Exploratory Systematic Review of Mixed Martial Arts: An Overview of Performance of Importance Factors with over 20,000 Athletes

International society of sports nutrition position stand: nutrition and weight cut strategies for mixed martial arts and other combat sports

Following an extensive literature review, the International Society of Sports Nutrition (ISSN) has developed an official position on nutritional and weight cut strategies for combat sports. The type of combat sport, length of the fight camp, and time between weigh-in and competition are factors influencing nutritional and weight cut strategies. The following 16 points constitute the Position Statement of the Society; the Research Committee has approved them. 1. Combat sports have differing weight categories, official weigh-in times, and competition frequencies, influencing the nutritional and weight cut strategies for training and competition. 2. As the duration of a combat match increases, >4 min, contribution of the aerobic system can rise to >70%, yet anaerobic alactic pathways and anaerobic glycolytic pathways support high-output bursts. 3. During the off camp/general preparation phase, athletes should maintain a weight ranging 12% to 15% above the weight division requirement. 4. Supplements including creatine, beta-alanine, beta-hydroxy-beta-methylbutyrate, and caffeine have been shown to enhance performance and/or recovery during preparation phases, competition, and post-competition. 5. During fight camp, strategic decreases in calorie intake are necessary for an efficient longitudinal weight descent. Individual caloric needs can be determined using indirect calorimetry or validated equations such as Mifflin St. Jeor or Cunningham. 6. Protein should be prioritized during longitudinal weight descents to preserve lean body mass, and the timely delivery of carbohydrates supports training demands. Macronutrients should not drop below the following: carbohydrates 3.0-4.0 g/kg, protein 1.2-2.0 g/kg, and fat 0.5 to 1.0 g/kg/day. 7. Suitable losses in body mass range from 6.7% at 72 h, 5.7% at 48 h, and 4.4% at 24 h, prior to weigh-in. 8. Sodium restriction and water loading are effective for inducing polyuria and acute water loss. 9. During fight week, water-bound glycogen stores can be depleted through exercise and carbohydrate restriction, facilitating a 1% to 2% loss in body mass, with equivalent losses from a low-fiber intake of <10 g/day for 4 days. 10. During fight week, acute water loss strategies, including sauna, hot water immersion, and mummy wraps, can be used effectively with appropriate supervision (optimally ~2-4% of body mass within 24 h of weigh-in). 11. Post-weigh-in, rapid weight gain strategies are utilized to recover lost body fluid/mass before competition with the intent of gaining a competitive advantage. 12. Oral rehydration solutions (1 to 1.5 liters/h) combined with a sodium range of 50-90 mmol/dL should take precedence immediately post-weigh-in. 13. Fast-acting carbohydrates at a tolerable rate of ≤ 60 g/h should follow oral rehydration solutions. Post weigh-in intake of fiber should be limited to avoid gastrointestinal distress. 14. Post-weigh-in carbohydrate intake at 8-12 g/kg may be appropriate for combat athletes that undertook significant glycogen depletion strategies during fight week. About 4-7 g/kg may be suitable for modest carbohydrate restriction. 15. Post weigh-in, rehydration/refueling protocols should aim to regain ≥10% of body mass to mitigate declines in performance and the negative effects of rapid weight loss. 16. The long-term effects of frequent weight cuts on health and performance are unknown, necessitating further research.

Immediate effect of ice and dry massage during rest breaks on recovery in MMA fighters : a randomized crossover clinical trial study

The MMA fight consists of 5 rounds of 5 min with minimal breaks between the rounds. The exertion load is excessive for the fighters, and the 1-minute breaks give little time for any intervention. This study aimed to examine the acute effects of two methods of regenerative strategies, ice massage and dry massage, and analyze their impact on Reactive Strength Index (RSI - m s- 1), muscles' biomechanical properties: muscle tone (T-Hz), elasticity (E - arb- relative arbitrary unit), stiffness (S - N/m), pressure pain threshold, (PPT - N/cm²), and compare their influence with passive rest. The maximum number of jumps (J - n) treated as an indirect effective measure of the interventions that were conducted was also recorded for each participant in each regenerative strategy. Thirty male MMA fighters took part in the study. Three subgroups of 10 participants (Ice massage, n = 10; dry massage, n = 10; and control, n = 10) were enrolled in the cross-over randomized clinical trial study design. The groups were randomized, and each group underwent each procedure (30 tested in each procedure). Five sets of jumps on a 50 cm box to exhaustion were used as a fatigue protocol with 1-minute breaks. The recovery interventions were performed during the breaks. The statistically significant results revealed in the post-exercise tests: RSI and number of jumps - the lowest decrease was observed in the massage group (p < 0.001 and p < 0.0001 respectively), the minor increases in T, E and S were also observed in the massage group ((p < 0.0001 for all measurements); the post-exercise PPT was the highest (higher means better) in the Ice group (p < 0.001). In every other parameter, the ice massage group showed slightly worse results than the dry massage group. Responder analysis confirms that the number of jumps profoundly impacted biomechanical variables, leading to increased muscle stiffness and tension, decreased elasticity and force endurance, and heightened pain sensitivity. Obtained results confirm that both dry and ice massage can significantly affect acute recovery following rounds of combat sport-related exertions. The Ice and Massage interventions differed in effectiveness - Massage was the most effective in preventing increases in stiffness and tension and preserving muscle elasticity. At the same time, ice cooling had a lesser impact, particularly on muscle elasticity changes but higher for PPT.

Doping in combat sports: a systematic review

PURPOSE

This systematic review aims to synthesize the current research on doping in combat sports, examining the prevalence, detection methods, prevention strategies, and overall impact on combat sports.

DESIGN/METHODOLOGY/APPROACH

Of the 21 identified articles, six met the inclusion criteria. A systematic approach was used, including content analysis based on specific criteria: articles in English, original research, and relevance to sport and doping.

FINDINGS

The review reveals an unsettling prevalence of doping across combat sports, suggesting that current detection and prevention efforts may be insufficient to address the unique pressures and risks within these disciplines. In particular, substances like anabolic agents, diuretics, hormone modulators, and NSAIDs are commonly detected, especially among athletes in heavier weight categories and those engaging in rapid weight loss. Psychological and social factors, including social norms and perceived acceptance within athletic environments, appear to play a significant role in shaping doping behaviors, complicating prevention efforts. Beta-agonists emerged as the sixth most frequent cause of adverse analytical findings (AAF) in 2020, according to WADA data, while kickboxing had the highest AAF rate among combat sports in a 2015 report. These trends suggest a pressing need for more comprehensive, nuanced approaches to regulation.

RESEARCH LIMITATIONS/IMPLICATIONS

Limited to English-language articles The honesty of athletes about their experience in doping could have influenced the results.

ORIGINALITY/VALUE

As the first systematic review on doping in combat sports, this study offers valuable insights and underscores the urgency of developing anti-doping policies and it provides insightful data for future research directions for addressing doping in these disciplines.

Is there a relationship between rapid weight changes and self-reported injury in combat sports athletes? A 14-month study of 24 combat sports events

OBJECTIVES

To explore the potential association between rapid weight changes and self-reported injury status (presence or absence of injury) 7 days following competitive events among male and female combat sports competitors.

DESIGN

A 14-month study of 24 events.

METHODS

A weight management questionnaire was completed 1-day post-competition, and an injury questionnaire was completed 7 days post-competition. These online questionnaires provided data on body mass and injury status. Mixed effects logistic regression models were used to analyse the odds ratios of rapid weight change variables and their impact on athletes' self-reporting as injured or non-injured.

RESULTS

There were 172 responses (155 athletes) to both questionnaires (37 females (24 %) and 118 males (76 %)); 88 athletes (51 %) reported no injury, and 84 (49 %) reported injury. Rapid weight loss 7 days (RWL -7 days) and 24 h (RWL -24 h) before weigh-ins was 4.9 % ± 3.4 % and 2.6 % ± 2.1 % for females, and 6.1 % ± 3.2 % and 3.0 % ± 1.9 % for males. Mixed effects logistic regression models returned the highest odds ratio for male RWL -24 h (odds ratio: 1.20, 95 % confidence interval: 1.00-1.43, p = 0.044). This indicates that for a 1 % increase in male RWL -24 h before official weigh-ins, the likelihood of reporting an injury increases by a factor of 1.2.

CONCLUSIONS

Male RWL -24 h before weigh-ins is associated with reporting an injury at 7 days post-competition. Therefore, athletes and coaches should carefully consider and aim to limit pre-competition rapid weight loss to minimise the likelihood of injury.

Biomechanical Profile after Dry Needling in Mixed Martial Arts

The purpose of this study was to compare the effects of dry needling (DN) intervention on the responses of muscle tone, stiffness, and elasticity, as well as power, pressure pain thresholds, and blood perfusion of the flexor carpi radialis muscle in mixed martial arts (MMA) athletes. Thirty-two trained/developmental men MMA fighters (25.5±4.5 years; 24.5±3 body mass index) participated in a randomized crossover study. Participants underwent a single intervention, receiving both DN and placebo. Laser Doppler flowmetry measured blood perfusion, while a myotonometer assessed the mechanical characteristics of muscle tone, stiffness, and elasticity of the flexor carpi radialis muscle. Pressure pain thresholds (PPT) were measured using an algometer, and maximal forearm muscle force was measured using a hand dynamometer. Outcomes were assessed at baseline, immediately after, and 24 hours and 48 hours post-intervention. A two-way repeated-measures ANOVA revealed significant Intervention*Time interaction for all outcomes: perfusion unit (p<0.001), muscle tone (p<0.001), stiffness (p<0.001), elasticity (p<0.001), PPT (p<0.001) and maximal forearm muscle force (p<0.001). The current study suggests that a single session of DN enhances muscle recovery, increases muscle strength, and improved PPT in MMA athletes. These positive adaptations appear to last up to 48 hours in some variables.

Immediate Effect of Compression Contrast Therapy on Quadriceps Femoris Muscles' Regeneration in MMA Fighters

Objectives: This study aimed to evaluate the immediate effect of Game Ready (GR) heat-cold compression contrast therapy (HCCT) on changes in the biomechanical parameters of the quadriceps femoris muscles and tissue perfusion. Methods: Fifteen male MMA fighters were subjected to HCCT on the dominant leg's thigh and control sham therapy on the other. The experimental intervention used a pressure cuff with the following parameters: time-20 min; pressure-25-75 mmHg; and temp.-3-45°C, changing every 2 min. For the control group, the temp. of sham therapy was 15-36 °C, and pressure was 15-25 mmHg, changing every 2 min. Measurements were taken on the head of the rectus femoris muscle (RF) 5 min before therapy, 5 min after, and 1 h after therapy in the same order in all participants: microcirculatory response (PU), muscle tension (MT), stiffness (S), flexibility (E), tissue temperature (°C), and pressure pain threshold (PPT). Results: The analysis revealed significant differences between the HCCT and sham therapy groups and the measurement time (rest vs. post 5 min and post 1 h) for PU, MT, E, and °C (p < 0.00001) (a significant effect of time was found) in response to GR therapy. No significant differences were found for the PPT. Conclusions: The results of this study prove that GR HCCT evokes changes in the biomechanical parameters of the RF muscles and perfusion in professional MMA fighters.

The Effects of Combined Contrast Heat Cold Pressure Therapy on Post-Exercise Muscle Recovery in MMA Fighters: A Randomized Controlled Trial

The purpose of this study was to evaluate the effects of contrast heat and cold pressure therapy (CHCP) on muscle tone, elasticity, stiffness, perfusion unit, and muscle fatigue indices after plyometric training consisting of five sets of jumping on a 50-cm high box until exhaustion. A prospective, randomized, controlled single-blind study design was used. Twenty professional MMA fighters were included in the study. The experimental group (n = 10) was subjected to the CHCP protocol (eGR), while the control group (cGR) (n = 10) was subjected to sham therapy. Both protocols consisted of three CHCP sessions performed immediately after plyometric exercise, 24 and 48 h afterwards. Measurements were taken at the following time points: 1) at rest; 2) 1 min post-exercise; 3) 1 min post-CHCP therapy; 4) 24 h post-CHCP therapy; 5) 48 h post-CHCP therapy. The results of the eGR compared to the cGR showed significantly higher perfusion at time point 5 (p < 0.001), higher muscle tone at time points 1, and 3-5 (p < 0.001 for all), higher stiffness at time points 1, 3-5 (p < 0.001 for all) and a higher pain threshold at time points 1 and 5 (p < 0.001 for all). This study suggests a positive effect of CHCP therapy on muscle biomechanics, the pain threshold, and tissue perfusion, which may contribute to increasing the effectiveness of post-exercise muscle recovery in MMA athletes.

Acute effects of cold, heat and contrast pressure therapy on forearm muscles regeneration in combat sports athletes: a randomized clinical trial

Due to the specific loads that occur in combat sports athletes' forearm muscles, we decided to compare the immediate effect of monotherapy with the use of compressive heat (HT), cold (CT), and alternating therapy (HCT) in terms of eliminating muscle tension, improving muscle elasticity and tissue perfusion and forearm muscle strength. This is a single-blind, randomized, experimental clinical trial. Group allocation was performed using simple 1:1 sequence randomization using the website randomizer.org. The study involved 40 40 combat sports athletes divided into four groups and four therapeutic sessions lasting 20 min. (1) Heat compression therapy session (HT, n = 10) (2) (CT, n = 10), (3) alternating (HCT, n = 10), and sham, control (ShT, n = 10). All participants had measurements of tissue perfusion (PU, [non-reference units]), muscle tension (T-[Hz]), elasticity (E-[arb- relative arbitrary unit]), and maximum isometric force (Fmax [kgf]) of the dominant hand at rest (Rest) after the muscle fatigue protocol (PostFat.5 min), after therapy (PostTh.5 min) and 24 h after therapy (PostTh.24 h). A two-way ANOVA with repeated measures: Group (ColdT, HeatT, ContrstT, ControlT) × Time (Rest, PostFat.5 min, PostTh.5 min, Post.24 h) was used to examine the changes in examined variables. Post-hoc tests with Bonferroni correction and ± 95% confidence intervals (CI) for absolute differences (△) were used to analyze the pairwise comparisons when a significant main effect or interaction was found. The ANOVA for PU, T, E, and Fmax revealed statistically significant interactions of Group by Time factors (p < 0.0001), as well as main effects for the Group factors (p < 0.0001; except for Fmax). In the PostTh.5 min. Period, significantly (p < 0.001) higher PU values were recorded in the HT (19.45 ± 0.91) and HCT (18.71 ± 0.67) groups compared to the ShT (9.79 ± 0.35) group (△ = 9.66 [8.75; 10.57 CI] > MDC(0.73), and △ = 8.92 [8.01; 9.83 CI] > MDC(0.73), respectively). Also, significantly (p < 0.001) lower values were recorded in the CT (3.69 ± 0.93) compared to the ShT (9.79 ± 0.35) group △ = 6.1 [5.19; 7.01 CI] > MDC(0.73). For muscle tone in the PostTh.5 m period significantly (p < 0.001) higher values were observed in the CT (20.08 ± 0.19 Hz) group compared to the HT (18.61 ± 0.21 Hz), HCT (18.95 ± 0.41 Hz) and ShT (19.28 ± 0.33 Hz) groups (respectively: △ = 1.47 [1.11; 1.83 CI] > MDC(0.845); △ = 1.13 [0.77; 1.49 CI] > MDC(0.845), and △ = 0.8 [0.44; 1.16 CI], < MDC(0.845)). The highest elasticity value in the PostTh.5 m period were observed in the CT (1.14 ± 0.07) group, and it was significantly higher than the values observed in the HT (0.97 ± 0.03, △ = 0.18 [0.11; 0.24 CI] > MDC(0.094), p < 0.001), HCT (0.90 ± 0.04, △ = 0.24 [0.17; 0.31 CI] > MDC(0.094), p < 0.001) and ShT (1.05 ± 0.07, △ = 0.094 [0.03; 0.16 CI] = MDC(0.094), p = 0.003) groups. For Fmax, there were no statistically significant differences between groups at any level of measurement. The results of the influence of the forearm of all three therapy forms on the muscles' biomechanical parameters confirmed their effectiveness. However, the effect size of alternating contrast therapy cannot be confirmed, especially in the PostTh24h period. Statistically significant changes were observed in favor of this therapy in PU and E measurements immediately after therapy (PostTh.5 min). Further research on contrast therapy is necessary.

Perceptions of the mouthguard in basketball, rugby, and soccer players. Qualitative study at a public university in Colombia

BACKGROUND/AIM

Orofacial and dental injuries in athletes, both amateur and professional, are highly prevalent. Mouthguards are devices to prevent this type of injury; however, athletes believe that the mouthguard limits their performance in the game and decreases their confidence. This study analyzed the perception that some basketball, rugby and soccer players from a public university in Colombia have about the use of mouthguards.

MATERIAL AND METHODS

Comprehensive qualitative study with ethnographic approach. Twenty-nine players participated. Three data collection tools were used: semi-structured interviews, field diary and discussion groups. Content analysis was carried out using a categorical matrix and triangulation of sources.

RESULTS

Participants perceive the mouthguard as a device to prevent orofacial and dental injuries, but unattractive to wear during competitions. Factors that determine the use or non-use of the mouthguard are player comfort and adaptability, communication and economic cost.

CONCLUSIONS

Players' perception of mouthguards in soccer, basketball and rugby is multifactorial, and is mediated by the idea of contact risk during sports practice, prevention of orofacial injuries, influence on sports performance, comfort and adaptability to the mouthguard.