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The big issue is I would say less Cain's injury layoffs and more that when he was fit he was still only fighting a 2 matches a year schedule.
You look at say Shogun in Pride, he had a long layoff after the Coleman injury but then when he returned he fought 4 times in a few months.
Before he got hurt Cain fought 4 times in 17 months. The problem was that it was twice each against Big Foot and JDS.