In a sport where the aim is to cause disabling injury to an extent that the opponent cannot continue, various injuries including broken jaws in mma are common. In mixed martial arts, with a large percentage of strikes aimed at the head and face it is a surprise that there are not more serious facial injuries. In fact facial injuries occur in only 10.1% of MMA matches according to Ngai et al. (2008) who examined 1270 fights over a period of 5 years and published his findings in the British Journal of Sports Medicine.
In the last month UFC heavyweight Stefan Struve and former UFC heavyweight champion Andrei Arlovski, now fighting for World Series of Fighting, have both suffered serious jaw fractures caused by their opponent’s strikes. The aim here is to discuss broken jaws in MMA (mandible fractures) as an area of potential injury and advise strategies prevent such injuries.
The jaw consiststs of the jaw bone (the chin) and its connections either side to the skull; also known as the temporomandibular joints (TMJ). These are the joints where the jaw bone (mandible) and the larger part of the skull (temporal bone) meet. It is a prominent protrusion from the front of the face and as such is generally an area to aim for when striking in combat sports. It has a complex anatomy including cartilage and a small disc, which allows it to slide and rotate and when dysfunctional can lock, dislocate or result in malaligment of your bite. Pain can refer into the neck, across the face or even cause headaches.
The TMJ is most stable in a closed packed position (when the jaw and mouth are tightly clenched). This stability is produced by strong bite which utilises muscles including the masseter, temporalis and pterygoid muscles. When contracted together the masseter muscles are one of the strongest in the human body according to the force it can apply.
Mouth guards, or gum shields, provide many benefits including shock absorption to lessen impact through the jaw. It is commonly thought that the main aim of gum shields is to prevent damage caused by the teeth of the lower jaw impacting the relatively softer teeth above. Whilst mouth guards do prevent some dental damage, the main aim is in fact to dissipate force from a strike landing on the jaw through the TMJ and into the cranium.
As mentioned, the preservation of stability in the jaw is by maintained by a closed bite. Biting into a mouth guard allows a greater dissipation of force and prevents excessive motion of the lower jaw which can help prevent broken jaws in MMA. This is also considered important for prevention of concussions.
Sudden movement of the jaw with subsequent rotation of the head and neck, is thought to cause activation of nerve fibers sending an excitatory wave across the ascending reticular activating system (ARAS)- a key area of brain stem neurons which are involved with inhibition of brain activity. This can cause a disruption of neuronal activity large enough to result in loss of consciousness (credit marvin). Therefore, the combination of isometric masseter contraction and isometric cervical spine (neck) musculature stabilizers (e.g. scalenes, trapezius, levator scapulae, sternocleidomastoid), are essential to counteract the force transferred from a strike. A mouth guard can work as a shock absorber to further prevent this effect.
– Do some of your strength and conditioning with the mouth guard in place. The guard won’t work if you are poking it out because it’s stopping you breathing.
– No gaps! Fit is everything! The greater the guard fits the contours of all of your teeth, the better. This means custom- made is far better than Boil & Bite
– Always have a spare. There is no excuse for sparring or competing without a mouth guard securely in place.
– Isometrically strengthen your neck muscles into extension, side flexion and rotation
– Develop your bite strength- use an old mouth piece to provide resistance to strengthen your masseter muscles or statically hold the jaw as you apply pressure on either side
As always, Stay Healthy & Keep Fighting!