Without legislation demanding that MMA promoters implement medical provisions to a basic standard, a voluntary organisation has been working with some UK shows to ensure that things are up to scratch.
Formed in 2012, Safe MMA is a not-for-profit voluntary medical project dedicated to the protection and safety of mixed martial artists in the UK and the Republic of Ireland and is the only organisation of its kind. Housed at The Centre for Health and Human Performance in London, Safe MMA’s medical team is head by a dozen doctors who are some of the country’s leading experts in the fields of sport and exercise medicine.
Safe MMA’s primary role is as a standardised and voluntary fighter registry and clearance system, along with a public active medical database outlining fighters' current medical statuses. Promotions and federations partner with Safe MMA and pledge only to book fighters to compete who are registered to their database and have been medically cleared for competition. In order to become registered, fighters must at least provide a valid annual medical examination by a doctor along with six-monthly blood tests, and must also pay a registration fee which covers their administration costs and is the only revenue coming into the project. Currently there are nearly 200 professional and amateur fighters registered to their database who would be cleared to compete today, unless they are subject to a medical suspension.
The aforementioned fighter requirements equate to Safe MMA’s most basic standard known as Mark 1, but there are also two higher standards that a promotion may demand from their fighters known as Mark 3 and Mark, with the idea being that Marks 2 and 4 would be determined down the line.
M1:
A yearly medical examination
Six-monthly blood tests
Pre and post fight medical examinations (at event)
M3:
A yearly medical examination
Six-monthly blood tests
Pre and post fight medical examinations (at event)
Dilated pupil eye-tests
One-off MRA of the brain
MRI of the brain every 3 years
M5:
A yearly medical examination
Six-monthly blood tests
Pre and post fight medical examinations (at event)
Dilated pupil eye-tests
One-off MRA of the brain and neck
Yearly MRI of the brain
“What became clear is that there’s probably a middle ground that people wanted,” said Yoni Gottleib, Records Manager for Safe MMA. “So we worked with those promotions to try and see what would best serve them and now we’ve got 3 marks, and I was quite keen them to call them Marks 1, 3 and 5 in order to make them uncontroversial and flexible. The reason being that one of our promotions might come along, take for example BAMMA who co-promote shows with Bellator, and because Bellator have EKG heart monitors, they might say let’s add those in, and we could call that say, Mark 4. So at least everyone knows what we’re talking about.”
Currently, Safe MMA are partnered with just 8 active UK promotions to at least the basic Mark 1 standard, including founding promotions BAMMA and Cage Warriors. They also medically clear athletes for international promotions who host events in the UK such as Bellator of the US and Poland’s KSW, and through their partnership with the International Mixed Martial Arts Federation (IMMAF), they have medically cleared all athletes competing at their amateur tournaments across the globe since 2015.
However, across the Irish Sea, Safe MMA Ireland have medically cleared all events held in Ireland since the tragic death of João Carvalho who passed away in April 2016 from an acute subdural hemorrhage from blunt force trauma to the head following a bout in Dublin. The government came under huge external pressure to ban the sport and the Irish Mixed Martial Arts Association (IMMAA) needed to demonstrate its ability to regulate the sport with the inclusion of agreed medical standards (what became M5).
“Safe MMA already had a strong presence in Ireland,” said Yoni. “One of the medical team Prof Dan Healy, who himself is a neurologist, and I think is also the team doctor for John Kavanagh’s team over at SBG, so he’s kind of in the sport and supported. There was a lot of fallout, understandably from what happened last April and there was lots of talk about the sport being closed down or pushed underground, or there having to be much more rigorous pre-fight standards which is the stuff that we deal with. So they essentially put together a new standard which was endorsed by what became IMMAA and since then every bout, professional and amateur, have reached different standards which are much higher than what Safe MMA had initially said should be the basic minimum.”
IMMAA is still currently in the process of working with Sport Ireland to achieve recognition (this is a 3 year plus processs) and therefore has not obtained regulatory powers. However, in the wake of Mr Carvalho’s tragic death, local councils and venues now require promoters to prove that they have an M5 Safe MMA standard of safety procedures in place in order for them to host events.
“In the UK it’s been more difficult, said Isobel Carnwath, Director of Brand, Marketing and Communications for IMMAF, who also is also involved in the administrative management of Safe MMA. “I think the biggest blocker has been cost. A lot of people pay lip service to wanting to make their show safe, and there are some promoters who will implement blood tests and have properly qualified doctors cage-side and so on, but perhaps either don’t see the value in the independent service, or a lot of promoters are frightened of losing the best fighters or relationships with gyms to other promoters. So I think there’s a view by some that it’s a tax on fighting, whereas the more forward thinking promoters, fighters, and the more professional end of the sport understands the value, the importance, and the limitation of risk.”
"You may have to fight at least three times before you start making a profit, and that's not even taking into account training fees and stuff."
A key reason that some promotions choose not to partner with Safe MMA is that it can become difficult to book fighters because the cost of registering with Safe MMA and carrying out the necessary medical tests is typically incurred on the fighters. Costs range from between £200 (M1 standard) and around £800 (M5), and includes the Safe MMA registration fee which are £40 annually for an amateur, and £135 for a professional.
“Some of the low-level guys are only getting maybe £300 or £400 to fight,” said fighter Jack Mason who is also the head coach of BKK Fighters and co-promoter for British Challenge MMA (BCMMA). “So you may have to fight at least three times before you start making a profit, and that’s not even taking into account training fees and stuff. It becomes a barrier to the shows that are doing it because there are lots of other shows that don’t do it, so the fighters are more attracted to fighting on those shows because it doesn’t cost them £800 or so to get their medicals. Obviously being sensible, you’d think that the fighters would rather look after their safety but when it comes to £800, a lot of people would rather risk it than not.”
With MMA yet to be recognised by UK Sport, the government’s department for directing the development of sport in this country, there can be no official governing body for MMA in the UK. The United Kingdom Mixed Martial Arts Federation (UKMMAF) hopes to one day become UK MMA’s ruling organisation but that cannot happen until the government chooses to recognise the sport. Should that happen, we could see a similar situation like we have in Ireland where all events would be sanctioned by Safe MMA (although still not legally binding) in conjunction with UKMMAF. Thankfully we are yet to see an MMA related tragedy take place in the UK, and hopefully it does not take one to occur for this stride in fighter safety to take place.
“If we are as professional as we aspire to be, said Yoni. “They may turn around to us and say, that’s a bona fide organisation that withstands third party scrutiny, why not carry on as you are?”