This review article on street combat data for emergency departments with mapping for training recordings is a shortened version of Chapter 1 of a book published in 2011 by the same author (Ref # 1).
For the past decade, I have been on a journey of comparing traditional Japanese karate from the mainland (distance-oriented strike-fighting and sweep / take-off techniques) to close in combat approaches. “Close In Fighting” has recently been widely termed “more practical”, which is why I have explored this world by expanding my understanding of kata bunkai and rethinking some of my judo / grappling skills (this is where I began my martial arts art for over 25 years ago). This journey has led me to start writing a book with a number of clinicians, identifying which injuries are actually recorded from street battles by the hospital’s emergency departments, and based on the extrapolate, which techniques seem to be more practical to train in relationship with others. Subsequent chapters of the book then dissect anatomy and physiology for techniques most likely to produce medical results based on the data.
The goal is to make it easier to think about what can be considered “practical combat training” so that one can train the right techniques to protect themselves from serious injury if a street room occurs. Even if you choose not to practice the techniques of street-based damage, understanding how others are likely to hurt you provides the best insight for defending against any attack.
This snippet article is not about dominating an opponent in a fight (ego-based outcomes) or submissive law enforcement techniques – as such encounters have no serious medical result. But one wants to identify techniques that have an incredibly low probability of occurring, based on police and hospital admissions data. For the purposes of this article, serious injury from the struggles is defined as one in need of urgent medical treatment – something less than it is definitely not worth training night after night, year after year to avoid.
Often, when I teach martial arts seminars, I urge participants to:
• why they train (the data below represents what I see as an answer in such seminars, ie the biggest% answer is self-defense (Ref # 1)
• how many have actually been in a fight?
• Further, of those who had been in a fight, how many considered the situation in a category related to “serious bodily harm”? Like ripped t-shirts, contexts from rolling on the ground and general brands all relate to ego, not to self-defense against serious bodily harm.
To address the topic of “practical combat training,” I will discuss the medical practice abbreviation “EBP”, which stands for evidence-based practice. Physicians use “evidence-based practice” as a practice path involving a physician analyzing data to establish a treatment pathway or future practice. In contrast, very few martial arts artists have looked at the medical facts related to people’s martial injuries and why they present in a post-match hospital. To ensure that we study the right type of self-defense techniques (avoiding serious injury in a fight), if that is the goal of most karate-ka, we need to look at what could potentially hurt, and combine it with a balance in the likelihood that such damage will actually occur. Unlike blindly practicing techniques year after year, which, according to medical and political data, rarely causes any harm in a street fight today.
In the martial arts world, all sorts of claims fly around this technique or approach that is more practical than another. Let’s start by reminding ourselves what practical means are to be sure that we do not start down a delusional line of argument:
Macmillan Dictionary Definition of Practical:
“involving or relating to real-life situations and events that are likely”
Some keywords to be noted in this definition are “real situations” and “likely”, ie. we need to train in techniques that are likely and lead to harm – otherwise we live in a delusional world or one of paranoia, possibly training in a situation that statistics show is incredibly rare.
The data should also define whether a given technique or style of martial arts is really:
1. only sports scenario given its low incidence of driver damage to the street
2. a vestige from feudal times (i.e. practicing something not relevant to today’s medical injury statistics)
3. something that does not cause any damage to the body with any degree of probability and is therefore not justified to spend many nights / years training to avoid (if the goal is to practice “practical” martial arts)
Using suffocation techniques as a first example. The reality of a street fight involving fighting that actually leads to asphyxiation (a medical result) is less than 0.001 percent of the population. When compared to the practicality of training with a 0.001 percent probability of suffocation, it means that someone feels that training 3-5 nights a week is worth something 100 times less likely than being hit by a car while one goes.
It is also worth noting that many of these rare suffocation cases are often older and women. Therefore, young men who focus on suffocation techniques fall somewhat further into the area of impracticality, as their odds are far lower than 1 in 100,000 of ever needing it to create / prevent a medical outcome.
Another data point that puts the risk of death by stifling in a modern-day street fight is to compare the likelihood of an average 35-year-old man being hit by cancer (odds are close to 1 in 100; modeling the likelihood of developing cancer in Germany by Breitscheidel & Sahakyan and published in The Internet Journal of Epidemiology 2006 Volume 3, Number 2). That is, cancer is 1,000 times more likely than suffocation – and yet many 35-year-old men go to a gym several nights a week for a couple of hours to participate in cancer prevention research and cancer diet options?
Of course, in most societies before 1800, one could guess that this technique was more practical as something to learn or to learn to defend against. But with the development of modern strict justice systems, forensic technology and probably a general higher regard for human life, this technique really has a place in the past, and the statistics point to it.
Grappling techniques and their likelihood of leading to medical outcomes. The data presented in detail in the forthcoming book highlight that impact injuries (e.g., a headache leading to hospitalization) as a result of street fighting are ten times more likely than grab-related injuries. Obviously, getting a high level of expertise by blocking or staying away from a fast incoming hit is all the key techniques for developing timing skills around (which is the very definition of karate’s core skill set as long as one includes hook and straight pistons). Unless you are in law enforcement, you are ten times more likely to need this than a giant skill to protect yourself on the streets (as a note, keep in mind that even the chances of needing percussion skills are low for it average citizen).
The UK police statistics for the 10 abusive activities (which differ only in a minor way to the top 10 medical results) are below (male to male data only):
1. The attacker pushes, the defender pushes back, the attacker throws a swinging punch to the head.
2. A swinging punch to the head
3. A front grab, with one hand, followed by a blow to the head
4. Two-handed front cover grips, followed by headband
5. Two-handle front cover, followed by knee to groin
6. Bottle, glass or ashtray for the head, swinging
7. A buzzing kick to the groin / lower legs
8. A bottle, glass attached to the face
9. A slash with a knife, usually 3-4 inches of lockblade or kitchen knife
10. A stunning style headlock
Note: The top 9 of the 10 mentioned are all impact-oriented forms of assault.
As a matter of fact as to the importance of mainstay on the street, unfortunately, in the month of writing this article, we had two adult members of our network in two distinct street battles. One was a kyu rank and the other fight involved one of our black belts. It’s a shame when such a thing occurs, but as an honor to their training, both cases saw a block and a single jerk unable to their opponents where the main punches were the issue. Of course, a single counter may not define the outcome every time, but the key point here is the head shots and the likelihood of injuries resulting from technique over another.
There is no data to show that once two fighters “go to ground”, whether trained or untrained, that there is any reason to believe that an injury is more / less likely to result (ie Anyone can “squeeze” another person without years of grappling training and the result via the medical statistics is, once they do, the likelihood of a medical injury is essentially gone). The grappler may get the better of a person who is not trained, but the statistics still show no significant medical results – so one has to ask, is it worth training for something with no result other than ego protection? We must return to true self-defense against serious bodily harm as a reason for not training an emphasis on ego-related issues.
Break-Fall techniques and the likelihood of them protecting one from medical outcomes. Given break-fall training (Japanese chemistry), the data shows that severe concussion (traumatic brain injury) [TBI]) from falls in an assault scenario results in hospitalization at a rate of 1 in 3,000 for Australian men around the age of 35 (Australian Institute of Health and Welfare Canberra, separation of hospitals due to traumatic brain injury, Australia 2004-05 by Helps, Henley & Harrison). It should also be noted that this data includes fall injuries after being stopped or kicked as well as from throws – so the actual fighter-related damage from fall / throw is lower than 1 in 3000. The reason for break training is therefore at least 35,000 times higher than strangulation techniques. Throwing / falling is actually the primary event that can cause an injury if a street fight moves from an impact scenario to a struggling event, so break fall training in these curricula is key if you are looking to tackle the ten most injury scenarios.
US data reflects the Australian results (Ref # 1) in relation to concussion (TBI = traumatic brain injury), and US data conclusions say that:
“Most physical assault related injuries were caused by one person being hit by another person. The next largest category involved falls / throws, etc., leaving less than 10% of injuries related to seizing.” – U.S. Department of Justice Office of Justice Programs Violence-Related Injuries Treated in Hospital Emergencies.
“Armbands” or reverse joint fractures and the occurrence of a medical result in a street fight. Common hyperextensions (e.g., armpits) had incidents at levels so low in the United States and Australian studies that comments in a number of reports provided include
• “too low to accurately report”
• “not too busy”
Speaking to emergencies, doctors, I bump through my work or friend connections highlighted the reality of the emergency department studies. For example, by interviewing 4 emergency medical consultants, each with approximately 20 years of experience (cumulatively being 80 years at 8 hours a day, hanging around in emergency departments), a match-related event involving joint hypertension (e.g., armpits) could occur. causing a dislocation and a need for medical treatment. So while the reverse Segal elbow Steven Segal films look good and bunkai from such kata as Seipai involving reverse breaks exist, injuries from such techniques never seem to be present in hospitals.
Budo training – “All roads lead to Rome”
The following summary could be extrapolated to the above data:
1. The likelihood of an assault leading to a serious medical injury to the average citizen is very low
2. If you happen to be one of the few who suffered a serious injury in an assault, statistics on medical admission and police assault show that very few serious injuries are the result of seizure compared to strikes (an approximate ratio of 1 to 10).
The data makes it very difficult to justify spending many nights a week for many years in a dojo for self-defense considering the likelihood of using the techniques to prevent injuries is far below such other remote options that cause bodily injury as cancer, and even pedestrian car strikes (i.e. other things we would never seem to spend so much time training for through preventative measures). But when practitioners are examined (above polling data), they indicate that their primary desire for training is self-defense against serious injury – this appears to be a discrepancy, or implies that a state of paranoia people tend to have it, that is out of proportion to other health / life-threatening events.
Remember that martial arts contains at least the following:
2. Health / fitness
3. Character development (confidence, stable feeling, clarity of mind)
According to the Macmillan Dictionary definition of “practical” given earlier in this chapter, the “self-defense” component of the above list may not fit into the practical area, regardless of one’s training style or weight. However, “Fitness” and “Character Development” are things we all want to use every single day of our lives to be the best we can be in life, work and family. Therefore, the weight and the rationale for training should lie in the two points mentioned above that we use every day instead of the one article that, according to statistics, we will probably never use. These questions should provide a compass for sensei to consider their curriculum and student outcomes.
In many ways, over so many decades and by so many of the martial arts masters, the “zen” or character development side of martial arts has been emphasized. The phrase “All roads lead to Rome” is very appropriate, no matter how analyzing martial arts inevitably discussions of Budo return to the inner journey to a better self. The statistics and likelihood of medical results from the matches also point to the same answer.