Skip to Content

Beyond the Concussion - Dehydration Dangers in Combat Sports


Today’s media spotlight in my field of medicine skews heavily toward the discussion of the dangers and risks surrounding concussion in sports. While those dangers are real and remain an important focus of mine, we must recognize that for many sports – there are topics aside from concussion which also pose a tremendous threat to the health and lives of the athletes who play them.

Last month, I had the opportunity as a board member on the California State Athletic Commission (CSAC) to participate in a more than three-hour summit on the current crisis of dehydration and weight-cutting in Mixed Martial Arts (MMA). And yes, it is a crisis.

The Scope of the MMA Dehydration Problem

According to the Association of Ringside Physicians (ARP), the organization created to develop medical protocols and guidelines to insure the safety and protection of professional boxers and MMA athletes, one recent study found that nearly 40 percent of MMA fighters enter the ring dehydrated on the day of their competition.

The first question someone not involved or familiar with combat sports may ask is: why would a fighter do that on purpose? The basic rationale is this: if a fighter can weigh-in for a bout at a lower weight class and then rapidly put weight back on in the day or so leading up to the match, the popular belief is that he may end up with a significant advantage over his potentially smaller opponent on the day of the fight.

As one can imagine, severe dehydration and rapid rehydration is a dangerous game. From negative effects on nearly every organ and bodily function, including the brain, heart and kidneys to mood swings and mental changes, the hazards are extreme and documented. Interestingly enough, what many fighters may not realize but science tells us is true, is that this practice actually decreases muscle strength, endurance, heart and cardiovascular function and reduces energy utilization and nutrient exchange. That means all that grueling training they’ve been doing for so many months can be significantly diminished.

Practical Education and Realistic Solutions

Of course, the goal in all of this is to educate combat athletes about the dangers of these dehydration practices and in doing so, to get them to look at better, healthier ways to train. But as we’ve seen time and again with the concussion crisis, “facts and fear” tend to have the opposite effect than the one that is intended. It’s human nature to think we’re immune to the statistics, no matter how frightening a picture they paint.

I believe we must give these fighters a positive incentive to engage in the behavior we’re looking for. We’ve got to find a way to tie the facts to performance. We must show how performance actually improves with proper hydration. Awareness for awareness-sake alone simply won’t work.

As one of the first steps in this multi-layered approach, the CSAC and the ARP are in support of an IV ban in an effort to help curb the dangerous dehydration/rehydration practices plaguing the MMA. It’s a controversial topic, I know. But the point is to protect these athletes. If we can remove one method of engaging in these dangerous practices, then we’re on our way to eliminating the practices in their entirety.

We’ve got a long road ahead of us, to be sure. And the discussions and debates on this topic will rage on, as they do with concussion and many other life-and-death considerations in the world of sport. So we’ll hash it out, discuss it, and work together to find a solution that will protect the health of these amazing athletes. And if in doing so even one life is saved – it will all be worth it. It always is.