By Dr. Pamela Fernandes  |  16 January 2021   

MMA athletes are prone to head trauma. Since concussions have no immediate side effects, most athletes continue to play despite the bumps and falls. However, repeated head trauma can cause CTE (chronic traumatic encephalopathy.)

 Veteran fighter Renato Sobral, who competed for Ultimate Fighting Championship (UFC), Strikeforce, and Bellator MMA is already experiencing CTE at 43. He can’t even walk a straight line and had to call time on his career. As martial arts have become popular, the numbers of TKO’s and KOs have climbed sparking concerns about head trauma.

How to Prevent Head Injuries in Martial Arts?

Prevention is key while training in martial arts. Ignoring head injuries can be fatal. The family of Tim Hague filed a lawsuit against the sporting commission, doctors, and directors after a bout when he died following a cerebral hemorrhage. He was 34 years old. And while many find it controversial, his family argued, Tim should not have been playing given his history of multiple recent concussions and head trauma. His death could have been prevented.

There’s No Need To Get Hurt

Train hard but train smart. The goal for you as you train is to gain skills and wisdom.

Don’t let that be at the expense of your body and worse at the expense of your brain. As you train, protect your head. Try and avoid head injuries. The occasional slip is understandable but don’t allow yourself to become a punching bag.

If you’re moving and sparring, there’s a chance that you take a hit to the head or fall awkwardly and bump your head against the floor.

You can protect your head by staying on guard. Keep your chin down, jaw closed, and one hand up at all times. Don’t make it easy for your opponent to hit your head.

Choose Your Training Partners and Instructors Carefully

We cannot stress this enough. You need to select the dojo, the teacher, and your training mates wisely. Your dojo must be a place that prioritizes safety. Your instructor must be able to reign in students who are too aggressive or have a “win at all costs” mentality. Your mates must be concerned about their own and your well-being.

Concussion Knockout | Fighting Arts Health Lab

If you are at a dojo where you’re punished or laughed at for an injury or fall, then run and don’t look back.  Avoid sparring partners who are just there to vent or even over-enthusiastic amateurs. There are plenty of folks on the forums who have developed life-altering injuries because these newbies do not understand the importance of safety and the basis of martial arts.


If your art form allows headgear, then wear protective headgear, mouthguard, and helmets. Train on mats and protected floors. Gloves and padding may mitigate the impact of head trauma.


Practicing the right technique is important in martial arts. In many aikido dojos, the first few months of training only involve learning how to fall and roll. This is to protect the head and neck regions from injuries. Spend time learning the right technique even if it seems repetitive. Additionally, ensure that your training partners have good technique.

Sit Out

Any mild head injury or head contact needs a break from play. The golden rule for head injuries is when in doubt sit it out. If someone has had head contact and is slightly unsteady, has slower reaction time, or has headache or nausea, then stop play at once and send him or her to the emergency room.

If you have a hit on the head, you’re done for the day. That’s it. No more fighting! How long you sit out depends on the grade of the concussion and head injury. Removal from play has proven to be the strongest predictor of a fast recovery.  

Return To Play Guidelines

After sustaining a head injury, follow the return to play guidelines. The CDC has a detailed 6 step return to pay guideline for all those who have a head impact, concussions, and brain injury. The HEADS UP program recommends that an athlete should only move to the next step if they do not have any new symptoms. If symptoms come back or if he or she gets new symptoms, this is a sign that the athlete is pushing too hard and needs to rest again.

Six Steps of the Return to Play Guidelines:

step 1

Back to Regular Activities

Athlete resume activities in a methodical manner

step 2

Light Aerobic Activity

Start with light aerobic exercise only to increase heart rate. This could be 5 to 10 minutes on an exercise bike, walking, or light jogging. No heavy lifting at this point.

step 3

Move to Moderate Activity

Continue with activities to increase heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting.

step 4

Intensify with Heavy, Non-contact Activity:

 Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills in 3 planes of movement.

step 5

Incorporate Full Contact into Heavy Practice

Return to practice and full contact in controlled practice.

step 6

Participating in Competitions

Return to competition. If any post - concussion symptoms occur while in the stepwise, discuss those new symptoms with your healthcare professional to ensure proper treatment. 

Use Your Peripheral Vision

Developing a peripheral vision is a skill. High-level athletes have very wide peripheral vision. It involves taking the focus past your opponent. Those athletes using direct vision tend to be slower or get hit immediately. While those athletes that use peripheral vision can avoid attacks to the head and spot attacks far earlier than others. This will protect your head from injuries.

Heads Up

Long-term side effects of head injuries result in memory loss, behavior changes, depression, and other neurologic deficits. Repeated head trauma can result in all of these and irreversible brain damage in the form of CTE (chronic traumatic encephalopathy).

You can watch the movie Concussion starring Will Smith if you’d like to learn more about this condition. Renato Sobral says, “The guys that start fighting have to know that the price to pay will come one day.” Now blind, and with zero balance he’s already dealing with CTE and wants fighters to know what they could lose due to head injuries.

Head injury is preventable. Protect your head at all times. If you have any tips to prevent head injuries let us know.

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About the author

Dr. Pamela Q. Fernandes is an author, doctor and medical writer. Born and raised in Kuwait, she graduated from Angeles University College of Medicine, Philippines in 2007. Soon after that, she started her career as a medical writer and physician. Pamela is an advocate of preventive health, rural medicine, women’s health and tele-medicine having been active in these roles for the majority of her decade long career in medicine. She an Aikido practitioner. You can find out more about her at https://www.pamelaqfernandes.com.

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