2016 tragically saw Nick Blackwell in a coma and the death of Muhammad Ali, amidst increasingly loud pleas from Medical Associations to ban Boxing.
With these incidents still fresh in our minds, why would any teenager even contemplate taking up Boxing? In a progressive global sporting climate seeing other Sports Associations increasingly prioritising the health of the athlete, such as World Rugby more heavily penalising high tackles aimed at the head to reduce growing numbers of concussions and the Football Association supporting further research into long-term brain damage caused by players heading the heavier balls in the '50s and '60s - is it now time to review the safety of Boxing?
Boxing remains a very popular sport; the high-impact, powerful punches are both thrilling and entertaining for spectators. But, beyond the glamour, press conferences and excitement, there is something far more sinister at play.
Brain Trauma.
Young people, like myself, should be made fully aware of the potential health risks posed by Boxing, to better inform our decisions as to whether to take up the sport. We are well aware of the benefits of Boxing such as developing cardiovascular fitness, coordination, self-defence and self-esteem. However, when presented with harsh criticisms of the sport, such as a joint statement in 2011 by the Canadian Paediatric Society and the American Academy of Paediatrics recommending that paediatricians vigorously oppose Boxing as a sport for any child or adolescent and the Australian Medical Association announcing that it believed that combat sports like boxing should be banned for children under 18 because of concerns about injuries during the match and over time, it calls the safety of the sport into question.
Olympian boxers are trained to throw high-energy punches with a translational acceleration of around 58 times that of gravity. To be effective, these punches are aimed at their opponents' most vulnerable regions - often the head. This can have enormous implications in both the short-term, and perhaps more significantly, the long-term. It is easy to lose sight of the damage that repeated high-velocity punches to the head could inflict upon the brain of a boxer.
Whilst receiving blows to the head, the brain of the boxer is ricocheting against the inside of the skull in a coup and contrecoup mechanism of trauma. This is particularly significant as the brain is such a delicate organ and its soft surface could be bruised and damaged with every collision with the inside of the skull. In the short term, this may lead to concussion, but it is the long-term damage that is of even greater concern.
The incidence of neurological conditions in boxers and ex-boxers is being increasingly recognised and one of the more frequently seen disorders is Chronic Traumatic Encephalopathy(CTE.) Defined by the NHS as 'a type of dementia associated with repeated blows to the head and recurrent episodes of concussion,' it is clear to see why boxers are at a heightened risk. Indeed, one study using imaging to examine the brains of boxers showed that around 40% of professionals and 10% of amateurs had abnormalities, probably resulting from Boxing.
CTE may affect many aspects of a person's functioning including mood, emotional regulation, personality, memory and cognitive capacity. The latter stages involve more severe cognitive deficits, causing disorders such as Dementia (a progressive neurological disorder with possible symptoms affecting memory, cognitive ability and communication) and Parkinsonism (with symptoms that mimic those of Parkinson's Disease including possible speech impairment, stiffness of muscles, slow movement and tremors.) In all stages, aggression, depression and impulse control problems may be seen, persisting throughout the individual's life.
One would think that perhaps the sport is safer for adolescents and younger boxers. It was previously assumed that their punches were not as powerful, and being young they would recover faster... The evidence suggests otherwise. Nationwide Children's Hospital research found that surprisingly, youth boxers were just as prone to concussions and closed head injuries as adult boxers. Studies have also found that concussions are actually particularly concerning in children and adolescents because there is evidence that a child's brain is more vulnerable to injury and that recovery from concussion is prolonged when compared to adults. One study of high school and college athletes who had suffered concussion found that older athletes were able to recover normal cognitive function in 3 days, whilst younger high school students had problems such as memory dysfunction for up to 10 days after injury.
As the risk to adolescents engaging in the sport is clearly significant, younger boxers should pay as much attention to these potential future complications as professional boxers.
There have been attempts to make Boxing safer. For example, using headgear, body protection and larger gloves; separating boxers into weight categories; focusing on Boxing techniques; and varying duration of the round. Authorities have proposed removing the head and neck as a target area and decreasing the emphasis on scoring head blows. Australia has a version of Boxing, 'Box'Tag', rewarding light, rapid punching rather than forceful impacts, with the head and neck being prohibited areas. Brain scans are now compulsory upon application for a boxer's licence and annually in Britain. There are suspension periods following knockouts.
However, even scientists cannot seem to agree. The use of headgear followed a 1982 American Medical Association move to ban Boxing, but recently the Amateur International Boxing Association (AIBA) medical commission cited medical studies that suggested fighting with headguards would increase risk of concussion. As such, boxers in the 2016 Rio de Janeiro Olympics did not wear protective headgear, which had been adopted before the 1984 Los Angeles games. It was initially felt that headgear would diffuse the impact of the blow allowing fighters to continue to sustain more head shots for a longer duration of time. However, it offered no protection to the chin, which was the target of many knockout blows and impeded peripheral vision. It was also thought that the headgear gave a false sense of security encouraging the fighter to take more risks and acted as a bigger target. Despite these findings, headgear continues to be used by women and youth boxers. The possible impact of repeated sub-concussive blows on the brain must not be overlooked.
The way forwards may be to attempt to reform the sport further, as is being attempted by other Sports Associations rather than ban a sport highly regarded by so many, and to continue to try to clarify and monitor the health repercussions on boxers over time. In a society where Boxing is so captivating for children and adolescents, it is essential that their safety and the health of a new generation of enthusiastic boxers is not compromised.