Thu. Sep 29th, 2022

Whether its college wrestling, amateur boxing or mixed martial arts – CTE is a threat that looms over each and every athlete involved.

Chronic injury and head trauma are difficult topics to discuss, especially for people whose entire livelihoods revolve around engaging in one on one physical confrontations. This does not change the fact that CTE and other forms of head injury are a grim reality that they will have to contemplate at some point in their careers. In worst case scenarios, the effects of said conditions will emerge later in one life – often with debilitating effects.

Up to as late as 2017, there were still doubts in both the sports and medical world about whether the condition truly existed. Debates around its existence are reported to have started in the early 1900s, but only recently have medical professionals been able to gather enough data to debunk the idea that it is a myth. 

In 2017 Dr. Ann McKee and other Boston researchers examined the brains of over 200 deceased American football players. In the 111 brains of former NFL players that were studied, 110 of them were found to have CTE. Finally putting to bed the air of uncertainty that still remained. 

What is CTE?

CTE (chronic traumatic encephalopathy) is a degenerative brain disease. Caused by repetitive head injury, combat-sports are a primed breeding ground for CTE and have been as early as the 1920s as stated by C.T.E. Centre at Boston University. 

Inherently problematic, one of the biggest issues about CTE is that it can only be diagnosed posthumously. This is done by doctors who specialise in brain disease according to the Concussion Legacy Foundation.

“Doctors with a specialty in brain diseases slice brain tissue and use special chemicals to make the abnormal tau protein visible. They then systematically search areas of the brain for tau in the unique pattern specific to CTE. The process can take several months to complete, and the analysis is not typically performed as a part of a normal autopsy”.

Photo by Boston University, showing a normal brain (left) and a brain with stage IV CTE (right)

Tau is a naturally occurring protein that builds up over time in the brains of those with CTE. These tau formations attack brain cells and consequently kill them over a long period of time. As a result, cognitive function declines.

CTE can cause a large array of ailments, including but not limited to depression, memory less, severe mood swings and slurred speech. Whilst many of these listed can be visible to those around them, others fly under the radar.

Living with CTE

Recent years have seen the issue become more and more spoken about in the combat-sports community – in large part due to its effects becoming more frequently seen in athletes. Mixed martial arts is still an extremely young sport, but it has been around long enough to start producing retired athletes. In turn, athletes suffering from CTE are now starting to emerge. 

In 2017, money was drying up rapidly for former UFC fighter Spencer Fisher. Not only had the UFC decided not to renew his contract, but he had been declared permanently disabled and unable to work by a neurologist. Early in 2021 he spoke to MMA Fighting about living with CTE in day to day life.

“I forget what I’m doing, depression, dizzy spells, calling people different names – not knowing their actual names. My kids, I’ve had incidents in the past where I couldn’t think of their name on the spot. Just my balance is shot. I have a hard time remembering what I did yesterday. Last week is a complete blur. My long term memory is okay but my short term memory is gone”.

Photo by Jim Kemper/Zuffa LLC via Getty Images

Fisher is now reliant on medication to get through the day, along with the support his family provides him with. 

“I gotta support a family that understands my conditions and tries to help me out the best they can. (…) I don’t want to die alone and not know anybody when I see them. I don’t want to go out of this world without knowing people I love.

As the years go by, Fisher will likely become one of many former fighters suffering from the aftereffects of an unforgiving fighting career. He however, hopes that up and comers will take heed of his story by prioritising their health over their career.

“The injuries I took from it – I don’t know if it was worth it. Now my message is to tell people that hey, this is a possibility, this could happen to you and it’s very real. I know I’m just one person talking, but I know for a fact that there are other people out there. Their symptoms may not be as severe as mine, but there are guys out there that do have problems physically. I just hope that people realise that along with the spotlight and fame, it does come to an end.”. 

CTE by the Numbers: Boxing

As a sport, boxing has existed for far longer than most combat sports such as mixed martial arts. As a result of this, there is far more data on CTE in the sport of boxing and how it can affect fighters. Reports on the issue can be found from as early as 1928, naming the issue as “punch drunk syndrome”. 

The Association of Neurological Surgeons claim that an unsurprising yet massive 90% of boxers suffer a brain injury at some point during their career, which would put them directly at risk of possessing CTE. 

There is no definitive statistic that can claim to know the number of boxers that actually have the condition, but it is estimated to be around 20% – although it could possibly be a larger number because of the nature of boxing. With 17 weight categories, there are approximately 20,000 boxers and this number doesn’t even take into account those who are now retired and may be suffering.

The Link with Domestic Violence

Last October, former 5x UFC champion speculated on Twitter that CTE may have been linked to a sudden surge in domestic violence cases within the MMA community.

“One of the first signs of widespread CTE in the NFL came when close family members started to notice violent changes in their loved ones personalities. We are still new to the sport of MMA and just now discovering the lasting effects of competition”.

The tweet came after Chuck Liddell, Luis Pena and Jon Jones were arrested on charges of domestic violence between the months of September to October. Whilst each athlete put the incidents down to differing reasons including mental health and alcohol – Cyborg’s astute observation should not be overlooked. 

Sadly, these are nowhere near the first cases of domestic violence in MMA. These incidents span back at least a decade, as far back as 2009 where Will ‘Kill’ Pope was convicted of domestic assault. Higher profile cases involve names such as Mike Perry, Arnold Bernon, ​​Abel Trujillo and Thiago Silva – the catalogue of names is somewhat endless. 

With 3 cases happening within such a short span of time, it not only raises the question of whether domestic violence is a serious problem within the sport, but also whether the condition plays a hand in its occurrence. What can be said is that the changes in mood caused by CTE could certainly contribute to such acts. 

Even more tragically, with it only being able to be discovered posthumously, it may be a long time before we know the true extent of its grasp in the minds of fighters.

CTE from the Perspective of an Amateur Fighter

To gain a better understanding of how such a glaring threat can affect the choices of an up and coming fighter, I spoke to amateur mixed martial artist Isaac Hassen about his own perspective on the condition as well as how it is perceived in the wider community by fellow athletes.

I opened the interview by asking about his awareness on the issue prior to starting out in his career.

“Honestly starting out I had the slightest idea what it was. I kinda had to do some research. The farther I got into the fight game the more I started looking up certain things about it and things it could do to my future and how it could negatively affect me. I haven’t learned a ton about it but I’ve learned enough to know that its really important to keep from getting hit a lot in the head”.

It was then revealed to me that Hassen had actually had the fortune of briefly discussing CTE with a doctor prior to starting his career in mixed martial arts. 

“I mean I’ve had a doctor somewhat talk to me about it because I wrestled throughout high school and I got slammed pretty bad on my head. He basically explained the things that could happen in the future if you keep doing stuff like this”.

Photo by Dynasty Combat Sports

The conversation mentioned here is something that many veterans of the fight game would not have had the opportunity to have. However with the issue of CTE being more prevalent than ever across the combat sports spectrum, it is likely that fighters will enter their careers educated on the subject.

Evidently the potential risks were not enough to stop Hassen from pursuing his goals. Explaining to me that despite the concern always being there, the potential financial gain largely outweighs the dangers fighting can bring.

“I feel like as a fighter there’s gonna be a concern but as you get to the higher levels such as the UFC and stuff like that. The thought process is gonna go down so much more because of the contracts you’re gonna sign and the amount of money you can make. And like, well – head damage in 20 years or $20,000 bonus tonight if i fight. I really feel like the money is going to persuade them the one way”.

He later went on to clarify that if he started noticing signs of the disorder in everyday life, he would almost immediately take the necessary action to prioritise his own wellbeing. 

“One hundred and ten percent. If I started seeing an effect in my day to day life then I would definitely start talking about it more and I’d get out of the fight game and probably coach high school wrestling or something like that”.

In this way, Isaac’s outlook differed drastically from some of the comments I’d seen made by certain fighters online. Part of me believes that this is due to the fact even at a young age and early on during his tenure in combat-sports, he had some form of education on the matter. When I asked him about why it is still stigmatised by the fighting community, he explained to me that in large part it’s because of the fear of losing work, as well as the pridefulness that fighters possess.

“Without a doubt it’s about pride. If you tell somebody you have it or have developing signs of it, and you’re under the contract for say the UFC – there’s a high chance that Dana could cut you because you’re going to become a liability after a while. You’re not going to fight how you should and the outcome could be horrible. Dana isn’t going to keep someone like that on his team”.

The stigma we spoke about here is not something that he believes will go away anytime soon, regardless of the increased information now on offer.

“Most definitely the stigma is going to stay. Personally I believe that if you’re going to start fighting a combat sport, I feel like that’s something you should talk about in the beginning. I don’t think a lot of people would take that risk, but then you have the few who probably would. But at the end of the day that’s on them – if they chose to do it then they chose to do it. I think the number of fighters would drop drastically if they realised what could really happen to them”.

Leaving the interview, it had become clear to me that Hassen had clearly given the topic thought. He answered the questions with a clarity that showed his understanding of the topic, as well as how it is viewed in the community as a whole. Giving me a far clearer insight into how a fighter might approach such a cause for concern in their career.

A Destined Peril?

A connection between combat-sports and the development of CTE in its athletes is undeniable. In only 2012, Gary Goodridge became the first notable professional mixed martial artist to claim to have the condition. As the years pass it will become worryingly apparent that he will not be the last to succumb to the effects of an extensive and hard fought career. 

The cases of veterans such as Fisher and Goodridge are living proof that a life of fighting does not always put you in the clear once retired – organisations should be obligated to do more. There is no denying that since their inception, the sports of boxing, mixed martial arts and so forth are infinitely safer and more safeguarded than when first created. It is arguable that for some fighters, CTE is inevitable. This does not, however, mean that there is no room for improvement in regards to how the subject is handled by the community. 

Athletic commissions and organisations are well aware of what risks combat-sports bring and it should be their responsibility to educate fans as well as practitioners of what dangers their sports pose. With data and research more accessible than ever, it would be beneficial for them to now approach the issue head on and bring awareness to the issue, as opposed to letting it linger over the livelihoods of potentially uneducated fighters – attempting to make a living.

By Ben Matthews

Aspiring journalist in the UK. Currently studying for a degree in Journalism and Publishing from BSU.