Baki Hanma and Biscuit Oliva are two of the most powerful fighters in the Baki universe,
let’s see what we can learn about the human body when they go head to head…
If you pick a fight with the most powerful man in the USA, you better be ready to back
it up.
Fortunately, Baki is very ready.
When you’re as powerful a fighter as he is, it can be difficult to find a suitable
sparring partner.
(flexing) I can relate.
In the latest season of Baki, our title character gets himself arrested and enters Arizona State
prison (also known as the Black Pentagon) where Biscuit “Unchained” Oliva resides.
Biscuit is widely known to be the strongest man in the USA, and Baki is sure that he is
a worthy test for his martial skills.
Shot in chest.
A highly paid mercenary, who lives in prison by his own choice, among many of the criminals
that he helped to put behind bars, Biscuit is an imposing man.
Baki is undeterred.
If anything, Oliva’s reputation only serves to get Baki more excited.
And with a swift unexpected kick, it is clear that he isn’t wasting any time…
Pause video
Now these juggernauts clearly do not experience injury in the same way that a regular human
might.
And that is part of the fun– I will not address every blow but rather the interesting
moments that give us an opportunity to learn something, as we suspend our disbelief for
the duration of the fight.
With that in mind, we’ll consider this first kick combo and Oliva’s follow up open hand
serve – a warmup!
Oliva: “the fight starts now”
Excellent, but Baki– are you sure you want to fight Oliva with your hands bound behind
your back?
Shoulder dislocation.
Well, that works.
In order to free himself of the thumb cuff that binds his hands behind his back, Baki
voluntarily dislocates both shoulders at the glenohumeral joints, simultaneously and seemingly
without pain.
He then flexes his muscles and snaps the joints back into place.
This is a special guy.
The glenohumeral joint is a ball-and-socket joint that connects the upper arm to the trunk.
It is a type of diarthrodial joint where joint surfaces are contained within a joint capsule.
It is a synovial joint where the bones that articulate with each other at their cartilage
surfaces within fluid that provides lubrication that facilitates free movement.
The glenohumeral joint, formed from the combination of the humeral head and the glenoid fossa
of the scapula, is a great example of this type of joint.
Normally, the shoulder is quite stable with stability provided by the joint capsule, its
intrinsic ligaments, the bony architecture of the joint, and the muscles around the joint
circumferentially.
Stability can be compromised by damaging any one of, or any combination of these stabilizing
structures.
Such is the case with those who have recurrent instability of the shoulder after a traumatic
dislocation.
With these patients, the shoulder frequently falls out of joint unintentionally during
activity, causing pain and disability until the shoulder has been reduced back into joint.
Patient with this problem often require surgery to correct the instability problem.
In some cases, however, a person may be able to intentionally dislocate one or both shoulders
in a number of directions without significant trauma.
Can you say double jointed?
You see, despite its name, double jointed does not mean that a person has extra joints.
It really just describes the hyperlaxity of the joint capsule leading to hypermobility
in the joint.
Meaning that, the ligaments that support the joints have more stretch than they should.
Some individuals have a genetic predisposition to loose joints and ligaments as a result
of abnormal collagen production.
Perhaps Baki holds this genetic predisposition or perhaps he has trained his joints and ligaments
to achieve this feat, flexing his muscles to exert internal tension on the joints and
pop them back into place.
Either way, Baki is creeping me out.
He makes me want to consent him for an shoulder stabilization.
Voluntary Anterior Dislocation of the Shoulder in a 10-Year-Old Child Treated Surgically.
The man in the cell next to Baki is surprised by this feat.
He obviously doesn’t know the son of ogre.
Well my friend, you’d better buckle up, because what you’re about to see next is
equally as shocking.
Baki attacks Oliva
Oliva defends against Baki’s next strike, and then grabs his younger opponent by the
arm pulling him against and then through the concrete cell wall.
(motion like you’re performing a seated row)...
I can’t even begin to fathom the amount of strength that Oliva possesses– He then
takes Baki by the wrist and ankle and swings him up and down through the air like a towel,
before violently tackling him, upside down through several brick walls in one go.
Even Baki felt that.
These attacks are certainly not going to improve the stability of Baki’s shoulders any.
Pressing on, Oliva looks to plant his monstrous right shoulder into the space between Baki’s
abdomen and his lower ribs.
The initial impact of the football tackle has blunt abdominal trauma written all over
it.
See?
BROLL slow motion tackle.
Blunt trauma to this region of the body commonly results in injury to the liver which is the
largest organ in the area, and in the human body aside from your Epidermis, weighing approximately
3-3.5lbs and about half the size of a football.
There are many other vital organs that also reside in the abdominal region including the
spleen, pancreas, stomach and large and small intestine.
Injury to any of these organs is undesirable and could potentially cause a contusion or
rupture of a solid organ, or a rupture of a hollow viscus organ, or internal bleeding
within the abdomen.
Generally speaking, these problems are all surgical emergencies.
These organs are filled with food in various stages of digestion, digestive enzymes, or
blood.
All of which do better in the GI tract or their respective organs, than they do outside
of it in the abdomen.
Spillage of these contents into the periotoneum, leads to peritoneal contamination, either
with food contents, digestive enzymes, poop in various stages of formation, bacteria,
or blood.
All bad, all pretty damn messy, and all requiring the attention of a general surgeon.
Judging by the location of impact– Oliva’s shoulder must have put pressure on Baki’s
lower ribs.
Now the bottom ribs are less likely to become injured because they have more flexibility
than do their counterparts above, which articulate in the rear to with the spine but also anchored
in front to the sternum.
But with Oliva level force, they could potentially be broken– and a fragment of broken bone
floating around in the abdomen can cause serious damage to the visceral organs located there.
Visceral Injuries in Patients with Blunt and Penetrating Abdominal Trauma Presenting to
a Tertiary Care Facility in Karachi, Pakistan - PMC
Now Oliva has graciously highlighted the part of the back where the Baki’s kidney resides.
If you watch boxing or MMA, then it’s likely you’ve heard the term kidney shot.
These organs play a vital function in waste removal and internal fluid homeostasis, or
the maintenance of balance, and are located on your lower back, below the rib cage.
Did I mention that they hurt like hell when struck.
Well, Oliva, where will you put the exposed back of our hero?
BROLL smashing through walls
Smashing back-first through three reinforced concrete walls on the shoulder of America’s
Strongest Man is… well, dangerous – 10/10 wouldn’t be recommended.
Not only does each individual impact increase the likelihood of all the aforementioned abdominal
injuries, but now we must also consider the effect of blunt force trauma to the low and
mid back.
Even Baki looks to be shaken up by this crushing attack.
Obviously, the spine and spinal cord are at risk when extreme compression, crushing or
deceleration forces are exerted upon it.
In these impacts, due to the momentum that would be necessary to break through three
consecutive walls, the cervical spine, relatively speaking, would be relatively less at risk
than the thoracic and lumbar regions.
Blunt Back Trauma - Emergency Management
Meme: cervical spine winning lottery.
Thoracic and lumbar spinal fractures are commonly encountered in blunt force trauma patients.
Approximately 50% of all vertebral fractures occur in the thoracolumbar spine, where the
thoracic and lumbar spine meet, and where the vertebrae are not supported by the rib
cage or the pelvis.
The incidence of TLS fractures in trauma patients presenting to level 1 trauma centres, where
the most severe patients are treated, is approximately 4-5%.
Neurologic injury to the spinal cord occurs in 19-50% of these patients and a delay in
diagnosis of TLF fractures can result in up to an eightfold increase in neurologic deficits.
Now granted, most TL vertebral trauma stems from falls from height or high speed motor
vehicle collisions.
However, being tackled through three reinforced concrete walls by Biscuit, certainly qualifies
as a high energy injury mechanism.
Thoracolumbar Spinal Injuries in Blunt Trauma, Screening for - Practice Management Guideline.
All that to say: if Baki had suffered a spinal fracture as a result of one of the impacts,
it would most likely occur in his low back and it would certainly benefit him to seek
medical attention immediately.
BROLL angry Oliva
Somehow, I don’t think that’s going to happen.
There is a small chance that with the initial impact, Baki is susceptible to a flexion-distraction
fracture in the thoracolumbar spine.
This mechanism is also known as a seat-belt fracture, and typically occurs in patients
in the backseat of a frontal car crash wearing only a lap seat belt.
The car stops suddenly and the body flexes forcefully forward over the seatbelt, causing
sudden extreme distraction force on the posterior and middle columns of the vertebrae – essentially
pulling the bone apart along its midline causing a horizontal fracture in the spinous process
and into the middle vertebral body.
This injury is often associated with gastrointestinal injuries, like those previously mentioned,
injury to the Posterior Ligamentous Complex and sometimes failure in the anterior column
due to compression.
Oliva’s attack exerts this type of force on Baki’s spine, with enough energy to drive
his opponent through a concrete wall.
Perhaps it isn’t farfetched to compare this impact to a crashing car…
The decision of whether or not to treat this injury operatively is based on the presence
or absence of mechanical instability or neurological deficits, but generally, with involvement
of the posterior elements of the spine stability is lost and surgical stabilization is required.
Baki would need to get a Radiograph, CT scan and possibly an MRI before we can determine
the severity of the injury and the optimal form of treatment.
BROLL Baki “I don’t think I’ll have time to visit the infirmary doc, can’t you
just clear me to continue?”
Chance Fracture (flexion-distraction injury) - Spine - Orthobullets
Sure, why not.
So let’s say that Baki snaps violently over Oliva’s shoulder and avoids this type of
injury altogether…
AO Spine classification of thoracolumbar injuries | Radiology Reference Article | Radiopaedia.org
Literally a split second later, we run into yet another problem: the crushing pressure
that Baki’s spine would experience with each concrete breaking impact.
Here Baki is susceptible to both incomplete and complete burst fractures.
A burst fracture of the spine usually results from significant trauma that compresses the
bone, such as motor vehicle accidents or severe falls– Maybe medical researchers should
consider adding Biscuit Oliva to that list?
He’s like a cross between a severe fall, a motor vehicle accident and an angry rhinocerous.
But I digress…
Normally, this force is applied to the spine axially, or from top to bottom, in line with
the spine.
However, here, Baki it bent forward so forcefully that the compressive force is caused by extreme
spinal flexion rather than axial loading.
Can anyone say Cirque De soleil?
[take tiktok clip of cirque contortionist benching here].
Burst Fracture Diagnosis & Treatment - NYC | Columbia Neurosurgery in New York City.
Columbia University's Department of Neurosurgery holds nothing back in their explanation: a
burst fracture is a serious problem, as the vertebral body shatters with enough force
to separate the bone fragments and compromise the vertebrae ability to support the spine.
Bone fragments can also be displaced into the spinal canal or foramen, leading to pressure
on the nerves and compromised function.
Were Baki suffering from this type of injury, he would require immediate medical assistance.
This may not be the best time for a medical assessment, but we’ve got to work with what
we’ve got.
BROLL Baki on the ground
So Baki, are you experiencing a) moderate to severe back pain that is worse
with movement?
b) numbness, tingling and weakness in the groin, lower extremity, or around the anus?
c) loss of bowel or bladder control?
Again, I jest– we’d need radiography, a CT scan and an MRI to assess the severity
of the injury, but the physical exam would give us clues about the injury present.
Depending on the assessment, the surgeon would determine the optimal approach for the injury
in question.
Similarly to flexion-distraction treatment, if no neurological damage is present a non-operative
approach may be sufficient.
In more severe cases, the surgeon may need to remove the bone that is compressing the
spinal cord and nearby nerves with spinal decompression surgery.
The surgical approach to the injured bone would be determined by the extent and the
location of the injury.
If the stability of the spine is mechanically compromised, the surgeon may need to re-establish
the stability through spinal instrumentation and fusion.
The surgeon will use a variety of grafting materials between damaged bones to stimulate
the vertebrae to fuse together.
Surgical implants such as screws and rods are used to hold the spine rigidly in place
while the bones fuse.
BROLL Baki “but doc, I’m fine.”
I don’t understand you guys.
BROLL Biscuit throwing Baki against the wall “yeah doc, he’s fine.
Take a shot of you closing your eyes and concentrating “suspending disbelief”
Well Mr. Oliva, you just grabbed him by the wrist and threw him against a thick steel
door with enough force to crumple his body, thus exacerbating the risk for spinal injury
and further shoulder instabilty.
We’ve already talked about this
BROLL: Biscuit– “he started it.
Now let’s continue the lesson.
Weren’t you talking about blunt force trauma to the abdominal region?
How’s this to support your lesson?
Admittedly, that is an excellent example of blunt force abdominal trauma, possibly more
so than your earlier impact since with this blow, you’ve crumpled a reinforced steel
door with several inches thickness like a tin can.
You’ve also recreated the crushing spinal chord trauma expertly.
Repetition, for memories sake!
Were you trained as a medical educator?
Now let’s talk about the resultant fall from height that sends Baki crashing to the
ground from 4-5 stories up.
For those of you at home wondering if typically a human being bounces like a tennis ball after
falling from such a height: no, they do not.
That is just Baki.
A quote from JBS Haldene seems relevant here.
“Gravity… to the mouse and any smaller animal presents practically no danger.
You can drop a mouse down a thousand-yard mine shaft; and, on arriving at the bottom
it gets a slight shock and walks away, provided that the ground is fairly soft.
A rat is killed, a man is broken, a horse splashes.”
The only logical conclusion?
I guess Baki is a mouse.
MEME
With his head between his hands, he flexes his abdominal muscles and upon impact with
the concrete floor, pulls his knees towards his chest.
He activates his sternocleidomastoid and anterior scalene muscles to fix his cervical spine
in a flexed position thus keeping his head out of harm's way.
An expert way to avoid blunt trauma to the skull, but focus the entire force of a four
story fall on his thoracic spine.
We’ve talked about this, but obviously everything we’ve talked about does not apply.
Baki is just built different.
In a realistic setting I would expect the muscles of the body to be overwhelmed by the
force of the impact, rendering it impossible for Baki to retain his forward crunch position.
His head and limbs would be catapulted against the ground in an explosive, blunt-force-to-the-head
fashion.
BROLL Baki face kick.
We’ll talk all about blows to the head as we continue our analysis of this incredible
fight scene next video.
Biscuit if you wanna win this thing, you’re gonna have to try a little harder.
As always that’s been a word from Dr. Chirs, not your everyday Ortho.