Cub Swanson knew something was wrong right away. He knew it the moment that Melvin Guillard’s knee smashed into his face during a routine sparring session at the Jackson-Wink MMA gym in Albuquerque, N.M. But the moment it became impossible to ignore was when he sat down to remove his mouthpiece.

“My teeth felt off,” Swanson told MMAJunkie. “I kind of had a headache. It didn’t knock me out or anything, but I remember that when I pulled my mouthpiece out I could feel my teeth moving. That’s when I started to freak out a little.”

The first thing to know is that, flying knees? During a sparring session? That’s considered a very uncool move in many MMA gyms. But then, Swanson said, that’s just the sort of thing Guillard did. It might be one of the reasons he was not welcomed back to Jackson-Wink MMA years later, even after he announced his return to the heralded fight gym.

As Swanson put it, Guillard “wasn’t very appreciated” in Albuquerque by then.

The second thing to know is that if you feel around in your mouth after a blow to the face and discover that there is a bone sticking through your gums, this is usually a bad sign. Still, when it happened to Swanson he had a not uncommon reaction among fighters. Even though he knew this was probably the kind of thing he should see a doctor about, and even though everything about the situation seemed to suggest a broken bone in his jaw, some part of his brain refused to accept it at first.

“I don’t know why, but when I went to the doctor I thought for sure they’d come back and tell me it wasn’t broken, nothing was wrong,” Swanson said. “Then they said I had like seven fractures and I’d have to have my jaw wired shut.”

For regular people, a broken jaw is something of a freak injury. You hear about it happening in a pickup basketball game maybe, or as the result of a particularly bad car accident. It generally isn’t an occupational hazard for ordinary citizens. It definitely isn’t likely to happen more than once.

But for people whose job includes a steady diet of punches, kicks, knees and elbows to the head, a broken jaw is a thing that happens sometimes. It’s not necessarily the most painful injury. It’s not even one that always sidelines a fighter for a particularly long time.

What it is, according to several fighters who shared their experiences with MMAjunkie, is one of the most psychologically difficult injuries that a professional fighter can face. It’s also not one that most people even think about, since what are the chances that your normal course of business will leave you with a broken jaw? How does a thing like that even happen?

Sam Alvey, UFC middleweight:

“It was a sparring day. I was doing rounds with Sean Strickland. There weren’t that many people there that day, so Sean and I were just kind of working together, and he used to have this style of kind of running from me, so I got cocky, dropped my hands, and just started going at him. He kind of faded away and threw this really light kick that caught me right on the jaw. I felt it immediately. It didn’t hurt. It didn’t rattle me or anything. But I just kind of waved him off and went and sat down. Everyone was asking me if I was OK. I said yeah, I was fine, and then I went to the bathroom and spit out a whole lot of blood. When I looked, my bottom two teeth were split wide open. I yelled out to my wife, who was watching practice, and said, ‘We’ve got to go to the doctor.’”

Aaron Riley, retired UFC lightweight:

“I was fighting Spencer Fisher on one of the first UFC Fight Night events back in like 2006. It was about halfway through the first round when he hit me, and at first I didn’t really know what had happened. It was just a really foreign feeling. It felt kind of like a tooth had exploded in my mouth. But I thought, no, that can’t be it. It took me a minute, and then it dawned on me. It was kind of like, ‘Oh, I think my jaw’s broken.’ I tried to open my mouth to check out the extent of the injury, and when I did that I could actually feel the bones pull apart. That’s when I knew I was in trouble.”

Eddie Wineland, UFC bantamweight:

“I think it was only four or five fights into my career. It was back in (2004), and they didn’t have sanctioning or athletic commissions or any of that crap. They just made up the rules as they went. It was a fight in this rinky-dink hotel ballroom. It was supposed to be a catchweight of 140 pounds. I weighed in, but I never saw my opponent weigh in. I saw him the next day and he was, like, easily 170 pounds. But in the fight, I was actually beating his ass. I kicked him and he fell down. I punched him and he fell into the cage. Then I just got cocky. He hit me with one good punch and it broke my jaw. I clinched with him, threw a couple of knees, but I realized that I couldn’t close my mouth. I let go to call the ref over and he popped off and hit me again. That made it even worse.”

Denial is a common reaction at first. Just like Swanson, who was sure the doctors would tell him his jaw was fine, some fighters either can’t or don’t want to believe that the situation is really as bad as it is.

“I think I knew it was broken,” said Alvey, “but when I went to the doctor I was praying they would tell me it wasn’t broken.”

When it happened to Wineland, he went through a mental checklist of other possibilities, with broken jaw being the very last possibility he wanted to consider.

“I thought, ‘Did I dislocate my jaw?’” Wineland said. “But my jaw actually folded down and I had a big gap in my teeth. So then I thought he knocked my tooth out. Then I started feeling around in there and all my teeth were still there. That’s when I knew something was really wrong. It was not a good feeling.”

In some cases, surgeons insert plates in the face to stabilize the fracture. That’s about as unpleasant as it sounds, according to several of the fighters, especially if, like Swanson, you have other nearby fractures in the face at the same time.

After the flying knee from Guillard, Swanson said, he also had a broken orbital bone to go along with his broken jaw. When the surgeon inserted the plates at the point where his nose met his cheek, one of the screws that held it in place touched a nerve in his face.

“Sometimes now I’ll have a feeling almost like a dead tooth,” Swanson said. “Sometimes when I spar I’ll feel it go all the way up to my brain. And I lost a lot of feeling on the left side of my face, but that’s kind of an advantage.”

Wineland was something of a rare case because, after the surgeon inserted a plate, his body rejected it. He only knew something was wrong because he started getting a bad taste in his mouth, “like something rotting,” and went back to the doctor two weeks after the initial procedure to deal with it.

Usually, once the fracture is set, the jaw is wired shut to keep it from moving. It typically stays that way for about six weeks, which means almost two months worth of drinking all your meals through a straw.

Believe it or not, this is perhaps the worst thing about the experience. On that, there is a firm consensus.

“You really don’t think about how much you enjoy eating food,” said Wineland. “You take it for granted.”

The challenge for many fighters is keeping weight on. Or rather, it’s keeping the right kind of weight on, since some nutrients are easier than others to get in liquid form.

“I lost close to 30 pounds in the six weeks, and I got really fat all at the same time,” said Alvey. “The first week I was on the diet I lost close to 14 pounds. I thought, this is too much, so I started drinking milkshakes just to keep the weight from falling off me. They were delicious, especially at first. But I haven’t had a milkshake since then.”

On the Internet you’ll find all kinds of advice for how to liquify healthy, balanced meals. Most of them, such as anything that involves putting chicken breasts in a blender, sound utterly disgusting. For Wineland, the challenge was the monotony of it. One can only drink so many protein shakes at so many meals on so many days before one starts to go a little crazy.

“Even now,” Wineland said, “I could tell you about 900 different ways to make a protein shake. I tried all kinds of different things to make it taste different, because it gets so repetitive. For breakfast I’d try to make it taste like French toast, just anything I could do, because it really was a miserable experience after a while.”

Riley’s problem was the occasional sweet tooth. He’d try to relieve it by spraying whipped cream in his mouth, he said, but he longed to eat an actual cookie or candy bar – something. He couldn’t stand day after day of applesauce and Ensure.

“You get so desperate, you wouldn’t believe it,” Riley said. “I have a friend who was a professional boxer and he had his jaw broken. That poor guy got so desperate for a Big Mac from McDonald’s that he tried putting it in a blender and pouring milk on it and mixing it all together and then drinking it that way. I don’t think it worked very well. I think a Big Mac is much better enjoyed in its natural state.”

But eating is only part of the problem. There’s also a strange claustrophobia that comes with having your jaw wired shut. Try closing your mouth and clenching your teeth together lightly. Now imagine that you can’t move from that position – not even a little bit, not even for a second – for the next six weeks.

And since, for fighters, a broken jaw often comes with either a loss or at least a sense of frustration and failure in the practice room, depression soon follows. Suddenly, they can’t workout like they’re used to doing. They can’t ease their stress in the gym. They can’t even seek solace in food, or talk in a clear voice to convey what they’re feeling.

You go through something like that after an on-the-job injury, how are you not supposed to question everything in your life, starting with the job itself?

Cub Swanson:

“Every morning you wake up with your jaw wired shut, that’s a (expletive) feeling. The hardest part for me was my family. Right away they said, ‘OK, you’re done, right? This is it? We agree that this is stupid now?’ Both times, I had to sit down and think about that. You ask yourself, could you be OK stopping here? Are you happy with where you made it to? Both times I just felt like, I know I can do better.”

Sam Alvey:

“No pain at all. For six weeks, no pain. When they took the braces off, then it hurt for like a week and a half. But during the six weeks? No pain. But I’ll tell you, part of the way through that six weeks, I really got down. I kept thinking, ‘Man, I don’t ever want this to happen to me again. Maybe I should do something else, be an accountant or something.’ It was real bad. The worst time was at night. I still taught my classes, still did all that. But with my jaw wired shut, come night time I’d feel like I’d been shouting all day. Because, with your mouth shut, just to talk you have to basically shout. Then I’m at home, I’ve got the two kids, and they can no longer understand anything I’m saying, so you just feel like it’s such a struggle by the end of the day.”

Aaron Riley:

“With other injuries, you think it’s all part of the sport. I can handle bumps and bruises. I can handle cuts. I’m tough. That’s what you tell yourself. But when you get your jaw fractured, I don’t know, it’s like a psychological injury at the same time. It affects you in more ways than you think it will. Eating is such a big part of our lives. There’s food that’s called comfort food, and it’s called that for a reason. Just the act of eating it, it makes you feel better. When you’re not able to sit down and eat, it does something to your mind.”

Eddie Wineland:

“You get a lot of demons to wrestle with when it happens. Especially my first one. I actually quit. I told myself, ‘This is stupid, I’m done. I don’t want to do this anymore.’ I mean, I made $600 (for the fight) and I had a $15,000 medical bill. That didn’t seem right. But I started going back into the gym, because I’m always going to be training and doing something. I started lifting weights with my mouth closed. Then I went in and hit the pads a few times. Then I got the wires off and I started training more and the next thing you know you get the itch again. That’s who we are. It’s what I know, is fighting. And when you’re like that and you put yourself around fighting, everybody gets that itch. Even the old-timers who still go to the fights, you know they wish they could still get in there. So 10 months later I fought again.”

Wineland was out for 10 months. Riley went seven months between fights after his first broken jaw. Swanson might have been unlucky in the sense that his happened in practice, but he was lucky in at least one other way. When he broke his jaw in 2011, it was the day after the UFC’s accident insurance policy for all contracted fighters kicked in.

“I think I was the first person to use it,” Swanson said.

Less than six months after Guillard’s flying knee, Swanson debuted in a losing effort against Ricardo Lamas at the first UFC on FOX event in November 2011.

Alvey’s injury happened this past December, less than two months before he was due to take on Daniel Sarafian at UFC Fight Night 82. He had to withdraw from the bout, which meant taking a financial hit to go along with the physical and mental one.

“That’s one of the hardest parts,” Alvey said. “This has been the longest layoff I’ve had in my life. I had such a good year with the UFC last year. My plan was, I was going to fight and buy a house. I had all my tax money saved up to pay off my good year last year, and then I broke my jaw and suddenly it was six months before I could fight again. All my tax money went into surviving. My house plan got pushed back. When I win my next fight, that money’s going to pay off last year’s taxes. It’s just a really crummy situation, and I feel terrible because I’m putting my wife and kids through this.”

Alvey’s return is scheduled for June 18 at UFC Fight Night 89. He’s not worried about how his jaw will hold up in that fight, he said. And, as others confirmed, by the time you make it to the fight itself, you’re usually not too concerned about your jaw anymore. It’s the return to sparring that can be really difficult, since that’s when you’re forced to find out whether you can still take a punch.

“For me, both times, it was about nine months before I got back to full sparring,” said Riley, who broke his jaw once in 2006, then again in 2011. “Even then, you’re hesitant. You’re a little gun-shy and you’re not sure how it’s going to hold up. But you get through that and then pretty soon you’re ready to fight again.”

Swanson, who also broke his jaw twice, in 2011 and in 2015, said he found himself hesitant in the gym for the first time in his career when he returned from that initial injury.

“I think once I got to the fight, I knew I was mentally ready to do it,” Swanson said. “I knew fear or doubt would only make it worse. It’s getting back into the gym for the sparring that’s the scary part.”

Wineland also broke his jaw twice, in 2004 and in 2014. As much as he hated it both times, he said, experience does help in knowing how to deal with it.

“My first fight back from it, I fought with my hands glued to my jaw,” Wineland said. “I don’t think I threw a single punch. I just grabbed the guy and guillotined him because I wanted to get it over with as soon as possible. The second time, I wasn’t as worried. I kind of knew what to expect.”

But that experience comes with a downside, as Riley learned when he broke his jaw for the second time in a bout with Tony Ferguson at UFC 135. It happened in much the same way the first one did. Early in the first round, a good punch found its way through his defenses, and he felt something in his jaw give way.

“But that time, I knew right away what it was,” Riley said. “I remember thinking, ‘Huh, my jaw’s broken again.’”

The first time, Riley had gone back to his corner between rounds and told his coaches that he thought his jaw was broken. They called in the doctor, who confirmed his suspicions and waved the fight off immediately. If he’d known that would happen, Riley said, he might have tried to fight through it. So he thought, anyway.

The second time around he had different coaches. When he told famed MMA trainer Greg Jackson that his jaw was broken, Riley said, Jackson’s response was characteristically upbeat and optimistic.

“Greg kind of said, ‘Don’t worry about it, boss. We’ll get through it,’” Riley said. “I had to tell him, no, forget it. I’m done.”

The problem wasn’t the pain, Riley said, though obviously the pain was significant. The problem was that, having been through it once already, Riley immediately knew what would happen next. He knew enough to dread it.

“As soon as it happened, my mind kind of shifted,” Riley said. “I started immediately thinking about what was going to have to happen now. I wasn’t focused on the fight anymore. Stuff just started flashing through my mind, stuff about the recovery, what the next six weeks was going to be like, all that. It jolted me out of the fight. I was just so frustrated. And the second time it happens, that’s when you really think, ‘This is not worth it.’”

Riley fought one more time, nearly two years after that second injury. He lost a split-decision to Justin Salas at UFC on FOX 8, where he suffered a broken nose, broken orbital, and a fractured cheekbone. He’d already decided to retire before that fight, he said, and he was surprised at the outpouring of support when he announced his decision on Twitter after the bout.

“The way I really decided (to retire) in the end was, if someone told me, ‘Hey, you have to do all that preparation and go in there and do all this again three months from now,’ I would have told them to just go ahead and shoot me instead,” Riley said at the time. “After so long of doing it, really, I’ve just had enough.”

Wineland was out a little more than a year after his second break. He lost a unanimous decision to Bryan Caraway upon returning, then went quiet for the rest of that year. For a while, it seemed like he might not return. Just this week he announced his next fight, against Frankie Saenz at UFC on FOX 20 in July. It will be a year to the weekend since his last fight.

Swanson, too, was out for a year after his second injury, but when he returned last month it was in victorious fashion, defeating Hacran Dias via unanimous decision at UFC on FOX 19. For him, the key was to never let himself get too down about what had happened or what he had to go through just to get another chance at having his face broken by a man’s fists.

“I knew I had to stay positive,” Swanson said. “I didn’t take any of the pain medication, because I knew that would make me depressed. I also knew that sitting at home would make me depressed, so I just made it a point to go out and do things and just be normal. I knew that if I had a negative outlook on it at any point, it would just be miserable. So I didn’t let myself.”

Of this group, Alvey is the only one who has yet to fight again after suffering his injury. By the time he fights Elias Theodorou, it will have been 10 months since the last time he set foot in the octagon. The injury and the layoff hurt his finances and left him racing to regain his conditioning in the final weeks of training camp, he said, but it also gave him a new focus and a new drive.

“Honestly, it just adds fuel to the fire,” Alvey said. “I really feel sorry for Elias Theodorou, because I’m going to destroy this boy. I’ve got a reason to fight this time and it’s going to be a very bad night for him.”

And maybe Alvey will be one of the lucky ones who never suffers another broken jaw. Maybe, unlike Swanson and Riley and Wineland, he’ll just go through that particular ringer once. If not, at least now he’s got experience with it. For better and for worse.

For more on the UFC’s upcoming schedule, stay tuned to the UFC Rumors section of the site.