back (3-level fusion). He apparently has interest in competing again.
Wow...I know that I shouldn't but...but...but I can't help myself!!
Medical clearances for combat athletes should be a simple and uniform process; unfortunately it is anything but. Each state creates its own process and not all states even have athletic commissions that govern combat sports. Clearances generally are not transferable from state to state. The current system is in need of an overhaul.
Those are just the procedural issues. The next issue is determining which specialties of physicians are qualified to provide the clearances. Many states allow any doctor that holds a valid license to complete the paperwork. So a Pediatrician or an OB/Gyn could clear a fighter. Some people incorrectly believe that since all doctors once upon a time went to medical school they are all qualified to provide these clearances. A long time ago in a land far, far away, I delivered more than 50 babies in medical school. You would be foolish to ask me to deliver your little 'bundle of joy' in any circumstances other than being marooned like Gilligan on a deserted island (sorry...did I just show my age with that Gilligan reference?).
Many doctors can tell you if the laceration that you had stitched is adequately healed to fight but that is very different than clearing you after a spinal injury or operation. More and more fighters are suffering serious neck and back injuries some of which require surgical intervention. Also, just because a fighter got slammed in the gym and was fine (you think?...he looked good to you and said he was ok...right?) doesn't mean that over the next 10-20 'slams' or cranks he'll continue to be as fortunate. Unfortunately, there are very few (if any) basic science or clinical medical studies that address this specific issue (is it safe in MMA). Attempting to utilize and apply info that we've learned from other sports may or may not be a safe/good practice. (just because that study was done in football players doesn't necessarily mean that it holds true for MMA athletes)
As a doctor, if you're wrong about a laceration and it gets re-opened...well I'm sorry but I can suture it again...no harm no foul. But if I'm wrong about allowing you to return to competition after your serious neck/back injury or fusion...Houston we have a problem.
As a physician clearing an athlete after a serious neck/back injury or surgery, the question is really- what might happen to this person if I am wrong? Also have I (as the clearing physician) done everything that is reasonable to determine if it is reasonably (not absolutely) safe for this athlete to participate in a particular endeavor?
As a physician that provides these types of difficult evaluations, I am humbled by the magnitude of my conclusions. If I am wrong and a person or athlete gets seriously injured we are both done. They may be paralyzed or if lucky will only suffer a lifetime of pain and my career (the only means that I possess to feed myself and family) is over.
It's funny how no one will remember all of the people who were screaming "Dude, who are you to tell a gladiator he can't fight!" when the gladiator gets paralyzed. He'll be paralyzed. I'll be ruined. The future of MMA will be crippled. And everyone will be watching that 'sick' slam on youtube 17-million times.
Comments