Protecting your internal organs from shots is as important as protecting your chin. Professional fighter and osteopath Rosi Sexton continues her series on protecting your insides from the outside…

The liver is a vitally important but much misunderstood organ.

Most fighters think about it in relation to their weekend alcohol consumption, or recognize the feeling of being dropped with a ‘liver shot’ in sparring. Having a healthy liver is also crucial for your performance in many other ways. 

The liver sits underneath your rib cage on the right hand side.

It’s like a chemical factory, responsible for producing many proteins and hormones and breaking down and detoxifying other chemicals.

It’s essential for survival; total liver failure leads to death within just a few days. 

Carbohydrate metabolism

The liver helps in the processing of carbohydrates. It stores sugars in the form of glycogen. When blood sugar levels drop, the liver is able to break down and release this stored sugar back into the blood stream, and it can also metabolize other nutrients such as amino acids and lactic acid to produce glucose in a process called gluconeogenesis. 

Glucose is a simple sugar, and is the main form of carbohydrate used by your body. Other forms of sugar must first be converted to glucose before they can be used to provide energy. Having a consistent source of glucose in the body is important for several reasons - firstly, because it is the brain’s only source of fuel (one reason why it becomes progressively harder to think clearly as you get more tired during a workout), and secondly because it is essential for anaerobic metabolism. Other energy sources, such as fats, need oxygen present in order to produce energy. Glucose alone allows you to ‘borrow’ energy quickly for bursts of increased intensity. 

In the run-up to a fight, fighters often decrease their carbohydrate intake in order to drop weight. This is an effective strategy, partly because stored glycogen is bulky and holds a lot of water.

A low-carb diet forces the liver to work hard to keep up with the demand for glucose production during training. 

Consuming high-carbohydrate meals, snacks and drinks after the weigh-in will allow the liver to restore much of this lost glycogen, and improve the fighter’s performance on the night. (Eating little and often is key; suddenly consuming large meals following a strict diet may cause digestive difficulties!)

Alcohol

It’s well known that alcohol can affect your performance and ability to train, and many fighters will stay away from it in the weeks leading up to a fight. Alcohol is detoxified in the liver, but a side effect of this process is that it inhibits gluconeogenesis. Dealing with the chemical consequences of your big night out prevents the liver from efficiently doing it’s regular job of managing your blood-sugar levels.

Alcohol also has other effects on your body that impact performance, including dehydration, reduced tissue healing and impaired aerobic capacity. Even moderate alcohol intake can affect your performance for up to 48 hours, and after a night of binge drinking it can take your liver several weeks to return to normal. 

Drugs and hormones

The liver protects your body from the damaging effects of many drugs by detoxifying them. Unfortunately, this means that the liver itself can be susceptible to damage from these drugs.

Performance-enhancing drugs often fall into this category – steroid hormones in particular can be toxic to the liver, leading to long-term damage or in some cases cancer. 

The liver shot

The ‘liver shot’ was popularized in MMA by Dutch striker Bas Rutten.

It refers to a punch, kick or knee that targets the liver (right hand side of the body, just under the rib cage). A precise impact here can be devastating, making it impossible for the fighter to continue.

It has often been compared to a groin shot in terms of pain and effect. 

There has been debate as to exactly what causes the severe pain and weakness that fighters experience after a strike to this organ.

Serious traumatic damage, although possible, is the exception rather than the rule. Many fighters recover fully by themselves within minutes after being dropped with a shot to the liver.

One theory holds that the impact may affect the vagus nerve, which causes a sudden drop in blood pressure. 

If you experience pain or other symptoms that don’t go away within a few minutes after a shot to the liver, then please seek medical advice.

Other diseases that affect your liver

Many conditions can affect the liver, but few of these are common in MMA fighters. An important disease to be aware of is viral hepatitis.

This comes in various forms, but two in particular (hepatitis B and hepatitis C) can be spread by blood contact.

Although these conditions can be treated, there is no ‘cure.’ They result in an inflammation of the liver, which can progress to cause chronic cirrhosis or cancer. 

Fighters should be tested for hepatitis B and C (as well as HIV) before competing. In training, care should be taken to clean up blood spillages appropriately, and to avoid contact with another person’s blood.

Hepatitis B is the more contagious of the two, as it can survive for several days outside the human body. There is a vaccine available. 

Symptoms of liver failure

The symptoms of liver failure can be subtle. Because of the liver’s capacity to repair itself and to compensate for damage, sometimes by the time clear symptoms appear the damage has already been done.

In the initial stages, there may be a general feeling of being unwell, tiredness, nausea or lack of appetite and a feeling of tenderness or discomfort around the liver. 

Later on, there may be jaundice (yellowing of the skin and eyes), dark black stools, weight loss, confusion or memory loss.

In men there may also be gynaecomastia - colloquially known as ‘bitch tits.’ Normally the liver breaks down estrogen (known as a ‘female’ sex hormone, but present in both men and women); when the liver isn’t functioning fully, this can build up in the blood stream, upsetting the balance of ‘male’ and ‘female’ sex hormones. 

If you have any concerns about your health, then speak to your doctor as soon as possible. 

Case Studies

> Bas Rutten used the liver shot to great effect in his 1996 Pancrase fight against Jason DeLucia, rupturing DeLucia’s liver and earning a TKO victory.

> Rich Franklin beat Matt Hamill with a liver kick at UFC 88. 

> In his Pride days, Mirko ‘Cro Cop’ produced three wins from strikes to the liver.