Consult a professional before embarking on any activity or lifestyle change. The author, publishers and distributors jointly or separately do not accept responsibility for any injury, damage or loss of anything, including, but not limited to life, person or property due to any advice from this book.
Copyright © 2004 by Kobus Huisamen. All rights reserved. Printed in the United States of America. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the author.
Pictures by John Yoo.
To the trainers who made the most impact in my career: Steve Kalakoda, Henk Pelser and Ivan Hippolyte.
I’ve added this chapter, because so many fighters and trainers have no clue how to treat their injuries that it’s a shame.
Fighters get injured so often, and so many times a delayed treatment can make things worse.
What I’ve put in here are things that I’ve been taught, tried and tested and still use with my fighters and on myself.
I don’t want you to think that this is a medical text, because it isn’t. These are methods that I’ve learned from cut men, from traditional martial arts practices and from improvisations that have worked.
Cuts
I’ve been at loggerheads with many physicians at fight events.
Sometimes the ring doctors are general physicians who have had little or no experience as sports doctors – especially at martial arts events.
Arguments between the doctor and me usually happen for two reasons.
The first reason is where there is a cut that bleeds a lot. Yes, head and facial wounds bleed a lot, generally speaking. If this happens, the doctor may want to stop the fight.
I hate that. Don’t stop the fight for a little blood – especially if the fighter is winning.
Yes, a dangerous cut would stop a fight, but what makes a dangerous cut – one that would stop the fight – differs from doctor to doctor.
Some doctors who are new to the fight game would want to stop it very quickly, whereas the more experienced ones would give more leeway.
But some are concerned more about the television cameras and how the public would react if they would let the fight continue.
A fight is stopped due to a cut only if it is potentially dangerous.
A cut is dangerous when it would damage the vision, cause any other long-term problems, or is so open that infection is almost sure to set in. The other reason is that one more punch on the cut would rip it open wide. For these reasons, they can and should stop the fight.
So, if a doctor asks me, “Don’t you think we should stop the fight?” Then I’ll tell him, “No, we fight. We never quit.”
In this sport, cuts are part of the game. If you don’t like cuts – get out of the ring.
The second one is after a fight, where the fighter has a cut and the doctor wants to stitch it up.
This is where I stop them; “No! No stitches.” And the doctor would look at me, telling me to get out of the way; the fighter has a cut and needs stitches.
“Yes”, I would say, “but this fighter wants to fight again. Putting in stitches is going to make a weak spot.” The doctors all get irritated and then I take the fighter away and treat him myself.
Very few doctors are able to put stitches on a fighter, the way that would not cause problems later on.
Basically, most doctors would use a 4-0-grade stitch, or even worse, when the cut is big, they may use a thicker 3-0 thread.
When they pull the skin together tightly, or sometimes make them overlap, it causes small “lumps” or “ridges” to form – especially when the thick thread.
The result is that these little lumps – when the cut is healed up – would increase friction on the gloves (because of a differentiated skin texture) and rip the skin open much more easily.
So, get stitches today and you’ll run the risk of getting cut consistently.
Not all doctors do this – some are quite excellent and put stitches in that would marvel a plastic surgeon.
But how do you know, unless you know the doctor?
Experienced ring doctors would tape it up, as I would, anyway. The taping up method is shown here below.
Figure 8.1: Cut phase 1.
Treating a cut phase 1: Clean the area around the cut.
Disinfect the cut, using a swab and an antiseptic liquid. Then dry it all off all around the cut.
Stick on a piece of tape either side of the cut. Stick it as close as possible to the edges of the cut.
Figure 8.2: Cut phase 2.
Treating a cut phase 2: Now, push the edges of the skin together. (You’ll need somebody to do it for you while you do the rest).
Then stick narrow strips (about 2 mm wide) of tape from one piece of base tape to the other.
The idea is to stick it to the tape and not so much the skin, in a way to hold the edges of the cut closed.
Figure 8.3: Cut phase 3.
Treating a cut phase 3: No put a piece of tape over everything to hold it all down.
Figure 8.4: Side view of the taping over the cut.
Looking at a diagram of the theoretical side view, you should have three layers of tape stacked on top of each other.
Treating cuts while fighting
When you get cut during sparring you should stop sparring and take care of it – as is explained above. The same goes for after a fight.
However, during a fight, you no choice but to keep on fighting – unless the cut makes it impossible.
During a fight, you treat all cuts the same way:
1. Stop the bleeding.
2. Stick the edges together, i.e. close it up
3. Smear Vaseline (petroleum jelly) over the cut
Stopping the bleeding
Wipe the excess blood off and apply something that will stop the blood. I usually use an iodine fluid, like “Steel Drops” or “Friar’s Balsam”. Steel drops stops blood very quickly, is a very “thin” liquid and wipes away easily. Friar’s Balsam is thicker, so apart from stopping bleeding, it also sticks the edges together nicely.
Stick the edges together
After stopping the bleeding (or the worst of it), squeeze the cut shut. If you’ve used Friar’s Balsam to stop the bleeding, it will stick nicely together. If you didn’t, press some ice on the cut (still keeping the cut closed) and hold it there for 10-20 seconds – that’s all you’ve got in a fight. In a Muay Thai fight, with a 2-minute rest between rounds, you have more time for this.
Smear Vaseline over the cut
Well, take a liberal amount of Vaseline and cover the cut and a half-inch perimeter around it. The Vaseline will keep the blood in, and protect the cut by making the surface slippery – so the gloves can slip off – and cause less damage. Now tell the fighter to keep his hands up and protect the cut.
However, in an MMA fight, Vaseline is not allowed, so you’ll have to make do with the ice. The water caused by the ice melting can be somewhat of a lubricant. Just keep the hands up and avoid getting hit on the cut – it’s all you can do.
Bruises
There is only one word for a bruise – ice. Use ice liberally. The only thing that really heals a bruise is time. The bigger the bruise – the longer the time.
However, ice is therapeutic and prevents excessive swelling.
Apply ice for about twenty minutes, with five minutes in between.
I’ve used hot-packs alternatively with ice packs for a bruise or two, but can’t really feel or notice the difference compared to just using ice.
The biggest culprit, when we talk about bruising, is usually the leg kick.
Some fighters in the K-1 have occasionally been leg-kicked so badly that they had to sit in wheelchairs afterwards.
Here, ice is non-negotiable – especially if you fly home the next day. Many fighters will tell you that their injured thighs (yes, the ones that were leg kicked) would swell to almost double its usual size in the aeroplane! And such a swelling it is quite painful.
There is another kind of bruise that we usually find in the muscles around the tibia.
This doesn’t have a surface swelling, but an internal swelling. It is called a “stress swelling”.
In this kind of swelling, the muscle feels hard and swollen but usually not painful.
This swelling occurs in the whole muscle, within a muscle “pocket”. It swells until the pocket is stretched to maximum capacity.
As the pocket can’t stretch any more, the muscle “swells” inwards. This means it takes up the space of the veins and arteries, by closing them up and using the space for the swelling.
This is really dangerous.
This can cut off the blood flow and thus, the oxygen and everything the muscle needs.
Then, the muscle dies. Yes, it dies. If you arrive at a physician before this happens, they will cut open the membrane to give the muscle room to continue swelling – until it, eventually, subsides.
Unfortunately, once the pocket is cut, it can’t be sewed back together, which means that you’ll have a permanently protruding muscle.
If you think that you’ve got this kind of injury, then you need to see you physician – and quickly.
He will use a sonogram – yes, like the one they use for pregnant women to look at the fetus – to check the blood flow in the muscle.
If the blood flow is still fine, you will be advised to take aspirin to thin the blood, you’ll also be prescribed rest – with the legs elevated, of course. And you will be told to apply, yes, ice, to help get the swelling down.
Fractures
When it comes to fractures, its simple – you can’t do anything. Just apply a splint and take the fighter to the hospital.
If it happens during a fight, stop the fight.
Some fighters are able to continue, but it’s risky. One of my fighters, named Craig, was winning his fight when he told me in the corner that his left arm is broken. He wasn’t quitting and I couldn’t see anything, so I told him not to punch with the left. Well he did punch with it and won the fight, but had to have serious surgery afterwards.
My friend Jan Nortje did the same. His left arm got broken with a kick, but he immediately stepped forward and knocked his opponent out with that same arm.
These guys took a risk. With the adrenaline in a fight, you don’t feel the pain so much – just the disappointment of coming so close after working so hard. For this reason some fighters want to carry on.
However, I would advise against that. Rather stop the fight and fight another day.
Broken nose
A broken nose is not really a problem.
If it is badly broken it may look bad, but should not affect the fighter much – as long as he can concentrate on fighting and not think about his nose – just breathe through the mouth.
This is all fine, as long as the fighter isn’t knocked out. If he is knocked out – lift him up so that the blood doesn’t flow backwards into the windpipe.
My nose was broken about 6 times, so by this time I know exactly how to fix it. Just do it as soon as you can – i.e. immediately.
Do this in front of the mirror so that you can see what you are doing.
The first thing you do is to straighten your nose – yes, manipulate it with your fingers. The bone is soft and can be manipulated quite easily.
Then stick your pinkies up your nostrils – as far as you can – to align the nose from the inside.
Then, blow. Blow out through your nose – hard, and at the same time, pluck out your pinkies.
A lot of blood and blood clots (and other tissue) will come out. This is to open up the channels so you can breathe in future. If you need to do the blowing action again, then do it, until you are sure the channels are open.
Now, stick some plugs in your nostrils to stop the blood. You can use tissues, cotton swabs, or anything that will work.
Then, put ice on the nose, to help control bleeding and swelling.
You will most likely have a swollen nose and two black eyes as a result. However, the good news is that a broken nose usually heals in about 2-3 weeks.
The swelling and discoloration should be gone after a week. After about two weeks after the break, the nose should be grown back, but still fragile and can easily re-break. Wait another week, then you should be good to go.
Bleeding
To stop bleeding, all you can really do is to apply ice and pressure.
However, if the fighter has a medical condition that causes excessive bleeding – off to the hospital with him – don’t take any chances, or you’ll need big insurance.
Different injuries will bleed differently. Head and facial wounds tend to bleed a lot – as do nose bleeds.
During a fight, all you can do to bleeding is to try and stop the bleeding as I’ve explained in the section about cuts.
If a nose bleeds, you can’t do much during the fight. However, if it bleeds excessively, plug the nose with cotton swabs, or the referee (or doctor) will stop the fight.
HIV
This is a sensitive issue. People are quick to say that we discriminate, and that they have a right to equal treatment, etc.
Sorry, but you have no right to go around and infect the world.
What it boils down to is that HIV positive people should not fight. Many fight organizations expect an HIV test before the fight, to allow the fighter to do it.
If my fighter bleeds, I don’t want to stress about the blood, I want to help him.
Nowadays, it is quite common to see trainers in the corners wear latex gloves. If you get infected by a fighter, no amount of insurance money can ever fix the problem, or even make you feel better.
As a trainer or manager, there should be something about this in your contract with the fighters.
Neck injuries
This is fear factor number one.
If you see this happening, it is best to stand back and call the paramedics. If you move your fighter, you may move some vertebrae and cause permanent paralysis.
I don’t want to be the cause of anyone to sit in a wheelchair – temporarily or permanently.
However, once, one of my fighters got swung down with a neck throw. He lay very still.
We all laughed – thinking that he got his wind knocked out of him.
When I bent over him to ask if he’s all right, he gave me the news. It wasn’t his wind – it was his neck.
Shock went through me. I knew it was going to be difficult for the paramedics to find us in the sports building complex where we were. So we decided to take him to the hospital.
We improvised a stretcher and one fighter brought a bundle of bubble wrap. (I still wonder where that came from).
Luckily we had a military medic training with us and he used the bubble wrap to make a neck-splint.
On the stretcher, we placed him on a pick-up truck and drove to the hospital.
The next day, everything was fine – he’d pulled a neck muscle.
I was really stressed, because you can’t really do anything. Anything that you do is risky when it comes to a neck or a back.
The fighter gets knocked out
A knockout does not come from the smash of the fist (or foot), but from the “secondary knock” as the brain is bumped against the inside of the skull during the repercussion.
Sometimes this happens so quickly that the fighter is out cold while he is still on his feet.
This is dangerous, because the fall on the ring floor may cause a second impact – depending on how he falls.
When a fighter gets knocked out, there are a few things you’ve got to be concerned about.
If his nose is bleeding, sit him up, to prevent the blood from running back into the esophagus (windpipe) and smothering him.
If there is no blood, ensure that his breathe-way is open anyway.
This is one area where I always stand back and let the ring doctor take over. If this happens in the gym, let your fighter go to a doctor when he comes to. If he doesn’t come to quickly enough – then take him to a doctor.
After a knockout, don’t let the fighter fight for about two months and no hard sparring either. Let him heal.
