Mixed Martial Arts combines the skills needed in wresting, kickboxing and jiu-jitsu into one violent sport.  In this century, MMA has gained popularity and consequently been legalized in most of America.  This past week, the New York legislature, Governor Cuomo and the State Athletic Commission entered the cage.

While MMA matches have been going on in New York for some years, legalization means that there will be regulations.  Specifically, these regulations include classifying 31 Acts that constitute a foul in the arena and would result in “disqualification from a mixed martial arts contest or exhibition… as determined by the referee.”  Five of these fouls specifically involve violence to the brain: Butting with the head, striking to… the back of the head, kicking the head of a grounded opponent, kneeing the head of a grounded opponent, and spiking an opponent to the floor surface on his head or neck.  Other rules are not specifically directed to the head, but could easily result in head trauma, such as “attacking an opponent on or during a break”.  Additionally, “New York [is] to Require $1 Million Brain-Injury Coverage for Mixed Martial Artist,” to be provided by the promoters.

However, the safety of the athletes was not directly the reason of the legalization… it was the money.  It is estimated that legalizing MMA will bring $140 million to New York in economic growth.

In covering this story, Forbes magazine notes that, “insurance doesn’t provide for fighter safety.  It provides compensation after fighter safety has failed.”  (On the other hand, the NYS Athletic Commission says it, “has taken another step toward ensuring the health, safety and integrity of its athletes and event.”)  Some people still want the sport banned.  Currently, the State is seeking comments from the public on this issue.  The proposed legislation can be found on this link and comments can be submitted for review until August 27, 2016.

He ran for the ball, knocking head-first into a concrete wall in a game versus the Washington Senators at Washington’s Griffith Stadium.  He then lay on the ground, unconscious, for five minutes.  Eventually, he arose, shook off the trauma and returned to play.

Such a story as the one above seems unfathomable in current athletics.  Now, if a player is hit on the head and falls unconscious, he would never be permitted to return to play immediately and, most likely, would be taken to the hospital for neurological testing.  However, this is what happened to America’s famed baseball player for the New York Yankees, Babe Ruth, in 1924.

Compared to many other sports, baseball does not have a high concussion rate.  Between ten to twenty players are put on the disabled list yearly because of concussions.  However, even one concussion is one too many.  Most prone to concussions are outfielders and catchers.

Recently, this was brought to my attention because of the story, Ex-Met Josh Satin explains why retiring is ‘the right thing’ after suffering head injuries.  Specifically, while playing for the Louisville Bats, the Triple-A affiliate of the Cincinnati Reds, Satin collided with his team’s third baseman, as both were going for a pop fly.  After being unconscious for five long seconds, Satin says he had a “weird feeling” and later was “never the same”.  He further stated that his depth perception, once his best skill, never fully recovered.  “The ball was always in a different spot than I thought.”  (Officially diagnosed with post-traumatic stress disorder (PTSD), Satin sat out most of last season.)

Similarly, in December 2012, Toronto Blue Jays’ utility player Ryan Freel, the first pro-baseball player diagnosed with chronic traumatic encephalopathy (CTE) who had to retire from playing the sport because of his injuries, committed suicide.  In 2013, Freel’s family donated some of his brain tissue to Boston University for study.  Though Freel’s behavior after his accident pointed towards CTE, he was not officially diagnosed until this postmortem study.

Dr. Robert Stern, co-founder of the Center of Traumatic Encephalopathy at Boston University, said, “I cringe [whenever] I see two guys going after the same ball.”  The MLB has said, “[it] will remain proactive on concussion and head injuries.”  Home plate collisions are no longer allowed and, in 2013, the MLB said it was instituting educational programs and rule changes to protect from concussions.  The prior year, the MLB mandated that any player who suffers a concussion must be put on the “disabled list” for at least 7 days.

This year, Major League Baseball established a lobbying office in the District of Columbia.  Lobbying is not new for the MLB, as they have always spent time and money lobbying, most notably in the 1998 – 1999 seasons when they spent $1.6 million on it.  (In comparison, last year the MLB spent about $320,000 lobbying.)  The office is run by Josh Alkin, a lawyer who, before the appointment as Vice President of Government Relations in this office, had been handling issues relating to the MLB for 15 years at the firm BakerHostetler.  In 2013, the MLB also stated that it aims, “to remain proactive on concussions and head injuries.”

I don’t think there is a way to entirely eliminate concussions from baseball but the MLB has instituted mandatory educational programs and certain changes to the rules to minimize these injuries. It is a good sign that the MLB, as of this year, has a lobbying office in the country’s capital to address a wide range of key government-facing issues including player safety.  With these steps, the MLB hopes to eliminate some concussions, but still keep the excitement of watching a game of America’s pastime.

There is a reason soccer is called football in other nations.  Much like American football, soccer requires getting the ball into a goal and preventing the other team from doing the same.  Such action requires exceptional offense and defense, which often includes certain violent maneuvers that are allowed under sports rules.

Briana Scurry, a two-time Olympic gold medalist in women’s soccer and a World Cup winner, knows this all too well.  In 2010, as the goalkeeper of the Washington Freedom, she “took the knee of a Philadelphia Independence forward to her temple at full velocity during a Women’s Professional match.”  The injury changed her life and ended her soccer career.  However, it also created a new career plan for her – advocate for brain health, particularly women’s brain health.

In 2015, U.S. Soccer banned heading in soccer for children under 10 and limited heading for children 11 to 13.  (Ages when children’s brains are still developing.) This was much needed because, as the Institute of Medicine and the National Research Council has confirmed, “young athletes in particular face a ‘culture of resistance’ when it comes to reporting and treating concussions”.  (Scurry also supports mandating that players wear headgear when they play.)  This action was partially brought to their attention by Scurry because, rightly so, “She sees herself as an advocate for women’s health, especially in relation to concussions and traumatic brain injury.”

This past week, Scurry, with Joanne Finegan, Alison Cernich, Yelena Goldin, Mike Colson and Rosemarie Scolaro Moser, all whom are traumatic brain injury advocates, and joined by Rep. Bill Pascrell (NJ), the head of the Congressional Brain Injury Task Force, spoke at the “Women and Traumatic Brain Injury: A Frontier Yet To Be Explored” conference at the Rayburn House Office Building in Washington D.C.  (Scurry also testified before Congress on the same issue in 2014.)  At this conference, Scurry told her story, including her accident, recovery and her ongoing struggles.  “Scurry hopes that her testimony… will help members of Congress understand the dangers and resulting issues of brain injuries… [and] take charge in making moves to change the way things… are conducted.”  This includes changing the knowledge of doctors who once told her things like, “You can’t possibly have post-concussive syndrome anymore because it’s been too long.”  Obviously these doctors were wrong, because they were uneducated about brain injuries.

Hopefully, her testimony will help educate doctors and the public about what a concussion can do to your brain.

Statistical note:

According to the NCAA, in soccer, females are at a 2.1 times greater risk of getting a concussion than males and later have more concussion symptoms, including, but not limited to, poor concentration and increased fatigue.  (More information and statistics can be found in the online NCAA article Do Female Athletes Concuss Differently than Males?)

This past week, Muhammad Ali lost his long struggle with Parkinson’s Disease*, but the memory of Ali is still very much in the minds of our politicians.  On May 26, Rep. Mullin (R-OK), a former professional mixed martial arts fighter, introduced H.R. 5365, the Muhammad Ali Expansion Act.  The proposed amendment expands the Muhammad Ali Boxing Reform Act of 2000, so that it applies to all combat sports.  This past Tuesday, “Rep. G. K. Butterfield (D-N.C.), the chairman of the Congressional Black Caucus (CBC), introduced a measure to recognize the “extraordinary life, accomplishments, and countless contributions” of Ali.

In his lifetime, Ali, a Muslim who changed his name from Cassius Clay when he converted to the Islam religion, was both an athlete and a political activist.  In addition to his well-known objections to war, he was a fierce advocate for civil rights.  (In remembrance of Ali, Senator Rand Paul of Kentucky plans to introduce the Muhammad Ali Voluntary Service Act, to replace the Selective Service, which Sen. Paul states, “… has a racial justice disparity.”)  In the years after his diagnosis, he became a fierce advocate and active fundraiser for Parkinson’s research, particularly for the Muhammad Ali Parkinson Center in Phoenix’s Barrow Neurological Institute .

Ali, who in 2005 received the Medal of Freedom from then President George W. Bush, would have liked the proposed legislations.  Unfortunately, we no longer have him here to advocate it.

*For the last 32 years of his life, Ali had the neurological disorder, Parkinson’s disease.  According to a Harvard Medical School neurologically professor, who met with Ali, “People who lose consciousness through head trauma are at 50% higher risk of Parkinson’s.”  Severe, ongoing head trauma, which is a consequence of heavyweight professional boxing, can cause the development of ‘Parkinson’s proteins’ or further the development of existing, inactive ‘Parkinson’s proteins’.

(June 10, 2016, Ali was laid to rest, at a funeral in his hometown of Louisville, KY.)