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Mixed martial arts (MMA) is one of the fastest growing sports worldwide, and recently surpassed boxing as the most popular full-contact sport in the United States.1,2 Although MMA is relatively new, an informal search (2015) using the terms mixed martial arts with Google’s search engine produced 24,700,000 results!

However, despite the proliferation of general information on MMA, there is limited high-quality evidence available to inform clinicians and strength and conditioning specialists about the sport. A recent PubMed search (2015) using the terms mixed martial arts yielded a mere 83 references.

Because few readers are likely to be familiar with MMA, the first part of this chapter provides general information on the sport, including the history and rules and regulations. The second part of the chapter includes a brief overview of some of the more popular MMA fighting styles. The epidemiology of MMA injuries is covered in the third portion, and the final part of this chapter contains key strength and conditioning and performance enhancement concepts for the mixed martial artist.

Historical Background and Development

Although interest in MMA has skyrocketed over the last two decades, the combat sport pankration, which was introduced into the Greek Olympic Games in 648 BC (Fig. 16.1), featured a combination of grappling and striking skills similar to modern MMA. As with MMA, pankration athletes utilized a variety of takedowns, chokes, and joint locks. In its current form, MMA has evolved out of an effort to determine the style of martial arts that is most effective in a real fight. In the late 1960s and early 1970s, the concept of combining multiple martial arts elements was popularized by Bruce Lee through his system of Jeet Kune Do. A pioneer of MMA, Lee believed that the best fighter was not a Boxer, Karate, or Judo athlete, but instead an individual who could adapt to any fighting style. According to Ultimate Fighting Championship (UFC) President Dana White, Lee studied techniques from many different disciplines, adopted those that were effective, and discarded the rest.3


Timeline of major events in the evolution of MMA. (From Mixed martial arts. Wikipedia. Accessed June 5, 2015. Text is available under the Creative Commons Attribution-ShareAlike License.)

The first regulated MMA-type fights in the United States, billed as “Tough Guy Contests” and later “Battle of the Superfighters,” occurred in Pennsylvania in 1980. In 1983, however the Pennsylvania State Senate passed a bill prohibiting these contests. In 1993, MMA was reintroduced in the United States by the UFC. The sport gained international exposure and widespread publicity when jiu-jitsu fighter Royce Gracie won the first UFC tournament, submitting three challengers in a total of just 5 minutes. Brazilian Jiu-Jitsu is largely credited for bringing widespread attention to ...

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