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Mixed Martial Arts (MMA)


Mixed martial arts (MMA) has grown in popularity in recent years. Due to the popularity of the sport I have seen an increase in the number of cervical (neck) injuries. I will very briefly review the history of MMA and the 4 powerful manoeuvres often used by mixed martial artists that may potentially cause a neck injury. If you are a professional and competitive MMA fighter you may be reading this article to find out which of these manoeuvres I will be discussing has the most powerful take-down recorded by scientific research to date. If you are a MMA instructor or recreational/professional MMA athlete you may be interested to learn how to avoid such risks of sustaining a neck injury.


  1. Brief History

  2. MMA KO

  3. The Big Four Manoeuvres

  4. The Fastest Take-downs    

  5. Kinematics of Head and Neck Impacts    

  6. Comparing the 4 Take-down Manoeuvres

  7. Injury Prevention

  8. Final Thoughts


1.  Brief History

Over the centuries martial arts have been practised by many and descriptions date back to Alexander the Great circa 325 BC. The ancient art form of Pankration is suggested to be one of the first sports recorded in ancient Greek Olympics.  Since its origins, many forms of mixed and unarmed martial arts have been developed from the battlefield from around the world.  Each region from around the world has their distinct discipline of martial arts history. Arguably masters of multiple martial arts have acknowledged that there is no single martial art that is superior than the other. An athlete that has a fusion of techniques is suggested to be more versatile and effective depending on level of ability and training.  From this knowledge MMA tournaments have been set up throughout the world by governing body’s such as the Ultimate Fighting Committee.  The sport of MMA permits athletes the use of both striking and grappling techniques, both standing and on the ground by means of various disciplines taken from the different martial arts and combat sports from around the world. Today MMA has become a popular full-contact sport amongst athletes and public spectators.



As in most combat sports, most bouts are determined by submission or knockout (KO). The KO in MMA is classed as being tendered unconscious rather than being able to continue. This can lead to the athlete being potentially injured or worst still sustaining fatal injuries. For this very reason I have chosen 4 take-down manoeuvres due to their kinematics of sustaining a severe or fatal injury to the neck region. Often these manoeuvres are performed by the fighter to put their opponent on the floor with the fighter on top of their opponent. I acknowledge there are many variations in such manoeuvres however to keep it brief I have selected 4 manoeuvres most commonly used in MMA [1-7].


3. The big four manoeuvres 


So what are they?


Many athletes familiar with the sport will likely know these manoeuvres that will be discussed. However for those people that are not familiar with these manoeuvres below are overviews of the big 4 take-down manoeuvres I have selected. Each of the following manoeuvres enables the fighter to use their own body weight to force their opponent on to the floor.


1. The O goshi (The hip toss)

This is a common manoeuvre from judo where both fighter and opponent are facing one another. The fighter moves into the clinch position and by using their shoulders swings their opponent over their hips to drive their opponent onto their back see here.


2. The Suplex 

This is a common manoeuvre in jujitsu where the fighter grabs their opponent around their waist to lift them up over their shoulders. Using combined centre of gravity and by maintaining the hold throughout the manoeuvre. The fighter then proceeds to fall backwards on to their back whilst at the same time their opponent falls forward on to their face see here.


3. The Souplesse (variation of the Suplex)

The fighter lifts their opponent from the waist to swing their opponent over their shoulder. This manoeuvre is followed through by rotating the opponent over the fighter’s upper chest and by slamming the opponent down on to their back. However there are many variations of the Souplesse and each fighter adopts their own preferred style see here.  


4. The Guillotine Drop (a choke hold) 

This is a common procedure in Brazilian Jujitsu martial arts. The fighter reaches around the back of their opponent’s neck with a single hand and with the other hand completes the choke. Whilst sustaining the choke manoeuvre, the fighter proceeds to fall backwards. This raises the opponent’s feet off the floor and at the same time flexes the opponent’s neck to force the opponent on to the floor. The fighter completes the manoeuvre by driving backwards to tighten the choke. However there are many variations of the guillotine choke hold manoeuvre and each fighter adopts their own preferred style see here.

4. The Fastest Take-downs


From reviewing the scientific literature;


The O goshi 

The fastest take-takedown recorded of 0.29 seconds from a estimated height of 115cm.

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The Souplesse

The second fastest take-down recorded of 0.31 seconds from a approximate centre of gravity of 142cm.

The Suplex

The 3rd fastest take-down recorded of 0.32 seconds from an average height of 155cm. Due to the trial run this manoeuvre was abandoned from further trials after the volunteer sustained an anterior cervical injury. No other volunteers stepped forward to proceed in further trails nor did the author! 


The Guillotine Drop (Choke hold)

The fourth fastest take-down recorded from an average height of 110 cm of 0.41 seconds. This was the most difficult manoeuvre to analyse due to the nature of technique as the choke hold was masked by the fighter.


5. Kinematics of Head and Neck Impacts

To be a good MMA fighter we need to understand some basic anatomy of human movement and learn how each manoeuvre works to become an ultimate MMA fighter. Using the scientific data recorded although not exhaustive to keep it brief and simple below is what occurred during each manoeuvre.    


The O goshi

On impact the opponent’s body came to rest quickly but the neck and head were still subject to acceleration by the force of impact. This caused the opponents head to move backwards combined with neck hyperextension until the back of the head (occiput) hit the ground. Prior to the opponents head coming to rest a forward motion of flexion occurred in the neck region.


The Suplex

From the trail run the opponent’s impact point was the mandibular symphyseal region. Due to the continual force of impact a sustained backward translation of the head was recorded with combined neck hyperextension until the opponent’s head came to rest.  The primary backward translation was suggested to occur from the atlanto-occipital segment during neck hyperextension. Interestingly during the manoeuvre there was no axial-rotation as the opponent did not rotate their head away from the full frontal impact force before hitting the ground. 


The Souplesse

On impact the opponent’s unrestrained head moved backwards combined with neck hyperextension until the occiput hit the ground. Prior to the opponent’s head came to rest in the neutral position from the force of impact. The opponent’s head moved forward beyond its starting position but within normal range of movement, however the opponent’s chin did not touch their front chest region.        


The Guillotine Drop (Choke hold)

This manoeuvre is suggested to position the opponent’s neck in to the forced flexed position. As the opponent falls to the ground the force applied by the fighter is thought to increase at the opponent’s atlanto -occipital motion segment.  As the fighter drives their opponent’s neck back, the opponent’s neck is once again driven forward but this time rapidly to create a strong neck flexion force at the cervical spine and its junction with the occiput.   

6. Comparing the 4 take-down manoeuvers   

The above 4 take-down manoeuvres were compared with similar neck injuries. Both the O goshi and Souplesse take-down manoeuvres were suggested to be the most powerful in ground force impact kinematics.  Interestingly, the reaction ground force of impact kinematics involved in these manoeuvres (posterior translation of the head) replicated similar impacts to rear motor vehicle collisions when compared with car impact models.

The research suggests that these manoeuvres (O goshi, Souplesse) may replicate similar comparable biphasic motion of whiplash injuries similar to motorists in martial artists.  For example the mechanical implications of obstruction from hyperextension of the neck region by the floor and the car seat headrest respectively. The Suplex manoeuver potentially produces significant risks of a cervical hyperextension injury whereas the guillotine drop kinematics resembles the mechanism of a cervical flexion injury [1,8-23,25].   

7. Injury Prevention

Studies suggest that adequate strength training can prevent sports injuries by one third and overuse injuries by 50% with greater effects if combined with proprioception training. As MMA involves boxing, it has been hypothesised that boxers can be prone to common muscle imbalances as they have the tendency to use the anterior musculature more than the posterior. Adequate strength and conditioning exercises combined with proprioception training is recommended to prevent the boxer’s likelihood of injury. Furthermore this will help address common muscle imbalances and insufficient weaknesses of the boxer’s posterior musculature (e.g. strength ratios between shoulder anterior and posterior rotator cuff muscles). Neck exercises will help the MMA fighter generate adequate eccentric strength particularly during defensive combat to help absorb impacts from opponents. Strength training the spinal muscles may also be beneficial to prevent knockouts to the abdomen and thorax. Detecting training errors by means of sport specific movement exercises during training for example may also prevent the likelihood of injury occurrence [1.23-27]. 


If you experience any serious pains or niggles that just won't go away it is highly recommended that you get it checked ASAP by consulting a health professional such as a sports therapist that understands your sport or doctor.          


8. Final Thoughts

From reviewing the literature it demonstrates that the forces applied by these 4 manoeuvres are significant. The kinematic consequences involved may also potentially result in serious cervical injuries from what we originally realised.  


It is important that instructors have an understanding in musculoskeletal biomechanics to help prevent training errors and injuries. A good instructor will explain to students the importance relationships on how best to optimise musculoskeletal biomechanics for optimal power for offensive and defensive capabilities.


As always thanks for reading this article, enjoy your sport. If you enjoyed reading this article you may enjoy reading my other article on Muay Thai.

or Call: 01298 600477


  1. Oler M, Tomson W. Morbidity and mortality in martial arts: a warning.Trauma 1991;31:251–3.

  2. McCarron MO, Patterson J. Stroke without dissection from a neck holding manoeuvre in martial arts. Br J Sports Med 1997;31:346–7.

  3. Panjabi MM, Cholewicki J. Mechanism of whiplash injury. Clin Biomech1998;13:239–49.

  4. Winkelstein B, Myers BS. The biomechanics of cervical spine injury and implications for injury prevention. J Am Coll Sports Med 1997:S246–52.

  5. Panjabi MM, Nibu K, Cholewicki J. Whiplash injuries and the potential formechanical instability. Eur J Spine 1998;7:484–92.

  6. Tsuyama K, Yamamoto Y. Comparison of the isometric cervical extension strength and a cross-sectional area of neck extensor muscles in college wrestlers and judo athletes. Eur J Appl Phys 2001;84:487–91.

  7. Rauschning W McAfee. Pathoanatomical and surgical findings in cervical spinal injuries. J Spinal Disord 1989;2:213–22.

  8. Ono K, Kanno M. Influence of the physical parameters on the risk of whiplash injury. Proceedings of the International Research Council on Biokinetics of Impacts Conference 1993:201–12.

  9. Nygren A. Injuires to car occupants: some aspects of the interior safety of cars.Acta Otolaryngol 1985;(suppl):395–6.

  10. Carlsson G, Nilsson S.Whiplash injuries in rear-end collisions. Proceedings of the International Research Council on Biokinetics of Impacts Conference 1985:277–89.

  11. McConnell WE, Howard RP. Analysis of human test subject responses to low velocity rear-end impacts. Proceedings of the 37th Stapp Car Crash Conference of the Society of Automative Engineers 1993.

  12. Penning L. Acceleration injuries of the cervical spine Parts 1 and 2. Eur Spine J 1992;1:7–19.

  13. MacNab I. Whiplash injuries of the neck. Manit Med Rev 1966:172–4.

  14. Geigl BC, Steffen H. The movement of head and cervical spine during rear-end impact. Proceedings of the International Research Council on Biokinetics of Impacts Conference. 1994: 127–137 (courtesy of British Library)).

  15. Silver PHS. Direct observations of changes in tension of the supraspinous and interspinous ligaments during flexion and extension. J Anat 1954;88:550–3.

  16. Grauer JN, Panjabi MM. Whiplash produces an S-shaped curvature of the neck with hyperextension at lower levels. Spine 1997;21:2489–94.

  17. Terry C. Barclay DK. Physiologic study of pressure point techniques used in martial arts. J Sports Med 1999;39:328–35.

  18. Harris RI, MacNab I. Structural changes in the lumbar intervertebral discs. J Bone Joint Surg [Br] 1954;36:267–72.

  19. Goel VK. Stress-strain characteristics of spinal ligaments. 32nd Transactions of the Orthopedic Research Society 1986.

  20. Chazal J, Tanguy A. Biomechanical properties of spinal ligaments. J Biomech 1985;18:167–72.

  21. White AA, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia: Lippincott, Williams & Wilkins, 1990.

  22. Kochlar T, Black DL, Mann B, Skinner J. Risk of cervical injuries in mixed martial arts Br J Sports Med 2005;39:444-447

  23. Hall CJ, Lane AM (2001) Effects of rapid weight loss on mood and performance among amateur boxers. Br J Sports Med 35: 390-395.

  24. Gordon SE, Kraemer WJ, Vos NH, Lynch JM, Knuttgen HG (1994) Effect of acid-base balance on the growth hormone response to acute high-      intensity cycle exercise. J Appl Physiol (1985) 76: 821-829.

  25. Keller H, Tolly S, Freedson P (1994) Weight loss in adolescent wrestlers. Pediatric Exercise Science 6: 212–224.

  26. Klinzing JE, Karpowicz W (1986) The effects of rapid weight loss and rehydratation on a wrestling performance test. J Sports Med Phys Fitness 26: 149-156.

  27. Br J Sports Med,. (2014) The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Jun;48(11):871-7. doi: 10.1136/bjsports-2013-092538. Epub 2013 Oct 7. Lauersen JB1Bertelsen DMAndersen LB.

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