Football vs. MMA: Which Is More Dangerous? Athletes and Physicians Weigh in

Scott Harris@ScottHarrisMMAMMA Lead WriterApril 12, 2019

Eryk Anders
Eryk AndersBuda Mendes/Zuffa LLC/Getty Images

Eryk Anders was the tip of the spear. His football coach at the time, Nick Saban, was known to be rather, shall we say, attentive to special teams. So when Saban designated the sophomore linebacker as a wedge buster on kickoff coverage, it wasn't something to be taken lightly.

In 2007, Anders and his team, the Alabama Crimson Tide, were playing Vanderbilt. Anders streaked down the field to disrupt the Commodores' kickoff return.

But almost the moment he hit the wedge, everything disappeared. When it reappeared, he was back standing on the sideline.

"I was knocked unconscious," he said. "I walked to the sideline, but I don't remember. I was over here, then I woke up, I was over there. A whole two minutes were gone."

The story is rough, but it's not unfamiliar to anyone who has played or even watched football (the American kind, anyway). What makes Anders' experience unusual is that after playing an integral role in his team's college football national championship victory, he became an MMA fighter. Today, he's a middleweight in the UFC with a pro record of 11-3. He's had plenty of success there, but he's had some tough days too, including a September knockout loss to Thiago Santos while competing at light heavyweight.

Anders (right) gets a game-sealing sack on Texas quarterback Colt McCory.
Anders (right) gets a game-sealing sack on Texas quarterback Colt McCory.Jae C. Hong/Associated Press

"I lost via TKO, and I took some elbows," he recalled. "The round ends and I'm trying to make it back [to my corner]. I remember everything, and I remember the cutman and my coach trying to get me back to my stool. Back in the locker room, I had mood swings. I was nauseous, started throwing up. ... I didn't want to go to the hospital, but the UFC was like, 'Yeah, you need to go to the hospital.'" 

Anders is in an unusual, but not unique, position. This Saturday at UFC 236, Anders will take on another top striker in Khalil Rountree, and he will be joined on the card by another fighter in a very similar position. Light heavyweight Ovince Saint Preux (23-12), who will face Nikita Krylov that evening, played at defensive end and linebacker for the University of Tennessee.

Ovince St-Preux (left)
Ovince St-Preux (left)Josh Hedges/Zuffa LLC/Getty Images

Both sports carry plenty of risk; that conclusion doesn't require an expert. But there's a wider story to be told by these two athletes, who have both risked brain and limb in arguably the two most dangerous sports on the planet.

So which sport do they think is truly more dangerous?

Take a quick look at the sports' top-line attributes. Football collisions have famously been compared to car crashes. There are no weight classes there, either, with 300-plus-pound players regularly crushing opponents 100 pounds lighter than them. At the same time, football players wear helmets and pads; fighters don't. Football doesn't have flying knees, either.

Close race? Not according to Anders and OSP. Perhaps a bit surprisingly, both are quick to render their verdict. 

"It's football," Saint Preux said. "Obviously anytime you get knocked out, you get a concussion. You get hurt, your bell gets rung, that's a concussion. What usually happens is you play through it. Week 1, you get a minor concussion, you keep going. Week 5 comes around, it's worse."

And what about Anders?

"In football [against Vanderbilt], I finished the game like that [after the concussion]," he said. "It wasn't the last kickoff I covered in the game. ... In MMA, you more accept the possibility of injury. You know more what you're getting into."

Anders struggles to walk during his TKO loss to Thiago Santos.
Anders struggles to walk during his TKO loss to Thiago Santos.Buda Mendes/Zuffa LLC/Getty Images

Those are interesting takes, but what does the science say? Take it from Charles Bernick, MD, MPH, one of the nation's leading brain injury experts and chief researcher for the Professional Fighters Brain Health Study, a project from the renowned Cleveland Clinic that examines brain health in fighters and other athletes. According to Bernick, a true comparison is essentially impossible.

"It may not be just the huge concussions. There are various sub-concussive injuries," Bernick said. "You would need sensors inside their mouth guards, and even then you can't know about the sub-concussive injuries or how it differs from person to person. You can get hit and have no symptoms. It's a very nebulous field. We don't know if it's cumulative or if the major hits are the worst. That's what we're working to find out. But we simply don't know."

Some statistics do exist, and at first glance, the data seem remarkably close. A 2018 study concluded that mild brain injury occurs in 23.6 percent of MMA fighters. Following the 2018 NFL regular season, 25 percent of concussion screenings came up positive, according to league officials.

Dr. Charles Bernick at the Lou Ruvo Center for Brain Health in Las Vegas
Dr. Charles Bernick at the Lou Ruvo Center for Brain Health in Las VegasJeff Bottari/Zuffa LLC/Getty Images

Still, therein lies the difference. The NFL is measuring concussions based on its own protocols; the MMA study measured mild brain injury using its specific criteria. So on a deeper level, those numbers could illustrate Bernick's point. It's not just apples and oranges. It's thumbtacks and rocking chairs.

In fact, the inability to compare the two sports speaks to how complicated it is to evaluate brain injury, period. Everyone knows getting hit in the head is bad. But dig deeper, and the science gets murky quickly. That's why, according to Bernick, any and all prevention or mitigation efforts are useful, and it's why culture change is, and should be, happening. The NFL has instituted well-publicized rule changes, among other things. MMA fighters are paying more attention overall and limiting risky behavior in the gym, even as the risk inside the cage remains essentially unavoidable.

"Some fighters are getting much more cautious. Knockouts happen in sparring, but they're not common either," Bernick said. "I'm not saying there's no concussions, but the ones that do happen there are few and far between. Football is also changing. Rule changes work because any time you reduce contact, it's helpful. Hopefully they can continue to do more in the future."

Those cultural differences may be what really sets MMA and football apart, at least until more science comes in. Neither is "better" or "worse" than the other, but MMA seems more evolved, if for no other reason than that its violence simply requires it.

"In MMA, you get time off. In football, after the concussion protocol, you can get time off, but not always besides that," Saint Preux said. "They still want to do hard sparring [in MMA], but not as much. You don't see a lot of football scrimmages anymore … But on the flip side, I've done a lot of boxing, and the reason I say it's football is you learn to be tough all the time."


Scott Harris covers MMA, sports medicine, and other topics for Bleacher Report.