Can Women Fight?
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“When my nose broke, I got angry. I had this overwhelming drive to kick ass. I got the takedown and was just raining punches down. After the fight my nose was busted and my face beat-up, but I knew I loved this sport. I knew I had what it takes to be a champion.”
Those are unmistakably the words of a fighter. But does the fact they were spoken by Miesha Tate, a talented young woman, make them unacceptable?
The question of whether women should fight for a living cannot be answered. Attempts to do so clarify only the answerer’s beliefs and biases. However, the question of whether women can fight -- can compete in MMA at an elite level -- is more tractable. It involves only analysis of sexual dimorphism, the differences in anatomy and physiology between the sexes. Quantifying the degree and importance of these differences, particularly in strength and endurance, lays the only legitimate foundation for discussion of women’s MMA. Several recent studies using MRI to measure skeletal muscle show that men carry 50 percent more muscle mass than women. Controlling for height and weight shrinks that gap to about 25 percent. Among highly trained endurance athletes the differences are narrowed further still. But short of prolonged starvation, women -- even athletes -- consistently carry more body fat and correspondingly less muscle: a differential of about 10 percent total body weight. A female fighter at 145 pounds carries approximately 50 pounds of muscle on her frame, a male in the same weight class, 65 pounds. That 15 pounds of muscle is the same difference that lies between male 155-pound lightweights and 185-pound middleweights. For a number of reasons -- bigger hearts, larger diameter airways, higher hematocrit, increased lung volume -- male fighters benefit from greater endurance as well. A standard laboratory measure of cardiovascular fitness at peak exertion is the VO2 max -- the amount of oxygen consumed by skeletal muscles at maximal exertion. Female VO2 max is approximately 20 percent lower than male; when the numbers are corrected for total muscle mass, the VO2 max gap narrows slightly. A healthy active male’s VO2 max runs in the 40s. Elite female athletes have VO2 maxes in the 50s (cycling), 60s (Nordic skiing) and 70s (track). For comparison, Todd Harbour -- owner of the 25-year NCAA mile record (3:50!) -- posted a VO2 max of 64. As an in vivo measure of capacity for prolonged high exertion, one may consider marathon runners. The marathon record in 2003 for men was 2:04:55, for women 2:15:25. That’s a difference of 630 seconds over 125 minutes and 26.2 miles: about an 8 percent performance gap. More importantly, it bears mention that the numbers under considerations are at the apogee of human performance: An athlete blowing a VO2 max in the 70s and running 26 consecutive five-minute miles is a phenomenal specimen regardless of sex. The degree to which athletic commissions have felt the need to compensate for sex-based disparity in endurance has been wildly disproportionate for much of women’s MMA history. The once standard three-minute rounds and the imposition of ludicrous two-minute rounds during a Gina Carano fight in California -- 40 percent and 60 percent less than men -- reflect not scientific differences but some other motivation. The most that the science can be used to justify is rounds truncated to 4:36; that is sufficiently close to the standard five-minute round that neither the Unified Rules for MMA nor America’s premier promoter of women’s MMA, Strikeforce, call for shorter rounds for women.* If these biological parameters for women’s MMA -- roughly 10 percent less endurance and strength -- are deemed unacceptable for high-level competition, one must consider not only writing off female MMA but also much of the men’s game: lightweight men’s classes for possessing insufficient muscle mass and heavyweights, too, for sub-elite cardiovascular endurance.
If, on the other hand, one accepts that women can fight at the highest level of MMA, the question that must follow is whether they can do so safely. Fighting is about more than strength and cardio. Professional MMA subjects athletes to brain accelerations on par with car crashes, supra-physiologic stresses on bones and ligaments, rigorous weight control and myriad forms of trauma.
Women are inarguably more susceptible to violent injury. Female skin is thinner, and women are endowed with lower levels of blood clotting factors; they are more likely to cut and more likely to bleed. Female bones are less dense, thus more susceptible to fracture. Women’s ligaments and tendons are thinner, a crucial factor in surviving joint locks without injury. Less upper body musculature means less resistance to the head accelerations that cause brain injury.
These risks may be mitigated by women’s lessened ability to deal out damage, but they are compounded by the relatively small pool of elite female fighters: The chance of highly trained fighters being pitted against women with much less skill and experience is real and puts those less skilled fighters at inordinate risk. This dangerous phenomenon occurred with tragic consequences in women’s boxing, with promoters inflating elite female fighters’ records in fights against opponents literally pulled off the street.
Elite women athletes are also prone to a syndrome of metabolic derangement so widespread it has become known in sports medicine as the Female Triad: anorexia, amenorrhea, osteoporosis. Sixty-two percent of female athletes report eating disorders. Almost by definition the period of restrictive caloric intake fighters undertake to cut weight for a fight meets this criteria. Women who are engaged in intense training may stop ovulating -- an evolutionary adaptive feature protecting physiologically stressed females from the additional stress of pregnancy. The combination of nutritional deficits and hormonal irregularities leads to the third, apparently irreversible part of the triad, the thinning of bone known as osteoporosis. Fighters are not thought to be at as high risk as gymnasts and runners, but the physiologic perils cannot be completely ignored.
Lastly, obviously, women are unique in the ability to carry new life. An MMA training regimen would be extremely difficult for a pregnant fighter to endure: kicks to the abdomen, diet control, prolonged high-level exertion. Pregnant women are prohibited from competition in every state of the Union: The arguments for this are self-evident. It is a cruel irony for women fighters that the period in life during which they are best suited for childbirth, the third and fourth decades of life, coincide exactly with the sweet spot of a professional fighter’s career. It would be unfair to suggest sexual dimorphism exclusively disadvantages female fighters. Women have greater flexibility and a wider pelvis -- particularly advantageous in MMA. Female skin heals more rapidly and women recover more quickly from exertion and injury. Women have superior immune systems, protecting them from infection. Fascinatingly, women also have a greater density of neurons in many parts of their brain. This may give female fighters a precious advantage in enduring repeated brain injury. MMA fans have the right to be sensitive regarding arguments about what is “unacceptable.” We are aficionados of a sport only recently deemed barbarism and human cock fighting. However, this does not mean potentially uncomfortable conversations about what is safe for fighters -- including discussions of whether women fighters deserve different athletic commission protections -- should not be undertaken. Indeed they must be: Women fighters have earned the right to have their sport taken seriously, and part of that serious consideration includes clear-eyed analysis of risks. But the least the sport -- and the athletes who love it and make a living by it -- deserves is that the analysis be based on legitimate medicine and science, not personal tastes and chauvinism. *For Strikeforce’s 135-pound tournament on Friday, rounds are limited to three minutes due to the single elimination, two fights in one night format.
Matt Pitt is a physician with degrees in biophysics and medicine. He is board-certified in emergency medicine and has post-graduate training in head injuries and multi-system trauma. To ask a question that could be answered in a future article, e-mail him at
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