Moving Ahead

Moving Ahead

As Cleveland Clinic enters its second year of an unprecedented brain injury study on professional fighters, FIGHT!’s Ron Kruck brings us Part II on a story he delved into one year ago.

In person, it didn’t look like one of those jaw-dropping, brain-rattling, he-just-got-knocked-the-F-out KOs that makes highlight reels, but as former Olympic wrestler Matt Lindland lay on the canvas stiff as a board, eyes wide open, and legs quivering right in front of me, it was a knockout that would forever be etched in my head.

At the January 2009 Affliction: Day of Reckoning event, Vitor Belfort delivered a solid straight left that dropped Lindland to the canvas, and he followed it up with four short rights that knocked “The Law” into unconsciousness before referee Doc Hamilton pulled him off.

As Belfort celebrated his 37-second KO, Lindland was trying to defend himself against doctors and medical personnel who were attempting to administer treatment. After several excruciating minutes, Lindland managed to sit up on his stool and finally regain his wits.

By this time in my broadcasting career, I had witnessed hundreds of fighters being knocked unconscious, however, this one truly affected me because it didn’t have much shock value to it until the end result. I learned a valuable lesson that night—any head trauma is not good.

Fortunately, Lindland would leave the ring under his own power. Ultimately, he was suspended by the California State Athletic Commission for 45 days, required a CT scan of his head and neck, and had to be cleared by a neurologist before he returned to the cage, which he did less than one year later, losing by way of an arm-triangle choke to Ronaldo Souza. Lindland has gone 1-4 following the brutal knockout. If being on the receiving end of a knockout like that doesn’t make a fighter call it quits, what would?


A landmark research study on the brain health of professional boxers and mixed martial artists in various stages of their careers is beginning its second year at the Cleveland Clinic Lou Ruvo Center in Las Vegas, Nevada. The objective is to try and understand the long-term effects of repetitive head trauma and determine at what point and under what circumstances damage to a fighter’s brain may take place.

“Our goal is to see if we can identify damage to the brain very early if it’s occurring, be able to predict who may have these long term effects that you hear about in contact sports, and ultimately be able to treat that and prevent these things from happening either by making recommendations on sports regulations or actually developing therapies that may help people who have been exposed to head trauma,” says Dr. Charles Bernick, Associate Medical Director at Cleveland Clinic and principal investigator of the study.

In 2011, 180 professional fighters enrolled in the study and underwent a battery of tests that included an annual MRI scan, genetic testing, voice analyses, and computerized cognitive testing that measured reaction time, memory, and the speed of processing information. For volunteering, athletes receive their MRI scans that they need for licensure at no cost, as well as ongoing assessment of their brain health.

The imaging results from the first year have Dr. Bernick and his team excited. By using the number of professional bouts a fighter had participated in, length of their careers, and how often they were fighting as markers to how much head trauma they may be exposed to, MRI scans were examined for physical changes in the brain.

“What we are finding is—not unexpectedly—the more professional fights an individual has, there’s a relationship between a decline in the size of certain areas of the brain, so we think in some instances these areas are shrinking.” Dr. Bernick says. “More excitingly, we are seeing very early changes in fibers that run across the brain—this has been suspected before, but now we can truly see images of this actually occur very early. Even the connections to different areas of the brain are disrupted relatively early in a fighter’s career. The good news is many of these changes occur after a period of maybe five years, so it seems there is some time to when you can absorb head trauma before we see physical changes, and then it starts to decline the more you fight. But in just looking at these large groups, there does seem to be a relationship between the number of professional fights and loss of certain areas of the brain and size of the brain.”

As the size of these areas of the brain declined, the cognitive tests showed a reduction in the speed of processing information. This may not be the news an active fighter in the prime of their career may want to hear, but the results may prevent longterm health issues and help fighters make informed decisions on when it may be time to hang up the gloves.

“We’re not trying to take away somebody’s livelihood or stop them from participating in a sport they love, says Dr. Bernick. “But we want to make the sport safer, so if we can determine that damage is occurring, then they should know about it—and if we have treatment options that should be started.”


While the study began by evaluating mixed martial artists and boxers at multiple stages of their careers—the rookies just getting started, those in their prime, and those veterans at the end of their career—moving into the second year, the research project has added two additional categories: retired fighters and people who match the age and education of the fighters but have never been involved in combat sports.

“We also developed a retired athletes clinic, because we don’t just want to poke and probe people,” says Dr. Bernick. “I think one of the goals for us is to be able to offer treatment to individuals who have been in fighting—either boxing or MMA—who may have sustained injuries to the brain, and we now actually have a treatment program to help them.”

The Cleveland Clinic added new services to those willing to volunteer their time, and is now offering the blood test that fighters need for licensure in addition to the free MRIs.

Apparently, word has spread to the gyms and training centers throughout Vegas, as close to 300 fighters have enrolled for the second-year study, however, Dr. Bernick believes the future will be the key to the success of the four- to five-year study.

“We are doing a good job in getting people to participate in the study, of course the real challenge is getting these guys back, because we need to understand what happens year after year, what changes occur,” Dr. Bernick says.

Backstage in the bowels of the Honda Center in Anaheim, Matt Lindland and I briefly spoke about the knockout. He told me he really couldn’t remember what happened.

Unfortunately, I haven’t forgotten.

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