Physio for Mixed Martial Arts

What is MMA?

Mixed Martial Arts or MMA (sometimes called cage fighting, no-holds-barred, or ultimate fighting) is a combat sport that utilises striking and grappling techniques from various disciplines. As i) the sport is relatively new (perhaps only truly beginning as late as 1993), ii) the ruleset is relatively unrestrictive, and iii) the primary goals are to knockout or submit your opponent, it is associated with some serious risk of injury.


What are some common injuries in the sport of MMA?

One of the goals of MMA is to damage your opponent. There are other goals of course, such as controlling the space the fight takes place in (usually a cage or ring), controlling your opponent, and effective aggression (a criteria the judges actually reward!). Arguably however, these are subservient to the goal of damage because it is damage that accomplishes a decisive victory. Damaging your opponent is accomplished by utilising strikes or submissions.

MinJoon (2016) looked at 455 MMA athletes through different competitions and was able to compare different locations of the injuries sustained. They reported the results in Table 2 (right).

It is likely no surprise the head and neck feature highly – one presumes punches to the head are more damaging than punches to the knee for example. The arm accounted for >30% of the injuries – perhaps because it is used both defensively and offensively, and can be injured from strikes and submissions. Hand and wrist injuries, such as sprains and fractures, also account for a large proportion of injuries. As the small bones and joints that make up these structures are primarily concerned with precision grasping, tool manipulation, and tactile differentiation, they are susceptible to injury when repeatedly slammed into another person. At the time of writing, a relatively new strike, the calf kick, has significantly risen in prominence. This has resulted in several fractured tibias and fibulas of late (most notably befalling Conor McGregor, Chirs Weidman and Anderson Silva), not to mention peroneal nerve damage (YouTube Sean O’Malley to see this one).


What are some common mistakes that MMA athletes make with their recovery?

The main mistake we see MMA athletes making with their recovery is this: their focus is in the wrong area. 

Usually, we see athletes high in passion and low in critical thinking. This can mean the newest topic discussed on Joe Rogan for example receives undue merit and the old boring advice (see the list below) is relegated to an afterthought. Athletes should ‘major on the majors’. Some of the ‘majors’ for recovery, in no particular order, might be; 

  • sleep (quantity and quality)
  • diet (micronutrients, macronutrients, fibre and hydration)
  • general exercise and activity (training load, periodisation, programming variables etc.) 
  • mental health status (beliefs, stress, anxiety, depression etc.)
  • social dimensions (relationships, socialisation, support etc.) and
  • work-related factors (work-life balance, financial position etc.)

The major mistake I see across all sports is a focus on the ‘minors’; namely passive interventions (massage, dry needling, cupping, hot/cold therapies etc.) and whatever is offered at the new recovery centre that’s just opened up down the road. 


What role does physiotherapy play in the sport of MMA?

Advice and education re: training (volume, intensity, frequency, exercise selection, etc.), injury reduction, tracking progress, and working with the coaching staff to facilitate peak performance for competition. Some other roles include stretching (static, dynamic, contract-relax etc.), massage, manipulations and mobility work. These other roles fall into ‘symptom modification’, which may allow some pain relief so the athlete can focus on what’s most important: conditioning and technique development.


Why is it important to see a physiotherapist who understands MMA?

They understand the unique demands of the sport and can provide a more tailored treatment approach with a specific focus on your needs. You also won’t have to spend the session explaining the movement that caused your injury or the movements that hurt – they know the nomenclature! The physio will also know exactly when you’re ready to return to the mats and what training you are suitable for (drilling, bag work, positioning rounds, live rounds, etc.). Lastly, the physio will likely have a personal relationship with MMA injuries themselves and know how to navigate a return to training.

Thanks for reading!

If you’ve got an injury from training and want a plan to get back on the mats, get in touch!

Mitchell Robinson, BExSci, BPhty
Mitchell Robinson, BExSci, BPhty