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    Ask the Fight Doc: Dr. Benjamin clears up the medical misconceptions at UFC 131

    by Dr. Johnny Benjamin on Jun 13, 2011 at 10:15 am ET
    from mmajunkie



    If a fighter's eyes are open after he suffers a knockout, is that a bad sign? Is it the femoral artery that makes leg/thigh kicks so debilitating? Was an open-mouth Shane Carwin more susceptible to a knockout? And why in the hell couldn't Carwin blow his nose between rounds?

    From a medical perspective, this past weekend's UFC 131 event offered a little bit of everything.

    So in our latest installment of "Ask the Fight Doc," MMAjunkie.com medical columnist Dr. Johnny Benjamin clears up some of the misconceptions.

    * * * *

    Joe Rogan makes a lot of medical statements during a UFC broadcast. Does he know what he's talking about? – Anonymous

    I thought that I may have been the only one that noticed. Clearly, I am not.

    Rogan will go into the UFC Hall of Fame for his masterful fight commentary. His knowledge of technique, fighters' tendencies and MMA history is nothing short of brilliant.

    In my opinion, he and Mauro Ranallo (I don't care what the haters say; I appreciate intelligence and eloquence in all forms – and especially when applied to MMA) are among the very best TV commentators in MMA.

    Rogan's commentary regarding medical – and, some would say, more than an occasional social issue – may leave a bit to be desired.

    Therefore, let us do a little medical fact checking, shall we?

    Dr. Rogan stated after the highlight-reel knockout of Yves Edwards at the formidable hands of Sam Stout that keeping one's eyes open while "asleep" after a KO was a bad sign. Incorrect.

    A "bad sign" was when Edwards' body became rigid/stiff and his legs began to shake uncontrollably (convulse). The observation of his eyes being open is visually compelling for the television audience, though it's immaterial from a medical viewpoint. An athlete experiencing a seizure after suffering a concussion is a medical matter that requires prompt and proper attention and appropriate follow-up.

    Is there anyone out there who still believes that concussions are not a big deal in sports?

    Thankfully, as UFC president Dana White mentioned in a recent interview, MMA regulatory organizations (athletic commissions) routinely mandate at least a six-month suspension and proper neurological evaluation before contact will be permitted after a fighter suffers a knockout.

    (Hello? Is anyone listening in the NFL or NHL?)

    Let us continue.

    The comment was made that repeated inside-leg/thigh kicks (Donald Cerrone's leg/thigh attack of Vagner Rocha serves as a perfect illustration) cause a great deal of pain/damage because of impact to the femoral artery.

    Oooh so close. But nevertheless, incorrect.

    The correct answer is femoral nerve. Actually the femoral nerve – not artery – lies more directly in the path of such a blow and carries the pain and motor signals to a large portion of the leg/thigh. Too bad there's no such thing as partial credit in medicine.

    Please, let's continue our grand rounds.

    During the main event, Shane Carwin was forced to breathe through his gaping mouth due to the blood and trauma to his nose. Rogan then commented that breathing with his mouth open during a fight is potentially dangerous because it would make Carwin more susceptible to getting hit (or have difficulty avoiding a strike).

    Not exactly.

    Breathing with an open mouth makes it more likely that one may suffer a broken jaw when struck. It also exposes a fighter's chin and relaxes the neck muscles and thus renders one more susceptible to a knockout.

    Combat Sports Medicine 101: Open mouth + exposed chin (not tucked) + relaxed neck muscles = recipe for disaster.

    The best medical commentary (cageside physicians not included) given all night was when legendary Philadelphia corner man Mr. Leon Tabb properly advised a battered Carwin not to blow his nose in an attempt to clear the blood and improve his breathing.

    Dr. Tabb (he received his honorary medical degree through job experience and tens of thousands of rounds in the trenches) intuitively knows that after the soft tissue around the eye becomes seriously injured due to repetitive blunt trauma, the vessels begin to leak. If the patient then strains/bears down (valsalva) to increase pressure to forcefully clear his nose, rapid blood loss that creates massive swelling will ensue – likely closing shut one if not both eyes.

    Three things were vital in allowing Carwin to persevere to an honorable, if not lopsided, conclusion:

    * His undeniable heart
    * Great officiating by referee Herb Dean
    * Superb corner work and advice by the legend, Mr. Leon Tabb

    I bow in respect.

    Meanwhile, will someone, anyone do something about this terrible judging?!

    Anyway, what an amazing night of athletic competition at UFC 131. Thank you, thank you, thank you!

    For more on UFC 131, stay tuned to the UFC Events section of MMAjunkie.com.

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