- By Bobbie Jackson
- BBC Sport
“Sorry I lost track of your question… that might be CTE.”
Julie Kedzie has suffered with depression, anxiety, hyperactivity, impulsiveness and lack of sleep since retiring from mixed martial arts in 2013. All are symptoms of chronic traumatic encephalopathy (CTE).
CTE is a brain condition linked to repeated blows to the head and concussion. The condition, which gradually gets worse over time and leads to dementia, can only be diagnosed post-mortem.
Kedzie competed 29 times as a professional, winning 16 and losing 13, until she retired on the back of four successive defeats, including two in the UFC.
The 42-year-old is still counting the cost of that career and has pledged her brain for post-mortem research.
“It seems a very normal thing to do,” Kedzie tells BBC Sport.
“I’ve been hit in the head a lot so we might as well see what is in there and get some good out of it for data.
“If there is a way that I can still keep pushing in this field [of mixed martial arts] and advancing the cause of women, then yeah.”
Athletes, across a wide variety of contact sports, are more aware of the risks involved, leading to an increase in brain donations to the Concussion Legacy Foundation (CLF).
Just 45 cases of CTE were confirmed worldwide when the CLF began investigating in 2007, and now more than 10,000 people, including Kedzie, have taken part in studies.
Dr Chris Nowinski, who has a PHD in neuroscience and is a former WWE wrestler, co-founded the CLF after “suffering chronic symptoms” during his own sporting career.
“Most professional MMA fighters that we’ve studied have had CTE and will continue to have CTE,” Dr Nowinski says.
“We don’t have 70-year-old former UFC fighters yet, so we haven’t fully seen what we’ve created here.”
‘Women need to lead this change’
Top-level MMA is in its infancy, especially when compared with boxing, and the small pool of subjects available for research has made it difficult for medical professionals to assess the long-term effects of repeated blows to the head.
Of the first 1,000 brains studied by the CLF, just 10 were from a martial arts background, and the majority of those were male.
Kedzie says: “I want to give back to the women in this sport because there are all these studies on male athletes’ brains and there might be something completely different from a female athlete’s perspective.”
So far, scientists have not been able to draw any conclusions on whether CTE acts differently depending on gender.
Anderson took her own life in 2022, aged 28, and had previously pledged her brain for post-mortem research with the CLF’s brain bank in Australia.
Dr Nowinski says: “Heather Anderson is not going to be the only woman with CTE and I hope we start changing what we do sooner rather than later.
“Women obviously need to lead this change. We need to start having these conversations, telling what we know and what we’ve learned from men.
“Maybe that will give us a faster cultural change than we’ve had with men’s sports.”
‘Knowledge base has grown’
Within the MMA community, Kedzie has seen attitudes and awareness regarding CTE change since she competed.
Roxanne Modafferi retired last year after a career spanning 45 fights and 19 years. Recently she said on social media the only person who mentioned the dangers of CTE to her before she started fighting was her father.
“The knowledge base has grown considerably,” Kedzie says.
“As critical as I can be of the UFC, because they are the best game in town and you want any glaring mistakes to be fixed, the Performance Institute is paying more attention to studies and I think that’s great.”
The Performance Institute (PI) is the UFC’s purpose-built facility in Las Vegas, offering fighters medical support, strength and conditioning, sports science, nutrition and sports psychology services.
Senior vice president at the PI, Dr Duncan French, acknowledges the UFC has a responsibility, not just to their own roster of between 650-670 fighters, but to those involved at a much lower level.
Dr French says: “The PI has built out a five-stage return-to-play [concussion] protocol with thresholds and levels of intensity elevation which athletes can now adhere to.
“We’ve circulated that throughout our roster and put that for open access on websites for anyone who wants it. We’re trying to change this narrative for the betterment of everyone.
“We are doing everything we can to educate, upskill and make athletes aware that it’s not something to fight through if you have a condition, because of the long-term consequences.”
Cognitive testing could become commonplace
Prior to opening the PI in 2017, the UFC teamed up with the Cleveland Clinic to be part of their Professional Athletes Brain Health Study, which began in 2011, with a pool of about 900 combat sports fighters taking part.
The Cleveland Clinic focuses on neurodegenerative diseases and also works with the Nevada State Athletic Commission, MMA promotion Bellator and boxing promotions Golden Boy and Top Rank.
Dr Charles Bernick, a neurologist at the Cleveland Clinic, believes they are playing catch-up on other sports.
“Here you have a sport where the whole intent is to cause brain damage and yet there is no tracking of it over a person’s career,” Dr Bernick says.
“The hope of what we learn from the study can then be applied either at a policy level or even informing participants what their risk is.”
As the world’s leading MMA promotion, the UFC says it has a responsibility to drive change for the better.
The UFC has, according to chief operating officer Lawrence Epstein, been working on ways to advance policy and protocol.
“We are very hopeful that some time in the relatively near future we can get to a point where every year a boxer, MMA fighter or any combat sports athlete would have to get tested every year. That would be cognitive testing and, of course, MRI scans,” Epstein says.
“If the athlete appears to be, for example, seeing an increase in the decrease of brain volume that’s greater than what would be natural, then that fighter wouldn’t be able to get a licence and they’d have to get out of the sport.
“We want to get to fighters before they get to a cognitive deficit.”
And that is something Kedzie supports.
“I love this sport so much and I want it to be better,” Kedzie says.
“If you stay in this sport long enough you are going to suffer. Athletes have to be protected.”
Olivia Martin is a dedicated sports journalist based in the UK. With a passion for various athletic disciplines, she covers everything from major league championships to local sports events, delivering up-to-the-minute updates and in-depth analysis.