Identifying High-Risk Combat Sport Athletes: Position Statement of the Association of Ringside Physicians

Abstract

Criteria that identify combat sports athletes with significantly increased risk of injury and mortality in combat sports competition include the following:• Age younger than 13 years or older than 35 years (LOE V).• Three consecutive losses, particularly by KO/TKO (professional) or Referee Stops Contest (RSC) (amateur) (LOE III).• Inactivity exceeding 1 year (professional) (LOE V).• No prior wins (LOE V).• Significant mismatches in record, experience, age, or physical conditioning (LOE V).• History of concussion, lack of full recovery and clearance from most recent concussion, or history of other significant neurological injury (LOE II).• Severe prebout hypertension (SBP >160 or DBP >100 mm Hg in adults, or stage 2 hypertension in pediatric athletes) (LOE V).• Any medical condition identified on licensing or prebout medical examination that compromises defensive abilities (LOE V).

Keywords: ARP; KO; TKO; athletic monitoring; combat sports; concussion; high-risk fighter; mixed martial arts; position statement; return to play.