The Ultimate Guide to Preventing and Treating MMA Injuries: Featuring advice from UFC Hall of Famers Randy Couture, Ken Shamrock, Bas Rutten, Pat Miletich, Dan Severn and more! (2016)

Besides traumatic injuries, one particularly important issue that sidelines mixed martial artists and other athletes is skin infections. Ignoring skin infections and not seeing a trained medical professional places not only a fighter at risk, but also his entire team and training partners. Sometimes, skin infections can become so severe they can lead to hospitalization and even surgery. Recognizing some of the more common athletic skin infections can go a long way in both treatment and prevention.

HERPES

The name herpes alone seems taboo for some athletes to discuss. There is often a stigma tied to herpes that links it to sexually transmitted diseases. While some of the herpes viruses are contracted via sexual contact, other types of herpes can be transmitted via skin-to-skin contact. They are not the same exact viruses, but share similar characteristics and are therefore grouped into the same family. In fact, the chicken pox falls into this same herpes virus family. The herpes virus often presents as a painful “cold sore” near the mouth and lasts four or five days. Eventually, the fluid-filled blisters crust over and disappear, but anytime the body is stressed and the immune system defenses are lowered, the sores may return.

During the contagious stage before the blisters are crusted over, any skin-to-skin contact between training partners or opponents can lead to infection. The site of infection isn’t limited to around the mouth. Cheeks or even fingers can become infected with herpes sores. The common association with wrestling and grapplers has even led to the term herpes gladiatorum, a reference to the Roman gladiators. While the condition is permanent, some medications help prevent or treat outbreaks. This is something to speak to your doctor about.

IMPETIGO

Staph infections are a common term thrown around locker rooms. Impetigo is a bacterial infection caused by two types of bacteria: staphylococcus (staph for short) and streptococcus (strep for short). When there is a break in the skin, even microscopic, sometimes the bacteria can get by the barrier and cause a skin infection. Impetigo is highly contagious and appears as a yellowish blister that leads to a honey-colored scab. Proper hygiene can help prevent its spread, and if a fighter is infected, proper antibiotics prescribed by a doctor can easily treat the infection. Studies have also shown that the best way to prevent spread is to keep infected skin lesions covered.

Demetrious Johnson had a bout with impetigo, and as a result, his training camp suffered. “My training partner had impetigo. He then gave it to me. Shortly after, I shaved my beard and it made it worse. It finally cleared up in about 10 days with antibiotics. It was the worst week of my training camp — really messed with my cardio.”

MRSA is one particular type of staph infection. MRSA stands for Methicillin-resistant Staphylococcus aureus, which means it’s a staph infection that is resistant to common medications similar to penicillin. This particular strain is becoming more common in the community, and it can spread quickly; therefore, prompt attention by a trained medical professional is important to prevent things from going from bad to worse. Sometimes it looks just like a small pimple, but that just may be the tip of the iceberg. The contents of entire NFL locker rooms have needed to be torn apart and rebuilt after falling under colonization from staph infections.

Staph infections are so pervasive that they almost brought an entire Ultimate Fighter season to a grinding halt. Mark DellaGrotte recalls his experience working with the fighters on The Ultimate Fighter: “About eight to 10 years ago, we started to see a lot of guys get staph infections in the gyms. It was a real problem. I was coaching season four of TUF. It was called ‘The Comeback’ show. They had me as a coach along with Georges St-Pierre, Randy Couture, and Marc Laimon. Edwin Dewees and another guy had some funny looking pimples on their body. I saw them and thought they looked suspicious for staph. I brought it to the attention of the staff and we went to the hospital, and it was in fact staph. I told Dana White to watch out for all of the cast to get it. This was a serious issue and could end the show if all of the cast members got it. And sure enough, one by one, everyone got it.

“Everyone at the UFC and the TV producers began to get worried. So I looked into how they cleaned the equipment. I asked if they sanitized the mats and they said ‘Yes, we clean the mats everyday.’ I then asked if they cleaned the walls too and they asked, ‘Why?’ Well, the walls were padded with mats, so they needed to be cleaned like the floor mats. These fighters are training shirtless and they are constantly rubbing their backs up and down against the wall. I asked them if they ever cleaned the wall mats in the last four seasons? Not once. How about the stability balls? No. So none of the equipment except the floor mats were cleaned for four seasons. I advised them to clean everything. Even the canvas needs to be changed after each event, regardless of whether the sponsors had changed. I even went as far as having them clean the vans they were driving the fighters around in. Edwin ended up getting hospitalized. Dana went as far as to say I saved the season, and now the UFC watches out for it. It ended up being a great season, with Matt Serra going on to defeat GSP for the UFC welterweight title in a dramatic upset. It often goes overlooked, but probably the most common and dangerous skin infection I have seen is staph.”

RINGWORM

Ringworm is perhaps the most well-known skin infection for grapplers and wrestlers. Ringworm is not caused by a virus (herpes) or a bacteria (staph/impetigo). Instead, ringworm is caused by a fungal infection. The proper name for ringworm is tinea corporis, but since the infection often leads to a red, scaly, ring-shaped lesion with a clear center, the name ringworm took hold. Like the other skin infections presented in this chapter, ringworm can be transmitted by skin-to-skin contact and can develop in many different areas of the body. Again, proper hygiene is important and all rashes should be covered to prevent spread. Anti-fungal medications can also be prescribed to battle this condition.

Sean Sherk advises looking out for yourself and your training partners. “I had ringworm two or three times. There have been a lot of guys at the gym that come in with that. I don’t know why guys show up with that and train and won’t tell you. If you have an infection, just get out of there. Train another day.”

Like many fighters, grappling coach Dean Lister has seen ringworm and has some tips on avoiding it. “If you are the 1% that has never had a skin infection, then congratulations. For the rest of us, one of the simplest tricks to minimize the chances of getting an infection is to wear a shirt in training and, most importantly, take a shower within 15 minutes of getting off the mat. If you do get something like ringworm, there are appropriate creams you can use to get rid of it.”

With all of these infections, prevention and proper hygiene are of utmost importance. According to UFC Hall of Famer Dan Severn, “Ringworm, impetigo, I have had it all. Someone has to bring it in. Personal hygiene is very important. You need to shower right after practice is over. Make sure to clean every piece of equipment, including all floor mats, wall mats, heavy bags, and gloves. And make sure those guys that bring their own equipment also regularly clean it. I make my athletes leave their shoes at the door and off the mats.” Frank Shamrock prefers to keep things simple when it comes to keeping equipment clean: “I don’t wear a gi. It’s one less thing to clean and harbor bacteria.”