Mixed martial arts (MMA) is a combat sport that has gained much popularity in recent years (11). Although rule sets vary, currently the dominant sport seen worldwide came into existence in April 2001, when the American state of New Jersey created the Unified Rules for MMA (http://www.leg.state.nv.us/NAC/NAC-467.html). It is important to recognize that although MMA in its current form is a new sport, combat using similar elements has been practiced and competed in since (at the very least) the classical period of ancient Greece (32). MMA's key characteristic as a combat sport is the freedom given to the competitors to fight in almost any way they see fit. Initially, this freedom in the current form of MMA attracted a variety of athletes skilled in single disciplines of combat, using their specific styles against others using different styles (9,22). As the sport has matured, a specific and discernible combat sport has emerged, taking aspects from other combat sports and blending them into a unique multielement combat sport. But, despite its growing popularity, MMA appears to have generated little scientific research.
Specifically lacking is an exploration of the possibly unique physiological profile of MMA athletes. This review will attempt to provide insight into such a physiological profile by examining current peer-reviewed research in MMA and breaking the sport into easily categorized parts and analyzing sports that use similar components of fitness. It is hoped that such information will provide some underpinning for evidence-based assessment and conditioning practices.
CURRENT PEER-REVIEWED RESEARCH INTO MIXED MARTIAL ARTS
SportDiscus, Google Scholar, Pro Quest, and Medline databases were searched with the keywords and phrases: Martial Arts, Mixed Martial Arts, MMA, No Holds Barred, UFC, and Ultimate Fighting Championship. Of the limited studies found, the majority were associated with 1 of 2 general foci. The first is the sociological and psychological research and commentary on the violence of MMA. The articles cover a wide spectrum that includes outright condemnation of the sport (16,55), to more impartial commentaries (22,51), and even articles that can be seen to take a celebratory view of the sport (26). The second major focus of the MMA research found was on the injuries related to competition in the sport. These articles either trended toward longitudinal studies on injury rates (7,14,42) or looked at MMA-specific movements and techniques for the potential to injury (6,24,37).
Only 6 peer-reviewed works were found that examined MMA from the perspective of performance-related exercise science. The most recent peer-reviewed article on MMA was from Bounty et al (11) published in the Strength and Conditioning Journal. Titled “Strength and Conditioning Considerations for Mixed Martial Arts,” the article aimed to provide training recommendations for strength and conditioning coaches of MMA athletes. The authors developed these recommendations by examining some of the current research into MMA, specifically the work of Amtmann examined later in this article, and current studies into other combat sports.
Amtmann et al (4) provided an analysis of the current understanding of the bioenergetics systems in MMA through research on blood lactate response to MMA training and fighting, as well as other research into various combat sports. This analysis produced general recommendations by the authors to use high-intensity intervals for training of MMA athletes based around either the fitness of the athlete or the specificity of MMA rounds and rest periods. Not included in the considerations for bioenergetic training is any recommendation for aerobic training, a necessary, if perhaps, secondary system to the anaerobic systems in MMA.
Other considerations for MMA discussed within Bounty et al (11) are the importance of cervical spine stability, as addressed specifically in both MMA literature and research into other combat sports, specifically wrestling and a need for isometric strength in the various holds found in MMA. Additionally, the article provides recommendations for strength, power, speed, and recovery for MMA athletes. These sections of the article provide guidance using appropriate data from current strength and conditioning research. A limitation in this guidance is that the sources used only one article that has any connection to combat sports. Although the other references in these sections are valid and the general physiology does not change drastically between the rugby players in the cited study by Kilduff et al (36) and an MMA athlete, with so little specific information on any combat sports, specific research into the demands and best practice of training an MMA athlete is needed before these training recommendations can be considered sport specific.
Another recent conference poster on MMA was published in Medicine & Science in Sport & Exercise (28). A physiological profile of 8 MMA fighters of undisclosed experience was examined. The authors looked to compare the profile of MMA fighters to that of elite judo, kung fu, and wrestling athletes. The poster did not include information about where the data on the other athletes was gathered from and only contained data about the sports in relation to MMA. Included in the poster was some of the methodology used and results found for the MMA athletes. The athletes were tested for body composition, mean total body fat (13.29 ± 4.22%), vertical jump height (58.42 ± 5.84 cm), flexibility (29.91 ± 9.04 cm), grip strength (91.5 ± 6.51 kg), o2max (53.44 ± 5.77 mL/kg/min), and 1–repetition maximum (RM) squat and bench press, relative strength for squat (1.45 ± 0.2%) and bench press (1.25 ± 0.14%). It is important to note that no protocols were included for any of the above tests. Results of the study found that MMA fighters were the most physiologically similar to judo players and least similar to kung fu athletes. This work appears to provide valuable insights into the physiological profile of MMA athletes even with its limitations.
Also published in 2010 was a pilot study comparing the physiological profiles of MMA athletes with those of a group of traditional martial artists practicing karate. The study by Braswell et al (13) examined 6 professional and amateur MMA fighters for their body composition via bioelectrical impedance, flexibility with the sit and reach test, leg power by vertical jump, muscular endurance testing 1-minute push-up and sit-up repetitions (reps), grip strength with 1-kg plate hold, upper-body muscular strength via 1-repetition bench press, and o2max. The results of the study found that except for a leaner body composition and a trend of greater aerobic fitness in MMA fighters, the profile of the martial artists was similar. Unfortunately, in its published form, the study produced only an abstract. As a published abstract, no results of the tests performed on the athletes were listed, and although the conclusions of the study were covered in the publication, for the purpose of this review, the information available does not appear to provide sufficiently detailed insight into the physiological profile of the MMA fighter.
The other 3 articles found were all written in part by the same author, Amtmann. Amtmann's first study, “Self-reported training methods of mixed martial artists at a regional reality fighting event” (3), examined 28 athletes using a survey at a regional event in Montana. Amtmann was a competitor in the event and knew the majority of the fighters' coaching staff personally. This was cited as a strength of the study, increasing the trust of the subjects and a possible reason for the 100% completion rate of the survey. The survey was given to the majority of the fighters immediately after the rules meeting, before their bouts. Four fighters did complete their surveys via mail, as they did not attend the rules meeting.
The results showed a wide variety of resistance training protocols and MMA training plans, including several athletes who did not participate in resistance training at all and others who participated in resistance training 7 times a week. Competitors were likewise found to have a wide variance in MMA-based training, running from 3 sessions per week to a maximum of 12 sessions per week. Half of the athletes surveyed did not report neck-specific exercises. Amtmann contends that this is an issue and cites studies claiming that neck exercises are important to reduce injury. Additionally, 5 of the fighters reported that they had used or were using anabolic steroids; this fact combined with the lack of neck exercises identifies not only performance-affecting issues in the potential training styles in MMA but also a serious lack of safety knowledge. Although the sample size for this study was small, it could be contented that it does serve as an appropriate representation of the wide variety of training currently used by MMA athletes. This variety could in part be due to a lack of definitive research on the physiological demands of the sport.
The second study by Amtmann et al (4) focused on the rate of perceived exertion (RPE) on Borg's category scale and blood lactate levels in response to training and competition in MMA. The research attempted to develop a training protocol that would produce a similar lactate and RPE response to that found in athletes competing in MMA. Four athletes were initially tested using interval training mimicking “MMA-specific actions,” two 4-minute sparring sessions, and cycling sessions based off of the Tabata cycle ergometer protocol (53). After the interval training sessions, a total of 6 subjects (2 additional athletes were added to the initial 4 test subjects) were tested for lactate and RPE after competition in a “national-level” MMA bout. Consideration must be taken at the mention of a national-level event in the research, as the fragmented nature of competitive MMA can result in entry-level amateur competition comprised of many first-time competitors.
The majority of the fighters tested were first-time fighters and amateurs, yet fought at a national event. This could indicate that the true fitness and skill of the fighters tested may not be reflective of that seen in the upper echelons of the sport. Results of the study showed that lactate and RPE produced in training (8.1–9.7 mmoL and 15–19, respectively) were similar to those found after competition (10.2–20.7 mmoL and 13–19, respectively). Any variation seen in the postbout lactate testing can be in part explained by the diversity in bout stoppage times, with some fights completing regulation time and others ending quickly in the opening rounds. Perhaps as important as the ending times of the bouts, the fighter's assorted ages, from 21 to 41 years, and training age, undisclosed in the study, could also account for the range of lactate levels found. The limitations of the research are obvious: only 4 total subjects in both the training and the postbout testing, the variety in bout ending times and outcomes, and age issues. Despite the limitations, as one of the only true works of research into the physiological demands of MMA and the physiological profile of MMA athletes, it could be contended that this article provides key insights for those involved with the conditioning of MMA competitors.
The final article written by Amtmann and Berry (2) was a guide for strength and conditioners of MMA athletes very similar to that of Bounty et al (11). The foci of the article were metabolic conditioning and strength training for injury prevention. When examining injury prevention, Amtmann and Berry point to the anterior dominant nature of the upper body when engaged in MMA. They suggest that the recommendation found in Essentials of Strength Training and Conditioning (57) should be followed for exercise prescription with a ratio of 2 movements for shoulder flexion for every 3 movements of shoulder extension prescribed, the goal being to prevent muscle imbalances that can predispose athletes to injury. Amtmann and Berry also strongly suggest that trainers integrate a strength training program for the neck to protect against cervical injuries that appear to be a risk in MMA bouts (37).
When prescribing training protocols, Amtmann and Berry attempt to take into account both the unique bout lengths, multiple 5-minute rounds found in MMA's Unified Rules (http://www.leg.state.nv.us/NAC/NAC-467.html) and the often short preparation time that has become synonymous with MMA. A 10-minute “sport-specific” circuit was designed to mimic the demands found in an MMA bout.
The circuit focused on body weight resistance movements, such as free squats and pull-ups, as well as skill-related drills, such as shadow boxing. Issues can be raised with the recommendations made in the circuit and the term “sport specific.” The majority of exercises and drills found in the prescribed circuit were not power or speed-strength movements that are likely to be found in MMA bouts. Although the article does make mention of the importance of training for power, with Olympic-style lifts specifically suggested, there are no comments on any type of training for the repeated applications of power over extended periods, the training component known as power endurance. It may be conjectured that, of all the facets of training, power endurance may be the most important for an MMA fighter. Unfortunately, at this junction, any arguments for or against any general scientifically accepted training method is simply conjecture, given the paucity of research in this area.
COMPONENT SPORTS OF MIXED MARTIAL ARTS
Because of the lack of research into the physiological demands of MMA, if a strength and conditioning coach is to train with any scientific basis for the MMA athlete, one must look into the component sports for direction. One aspect of MMA that differentiates it from other sports is that, in each bout, competitors can, and frequently do, mix major aspects of other well-established combat sports, explaining the term “mixed” in mixed martial arts. For this review, they will be subsequently referred to as the component sports of MMA.
The component sports can best be grouped into 3 ranges of combat: standing strikes, clinch, and grappling. It is important to acknowledge that within the framework of the 3 ranges of combat, there is no set order or finishing point. A bouts begins standing but may go to the ground via strikes or the clinch, and then move dynamically between standing, clinching and grappling. It is also important to note that a bout can reach its ending in any range with strikes and submission holds applicable at almost all times (29).
Standing strikes, the range of combat in which the bout begins, is composed of punches, kicks, knees, and elbows. This range is commonly seen in the Olympic sports of boxing and taekwondo (TKD) and the popular martial arts of Thai boxing and kickboxing. There are no rules currently requiring the fighters from ever leaving this range, and many fights have had their entire duration in the standing striking range. If strategically viable for a fighter and within their ability, the striking range can transition into the clinch range via various techniques for closing distance between the fighters and grabbing the opponent.
The clinch can best be described as a standing grappling range of combat where competitors are in close contact while attempting body control of the opposing fighter and engaging in short strikes, such as punches, elbows, and knees. If a fighter chooses and is able, the fight can be brought to the ground via trips, throws, or takedowns. The most common striking style used in the clinch is Thai boxing, which uses powerful elbow and knee strikes from within the clinch (44). Boxing style techniques are used in the clinch as well although commonly termed “dirty boxing” because of the fact that current Olympic and professional boxing regulation forbids holding and striking in the clinch in both amateur (http://www.aiba.org/) and professional bouts (http://wbcboxing.com). Trips, throws, and takedowns used in the MMA clinch come primarily from the Olympic combat sports of judo and freestyle and Greco-Roman wrestling. The techniques in the MMA clinch do vary from the clinch found in other combat sports because of the changes in athletic apparel, such as the lack of the Gi, which is required as per the rules of the International Judo Federation (http://www.intjudo.eu/Rules), which plays a major role in judo and the obvious addition of strikes.
If a fight reaches the ground, the third range of combat, grappling, begins. When grappling, the competitors engage in holds, pins, and other controlling measures. Simultaneously, in Unified Rules bouts, the athletes are allowed to punch and elbow each other to the head and body as well as knee and kick to the body. These added striking aspects allow grappling in MMA to vary widely from grappling in its related component sports, much more than that seen in striking and the clinch. Despite the divergence from the original combat sports, MMA grappling still draws heavily from the Olympic sports of freestyle and Greco-Roman wrestling and to a lesser extent current Olympic judo. Other stylistic influences come heavily from Brazilian jiu jitsu, as well as the Russian art of sambo, submission wrestling, traditional judo, and the protoforms of wrestling known as “Catch as Catch Can” wrestling. The difference between traditional and Olympic judo occurring in international rules focused on less time on the ground and more on high-amplitude throws (17).
By breaking down MMA into 3 distinct but interchangeable ranges of combat and then breaking those ranges into the component sports, we are now able to search a far greater library of information for insights into the physiological profile of the MMA athlete. Although not the perfect answer for questions regarding the optimum profile, current academic research into the component sports will serve to inform the analyses and conclusions found in this review.
ANALYSIS OF COMPONENT SPORTS
CLINCH AND GRAPPLING
Wrestling is perhaps the oldest combat sport known to man. Evidence found in an Egyptian tomb shows the existence of the sport at the very least as far back as 2300 bce (18). In its modern form, wrestling is represented in the international sporting arena by 2 similar, but distinct, sports, Greco-Roman and freestyle wrestling. Comparative physiological testing between the 2 sports has found that although similar in many aspects, there are significant differences (5,27,60). Because of these differences, this review will examine the physiological profile of athletes for each sport separately and compare and contrast them.
When examining the research on Greco-Roman wrestling, variances, as expected, were found in the testing batteries performed by the various researchers. The greatest difference was found in the tests used by the Eastern European researchers when compared with others from around the world. Baic et al (5) included gymnastic movement tests, such as a maximal jump with turn for degrees of rotation, 808.39 ± 137.94° for Greco-Roman wrestlers, and backward handsprings, 2.99 ± 0.61 handsprings. Gierczuk (27) investigated gymnastic movements, passes on a balance beam, as well as rhythmic cycling, skipping tests, reaction tests, and grabbing a dropped Ditrich stick, forgoing tests found in the other articles. Comparatively, Rahmani-Nia et al (45) and studies explored by Yoon (60) choose to forgo gymnastic tests, instead focusing on characteristics such as maximal strength, muscular endurance, o2max, and body composition. Yoon's investigations also included testing for quickness and reaction time of the athletes. The articles reviewed produce the following comparative physiological chart of Greco-Roman wrestlers viewed below in Table 1.
With only body fat percentage tests being common among the 3 reviewed Greco-Roman wrestling studies, it is difficult to establish a profile of the sport. When viewed with the other grappling sports, the data found on Greco-Roman wrestling does serve to establish a greater profile.
In many ways, freestyle wrestling can be considered the more dynamic of the 2 wrestling sports. Results from Gierczuk (27) indicate that the freestyle wrestlers have greater dynamic balance when compared with Greco-Roman wrestlers, performing a greater number of passes on a balance beam than that performed by the Greco-Roman wrestlers. Additionally, a study by Baic et al (5) showed greater muscular endurance in the upper body of freestyle wrestlers than their Greco-Roman counterparts. This may be of importance in the context of MMA because the dynamic nature of MMA may require the athletes to have a physiologic profile more representing a freestyle wrestler than a Greco-Roman wrestler.
There is also a variant of freestyle wrestling known as collegiate wrestling or in some regional areas as scholastic or folkstyle wrestling. Collegiate wrestling is currently practiced in North America, particularly the United States. As the name implies, collegiate wrestling is primarily performed by school-aged athletes. The physiological profile of collegiate wrestling has been found to be similar to that of freestyle wrestlers. There exists substantial anecdotal evidence of collegiate wrestlers transitioning to freestyle with great success, as well as a general consensus found in the literature reviewed that the physiological demands of both sports are similar (35,39,60). In this review, testing data from both freestyle and collegiate athletes will be considered together in a single category and can be viewed in Table 2.
The profile of freestyle wrestlers that the data found establishes one of low body fat and strong strength levels that trend toward greater upper-body than lower-body strength. There is no consensus among the data concerning energy systems as both anaerobic and aerobic tests show variation. There is also variation in the total number of pull-ups performed but the high numbers found do point to a high level of relative strength to body weight. In the grappling results section, freestyle wrestlers are viewed in the greater context of the grappling and clinch range.
Judo is a combat sport originating from Japan created by Kano in 1882 (33). Drawing on the traditional martial arts of Japan, Kano created a competitive sport that has been part of the Olympic games since 1964 (33). Additionally, with such innovations as the colored belt ranking system developed by Kano (17) now ubiquitous across martial arts and combat sports, judo's impact on MMA cannot be overstated.
One point of difference that immediately stands out from the research found regarding judo is the focus on testing members of both genders. This can in part be explained by judo's long history of female involvement at elite levels and the inclusion of women's judo as an Olympic sport since the 1992 Barcelona games (46). This differs greatly from the majority of combat sports, where female involvement at an international level has been a more recent occurrence (46). This is especially true of MMA, where women have only begun major participation in the last decade. Table 3 displays the found physiological information on judo athletes.
Judo athletes showed similar strength trends to freestyle wrestlers when performing the Portico hack machine and bench press but trend the opposite displaying greater lower-body strength when tested on the leg press. Because of this fact, it is difficult to state categorically that judo athletes have greater upper-body strength than lower-body strength. A trend that does appear is the relatively high o2max levels found across the studies reviewed. This trend will be compared below with the other component sports.
GRAPPLING AND CLINCH RESULTS
Analysis of the results from the grappling and clinch component sports show several domains of similarity across the sports. The greatest similarities lie in the lower-body strength and power of the athletes. Vertical jump testing by Baic et al (5) of Freestyle and Greco-Roman wrestlers and Sertic et al (50) testing of judo competitors showed differences of scores that fell within each others' standard deviations. Jumps of 53.99 ± 5.63 cm were recorded for Greco-Roman wrestlers, 57.41 ± 7.68 cm for freestyle wrestlers, and 58.3 ± 5.4 cm for judo competitors. Both studies excluded the protocols of the jumps performed. A contrast in the research found in the grappling component sports was the study by McGuigan et al (39) on collegiate wrestlers, which found a mean jump height of 45 ± 4 cm, following the Bosco jump protocol. A potential explanation for this difference in scores may be due to the fact that the wrestlers tested by McGuigan et al (39) were in the NCAA Division III, a lower division in American collegiate athletics, whereas the athletes in the other studies were members of the Polish National Team (5) and “elite” Croatian judo fighters (50). Other reasons for the variance in results could be due to a lower level of demands for lower-body power in collegiate wrestling in general or it could be a miscalculation due to the possible variety of testing methods. In the context of MMA, it could be contended that the differences in McGuigan et al (39) are similar enough to the other studies in the review that when viewed as a whole provide insights into the lower-body power of grapplers. Likewise, lower-body maximal strength appears similar between the sports in the studies. Of those choosing to test lower-body strength with a maximal squat, Baic et al (5) found Greco-Roman wrestlers to have a slightly stronger squat than freestyle wrestlers, with reported squats of 111.71 ± 21.58 kg and 107.68 ± 23.27 kg, respectively, at mean body weights of 74.7 ± 14.8 kg and 74.5 ± 14 kg. McGuigan et al (39) found similar squat results in collegiate wrestlers with 105 ± 19 kg reported at a similar weight (78 ± 4.2 kg), whereas in judo, a squatting-like movement on the Portico hack machine provided similar indicators of lower-body strength with 104 ± 27 kg reported but at a much higher mean body weight of 90.6 ± 23.8 kg (25).
The greatest variation between the grappling and clinch component sports appeared in the upper-body maximal strength measurements. Greco-Roman wrestlers were found to have a bench press of 92.66 ± 18.71 kg (5), where in the same study, freestyle wrestlers' had a bench press of 117.44 ± 230.15 kg, and in the study by McGuigan et al (39), a mean total of 129 ± 19 kg was observed for freestyle wrestlers' bench press, all performed by athletes of similar weight. In the study that documented the highest level of upper-body strength, Sbriccoli et al (49) found judo fighters to have a bench press of 160 ± 29.8 kg, although the athletes tested by Sbriccoli et al (49) were the largest of the grapplers tested with a mean weight of 109 ± 29.3 kg. This wide range of results does not provide the potential refinement of the MMA physiological profile in the ways that the lower-body strength and power findings may provide.
Notably absent from this analysis of the grappling/clinch component sports are the sports of Brazilian jiu jitsu, sambo, and submission wrestling. The authors were able to find only 1 piece of research examining the physiology of these athletes. Costa et al (20) examined the 1RM bench press of a group of 20 male Brazilian jiu jitsu practitioners and the acute effects of static stretching. At their peak, before stretching, the subjects averaged 85.8 ± 17.8 kg lifted, the lowest of all the grappling/clinch component sports. With only one study found, it is not possible to understand the potential impacts that Brazilian jiu jitsu, sambo, and submission wrestling may have on the MMA athlete's physiological profile.
When performing these comparisons for grappling, the results of only the male athletes were included, as of the time of writing, there was no information found on any female Greco-Roman wrestlers, making comparison between the 3 sports impossible.
The combat sport of TKD arguably originated in Korea in the year 1955 (1). With a history dating as far back as the late 11th century (1), the martial arts of Korea and the surrounding regions served as the building blocks for the modern sport. After the sport's creation in 1955, it slowly evolved over several decades, eventually becoming the combat sport seen today, and as of the 2000 Sydney Summer Olympics, modern TKD has become an officially represented Olympic sport (34).
Of the striking styles investigated in this review, TKD is in many ways the least similar to that seen in MMA. The rule set of the World Taekwondo Federation limits strikes to specific areas (http://www.wtf.org/wtf_eng/site/rules/competition.html); kicks are only allowed to the body and head, whereas punches are only allowed to the body. This differs from virtually all areas being legal to strike in MMA (http://www.leg.state.nv.us/NAC/NAC-467.html). Protective gear is required when competing in TKD, covering the head, trunk, arms, hands, shins, and groin. In MMA, the only allowed protective gear is a mouthpiece, groin protector and 4-oz gloves. Finally, in TKD, there is a greater focus on landing strikes for scoring rather than landing a strike to damage an opponent. This differs greatly from MMA in that while scoring is still a viable tactic, the majority of strikes thrown have the intent to damage.
TKD is still important as a striking art in the context of MMA because of the unique nature of TKD style kicks, which may place different physiological demands on an athlete than those from other styles of kicking. As well, the extremely dynamic nature of TKD and advanced footwork used may provide insights into the demands of MMA, specifically when compared with the relative static nature of striking sports like boxing. Data found concerning the physiology of TKD athletes can be found in Table 4.
The key aspect of the physiological profile of TKD athletes that stands out is the similarity found in the mean watts produced by the 30-second anaerobic test, both of which show relatively high scores. As a primarily kicking sport with a focus on scoring strikes rather than damaging strikes (59), the results found in anaerobic testing appear appropriate. The rapid quick kicks require different energetics than that seen in more static component sports.
Kickboxing and Thai boxing
Kickboxing and Thai boxing are striking-based combat sports that are defined by their use of punches and kicks. Although currently there is no clear origin of the sports (15), they have developed popularity throughout the world. Many of the same issues that face MMA also face kickboxing and Thai boxing, regarding the lack of research into the physiology of the fighters. There was a lack of research found despite the fact that although very similar, kickboxing and Thai boxing can be considered 2 separate sports that individually could demand examination.
Of the striking styles explored in this review, kickboxing and Thai boxing are arguably the most relevant to MMA. All 3 of these sports use similar striking options, and when these options are viewed from a constraints-led perspective, the development of similar strategic motor learning can be seen (47). These constraints include the need to adjust the combat stance to block kicks to the lower extremities, a nonissue in TKD due to the rules of that sport, and the lack of ducking and other head movements that is seen in classic boxing, which can be dangerous due to the knees and kicks allowed in kickboxing, Thai boxing, and MMA. A comparative physiological chart of kickboxers and Thai boxers can be viewed below in Table 5.
Although the literature is very limited in this area, conclusions on kickboxing and Thai boxing display one important similarity, o2max results. These o2max results may be different from those found in MMA athletes because kickboxing and Thai boxing have relatively short bout times (15) that generally differ from the bout times found in MMA and both striking sports lack a grappling phase, which is a key component of MMA.
The research found investigating boxing is primarily focused on the potential injuries from participation in the sport (8). Particularly, there is a large body of study into traumatic injuries to the brain (23,56,61). This focus can in part be attributed to the very public health problems faced by prominent former boxers (54) and the general reluctance of those in the boxing world to accept innovation from those in the sports science community (12). Of the articles analyzing the physiology of the modern boxer, we found fewer concerning boxing than what was found for the other Olympic combat sports. There were 3 studies for boxing compared with 9, 6, and 5 studies included in the review for wrestling, judo, and TKD, respectively. Information for the 3 studies can be found in Table 6.
Included in the research reviewed is a case study by Morton et al (41) of a 25-year-old professional featherweight champion boxer. Potential limitations of the study include: a sole athlete was the focus of the article and the fact that the athlete was coming off a 3-month lay-off from training. Despite these limiting factors the case study was included in this review because the athlete in the study was a standing champion at the time of physiological testing and that the lay-off from training is common occurrence in the upper echelons of boxing. Similar lay-offs exist in the upper echelons of MMA as well.
Contrasting the results of the kickboxing and Thai boxing studies, boxers were found to have very high o2max levels in multiple studies. This, as in kickboxing and Thai boxing, is in part due to the bout length which is far longer in boxing (58) but could also be due to the folklore-style training prominent in boxing, which places an extreme emphasis on aerobic training (12). The general impact from boxing to striking as a whole can be seen in the Striking Results below.
When examining maximal oxygen consumption across the striking sports, direct comparison is difficult to make because the testing protocols used varied from study to study. These variations in protocol and testing equipment result in differences that may not be solely attributed to variance between sports. With such limitations acknowledged, there are several trends that can be observed from the collected data. Chan and Pieter (19) and Bouhlel et al (10) tested TKD athletes using the Multistage Fitness Test. Their results, however, were markedly different because Chan and Pieter (19) tested skilled “colored belts” who participated in TKD recreationally, whereas Bouhlel et al (10) examined members of the Tunisian national team. Testing showed that the subjects in the study by Chan and Pieter (19) had a o2max of 46.5 ± 4 mg/kg/min, whereas the athletes in the study by Bouhlel et al (10) had a significantly higher o2max of 56.22 ± 2.57 mg/kg/min. Although using protocols other than the Multistage Fitness Test, a treadmill, and cycling test, the results of the 2 groups of Thai boxers showed lower results than the elite Tunisian TKD fighters. Saengsirisuwan et al (48) found young professional fighters to have a o2max of 47.8 ± 0.9 mg/kg/min in cycling tests, and Crisafulli et al (21) found competitive Thai boxers to have a o2max of 48.52 ± 1.7 mg/kg/min when tested on treadmills. Of all the striking sports, boxers appear to have maximal oxygen consumption equal to or greater than that of the highest scores found in TKD athletes in this review. The results of Morton et al (41) show their champion boxer to have a o2max of 61.4 mg/kg/min in an unspecified test. Guidetti et al (30) showed similar results of 57.5 ± 4.7 mg/kg/min on treadmill tests.
In relation to MMA, these last studies may provide the most relevant information, as of the striking sports explored boxing's bout length is similar, 11 minutes in an amateur Olympic style bout (30) to that of 15 minutes in an MMA bout. If an estimation of the o2max of MMA athletes is to be made, one would assume, with similar work rates, that it would be closer to that of a boxer than that of a Thai boxer or kickboxer. As with the comparison of grappling, there were limited data found on female participants and as such we were unable to synthesize any comparison between female athletes in the striking sports.
DISCUSSION OF COMPONENT SPORTS RESULTS
When looking at the examined component sports as a whole, the age of the athletes was found to be less than 30 years, with the majority of athletes being younger than 25 years. This differs from MMA because the top athletes tend to be older than 30 years. For example, 4 of the last 6 light-heavy weight champions of the Ultimate Fighting Championship have been 30 years of age or older. This age distinction may influence the physiological profile of MMA fighters from those of the examined component sports, but research is needed to substantiate such a claim. The training experience of the athletes in these studies was in general more than 5 years, and the athletes were identified as being of a high level of skill, which may or may not be comparable with that of professional MMA fighters.
Across all the athletes examined in the studies, there are several commonalities of interest. The body composition of the athletes fell in a similar range with mean body fat percentage between 8.6 ± 0.6% (48) and 16.3 ± 4.4% (31) for men and 16.5 ± 2.7% (38) and 28.7 ± 1.5% (43) for women. The exception was the study by Pieter and Bercades (43); male subjects averaged 26.8 ± 7.4% mean body fat. Also of note, there was a multitude of equations used to calculate body fat in the studies found, and any direct comparison between findings is inappropriate. Still, a general understanding of the low endomorphy of combat sport athletes can be gathered from the results found. Vertical jump testing, although less common among the literature reviewed, was found to contain notable similarities because of the 5 tests performed, 3 were above 50 cm and were within the standard deviations of each other.
These results show general trends that could be expected to be seen in the profile of MMA fighters. Although further research is needed, the data found could provide a greater understanding of the MMA athlete.
Some of the researched results showed less apparent consistency between component sports. Maximal strength testing found that the strength levels in the upper body tended to be greater than lower body in several studies, including the study by Pieter and Bercades (43) on female TKD athletes, McGuigan et al (39) on freestyle wrestlers, and Franchini et al (25) on judo athletes. Several studies showed greater lower-body strength in the involved athletes, including the study by Markovic et al (38) on female TKD fighters, the case study by Sbriccoli et al (49) on judo fighters, and the study by Baic et al (5) on Greco-Roman wrestlers. Except for studies of wrestling, no other researchers chose to test their subject for maximum pull-up reps, and as such, this measurement must be left out of any comparison. These inconsistencies do little to build an understanding of the relationships between the component sports let alone help form views on an MMA physiological profile.
The majority of results found in the comparison of the component sports vary widely from sport to sport. The greatest of these fluctuations occurred in energy system data. The testing found for mean anaerobic power showed a large amount of variation, with the lowest of the cycle tests showing results of 455.0 ± 87.6 W (40) and the highest showing a score of 724.53 ± 147.16 W (52). Looking at the scores of other component sports, wrestling was on the lower end, whereas judo and TKD tended to show the highest scores.
Maximal oxygen consumption was found to be varied across the majority of the component sports, with wrestling and boxing showing the highest levels, 60.24 ± 5.13 mg/kg/min (60) and 61.4 mg/kg/min (41), respectively. The lowest o2max of the elite athletes was that of judo fighters (47.3 ± 10.9 mg/kg/min) (49). But again, it is important to note that data in all these studies were generated with differing equations and protocols.
These results raise interesting questions when related to the physiological profile of MMA athletes because the levels of anaerobic and aerobic fitness may be similar to one of the component sports or could be a mixture of multiple sports. An estimated profile of MMA athletes could be argued to contain the strongest aspects of all the component sports, because an elite MMA fight would face similar challenges. In this regard, discovery is limited by an analysis of the component sports and to obtain any true understanding, again, further research is needed into the physiological profile of MMA athletes and the demands faced by them.
At this point, any attempt to develop a complete validated physiological profile of the average professional MMA fighter based on the available data is not possible. Current sport science research has not explored MMA at any detailed level, and even with the large amounts of research into the component combat sports, shared data patterns may not transfer to MMA. There are a few qualities that appear to be relevant to all combat sports, for example, similar somatotypes, but of the explored data no clear pattern develops. This review although unsuccessful in developing an in-depth understanding of MMA does help to provide a greater understanding of the component sports and solidifies an argument for the need for quality research into the sport and the athletes who compete in it. This will be of special importance as the sport moves into the future and MMA develops into what it indicates it will be, the premier combat sport of the 21st century. If sports science fails to effectively study and provide guidance in MMA, the sport could fall into the folklore-style training methods that have historically dominated other combat sports.
The authors thank Luigi Bercades and Willy Pieter for their guidance and help in the early stages of the writing of this article.
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