Ask the Doc: Dr. Benjamin's column

T-Bone · 08-14-2008, 07:26 PM

Some of you may have seen this guy on Inside MMA. He seems very knowledgeable and this is a pretty good read....

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After a hugely successful debut column, MMAjunkie.com medical consultant and columnist Dr. Johnny Benjamin is back with his latest "Ask the Doc" feature.

Dr. Benjamin, a veteran combat-sports specialist and a member of the Association of Boxing Commission's medical advisory team, this week takes a look at some MMA-related injuries and how to prevent them.

What exactly is cauliflower ear? Why is Fedor Emelianenko susceptible to hand injuries? And what's the doc's opinion on knees to the head of a down opponent?

Dr. Benjamin discusses all those topics in his latest column.

Q. What exactly does "cauliflower ear" entail? How is it treated? Is it serious?

A. First, a basic anatomy lesson. The ear is composed of cartilage covered by perichondrium covered by skin and little else. The cartilage has no blood supply; it merely supplies shape. The adherent overlying perichondrium is the lifeline for the cartilage by supplying blood that carries oxygen and nutrition to the cartilage. Bored you to death yet? Simply put, without the perichondrium nursing the cartilage, the ear may die or become disfigured. When combatants take blows to their ears or get their ears repeatedly ground into the mat, the friction can shear (tear away) the perichondrium from the cartilage. This "new" space is quickly filled with blood (hematoma) -- just like the "mouse" under someone's eye when they catch an "eye jammie."

This early/fresh (acute) -- let's call it an ear "mouse" -- should be drained ASAP before the blood begins to thicken (coagulate). Old thickened blood is much harder (read: more painful) to drain than fresh blood. After the collection of blood is properly drained, a compressive dressing should be applied so that the blood won't re-accumulate. Although I am aware that the medical oracle YouTube is replete with how-to videos on draining cauliflower ears and there is an ol' sage lurking in every self-respecting dojo that will be more than happy to "drain it for ya for free," remember that it is free for a reason. Make certain that you ask Dr. Priced Right if he or she also takes care of the rip-roaring infection that may end up costing you part of your ear. Also, hearing damage is often associated with cauliflower ears. So I hope for your sake that your dojo doctors are also ENT specialists in their spare time.

If you are a teenager and subscribe to the "chicks dig it" school of thought and feel that is sufficient rationale to alter your body or make any other lifelong decision, rest easy there is hope: it's called maturity and plastic surgery. Both of which can be difficult, painful and expensive.

If you are an adult and choose to leave your cauliflower ear untreated, I say good for you. That is one of the many privileges of being grown. You're not hurting anyone. (Who made The New York Times the boss of you?)

Q. I saw Bas Rutten on "Inside MMA" discussing Fedor Emelianenko's recurring hand issues. Why does he seem to be prone to hand injuries? What's your take?

A. I can't speak about Fedor specifically because I've never examined him, but I'll tell you what I do know. Improper technique, misplaced strikes, devastating power, limited padding in grappling gloves and small hands are common factors involved in combat-sport hand injuries.

A properly executed punch should make contact with the second and third knuckles (index and long finger) with a tightly clinched fist and the wrist locked and straight. Combatants throwing wide looping strikes with a partially closed fist are at risk. Also, striking the top of the head where the skull is the thickest is a very common source or hand injuries.

A simple, old-school training technique may be worth revisiting: knuckle push-ups. Knuckle push-ups performed on the first two knuckles help to reinforce proper alignment of the wrist for striking. Loading during this special type of push-up also helps to strengthen the bones and ligaments of the hand. It also encourages you to keep a tightly clinched fist.

Q. Since you are one of the doctors on the ABC rules committee, what do you think of knees to the head of a grounded opponent?

A. Once again, blood, cuts and to some extent broken bones are not particularly dangerous, usually cause no long-term dysfunction, and frankly, we are pretty good at handling them. But concussions, more serious closed head injuries and broken necks are another animal all together. This is a sport and should never become a matter of life, death or loss of livelihood.

The quads and glutes are the strongest muscles in the body. When an elite athlete applies these combined forces correctly through the longest, strongest bone in the body -- the thigh bone (femur) -- devastation is lurking. A grounded opponent is uniquely vulnerable because in certain situations his or her head can be pinned by a knee to the floor or cage with potentially life-altering consequences. Legalizing this "perfect storm" is bad for the sport and even worse for the athletes and their families.

Ask the Doc: Dr. Benjamin on cauliflower ear, hand injuries and knee strikes | MMAjunkie.com

Here's the link to the first Ask the Doc segment
Ask the Doc: Dr. Benjamin on scar tissue, ABC rules, youth MMA and more | MMAjunkie.com

opsy · 08-14-2008, 08:14 PM

*smashes head against wall, grabs a syringe to try it out*

T-Bone · 08-28-2008, 03:09 PM

if anyone's interested, here's his latest...

Ask the Doc: Dr. Benjamin on fighter safety, weight cutting and drug tests | MMAjunkie.com

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Sure, one punch can have horrible consequences, but more commonly, it is the accumulation of blows that takes its toll on a fighter's health.

Let's look at two examples:

* Georges St. Pierre vs. Jon Fitch at UFC 87 (which we can fairly call a 25-minute, mostly stand-up war): 68 vs. 55 total strikes landed
* Kelly Pavlik vs. Jermain Taylor at the February 2008 HBO Boxing broadcast (12 rounds, 36 minutes): 267 to 168 total strikes landed

fullonshred · 08-28-2008, 07:37 PM

I enjoyed both columns T-Bone. Thanks for the posts/links.

FatCat · 08-28-2008, 08:52 PM

I like the Doc, he's extremely knowledgeable and a true fight fan.

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In all sincerity, this is an excellent -- albeit controversial -- question. Athletes who routinely cut weight are already rolling their eyes and calling me a "nut hugger" (this one was new to me, but thanks guys for teaching it to me here). Although I am not completely sure of what a "nut hugger" is, I am absolutely certain that I am not one.

I lol'd.

T-Bone · 09-11-2008, 07:33 PM

another Doc update...
Ask the Doc: Dr. Benjamin discusses the medical mystery of concussions | MMAjunkie.com

FYI...

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As always, if you have a question you'd like answered in a future column, my contact information is below.

T-Bone · 10-08-2008, 01:35 PM

More Doc Benjamin...

Ask the Doc: The dangers of shin conditioning and MRSA skin infections | MMAjunkie.com

The Doc ends with this (good question):

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May I ask a question to the MMA faithful? Beyond the sexual thrill of watching "chicks" fight (I get that aspect – and truly no disrespect intended), what is the fascination with women's MMA and especially Gina Carano? I'm trying to keep an open mind, but I just don't get it. At this point in time, they don't seem very good.

In closing please remember to vote for me in the upcoming election. Change is coming! (lol)

WanderleiSliver · 10-08-2008, 01:55 PM

This is some really interesting stuff, cheers for posting it.

stillstanding · 10-10-2008, 07:45 PM

I found this today with the search function. Very interesting. I have been very careful not to get califlower ear. (Califlower does not automatically render respect) But I finally got it this past week and got most of it drained out but my ear has a little small, hard groove left. Every info helps.

T-Bone · 10-13-2008, 07:40 PM

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Originally Posted by stillstanding

I found this today with the search function. Very interesting. I have been very careful not to get califlower ear. (Califlower does not automatically render respect) But I finally got it this past week and got most of it drained out but my ear has a little small, hard groove left. Every info helps.

Hey still, some chicks dig the cauliflower ear. Kim Couture, for example.

KungFuGrip · 10-14-2008, 12:02 AM

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Originally Posted by T-Bone

Hey still, some chicks dig the cauliflower ear. Kim Couture, for example.

Better not be peeking out her goods.

Kim Couture Accuses Jared Shaw Of Checking Out Gina Carano's Goods - MMARated.com

Gygax · 10-15-2008, 12:24 PM

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Originally Posted by stillstanding

I found this today with the search function. Very interesting. I have been very careful not to get califlower ear. (Califlower does not automatically render respect) But I finally got it this past week and got most of it drained out but my ear has a little small, hard groove left. Every info helps.

If there is a semi hard ridge formed, that is basically now permanent. Its a fibrous tissue that formed when your ears cartilage was damaged. The only solution is minor surgery.

T-Bone · 10-22-2008, 09:05 PM

The latest installment of Ask the Doc:

Ask the Doc: Dr. Benjamin on the anatomy of choke-outs and body shots | MMAjunkie.com

I think Bas asked that second question.

T-Bone · 11-04-2008, 03:32 PM

...and another one

Ask the Doc: Should rounds be extended to five minutes for female MMA fights? | MMAjunkie.com

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I have some suggestions.

Maintain women's MMA at three, three-minute (hopefully action-packed) rounds. Men early in their careers with limited professional MMA experience (say, five fights or fewer, though it's certainly open to debate) should also be limited to three, three-minute rounds. (Sorry, but sweaty, gassed dudes hugging and lying on top of each other begging for air is not why I tune in.)

Funny dude.

T-Bone · 11-12-2008, 09:33 PM

Medical Beat: The truth about MMA supplements and energy potions | MMAjunkie.com

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Have you ever wondered why these products are so heavily marketed to MMA fans? It is not because they improve MMA performance. It is access to the infinitely valuable 18-34 male demographic that MMA has captured. These products are wildly popular with kids, teens and young adults – who are those most at risk for health related issues associated with many of these products.

T-Bone · 11-19-2008, 04:01 PM

Ask the Doc: Dr. Johnny Benjamin on a surprisingly effective supplement | MMAjunkie.com

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Q. Doc, are there any supplements that you would recommend? (from Anonymous)

Despite my better judgment, I will try again with this topic.

I'll offer one (there may be others) that has actually been reasonably tested and does not come with too much hype.

Seemingly every athlete, regardless of his or her level, is looking for an edge, a little help, something with which to train and/or perform better. Hence, the tremendous sum of money being spent on "performance" products and supplements. In these trying economic times, I have an inexpensive little secret for you: chocolate milk.

Yep, you heard it right: chocolate milk.

FatCat · 11-19-2008, 04:06 PM

I always drink milk post-workout with whey. Not new info by any means, but the Doc is on point as usual.

T-Bone · 12-17-2008, 12:48 PM

Ask the Doc: Dr. Johnny Benjamin on ice baths and broken legs | MMAjunkie.com

Hey Gygax, what do you think about his ice bath comments?

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A few words on Corey Hill's injury

This injury was primarily about shin conditioning and secondarily weight – not really muscle mass...

figured that...he needs to kick some trees MT style.

Gygax · 12-17-2008, 02:03 PM

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Originally Posted by T-Bone

Hey Gygax, what do you think about his ice bath comments?

See my post here.

The positive that he said is that it is not for lactic acid flushing, a long held thought in lactic acid buildup that is finally being washed away.

I don't agree at all with what he is saying about a shower being proficient enough. That's very old fashioned, similar to the old school nurse who would place a paper towel between an icebag and your skin so you didn't get something like frostbite. A cold shower, even if its coming out of the faucet at 55-60 degrees F, is simply not going to penetrate deeply enough into the musculature to promote reduction of swelling due to the microtears of muscle re-structuring. A cold spa/whirlpool is best for penetration, but a plain ice bath is fine as well. The bath will cover a much greater surface area for a longer period of time than any shower would. Thus, he's off base with that conclusion IMO.

T-Bone · 12-17-2008, 02:31 PM

Different schools of thought.

This topic sounded familiar...yup, that's the link.

Do you think most athletes do the baths...guess it's more dependent on the athletic facility or trainer(s), right? Boxers take those cold ones, don't they?