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Injury Rates and Risk Factors in Competitive Professional Boxing
Abstract
To determine injury rates and risk factors for injury in a cohort of professional boxers.
Retrospective cohort design reporting on data collected for a fight statistics database maintained by the Professional Boxing and Combat Sports Board of Victoria, Australia. Data were extracted for the years January 1997 through June 2005.
Victoria, Australia.
545 professional boxers (age, 18 to 43 years) who participated in a total of 907 fights over the study period.
Independent variables under investigation included age, gender, weight, bout exposure, and location of the bout (within or outside of the State of Victoria).
Physician-reported acute boxing injuries occurring during bouts of any region or nature.
214 injuries were sustained over the 8.5 years, corresponding to an injury rate of 23.6 per 100 professional fights. The majority of these injuries were lacerations to the head and face. An increasing age and an increasing number of fights were both significant predictors of injury.
Injury reduction strategies for professional boxing might include restrictions of eligibility to fight based on age and boxing bout exposure. Future research using prospective cohort designs and standardized injury definitions are needed to confirm these results. Greater mechanistic detail and more complete data entry are necessary to ensure that optimal injury prevention strategies can be developed and implemented. Upon confirmation of the results of this study, the Professional Boxing and Combat Sports Board of Victoria may consider different criteria upon which to sanction a fight.
... Different authors tend to focus on varied populations in terms of the level of the professionalism of the athletes. In the reviewed boxing publications, all the people were professionals [15][16][17][18][19]. The same is true for judo [9,11,22,23]. ...
... 18-43 [15][16][17][18][19] 15-48 [20,21] 10-35 [9,11,22,23] 15-39,6 [10,12] 6-53 [24][25][26] 10-36 [7,8,27,28] 9-34 [13,14,29] works contain both professionals and amateur participants [7,8]. Publications about wrestling described only professional athletes. ...
... In this case the frequency was respectively 250.6 injuries per 1000 fight participations and 220.1 injured boxers per 1000 fight participations [15]. The same author in his other work described injury rate 23.6 per 100 professional fights [18]. [25]. ...
Injuries in combat sports can happen to any athlete, regardless of gender, age, training experience or whether he or she is an amateur or a professional. The range of injuries varies from superficial, short-term damage to severe injuries with serious consequences, including death. There are many types of combat sports, each with different rules and specific injuries. Amongst various divisions of combat sports, one of the basic ones is the division into ground and stand-up sports. In the following work, using the available literature, we wanted to present the specifications of several of the most popular combat sports and compare their most common locations of injuries, types of injuries and mechanisms of their formation, paying attention to which of these categories a given sport belongs to. We also discuss differences in the rate of injury for different age, genders, prevalence of injuries during situations of practice and competition. In the end, it is presented what are the possible long-term complications of injuries in combat sports and which actions such as protective gear, bans on certain techniques or behavioural changes might reduce the injury rate to protect the athletes health, well-being and decrease the economic burden on healthcare systems.
... A total of 7 studies reported injuries in amateur boxing, 8,9,35,37,47,59,69 while 5 studies covered professional boxing. 10,29,56,68,70 The NEISS studies were not identifiable in terms of competition formats and were defined as "mixed." One study reported boxing injuries in 3 consecutive Olympic games with exclusive disclosure from the International Olympic Committee. ...
... P < .000). 10,29,68,70 However, IR N was significantly lower in 2 studies reporting female boxing (30.1 and 55.6), 8,9 and even lower in 2 studies using NEISS data (12.7 and 42.3). 43, 48 Loosemore et al 35 reported an IR N of 4500 among elite-level amateur boxers in the Great Britain squad. ...
... P < .001). 10,56,68,70 Interestingly, a much lower IR E of 76.6 was noted in the latest Olympic boxing (amateur level) than earlier amateur boxing (227.8 to 250. 6; 1996-2003) 37,47,69 ; this might be attributed to the revisions of rules from time to time, making amateur boxing much safer. ...
Background
To the best of our knowledge, an evidence-based investigation into 21st-century boxing-specific injury rates and types has yet to be performed.
Purpose
To provide an overview and quantitative synthesis of the incidence rates (IRs) and pathological categorizations of boxing-specific injuries in the 21st century.
Study Design
Systematic review; Level of evidence, 3.
Methods
Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched literature published from January 2000 to November 2021 in PubMed and the Cochrane Library systematically for qualifying epidemiology studies of organized boxing activities across the world. Two independent reviewers completed the literature review, data extraction, and quality assessment. The IRs of injuries per 1000 boxers (IR N ), per 1000 competition exposures (IR E ), and per 1000 minutes of competition (IR C ) or training (IR T ) were subsequently calculated. Single-arm meta-analyses were performed for the subgroups of different types of boxing. Sample size weighted means were calculated using a random-effects model in all studies with 95% CIs.
Results
Out of an initial 9584 articles, 14 studies were included, with most (11/14) having a moderate level of quality. The pooled IR N in overall injuries was 223.9 (95% CI, 157.5-290.4), the IR E was 233.3 (95% CI, 161.3-305.2), and the IR C was 13.0 (95% CI, 8.9-17.1). In professional boxing, the IR N (399.8), IR E (379.8), and IR C (23.9) were all significantly higher than in the amateur and female groups. The IR E (76.6 vs 250.6; P < .000) and IR C (9.2 vs 15.4; P < .000) in amateur boxing were significantly lower in studies between 2010 and 2019 than in earlier studies. For pathology categorization, the pooled frequencies were 12.3% (95% CI, 8.7%-15.9%) for concussion, 21.4% (95% CI, 14.1%-28.6%) for skin laceration, 30.2% (95% CI, 22.1%-38.2%) for soft tissue contusion, 15.3% (95% CI, 7.7%-22.9%) for sprain and muscle/ligament injury, and 11.4% (95% CI, 2.7%-20.1%) for fracture.
Conclusion
IRs of injury remain high in professional boxing, although they have decreased in the past 10 years in amateur boxing. Soft tissue contusion was the most common injury type. Better exposure measurements and epidemiologic indicators should be applied in future studies.
Registration
CRD42021289993 (PROSPERO).
... In 13 included studies we detected three different study designs: Retrospective cross-sectional study (12)(13)(14)(16)(17)(18)) (n = 6), retrospective case-control study (19) (n = 1), prospective cohort studies (5,6,15,(20)(21)(22) (n = 6). ...
... Sample sizes ranged from 16 to 11,173 included athletes (median = 105), with 5 studies (5,6,(20)(21)(22) including small samples of < 100 athletes, 4 studies (15,(17)(18)(19) including medium samples of 100-1,000 athletes and two studies (13,14) including > 1,000 athletes. Most of the included studies displayed cohorts of male boxers with 4 studies including only males(6, 20-22), 3 studies with at least 90% males (5,17,19), one study including 70% males(18), one study including only females (13), and 3 studies not giving any gender characteristics (12,14,16) (considering however, that these studies have been published before 2000 and females have not been allowed at the Olympic games until 2012, it can be assumed that most cohorts were male). ...
... Sample sizes ranged from 16 to 11,173 included athletes (median = 105), with 5 studies (5,6,(20)(21)(22) including small samples of < 100 athletes, 4 studies (15,(17)(18)(19) including medium samples of 100-1,000 athletes and two studies (13,14) including > 1,000 athletes. Most of the included studies displayed cohorts of male boxers with 4 studies including only males(6, 20-22), 3 studies with at least 90% males (5,17,19), one study including 70% males(18), one study including only females (13), and 3 studies not giving any gender characteristics (12,14,16) (considering however, that these studies have been published before 2000 and females have not been allowed at the Olympic games until 2012, it can be assumed that most cohorts were male). One study reported on a mixed cohort of different combat sports with boxing as a subgroup (22), while the rest of the included study cohorts were boxers only. ...
Background: High injury rates are to be expected in combat sports. Although case reports and epidemiological studies have documented shoulder injuries in boxers, numbers differ and there is currently no systematic review reporting injury prevalence.
Purpose: The aim of this study was to offer an analysis of existing studies documenting shoulder injuries in boxing. Additionally, we wanted to evaluate, if chronic shoulder pathologies seen in former boxers, originate from acute injuries or result from chronic overuse syndromes.
Study Design: Systematic Review
Methods: We performed a systematic database research according to the PRISMA guidelines on PubMed, Scopus and Google Scholar for the keywords “boxing”, “injury” and “shoulder” or their respective synonyms. Any epidemiological cohort- and cross-sectional studies on boxing, that documented shoulder injuries and were published in German or English language up to January 2020, were included. Statistical analysis including individual and overall proportion with 95% Clopper-Pearson confidence intervals was performed to determine shoulder injury rates for amateur and professional cohorts separately.
Results: Methodological quality was assessed using the STROBE statement and a modified Downs&Black's checklist. 13 studies were included, 10 of which met the criteria for statistical analyses. The heterogeneity in study design and cohort characteristics did not allow for detailed quantitative analysis. Overall, shoulder injuries occurred almost twice as often in amateur athletes than in professionals (overall proportion [95% CI]: amateur athletes: 9% [6%; 12%], professionals: 4% [2%; 8%]).
Conclusion: No study investigating the long-term effects of boxing on shoulder pathologies was identified. Although specific information on injury type is mostly missing, the few studies addressing it report shoulder dislocations, strains, tendonitis, or chronic impingement syndromes. Unlike head trauma, shoulder injuries do not necessarily lead to cessation of fight, therefore at the ringside gross underreporting of shoulder pathologies must be taken into consideration.
... The bias assessment included four factors: study population and sample, measurement selection and controlling of confounding variables, analysis approaches, funding and disclosure of interest. Among the reviewed literature, eight papers were considered to have a degree of bias (Benson, Hamilton, Meeuwisse, McCrory, & Dvorak, 2009;Davis et al., 2017;Howell et al., 2017;Loosemore et al., 2007;Loosemore et al., 2015a;Siewe et al., 2015;Zazryn, McCrory, & Cameron, 2009;Zazryn et al.2006). The articles with identified bias included bias of sample (Benson et al., 2009;Davis et al., 2017;Howell et al., 2017;Siewe et al., 2015;Zazryn et al., 2009;Zazryn, Cameron, & McCrory, 2006), measurement selection (Davis et al., 2017;Siewe et al., 2014;Zazryn et al., 2006) and analysis approaches (Loosemore et al., 2007;Loosemore et al., 2015a;Zazryn et al., 2009). ...
... Among the reviewed literature, eight papers were considered to have a degree of bias (Benson, Hamilton, Meeuwisse, McCrory, & Dvorak, 2009;Davis et al., 2017;Howell et al., 2017;Loosemore et al., 2007;Loosemore et al., 2015a;Siewe et al., 2015;Zazryn, McCrory, & Cameron, 2009;Zazryn et al.2006). The articles with identified bias included bias of sample (Benson et al., 2009;Davis et al., 2017;Howell et al., 2017;Siewe et al., 2015;Zazryn et al., 2009;Zazryn, Cameron, & McCrory, 2006), measurement selection (Davis et al., 2017;Siewe et al., 2014;Zazryn et al., 2006) and analysis approaches (Loosemore et al., 2007;Loosemore et al., 2015a;Zazryn et al., 2009). Specific descriptions of our assessment of bias in these studies can be found in Table 2. ...
... Among the reviewed literature, eight papers were considered to have a degree of bias (Benson, Hamilton, Meeuwisse, McCrory, & Dvorak, 2009;Davis et al., 2017;Howell et al., 2017;Loosemore et al., 2007;Loosemore et al., 2015a;Siewe et al., 2015;Zazryn, McCrory, & Cameron, 2009;Zazryn et al.2006). The articles with identified bias included bias of sample (Benson et al., 2009;Davis et al., 2017;Howell et al., 2017;Siewe et al., 2015;Zazryn et al., 2009;Zazryn, Cameron, & McCrory, 2006), measurement selection (Davis et al., 2017;Siewe et al., 2014;Zazryn et al., 2006) and analysis approaches (Loosemore et al., 2007;Loosemore et al., 2015a;Zazryn et al., 2009). Specific descriptions of our assessment of bias in these studies can be found in Table 2. ...
In 2013, the International Boxing Association (AIBA) prohibited the use of headguards for elite male Olympic boxing competitions. Could the removal of the headguard from elite male boxing competitions potentially cause increased injury risk for boxers? The aim of the literature review is to analyse current knowledge about the use of protective headgear and injury prevention in boxing, in order to determine if there are increased injury risks associated with headguard use. Peer‐reviewed studies (language: English, Norwegian, Swedish, Danish and Dutch) published from 1980 and onwards were considered. Five academic databases and grey literature sources were searched, and articles were assessed for methodological quality. Only studies that included boxers as the study population with headguards as a factor were considered. A total of 39 articles were included in the review. The analysis of the reviewed literature indicates that headguards protect well against lacerations and skull fractures, while less is known about the protective effects against concussion and other traumatic brain injuries. Most of the analysed studies however use indirect evidence, obtained through self‐report or observational techniques with relatively small non‐representative samples. There are almost no randomised control trials, longitudinal research designs or samples from recreational boxing. Therefore, AIBA's decision to remove the headguard has to be seen with caution and injury rates among (male) boxers should be continuously evaluated.
Highlights
Research does not sufficiently support the statement that boxing without protective headgear is safer than boxing with a headguard.
Headguards protect well against facial cuts and skull fractures. The systematic review indicates that headguards provide some protection against linear impacts to the head. The headguards protective effects against concussion are however uncertain.
A research agenda is proposed. Priority areas include a focus on longitudinal research designs, randomized control trials, samples from recreational competitive boxing, as well as further research into coaches' and athletes' experiences and perspectives on headguards and injuries.
... There is a high overall rate of injury in combat sports, with varying risk depending on the type of rules and experience of the athlete. In large studies of professional boxing matches, there was an injury rate between 17.1 and 23.6/100 matches, or 3.4 per 100 boxing rounds [30,31]. A study by the same group also analyzed professional mixed martial arts competitions and found a significantly higher rate of injury at 12.5/100 rounds [32]. ...
... This is logical, as sports with a lower emphasis on striking compared to grappling, throws, and submissions are more likely to overstrain a joint compared to more strike focused sports which will have a high rate of fractures and contusions. In striking sport such as boxing and mixed martial arts, fractures have been reported to be between 8.4 and 43.3% of all injuries [31,47]. ...
... In mixed martial arts, injury location has a more equal distribution, with injuries to the head and neck, upper extremities, and lower extremities having a much closer rate than other sports due to the fact that there is no one particular focus or technique that can be used [45]. For head and neck injuries, up to 64% of injuries have been reported to be facial lacerations, while concussions are up to 33% of all injuries and 47% of head injuries [31,32,54]. ...
Although it is unknown when sports were first played indoors, we know that sports have been around for over 15,000 years, with the first documented event as a footrace between two cavemen. Progress in architecture and technology have allowed for outdoors competition to transition into indoor sporting events. In modern day, indoor sports continue to represent a high proportion of athletic events as many outdoor sports are being played under the confines of an indoor facility. Indoor sports allow for a healthy alternative to playing outdoors all year round. Participation can occur during any time of the year and training has subsequently improved. Indoor sports participation is also on the rise as heat and cold illness awareness has increased. Participating in sports in an indoor environment can place unique demands and challenges on the athlete, coaches, healthcare team, and administration.
... Boxer dagegen hatten im Durchschnitt mehr Kämpfe, aber die degenerativen Veränderungen am Knochen waren bemerkenswerterweise signifikant geringer (▶ Abb. 2 und ▶ Abb. 3), obwohl eine höhere Anzahl an Kämpfen eine erhöhte Wahrscheinlichkeit für eine akute Verletzung mit sich bringt [23]. ...
... Boxen hat im Allgemeinen ähnliche Verletzungsquoten (25 %) [4,17,23], wobei nur 7 % auf Verletzungen der Finger zurückgehen [23]. Verletzungen während des Trainings betreffen in 34,5 % [26] und in nur 20,3 % während eines Wettkampf die Region der Hand und des Handgelenks [26] [26], wobei es sich vorwiegend um Bandverletzungen handelt (69 %) [22]. ...
... Boxen hat im Allgemeinen ähnliche Verletzungsquoten (25 %) [4,17,23], wobei nur 7 % auf Verletzungen der Finger zurückgehen [23]. Verletzungen während des Trainings betreffen in 34,5 % [26] und in nur 20,3 % während eines Wettkampf die Region der Hand und des Handgelenks [26] [26], wobei es sich vorwiegend um Bandverletzungen handelt (69 %) [22]. ...
Zusammenfassung
Hintergrund: Mixed Martial Arts (MMA) ist eine Kombination verschiedener Kampfsportarten. Akute Verletzungen sind bekannt und in der Literatur allgemein beschrieben. Nichtsdestotrotz gibt es kaum Erkenntnisse über degenerative Veränderungen am muskuloskelettalen System. Das Ziel dieser Studie war die Bestimmung des Einflusses von beim MMA genutzten Techniken auf das Auftreten degenerativer Veränderungen im Vergleich zum klassischen Boxen.
Methoden: Hierzu wurden 11 MMA-Kämpfer und 10 Boxer mit chronischen Handgelenkschmerzen klinisch untersucht. Alter, Gewicht, Erfahrung, Anzahl der Kämpfe und wöchentliche Trainingsstunden wurden erfragt. Um die degenerativen Veränderungen zu bestimmen, wurde ein MRT der schmerzhaften Hand ausgewertet.
Ergebnisse: Erfahrung, Niveau des Wettbewerbs und Anzahl der Kämpfe waren nicht signifikant unterschiedlich in beiden Sportgruppen (p < 0,05), jedoch trainierten die MMA-Kämpfer signifikant mehr Stunden pro Woche (19,5 vs. 8,5 h/w; p < 0,001). Allerdings hatten die MMA-Kämpfer öfter und schwerwiegendere degenerative Veränderungen an allen untersuchten Strukturen (Knochen, Faserknorpel, Bänder und Sehnen). In der Kategorie „Knochen“ waren die Unterschiede signifikant (p = 0,002).
Schlussfolgerung: MMA-Kämpfer zeigen eine höhere Inzidenz und einen höheren Grad an degenerativen Veränderungen an Hand und Handgelenk. Genaue Erklärungen sind noch nicht bekannt. Weitere Forschung wird benötigt, um den Einfluss der Techniken auf die Schwere der degenerativen Veränderungen an Hand und Handgelenk zu bestimmen.
... G e n e r a l l y Sports injuries in both sport events are caused from lack of skills, excessive training, mental and physical state of tension, lack of attention, lack of warm-up exercises, and foul or aggressive actions during training or match, in both games and the nature of the injury is related to physical activities and therefore unique injuries are observed for different sports. Among these sports injuries, injuries from martial arts sports account for 10.2% of all sports injuries (Tenvergert, 1992), and boxing is observed to have 23.6% injury rate (Zazryn et al., 2009). Similarly, since boxing requires consistent contact with opponents and high-intensity training, coaches as well as boxers themselves are also exposed to the danger of many injuries based on training environment. ...
... Bianco et al.(2007) showed that adequate amount of exercise and training is related to increasing expectancy of satisfactory life, and thus boxing may decrease expectancy of satisfactory life as it causes injuries from intentional, repetitive impacts. Researches on the injuries of boxers due to the nature of boxing are continuously carried out (Ohhashi et al., 2002;Zazryn et al., 2009;Vent et al., 2010), but there is no research case where coaches, who are exposed to unexpected high probability of injury during training, were the subject of injury research in both domestic and international field. The athletic performance of boxers and cricketers can largely be affected not only by the conditions of boxers and cricketers themselves but also by the state of health of coaches of both sports. ...
... Therefore, during the mitt training, it is important that the coaches wrap their wrists with bandages and participate in the training after sufficiently stretching their arms and bodies, and that the coaches educate their boxers in order for them to demonstrate techniques accurately. In the study conducted by Zazryn et al. (2009) on rates and causes of injuries for boxers, it was reported that boxers exhibit 23.6% injury rate, and that it is important to be prepared with strategies that reflect on the characteristics of the boxers and the possibility of participating in a match. <Table 3> shows punch types that result injuries during training. ...
Sports training methods aimed at developing the level of sports performance reaching "to achieve high
levels of achievement in various sports games, the diversity of these methods and the different effects
stimulate interested and involved in the field of sports training to choose the means and the most
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curricula and programs containing means and exercises, will improve what he needs from requirements
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must recognize the coaches and players over the difficulties which are an obstacle to the achievement
and improvement of the great achievements, some studies indicate to the importance of training aids
which accompany many of the training curriculum, which are designed according to their objectives
whether it (physical, skill, plans).The Importance of research is to study comparative evidentiary exercises
climbing on the ropes in the development of some aspects of muscular strength for the volleyball players,
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... Relative to the popularity of these sports, researchers know little about punching impacts (Nakano, Iino, Imura, & Kojima, 2014). What is known, however, is these impacts are significant enough to result in traumatic injuries to the person being hit (Bledsoe, Hsu, Grabowski, Brill, & Li, 2006; Fife, O'Sullivan, & Pieter, 2013; Heath & Callahan, 2013; Hutchison, Lawrence, Cusimano, & Schweizer, 2014; McClain et al., 2014; McCrory, Zazryn, & Cameron, 2007; Scoggin et al., 2010; Stojsih, Boitano, Wilhelm, & Bir, 2010; Walrod, 2011; Warner, 2014; T. Zazryn, Cameron, & McCrory, 2006; T. R. Zazryn, McCrory, & Cameron, 2009a, 2009b) and to cause fractures/dislocations (or other related injuries) to the puncher's hand (Bartsch, Benzel, Miele, Morr, & Prakash, 2012; Hutchison, et al., 2014; Lystad, 2014; McClain, et al., 2014; Scoggin, et al., 2010; Seidenberg, 2011; Shirani, Kalantar Motamedi, Ashuri, & Eshkevari, 2010; Walrod, 2011; T. R. Zazryn, et al., 2009b). The resulting injury rate during striking sport competitions is between ~10-30% (Bledsoe, et al., 2006; McClain, et al., 2014; McCrory, et al., 2007; Ngai, Levy, & Hsu, 2008; T. Zazryn, et al., 2006; T. R. Zazryn, et al., 2009a Zazryn, et al., , 2009b). ...
... What is known, however, is these impacts are significant enough to result in traumatic injuries to the person being hit (Bledsoe, Hsu, Grabowski, Brill, & Li, 2006; Fife, O'Sullivan, & Pieter, 2013; Heath & Callahan, 2013; Hutchison, Lawrence, Cusimano, & Schweizer, 2014; McClain et al., 2014; McCrory, Zazryn, & Cameron, 2007; Scoggin et al., 2010; Stojsih, Boitano, Wilhelm, & Bir, 2010; Walrod, 2011; Warner, 2014; T. Zazryn, Cameron, & McCrory, 2006; T. R. Zazryn, McCrory, & Cameron, 2009a, 2009b) and to cause fractures/dislocations (or other related injuries) to the puncher's hand (Bartsch, Benzel, Miele, Morr, & Prakash, 2012; Hutchison, et al., 2014; Lystad, 2014; McClain, et al., 2014; Scoggin, et al., 2010; Seidenberg, 2011; Shirani, Kalantar Motamedi, Ashuri, & Eshkevari, 2010; Walrod, 2011; T. R. Zazryn, et al., 2009b). The resulting injury rate during striking sport competitions is between ~10-30% (Bledsoe, et al., 2006; McClain, et al., 2014; McCrory, et al., 2007; Ngai, Levy, & Hsu, 2008; T. Zazryn, et al., 2006; T. R. Zazryn, et al., 2009a Zazryn, et al., , 2009b). Recent reports in boxing and MMA indicate professionals fighters are 2-3 times more likely to suffer fractures and other injuries during competition than amateurs (McClain, et al., 2014; Rainey, 2009; T. Zazryn, et al., 2006; T. R. Zazryn, et al., 2009a). ...
... The resulting injury rate during striking sport competitions is between ~10-30% (Bledsoe, et al., 2006; McClain, et al., 2014; McCrory, et al., 2007; Ngai, Levy, & Hsu, 2008; T. Zazryn, et al., 2006; T. R. Zazryn, et al., 2009a Zazryn, et al., , 2009b). Recent reports in boxing and MMA indicate professionals fighters are 2-3 times more likely to suffer fractures and other injuries during competition than amateurs (McClain, et al., 2014; Rainey, 2009; T. Zazryn, et al., 2006; T. R. Zazryn, et al., 2009a). Although the reason for this difference is multifaceted (e.g. ...
Punching is integral to success in combat sports, making it a frequent activity during practice/training. Improving safety of this activity benefits both the athlete and training partners. This study was designed to 1) test the precision and reliability of a commercially available striking device and 2) assess the influence of a novel padded hand wrap on punching force in elite and untrained punchers. Fourteen male professional boxers and mixed martial artists (PRO; age=29.2±5.6y; height=180.3±9.0cm; mass=87.1±17.9kg, winning %=73.8±13.8%, number of victories via knockout/technical knockout=35.6± 21.9%) and 24 untrained male punchers (UNT; 27.6±6.9y, 177.6±18.3cm, 84.3±16.9kg) wore a standardized boxing glove and performed 20 maximal punches (4 sets of 5) into a device designed to measure punching force. All participants performed, in a counterbalanced order, 2 sets of 5 with a standardized hand wrap and 2 sets of 5 with the same wrap plus an additional 1.2cm thick cylinder 4g foam-like pad (WRAP) placed over the knuckles. PRO produced significantly more punching force than UNT, regardless of condition. Punching force was lower by 12.6% (p<0.05) for PRO and 8.9% (p<0.05) for UNT with WRAP (compared to no WRAP). These findings suggest WRAP significantly reduces punching force, which may be important for long-term safety of the puncher's hand and/or the person receiving the strike.
... 45 Boxing Approximately 2% to 40% of all boxing injuries are sustained to the face in amateur boxing, 49,50 compared with professional boxing (66%-73%) 51-53 and female boxing Epidemiology of Facial Injuries in Sport (78%-100%). 51,54 Facial injury rates reported in professional boxing range from 78 to 178 injuries per 1000 bouts [51][52][53] and in female boxing 23 to 49 injuries per 1000 bouts. 51,54 The most common types of facial injuries were lacerations and the most common location was the eye region (ie, eye, eyelid, and eyebrow). ...
... 51,54 The most common types of facial injuries were lacerations and the most common location was the eye region (ie, eye, eyelid, and eyebrow). [50][51][52][53][54] Floorball According to the International Floorball Federation, floorball has been increasing in popularity over the last 30 years. 55 In 2015 there were approximately 310,000 licensed floorball players worldwide, with the highest participation rates in Sweden, Finland, and Czech Republic. ...
Facial injuries can pose a large health burden for athletes, potentially resulting in time loss and surgery. This article reviews the incidence, common mechanisms, and risk factors of facial injuries in several sports globally. Estimates of facial injury rates are complicated by a lack of, or inconsistent, reporting on specific types of injury. Much of the epidemiologic literature is based on hospital-based injury surveillance and there is a paucity of literature examining sport-specific risk factors. Future research should focus on prospective injury surveillance methodologies with consistent injury definitions examining risk factors and the effectiveness of facial injury prevention efforts.
... Although many trials have reported that the greatest proportion of injuries in boxing occur to the head and face [1,2,3], a small number of studies have found that the upper extremity, particularly the hand, may be equally at risk [4,5]. Timm et al. retrospectively collected injury data in relation to amateur boxers from the Olympic training center in the US over a 15-year period and found that 25% of injuries occurred in the upper extremity [4]. ...
... The results of this study demonstrate that this unique method of using pressure film can (1) differentiate between the impact forces displayed during punching and no punching, and (2) differentiate between the impact forces displayed at individual knuckles and within subjects. ...
Objectives: The hand is commonly injured in boxing but it is not clear why some athletes sustain hand injuries while others do not. It is possible that there are differences in the distribution of impact forces at the knuckle during punching between athletes and that certain distribution patterns may be predictive of increased injury risk. We developed a method of analysing the distribution of impact forces at the knuckle during punching using pressure film. Pressure film allows a calculation of the distribution and magnitude of pressure and force between any two surfaces that come into contact. Methods: Pressure film was inserted into the gloves of three male subjects prior to punching a stationary target. After each punch, the pressure film was removed and analysed to determine the distribution of the impact force during each punch across each of the four knuckles. Punches were repeated multiple times for each subject. The proportional distribution of the impact force during punches was compared between knuckles and within subjects. Results: The proportional distribution of the impact force exerted during punches was significantly different between knuckles and within subjects (p < 0.05). Knuckle 2 displayed the largest proportion of impact forces while knuckle 3 displayed the smallest proportion of impact forces. Conclusions: Pressure film inserted into boxing gloves can be used to analyse the distribution of impact forces across the knuckles during punching. Further work is needed to confirm the reliability and validity of the technique and establish whether there is an association between the impact forces at the individual knuckles and hand injury risk during boxing.
... Although many trials have reported that the greatest proportion of injuries in boxing occur to the head and face [1,2,3], a small number of studies have found that the upper extremity, particularly the hand, may be equally at risk [4,5]. Timm et al. retrospectively collected injury data in relation to amateur boxers from the Olympic training center in the US over a 15-year period and found that 25% of injuries occurred in the upper extremity [4]. ...
... The results of this study demonstrate that this unique method of using pressure film can (1) differentiate between the impact forces displayed during punching and no punching, and (2) differentiate between the impact forces displayed at individual knuckles and within subjects. ...
Objectives: The hand is commonly injured in boxing but it is not clear why some athletes sustain hand injuries while others do not. It is possible that there are differences in the distribution of impact forces at the knuckle during punching between athletes and that certain distribution patterns may be predictive of increased injury risk. We developed a method of analysing the distribution of impact forces at the knuckle during punching using pressure film. Pressure film allows a calculation of the distribution and magnitude of pressure and force between any two surfaces that come into contact. Methods: Pressure film was inserted into the gloves of three male subjects prior to punching a stationary target. After each punch, the pressure film was removed and analysed to determine the distribution of the impact force during each punch across each of the four knuckles. Punches were repeated multiple times for each subject. The proportional distribution of the impact force during punches was compared between knuckles and within subjects. Results: The proportional distribution of the impact force exerted during punches was significantly different between knuckles and within subjects (p < 0.05). Knuckle 2 displayed the largest proportion of impact forces while knuckle 3 displayed the smallest proportion of impact forces. Conclusions: Pressure film inserted into boxing gloves can be used to analyse the distribution of impact forces across the knuckles during punching. Further work is needed to confirm the reliability and validity of the technique and establish whether there is an association between the impact forces at the individual knuckles and hand injury risk during boxing.
... In Victoria, Australia, analysis of 907 professional boxing bouts among 545 boxers over 8.5 years found 214 injuries reported in 177 (19.5%) fights, giving an injury rate of 23.6/100. 4 This rate increased to 60.7 injuries per 100 fights when including knockout and technical knockout losses. The most common injuries were wounds or lacerations to the head (61.7%), concussion (11.7%), and fractures (8.4%). ...
... One death occurred as a result of complications of a left frontoparietal subdural haemorrhage with cerebral infarction and associated oedema. 4 These rates do not include injuries during practice fighting (sparring) so actually rates are higher. ...
The death of professional boxer Braydon Smith after a fight last year prompted renewed calls for the sport to be banned, including from Shaun Rudd and colleagues . But Peter Lewis and Michael Wang say that this would restrict individual autonomy and is impractical
The first important recognition of boxing as a sport was its inclusion in the ancient Greek Olympiad in 688 BC.1 Since then, despite society’s evolution, boxing has persisted as a relic of the barbarity of bygone eras. It is time we recognise boxing as little more than state condoned assault that should be banned immediately. Professional boxing is a commercial activity, with some fighters highly rewarded for taking risks.
Medical professionals have long called for bans, with the World Medical Association noting “its basic intent is to produce bodily harm in the opponent. Boxing can result in death and produces an alarming incidence of chronic brain injury.”2 This criticism is well founded. Acute and long term injuries are prevalent—unsurprising considering that the force of a professional boxer’s punch is comparable with being hit with a 6 kg bowling ball travelling at 32 km/hour.3
### Injury rates
In Victoria, Australia, analysis of 907 professional boxing bouts among 545 boxers over 8.5 years found 214 injuries reported in 177 (19.5%) fights, giving an injury rate of 23.6/100.4 This rate increased to 60.7 injuries per 100 fights when including knockout and technical knockout losses. The most common injuries were wounds or lacerations to the head (61.7%), concussion (11.7%), and fractures (8.4%). One death occurred as a result of complications of a left frontoparietal subdural haemorrhage with cerebral infarction and associated oedema.4 These rates do not include injuries during practice fighting (sparring) so actually rates are higher.
A prevalence study in Canada between 2000 and 2012 using medical …
... There was a greater mechanistic detail and more complete data entry are necessary to ensure that optimal injury prevention strategies can be developed and implemented. [2] There is concern over the potential for a traumatic brain injury caused by KO. This is despite a lack of prospective data evaluating the risk for modern day participants. ...
The aim of the present study is to conduct a trauma and disability survey in amateur boxers and show the actual conditions of injuries based on the current situations. We have obtained 663 valid responses from male and female boxers. In the questionnaire survey who was carried out on a Web questionnaire form. The questions involve that Face Sheet (gender, height, weight, athletic experience, etc.) and prepared 10 questions about trauma and impairment, 7 questions with concussion or damage on head. and, set 11 self-evaluations, which the boxers assessed their boxing skills. The subjects include amateur boxers who are all high school students (15 years old) and retired boxers. We had analyzed relation between the skills and the injuries. And, main outcome was that make a measure to setting whether or not questionnaires have been knockout (KO) as a variable, we applied a method of multiple logistic regression analysis. Moreover, as for the group who got KO in the past, we have also applied multiple regression analysis by using stepwise regression to factors affecting numbers of symptoms. The number of hits they experienced was smaller in international tournament matches, and the odds rate for KO was 0.669. And, KO experience group was compared with non-KO experience group, and the factors influencing the number of severity symptoms were examined. As a result, 2 factors were selected what "Seriousness in practice" and "Fighting spirit in games". It might be possible that the relation between the experience of being KO and self-assessment of boxing performance.
... KKU reports of dental and jaw injuries [6] were similar to the prior studies [33,34], which have reported occurrences of injuries to the body as well as to oral cavity and jaw. We found that the location of boxing camps in the upper northeast of Thailand as well as boxing camps in rural area were directly related to dental trauma and injuries among these Thai boxing athletes. ...
To improve the efficiency of the dental care service system in Thailand. To synthesize content from Khon Kaen University (KKU) staffs and students’ research and presentations from 1984 to 2020 about oral health hygiene and related diseases. Sixteen publications and presentations by KKU staffs and their students about oral health problems and management were retrieved, reviewed and analyzed. Poor oral health of people in the northeast of Thailand is found in every age group: children, adults and the aging, both male and female. There are still many oral health problems of Thai people in the northeast. KKU Field Works, Projects and Research were able to help reduce these oral health problems. An appropriate preventive oral health program needs to be developed and implemented in Northeastern Thailand.
... 7 A frequência de lesão tende ainda a ser superior em combates terminados por knockout ou knockout técnico. 7 As lesões mais comuns registadas foram as feridas e lacerações na cabeça (61,7%), concussão cerebral (11,7%) e fraturas (8,4%). Os autores verificaram ainda uma morte devido a complicações decorrentes de uma hemorragia subdural na região frontoparietal esquerda. ...
Amateur boxing practiced at the Olympic Games has been evolving in conditions of safety for its athletes. The most common injuries are head wounds and lacerations, brain concussions and fractures. However, professional boxing has not kept up with this trend of revising rules and promoting greater safety, turning their athletes prone to severe injuries, especially head and neck injuries. The knowledge of epidemiology and biomechanics of boxing injuries may allow athletes and coaches to anticipate injuries and adopt effective prevention strategies.
... In our study 96.7% of Tae kwon do and 86.7% of MMA and boxers encountered trauma whilst playing amongst which 93.3% of the taek-wondo players, 70% of MMA and boxers had previous experience in managing trauma cases. This is found in disparity to the study performed by Zazryn TR, McCrory PR, Cameron PA among Australian professional boxers was found to be 23.3% [12] and at the same time 23.6%. in study conducted by Ngai KM, Levy F, Hsu EB among American mixed martial arts competitors [13]. ...
... Within MMA literature, a fight-participation is defined as 1 athlete's experience of 1 fight, and it is used to calculate injury rates relative to the number of participants rather than the number of bouts. The injury rate identified in the present study was approximately 40 injuries per 100 fight-participations, which is notably higher than the injury rates of other combat sports, such as boxing (25 per 100 fight-participations) and kickboxing (11 per 100 fightparticipations). 22,23 In a recent study about MMA injuries, Fares et al 4 identified a slightly higher injury rate of 51 per 100 fight-participations. A similar study by Jensen et al 8 reported an injury rate of 22.9 to 28.6 per 100 fightparticipations. ...
Background
The popularity of mixed martial arts (MMA) continues to grow in the United States. Although prior work has provided valuable insight concerning injuries in the sport, much of the available literature is limited by factors such as small sample sizes, varying athlete demographics, and inconsistent data collection methods.
Purpose
To report injury rates and types in MMA and analyze potential variance between competition and match variables.
Study Design
Descriptive epidemiology study.
Methods
We performed a retrospective review of injuries sustained by fighters during MMA contests between 2018 and 2019 using ringside physician postmatch injury reports from Wisconsin and Arizona. The prevalence of overall injuries and specific injury types was compared by location (Arizona vs Wisconsin), competition level (amateur vs professional), match result (decisions vs any other result), and match winners versus losers.
Results
In 503 contests, 285 (57%) had at least 1 injury. In these 285 matches, participants experienced 401 injuries: 197 (49%) in professional bouts and 204 (51%) in amateur bouts. The match injury rate was higher in professional bouts than in amateur contests (68% vs 51%; P < .001). Amateur fighters had more contusions and hematomas (31% vs 22%; P < .001), while professional fighters had more lacerations (39% vs 23%; P < .001). Losers exhibited a higher match injury rate than winners (48% vs 24%; P < .001). Winners experienced a higher proportion of fractures (19% vs 9%; P = .005), and losers experienced more concussions (17% vs 2%; P < .001).
Conclusion
Professional fighters and losers of MMA bouts exhibited higher injury rates relative to amateurs and winners. The prevalence of specific injury types varied by competition level, match result, and match winners versus losers. The results of this study may be used to better understand the current injury profile in MMA and to develop targeted strategies for injury prevention.
... Previous findings on association between weight class and injury have been mixed. Higher rates of injury have been documented in heavyweight Muay Thai 14 and MMA 15 fighters, whereas other studies showed no difference in risk of injury by weight in boxing 16 and MMA. 17 Prior analyses have found differences in fight dynamics by weight division, such as fewer but stronger strikes in heavyweight fighters 18,19 and more time spent in high-intensity combat situations in lightweight fighters. 20 However, few studies have examined the effect of weight class on longitudinal changes subsequent to RHI, such as regional brain atrophy, cognitive decline, and behavioral changes. ...
Traumatic brain injury (TBI) is a common source of functional impairment among athletes, military personnel, and the general population. Professional fighters in both boxing and mixed martial arts (MMA) are at particular risk for repetitive TBI and may provide valuable insight into both the pathophysiology of TBI and its consequences. Currently, effects of fighter weight class on brain volumetrics (regional and total) and functional outcomes are unknown. Fifty-three boxers and 103 MMA fighters participating in the Professional Fighters Brain Health Study (PRBHS) underwent volumetric magnetic resonance imaging (MRI) and neuropsychological testing. Fighters were divided into lightweight (≤139.9 lb), middleweight (140.0–178.5 lb), and heavyweight (>178.5 lb). Compared with lightweight fighters, heavyweights displayed greater yearly reductions in regional brain volume (boxers: bilateral thalami; MMA: left thalamus, right putamen) and functional performance (boxers: processing speed, simple and choice reaction; MMA: Trails A and B tests). Lightweights suffered greater reductions in regional brain volume on a per-fight basis (boxers: left thalamus; MMA: right putamen). Heavyweight fighters bore greater yearly burden of regional brain volume and functional decrements, possibly related to differing fight dynamics and force of strikes in this division. Lightweights demonstrated greater volumetric decrements on a per-fight basis. Although more research is needed, greater per-fight decrements in lightweights may be related to practices of weight-cutting, which may increase vulnerability to neurodegeneration post-TBI. Observed decrements associated with weight class may result in progressive impairments in fighter performance, suggesting interventions mitigating the burden of TBI in professional fighters may both improve brain health and increase professional longevity.
... Typically, sport-governing bodies have rules and regulations outlining the use of protective equipment including helmets, headgear, and mouthguards. Although helmets protect against catastrophic focal head injuries, headgear can reduce superficial facial wounds (Jako 2002;Jákó 2009;Zazryn et al. 2009), and mouthguards protect against oral injuries (Labella et al. 2002;Quarrie et al. 2005;Cohenca et al. 2007;Tanaka et al. 2014), this equipment is not completely effective at preventing concussions from occurring (Benson et al. 2009;Benson et al. 2013). Studies examining helmet fit, design, and age have reported a reduction of concussion symptoms and symptom duration associated with appropriate helmet fit (Greenhill et al. 2016), a reduction of concussion risk associated with a helmet that has thicker padding over the zygoma and mandible (Riddell revolution helmet) when compared with other helmets (Collins et al. 2006;Rowson et al. 2014), and no difference between helmets that are different ages (McGuine et al. 2014). ...
... Nella sua identificazione e valutazione devono quindi essere escluse le morti che avvengono per traumi, errori tecnici e assunzione di farmaci, compresi quelli correlati con il doping. 9 ...
Sudden Cardiac Death in Sports and Boxing: Data and Prevention in Italy by FIMS (Italian Federation of Sports Medicine)
... The available research shows hand and wrist injury rates of 5-17.7% in MMA. Hand and wrist injuries reported for other martial arts are also limited but include 6.5-17% [6,[15][16][17] for boxing, 2.1-2.9% [18,19] for Muay Thai kickboxing, 3.0-12.5% ...
The sport of mixed martial arts is a blend of many martial arts resulting in a combination of striking and grappling in a fighting contest. A clear set of rules direct the sport’s action. Techniques include strikes with the extremities, throws and takedowns, as well as joint manipulation and chokes. Its popularity is rapidly growing worldwide. Just as with any combat sport, injuries are inevitable. However, research into the sport is still in its infancy. Given its surging popularity, surgeons who treat the hand and wrist should have an understanding of the sport, its potential causes of injury, and the current research that exists.
... Por consiguiente, cuando se intenta reducir la tasa de lesiones, los presentes hallazgos destacan la importancia de limitar el número de competiciones como una forma de reducir la exposición a las lesiones. Por ejemplo, en otros deportes de combate, en que se constató que una edad cada vez mayor y un número cada vez mayor de combates eran predictores de lesión, se propuso incluir restricciones de elegibilidad para luchar, según la edad y la exposición al combate del boxeo 33 . Del mismo modo, parece aconsejable aumentar el nivel de condición física y la capacidad técnica de los luchadores menos calificados para reducir la posibilidad de sufrir una lesión 34 . ...
... For instance, in other combat sports where an increasing age and an increasing number of fights were both found to be significant predictors of injury, it has been proposed to include restrictions of eligibility to fight based on age and boxing bout exposure. 33 Similarly, it seems advisable to increase the level of fitness and the technical ability of the less skilled wrestlers in order to reduce the possibility of suffering an injury. 34 For instance, in judo it has been proposed that improving upper body muscular strength and flexibility could be a useful approach to reduce injury risk. ...
Introduction
Traditional wrestling is considered a cultural heritage of humanity and it should be protected. The study of injuries and their associated factors can be useful to protect this heritage. The present study has as its aim an analysis of the incidence of injuries and the associated factors in competition of a traditional wrestling modality, “Leonese wrestling” (LW).
Material and methods
Observational, prospective cohort study that collected injuries during the summer seasons from 2005 through 2015. Incidence rates of injuries were calculated by 1000 athlete exposures (AEs) and as a function of age at initiation in LW, mid-season age, regularity or those who participated in the competitions of each season, winner type, and weight category. At the multivariate level, a generalized linear mixed model was used assuming the frequency of the injuries followed a Poisson distribution.
Results
A total of 308 wrestlers and 406 injuries were reported in 31,970 AEs. The incidence of injuries per 1000 AES was 3.0 (serious), 6.7 (moderate and serious) and 12.7 (total injuries registered). Higher incidence was observed among those who: were no regulars (IRR = 1.076; CI: 0.846–1.368), were considered non-winner type and started as teenager vs child (IRR = 1.115; CI: 0.856–1.452). Non-winner type wrestlers were at much higher risk of injuries in the semi heavy and heavy weight categories.
Conclusions
The incidence of injuries in LW is consistent with that incidence expected in combat sports. Showing a low regularity, having started late in their practice, showing a non-winning profile and competing in the heavy weight category are injury risk factors for LW wrestlers.
... Most of contestants experience, at least once in their sport career, some injuries, which prove high level of danger involved in practicing of these disciplines of sport. According to the study presented by Zazryn et al. [4] injuries in the group of boxers mainly include the areas of head and neck. Porter et al. [5], on the basis of the results of a few-month prospective investigations prove that neurological injuries typically occur only during competition. ...
... Most of contestants experience, at least once in their sport career, some injuries, which prove high level of danger involved in practicing of these disciplines of sport. According to the study presented by Zazryn et al. [4] injuries in the group of boxers mainly include the areas of head and neck. Porter et al. [5], on the basis of the results of a few-month prospective investigations prove that neurological injuries typically occur only during competition. ...
... Injuries during both amateur and professional boxing have been documented in many previous investigations, [2][3][4]16,25,33,35,36 but most attention has been paid to head and neurodegenerative injuries and conditions as a result of boxing. 15 A recent 5-year prospective investigation of injuries in elite amateur boxing showed that injuries to the hand region were in fact the most frequent and also led to the most time lost from training and competition. ...
Background:
The purpose of this investigation was to explore prospectively the nature and duration of hand and wrist injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2012.Methods:Longitudinal prospective injury surveillance of the GB boxing squad was performed from 2005 to 2012. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 hours.Results:Finger carpometacarpal instability and finger metacarpophalangeal joint extensor hood and capsule sprain also known as "boxer's knuckle" injuries were significantly more common than other injury diagnoses. The number of injuries during training or competition was similar, which is remarkable given the far greater number of training hours than competition hours performed. Injury rate for hand and wrist injuries in competition was 347 injuries per 1000 hours, while the estimated injury rate in training was <0.5 injuries per 1000 hours.Conclusion:Carpometacarpal instability and boxer's knuckle were more common than any other kind of hand and wrist injury in this cohort of elite amateur boxers. The rate of hand and wrist injuries was higher in competition than in training. Our study highlights the importance of hand and wrist injury prevention in the competition environment.
... [10][11][12] Compared to men's boxing, women's is safe, and it rarely requires hospitalization. [5,13,14] In boxing, head injuries generally occur because of contact between the fist and head, head and head, or head and some part of the boxing ring. A number of factors that affect the outcome of neurological injury in combat sports have been assessed in a laboratory setting. ...
... This type of study has yet to be replicated without headgear. In contrast, the incidence of head injury observed in professional boxing, the model increasingly followed by amateur boxing, is high [30,31]. Differing definitions of concussion, measurement methods [32] and variable symptom presentation [33] may also mean concussion rates are often underestimated. ...
Background:
In 2013, the Amateur International Boxing Association (AIBA) introduced a rule banning headgear for male-senior open class boxers during competition. The AIBA has defended the rule change as motivated by safety and supported by internal unpublished studies. As a result, in 2018, the AIBA plans to universally prohibit headgear in competition: for all competitors (male and female), all ages and all levels. Within Canada, this ruling has generated controversy in the boxing community, yet there has been no overall measure of opinion.
Methods:
To address this, we instituted a voluntary, anonymous, online open-access poll to allow members of the boxing community to express their stance on headgear use in competition.
Results:
In total, 636 responses were received. A total of 71.5 % of Canadian respondents believed headgear should be mandatory at all levels. Only 5.8 % agreed that headgear should be prohibited, as planned for 2018. Estimating results on a representative breakdown of boxing membership in Canada, a similar pattern emerged, whereby 68.2 % concurred with mandatory headgear while only 4.95 % supported its prohibition. Parents of boxers were almost unanimously against banning headgear, stating they would change sports as a result. Similarly, only 1.7 % of women believed headgear should be prohibited.
Conclusions:
The consensus of the Canadian boxing community largely opposes the rule changes that the AIBA has implemented. The results highlight risks posed to the long-term viability of the sport, if significant grassroots safety concerns are disregarded.
Boxing is the physical skill of fighting with fists.Boxing involves fusion of coordinated fast paced movements of hands and feet, dodging skill, muscular strength and high aerobic capacity. Boxing is similar to other physical activities in that there is a presumed risk of injury through participation.Previous literature suggests that 27.1-93.4 % of injuries involve the head in which most injuries are minor, with lacerations and contusions being most common.In the opinion of the authors that head and hand/wrist related injuries should be considered an inherent risk to boxing, caused by impact and equipment related factors. Thus, the present study focuses on injuries in boxers during training sessions.
The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.
El boxeo es un deporte popular que implica golpes repetitivos a la cabeza, los cuales podrían producir alteraciones en el funcionamiento cerebral. Aunque existe evidencia del daño cerebral causado por la práctica del boxeo a nivel profesional, permanece la controversia sobre los posibles riesgos en el boxeo aficionado. El objetivo del presente estudio fue analizar si existen diferencias en el funcionamiento ejecutivo en boxeadores amateur universitarios en función de su nivel de experiencia en la práctica deportiva y su interacción con la categoría/peso. Método: Participaron mexicanos amateurs agrupados en novatos y experimentados y por su categoría de peso en ligero y medio. Se utilizó la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales BANFE-2 (Flores-Lázaro et al., 2014). Resultados: se realizó un MANOVA, los contrastes multivariados indican que hay diferencias en la interacción de las variables dependientes, de acuerdo con el nivel de experiencia F (4,17) = 3.75, p = .023, ηp2 = .469, 1-β=.56. En particular, las tareas en que se observan diferencias significativas son aquellas que evalúan el control inhibitorio (stroop) y la toma de decisiones de riesgo beneficio (juego de cartas), procesos que se encuentran asociados al funcionamiento de la corteza prefrontal orbito medial. Los hallazgos sugieren que la evaluación del funcionamiento ejecutivo puede ser una herramienta útil para evidenciar cambios funcionales en boxeadores amateur.
Herbal medicine has long been used to prevent and control disease, and it can minimize the potential side effects of chemical products. However, side effects from herbs do exist. Most of the challenges with herbal medicine revolves around inadequate information about the effect of herbs in the oral cavity, the mechanism of action, and potential side effects. There are several herbs described in this chapter have anti-inflammatory, anti-bacterial, anti-viral, anti-fungal in oral micro-organisms. It includes aloe vera, ginger, clove, cinnamon, garlic, neem, miswak, turmeric, tulsi, green tea, chamomile, fenugreek, anise plant, peppermint, bloodroot, caraway, eucalyptus, phyllanthus emblica, black seed, myrrh, rosemary, sage, and thyme; some may act as an alternative management option to current treatments for oral conditions such as caries prevention, gingivitis, periodontitis, oral burn, ulcers and inflammation, after extraction, dry mouth, pain reduction, anesthesia, intracanal medications, ill-fitting dentures, peri-implant mucositis and peri-implantitis. It can be used in several forms such as mouthwashes, toothpastes, topical agents or local drug delivery devices. However, more research is needed to understand their mechanisms and potential side effects.
Objective:
There is a high incidence of concussion and frequent utilization of rapid weight loss (RWL) methods among combat sport athletes, yet the apparent similarity in symptoms experienced as a result of a concussion or RWL has not been investigated. This study surveyed combat sports athletes to investigate the differences in symptom onset and recovery between combat sports and evaluated the relationships between concussion and RWL symptoms.
Design:
Cross-sectional study.
Setting:
Data were collected through an online survey.
Participants:
One hundred thirty-two (115 male athletes and 17 female athletes) combat sport athletes.
Interventions:
Modified Sport Concussion Assessment Tool (SCAT) symptom checklist and weight-cutting questionnaire.
Main outcome measures:
Survey items included combat sport discipline, weight loss, medical history, weight-cutting questionnaire, and concussion and weight-cutting symptom checklists.
Results:
Strong associations (rs = 0.6-0.7, P < 0.05) were observed between concussion and RWL symptoms. The most frequently reported symptom resolution times were 24 to 48 hours for a weight cut (WC; 59%) and 3 to 5 days for a concussion (43%), with 60% to 70% of athletes reporting a deterioration and lengthening of concussion symptoms when undergoing a WC. Most of the athletes (65%) also reported at least one WC in their career to "not go according to plan," resulting in a lack of energy (83%) and strength/power (70%).
Conclusions:
Rapid weight loss and concussion symptoms are strongly associated, with most of the athletes reporting a deterioration of concussion symptoms during a WC. The results indicate that concussion symptoms should be monitored alongside hydration status to avoid any compound effects of prior RWL on the interpretation of concussion assessments and to avoid potential misdiagnoses among combat athletes.
Background
Professional bare-knuckle fighting (BKF) is a variation of boxing which held its first modern legal event in 2018 in Wyoming. Since then, the sport has expanded with state-sanctioned events held in Florida, Missouri, Mississippi, Kansas, and Alabama. The purpose of this study was to evaluate the epidemiology of injuries in bare-knuckle fighting bouts and to discern any trends which may distinguish it from traditional boxing with padded gloves.
Methods
Observational data collection for all state-sanctioned professional bare-knuckle fighting bouts was conducted sequentially over a two-year period from June of 2018 through November of 2020. Information related to fight outcome, injury diagnosis, and injury location was documented. This data was then analyzed and the incidence rates by injury type and location were calculated.
Results
There were 141 bouts conducted during the study period. Out of the 282 individual combatants, 105 (36.6%) sustained at least one injury during the event and 123 total injuries were recorded. In total, 98 (34.8%) lacerations were recorded; on average, 6.2 +- 4.5 sutures were required per laceration. There were 5 superficial hand lacerations and 80 facial lacerations. Seventeen (6.0%) fractures occurred, with 8 hand fractures, 6 nasal fractures, 2 orbital fractures, and 2 dental fractures. There were 8 (2.8%) periorbital hematomas sustained by fighters. Transfer to the hospital was required on 5 (1.8%) separate occasions, twice for orbital fractures and 3 times for traumatic brain injuries. In all, there were 8 (2.8%) concussions with symptoms.
Conclusion
The most frequent injuries in BKF include lacerations and hand fractures. Concussions are relatively uncommon compared to other injuries.
Facial skeletal fractures continue to affect humankind, and many methods to alleviate and prevent the injuries outright have been sought after. Prevention is desired, but the implementation and general compliance may contribute to missed opportunities to decrease the burden of facial skeletal trauma. In this article, we explore the preventative as well as postoperative options for the protection of the facial skeleton.
Boxing for sport has existed in one form or another for thousands of years, but became the modern sport we know today in the late nineteenth century with the introduction of the Queensbury Rules. Medical personnel have been integral to boxing since its early day, both as medical providers and as true advocates for the safety of athletes. While the risk of severe injury is certainly higher during bouts, most injuries still occur during training hours, even though it is a more controlled setting. While there are differences in injury epidemiology between amateur and professional boxing, in both of these the majority of injuries occur within the head/neck region, followed by upper extremity. Lower extremity injuries are uncommon in boxing. Unlike other sports, clinicians have the responsibility to stop boxing matches if they feel the athlete’s health is in danger. Overall, boxing presents challenges to medical providers who are responsible for treating athletes competing in a sport where the goal is to inflict bodily harm on their opponent.
Background
There is limited literature that examines risk factors for injury and mild traumatic brain injury (mTBI) in mixed martial arts (MMA). An examination of previously unstudied bout and athlete characteristics that may pose health risks while partaking in this sport is warranted.
Hypothesis/purpose
To determine the incidence of injury and concussion, along with the identification of risk factors that contribute to injury and mTBI in amateur and professional MMA bouts in Calgary, Alberta.
Study design
A retrospective cohort study with case–control design.
Methods
Calgary amateur and professional MMA records were examined from 1 January 2010 to 31 December 2015. Descriptive statistics were used to describe the incidence of injury and concussion, along with univariate and multivariable logistic regression to identify risk factors for injury and mTBI.
Results
The injury rate per 100 athlete exposure (AE), the injury rate per 100 min of exposure and the concussion rate per 100 AE were 23.6 (95% CI 20.5 to 27.0), 4.1 (95% CI 3.48 to 4.70) and 14.7 (95% CI 11.8 to 17.2), respectively. The most common location of injury was the head and mTBI was the most common type of injury. Athletes whose bout was finished by a knockout/technical knockout, corner stoppage, draw, no contest or physician, and those whose country of origin was non-Canadian, were more likely to sustain an injury. No risk factors for concussion were shown to be significant.
Conclusion
Engaging in MMA exposes athletes to inherent risk and several recommendations are proposed to reduce these risks. Future prospective investigations are necessary to better delineate the findings in this study.
Background
Injury prevention requires information about how, why, where and when injuries occur. The Australian Sports Injury Data Dictionary (ASIDD) was developed to guide sports injury data collection and reporting. Sports Medicine Australia (SMA) disseminated associated data collection forms and an online tool to practitioners and the sports community. This paper assesses the long-term value, usefulness and relevance of the ASIDD and SMA tools.
Methods
A systematic search strategy identified both peer-reviewed and grey literature that used the ASIDD and/or the SMA tools, during 1997–2016. A text-based search was conducted within 10 electronic databases, as well as a Google Image search for the SMA tools. Documents were categorised according to ASIDD use as: (1) collected injury data; (2) informed data coding; (3) developed an injury data collection tool and/or (4) reference only.
Results
Of the 36 peer-reviewed articles, 83% directly referred to ASIDD and 17% mentioned SMA tools. ASIDD was mainly used for data coding (42%), reference (36%), data collection (17%) or resource development (14%). In contrast, 86% of 66 grey literature sources referenced, used or modified the SMA data collection forms.
Conclusions
The ASIDD boasts a long history of use and relevance. Its ongoing use by practitioners has been facilitated by the ready availability of specific data collection forms by SMA for them to apply to directly their settings. Injury prevention practitioners can be strongly engaged in injury surveillance activities when formal guidance is supported by user-friendly tools directly relevant to their settings and practice.
There is evidence that eye protection, mouth guards, helmets, and face guards are effective in reducing the risk of facial injury; however, such safety practices are not adopted universally by all athletes playing high-risk sports. Underlying beliefs about risk perception, comfort, ineffectiveness, utility, and a lack of awareness or enforcement have been identified as reasons people may not adopt preventive measures. There are several high-risk sports that have not mandated or do not enforce use of protective equipment. Valid evidence can assist with addressing the resistance caused by prevailing beliefs and could be essential in influencing rule changes.
Background:
Boxer's elbow has been described in the literature as an extension and hyperextension injury. However, in our experience, there is a coexisting impingement lesion in the anterior compartment of the elbow that has not previously been described. We report a series of professional boxers with elbow disease treated arthroscopically. The aim of the paper was to accurately describe the pathoanatomy of the condition, the key points in its diagnosis, and the outcomes of surgical treatment.
Methods:
Seven professional boxers were treated for symptomatic elbow disease. Clinical evaluation included range of motion and Disabilities of the Arm, Shoulder, and Hand score. The arthroscopic findings and procedures were documented.
Results:
Symptoms were mainly those of anterior and posterior impingement; 6 elbows had an anterior impingement lesion and 6 had a posterior impingement lesion. Postoperatively, the mean Disabilities of the Arm, Shoulder, and Hand score was 2.7 (range, 0-13.3) at a median of 15 (range, 6-36) months postoperatively. All boxers returned to their previous level of competition and 5 won their next bout. All of the boxers used an orthodox stance, and in all but 1 case the left elbow was the pathologic elbow.
Conclusion:
Boxers are prone to development of anterior and posterior elbow impingement. The side of the pathologic process is related to the boxer's stance, with the lead arm being more vulnerable. Arthroscopic débridement is an effective treatment, enabling return to a high competitive level. Surgeons, sports medicine physicians, and physiotherapists should be aware of the condition.
Objectives/hypothesis:
To estimate the incidence of patients presenting to emergency departments (EDs) for facial trauma sustained from participation in combat sports and evaluate injury patterns and patient demographics.
Methods:
The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from wrestling, boxing, and martial arts leading to ED visits from 2008 to 2013. Relevant entries were examined for injury mechanism, location, type, as well as other patient characteristics.
Results:
There were 1143 entries extrapolating to an estimated 42 395 ED visits from 2008 to 2013. Injury rates for boxing, marital arts, and wrestling were, respectively, 44, 56, and 120 injuries per 100 000 participants. Males comprised the majority (93.7%). A plurality of injuries involved lacerations (46.0%), followed by fractures (26.2%) and contusions/abrasions (19.3%). The proportion of fractures was highest among boxers (36.9%). Overall, the most common mechanisms of injury were punching, kicking, and head butting.
Conclusions:
The significant number of ED visits resulted from combat sports facial trauma, reinforcing the importance of familiarity with injury patterns among practitioners managing facial trauma. As most injuries involve individuals younger than 19 despite guidelines suggesting children and adolescents avoid combat sports, these findings may be used for patient education and encouragement of the use of personal protective equipment. Furthermore, injury patterns reported in this analysis may serve as an adjunct for enhancing clinical history taking and physical examination.
Background and Aim: Nonalcoholic fatty liver disease (NAFLD) comprises a disease spectrum which includes variable degrees of simple steatosis (nonalcoholic fatty liver disease, NAFLD), nonalcoholic steatohepatitis (NASH) and cirrhosis. NAFLD is the hepatic manifestation of the metabolic syndrome. Considering the increasing incidence of metabolic syndrome and NAFLD and their complications worldwide, and presence of few data in Iran, we conducted this study in Kurdistan province. Methods and Materials: In this descriptiveanalytic study 65 adults which were diagnosed as having metabolic syndrome in a previous population based study were reevaluated. Finally, 57 patients were assessed for presence of NAFLD by sonography and importance of risk factors in developing NAFLD. Results: In this study, 29.8 % of patients with metabolic syndrome had NAFLD. In those who had NAFLD; 100% had increased alanine aminotransferase (ALT) levels, while 88.2% had increased waist circumference and triglyceride (TG) levels. Hypertension was seen in 82.4% of patients. Aspartate aminotransferase (Ast), fasting blood sugar (FBS) and high density lipoprotein (HDL) serum levels (52.9%) were not good predictors of fatty liver in patients with metabolic syndrome. BMI [odds ratio, 0.63 (95% CI, 0.39 to 0.99)] and ALT serum level[odds ratio, 0.80 (95% CI, 0.65 to 0.99)] can predict presence of NAFLD in the setting of metabolic syndrome (p= 0.05 and p=0.046, respectively). Conclusion: NAFLD can be detected in nearly one third of patients with metabolic syndrome. Increased BMI and ALT serum levels have predictive value for NAFLD in metabolic syndrome.
This chapter summarizes a series of investigations conducted to determine the variables predictive of positive and negative boxing performances. These studies found that previous success was the main predictor of winning a boxing bout while increased age, previous defeat and fighting in the United States when it is your homecountry were the predictors of losing a boxing bout. The implications for these findings and ideas for future research are discussed.
Although the injury risks of boxing is well known, this sport continuous to attract athletes and an increase of introduction to boxing is observed in the last decade. In terms of injury locations, head and face are reported as most common sports. Present study aimed to examine the hearing differences of elite amateur boxers as a result of punch strokes in boxing. Subjects are interested in active boxing for 5-14 years (mean 6.67) and between the age of 18-32 (mean 21.71). Screened group consisted of 21 male boxers. Auditory brainstem responses, pure tone and high frequency audiogram tests were conducted for boxers and unscreened groups in the standard acoustically controlled rooms using Interacoustics Clinical Computer Audiometer. Mean ± standard deviations are reported. Groups were compared by Student's t test p<0.05. Auditory brainstem responses and pure tone values were determined in range of I-V inter-pick latency (ms).There were no statistically significant differences in the hearing level of elite amateur boxers in contrast to non-boxers. It is seen to be important that amateur boxers wear protective materials as a helmet and mouth guard to minimize the risk of injury. The use of protective equipment must be encouraged for boxer's health.
Head injuries represent a major cause of death in subjects under 45 year old. In the USA, 2 million people suffer from head injuries every year and 20% of them have related brain damage; 300000 such cases are due to sports. Head injuries are caused by the impact of the head with a solid, hard object. There are various grades of brain symptoms, including temporary loss of consciousness, altered consciousness, and irreversible brain damage. A review of the literature suggests that the proportion of head injuries occurring in combat sports varies, the face being the main target in boxing, for instance, while in kick-boxing and Muay-Thai injuries tend to affect the lower limbs more than the head. Compared with other sports (e.g. hockey, football), combat sports do not have a higher rate of head injuries, so they are really no more dangerous. It is nonetheless important to take action to make these sports safer and to avoid the risk of chronic disorders such as dementia. Head injury prevention programs must be implemented on several levels, concerning the rules, coaching, training, equipment, and medical supervision. What makes combat sports dangerous is failure to control the related risk factors, e.g. fighting without wearing the necessary safety equipment, or with an excessively aggressive attitude. If combatants abide by the rules, safety equipment is used, honest coaching is provided and medical attention is available, then combat sports can be practised with peace of mind.
In order to develop effective strategies to prevent sports injuries, we need to have an understanding of the people and populations who are most at risk of injury as well as the risk factors associated with sustaining injury. Spatial epidemiology is a method used to address questions of when, where, to whom and how health outcomes such as sports injuries occur at a population level, taking into account geographic variation. The aim of this article is to outline the potential application of spatial epidemiology to achieve a better understanding of sports injuries to inform prevention strategies.
To document the injury rate in three British Shotokan karate championships in consecutive years. In these tournaments strict rules governed contact, with only "light" or "touch" contact allowed. Protective padding for the head, hands, or feet was prohibited.
Prospective recording of injuries resulting from 1770 bouts in three national competitions of 1996, 1997, and 1998. Details of ages and years of karate experience were also obtained.
160 injuries were sustained in 1770 bouts. The overall rate of injury was 0.09 per bout and 0.13 per competitor. 91 (57%) injuries were to the head. The average age of those injured was 22 years, with an average of nine years of experience in karate.
The absence of protective padding does not result in higher injury rates than in most other series of Shotokan karate injuries. Strict refereeing is essential, however, to maintain control and minimise contact.
Although a popular endeavor, boxing has fallen under increased scrutiny because of its association with traumatic brain injury. However, few studies have investigated the overall epidemiology of boxing injuries from representative samples, and no study has ever documented the incidence of injuries in female boxers. This study is a review of professional boxing data from the state of Nevada from September 2001 through March 2003.
Medical and outcome data for all professional boxing matches occurring in Nevada between September 2001 and March 2003 (n = 524 matches) were analyzed on the basis of a pair-matched, case-control design. Cases were boxers who received an injury during the boxing matches. Boxers who were not injured served as control subjects. Both conditional and unconditional logistic regression models were used to assess risk factors for injury.
The overall incidence rate of injury was 17.1 per 100 boxer-matches, or 3.4 per 100 boxer-rounds. Facial laceration accounted for 51% of all injuries, followed by hand injury (17%), eye injury (14%), and nose injury (5%). Male boxers were significantly more likely than female boxers to receive injuries (3.6 versus 1.2 per 100 boxer-rounds, P = 0.01). Male boxing matches also ended in knockouts and technical knockouts more often than did female matches (P < 0.001). The risk of injury for those who lost the matches was nearly twice the risk for the winners. Those who lost by knockout had double the risk of injury compared with those who lost by other means. Neither age nor weight was significantly associated with the risk of injury.
The injury rate in professional boxing matches is high, particularly among male boxers. Superficial facial lacerations are the most common injury reported. Male boxers have a higher rate of knockout and technical knockouts than female boxers. Further research is necessary to determine the outcomes of injury, particularly the long-term neurologic outcome differences between sexes.
To examine the incidence of head blows and concussions in competition taekwondo.
Incidence cohort design.
Taekwondo tournament in 2001, in South Korea.
A total of 2328 competitors (female, 676; male, 1652; age, 11-19 years) from 424 schools participated in the tournament. All recipients of head blows were interviewed immediately after the match. All matches were recorded on videotape.
Head blow and concussion rates were calculated. Also, factors associated with head blows and concussions were analyzed.
The incidence of head blows and concussions was 226 and 50 per 1000 athlete exposures, respectively. Only 17% of competitors reported that they had had a concussion in the last 12 months. A multinomial logistic model showed that head blows and concussions were associated with young age and a lack of blocking skills.
The incidence of head blows and concussions is high in competition taekwondo. Promoting blocking skills to prevent head blows could decrease concussions in taekwondo.
In brief: Over a two-year period, we reviewed all acute boxing injuries among professional boxers statewide (484 the first year, 422 the second year). During the study period, the boxers fought 3,110 rounds and incurred 376 injuries (262 craniocerebral injuries, 114 other injuries), ie, they incurred 1.2 injuries per 10 rounds fought (0.8 craniocerebral, 0.4 others). Only four boxers required immediate neurological evaluation at a hospital after a fight; one of the four died as a result of bilateral subdural hematomas. Facial lacerations were the most common other type of injury (66 cases), followed by hand and eye injuries (8 cases each). The authors suggest that severe, acute neurological injuries are rare in professional boxing when strict medical supervision is present. However, they caution that their findings should not be used to draw inferences about the development of chronic neurological injuries among professional boxers.
This paper presents the injury statistics for the 1981 and 1982 USA/Amateur Boxing Federation National Championships. These tournaments consisted of 547 bouts with 1,094 participants. Eighty-five injuries of varying degrees of severity were recorded; 52 were considered notable. The most frequent injuries were head blows, soft-tissue hand injuries, and facial lacerations. Forty-eight matches were stopped because of head blows, which occurred at a rate of 4.38%. All other injuries occurred at a rate of 4.75%. Amateur boxing injuries could be reduced if the sport were included in the scholastic milieu and if headgear, mats, and gloves were better designed.
Over a two-year period, we reviewed all acute boxing injuries among professional boxers statewide (484 the first year, 422 the second year). During the study period, the boxers fought 3,110 rounds and incurred 376 injuries (262 craniocerebral injuries, 114 other injuries), ie, they incurred 1.2 injuries per 10 rounds fought (0.8 craniocerebral, 0.4 others). Only four boxers required immediate neurological evaluation at a hospital after a fight; one of the four died as a result of bilateral subdural hematomas. Facial lacerations were the most common other type of injury (66 cases), followed by hand and eye injuries (8 cases each). The authors suggest that severe, acute neurological injuries are rare in professional boxing when strict medical supervision is present. However, they caution that their findings should not be used to draw inferences about the development of chronic neurological injuries among professional boxers.
Via neuropsychological testing, this research team found post-match cognitive impairment in amateur boxers despite the fighters' use of headgear.
Acute traumatic brain injury (ATBI) represents the neurologic consequence of concussive and subconcussive blows to the head. Evidence suggests that ATBI may be associated with boxing and collision sports such as American football and soccer, thus potentially exposing millions of athletes annually.
The objectives of this study were to determine whether significant ATBI occurs in boxers who compete and, if present, the nature of the cognitive impairment. A secondary objective was to determine if headgear could reduce the risk for ATBI in amateur boxing.
In this inception cohort study, 38 amateur boxers underwent neuropsychological examination before and shortly after a boxing match and were compared with a control group of 28 amateur boxers who were tested before and after a comparable physical test. The main outcome measures were neuropsychological tests (memory, mental and fine-motor speed, planning, and attention) proven to be sensitive to cognitive changes incurred in contact and collision sports.
The boxers who competed exhibited an ATBI pattern of impaired performance in planning, attention, and memory capacity when compared with controls. They had significantly different findings in the Categorization Task Test (P = 0.047); Digit Symbol Test (P = 0.02); Logical Memory: Short Term Memory and Long Term Memory subtests (both tests, P < 0.001); and Visual Reproduction: Short Term Memory subtest (P < 0.001) and Long Term Memory subtest (P < 0.03).
Participation in amateur boxing matches may diminish neurocognitive functioning despite the use of headgear. The neurocognitive impairment resembles cognitive symptoms due to concussions. Guidelines are needed to reduce the risk for repeated ATBI.
Eighty six amateur boxers underwent a series of neuropsychological assessments on three occasions--pre bout, immediate post bout and follow up within two years; 31 water polo players and 47 rugby union players acted as controls. The neuropsychological tests were selected as being sensitive to subtle cognitive dysfunction and formed part of a battery of other neurological and ophthalmic assessments. No evidence of neuropsychological dysfunction due to boxing was found, either following a bout or a series of bouts at follow up. None of a range of parameters including number of previous contests, recovery from an earlier bout, number of head blows received during a bout and number of bouts between initial assessment and follow up, were found to be related to changes in cognitive functioning.
To determine the incidence, pattern, and severity of injuries resulting from participation in amateur boxing.
A prospective 5-month survey of injuries which occurred during competitive amateur boxing and training.
Amateur boxing competitions held in Dublin between November 1992 and March 1993, and the six largest amateur boxing clubs in Dublin.
All the competitors in the tournaments and the > 16 year old members of the boxing clubs.
Participation in competitive amateur bouts and/or boxing training.
Incidence, pattern, and severity of injuries sustained in competition and training.
The incidence of injuries in competition was 0.92 injuries per man-hour of play (or 0.7 injuries per boxer per year), while the incidence in training was 0.69 injuries per boxer per year. Cerebral injuries were reported only in competition, most of these being mild concussion. Hand, wrist and facial injuries were related to direct impact and occurred more frequently in competition than training, while injuries to other body parts were predominantly chronic and training-associated. Shoulder and knee injuries were the most debilitating injuries seen.
The yearly risk of injury resulting from participation in amateur boxing is relatively low when compared with other sports. Cerebral injuries, which occur almost exclusively in competition, are predominantly mild concussions.
To investigate the location, type, situation and mechanism of head and neck injuries in young taekwondo athletes.
Experimental design: Prospective. Setting: National and international taekwondo tournaments. Participants: 3,341 boys and 917 girls, aged 6 to 16 years. Measures: Injury rates per 1,000 athlete-exposures (A-E) for total number of head and neck injuries, location, type, situation, and mechanism of injury.
There was a significant difference between young male and female taekwondo athletes in total head and neck injury rate (p < 0.001) with the boys (21.42/1,000 A-E) recording a higher rate than the girls (16.91/1,000 A-E). The head was the most often injured body part (6.10/1,000 A-E and 4.55/1,000 A-E for boys and girls, respectively). The contusion was the most often occurring injury type for both boys (8.41/1,000 A-E) and girls (7.80/1,000 A-E). The cerebral concussion ranked second in both boys (5.11/1,000 A-E) and girls (4.55/1,000 A-E). The unblocked attack was the major injury situation for both boys (19.78/1,000 A-E) and girls (14.96/1,000 A-E). As a consequence, the major injury mechanism was receiving a blow (20.93/1,000 A-E and 16.25/1,000 A-E for boys and girls, respectively). Only the boys (0.66/1,000 A-E) incurred the most serious head and neck injuries that resulted in > or = 21 days away from participation.
The national and international taekwondo governing bodies should review their current injury prevention measures. Given the potentially debilitating nature of these injuries, implications for any diagnostic capabilities on site should be carefully reviewed.
Concerns about the significant injury risks in boxers have been well documented. To inform the continuing debate, updated information about the risk of injury for participants, and suitable means of modifying or preventing these risks, need to be identified.
Data describing all professional boxing fight outcomes and injuries sustained during competition, from August 1985 to August 2001, were obtained from the Victorian Professional Boxing and Combat Sports Board.
A total of 107 injuries were recorded from 427 fight participations, corresponding to an injury rate of 250.6 injuries per 1000 fight participations. The most commonly injured body region was the head/neck/face (89.8%), followed by the upper extremities (7.4%). Specifically, injuries to the eye region (45.8%) and concussion (15.9%) were the most common. About three quarters of all injuries were lacerations/open wounds or superficial. No information was available on the mechanism of injury.
Future research should collect information on the mechanism of injury, as this is crucial for the development and implementation of effective injury prevention strategies. A suggested boxing injury report form is provided to facilitate this.
To determine the rate and type of injuries occurring to registered professional kickboxers in Victoria, Australia over a 16 year period.
Data describing all fight outcomes and injuries sustained during competition for the period August 1985 to August 2001 were obtained from the Victorian Professional Boxing and Combat Sports Board.
A total of 382 injuries were recorded from 3481 fight participations, at an injury rate of 109.7 injuries per 1000 fight participations. The most common body region injured was the head/neck/face (52.5%), followed by the lower extremities (39.8%). Specifically, injuries to the lower leg (23.3%), the face (19.4%), and intracranial injury (17.2%) were the most common. Over 64% of the injuries were superficial bruising or lacerations.
The nature of kickboxing, whereby kicking the opponent is the prime movement and the head a prime target, is reflected in the distributions of body regions most commonly injured by participants. Further research into injury patterns in different styles of kickboxing and the mechanism of injury occurrence is required. Exposure adjusted prospective studies are needed to monitor injury rates over time.
Few studies have reported acute postbout cognitive function in amateur boxers, and none have documented the effects of repeated boxing bouts within a short time frame.
To determine whether participation in a 7-day amateur boxing tournament is associated with acute deterioration in cognitive test performance.
A prospective study was done of 82 collegiate amateur boxers participating in a 7-day single elimination tournament and a group of 30 matched nonboxing control participants. No participants had a history of recent concussion or past history of brain injury. For boxers, cognitive assessment using a computerized test battery was performed before the tournament and within 2 hours of completing each bout. Tests of simple and choice reaction time, working memory, and learning were administered. Analysis of variance was conducted to compare the serial performance of control participants with that of boxers participating in one, two, and three bouts.
The 82 boxers fought 159 times. Cognitive testing was performed after 142 of these bouts. On simple reaction time, choice reaction time, and working memory tasks, the serial performance of boxers participating in three bouts (n = 22) was equivalent to that of boxers participating in two bouts (n = 22) and one bout (n = 32) and to nonboxing control participants (n = 30). An improvement in performance was observed on the learning task in boxers participating in three bouts. Boxers whose bout was stopped by the referee (n = 7) displayed significant slowing in simple and choice reaction time.
With the exception of boxers whose contest is stopped by the referee, amateur boxers participating in multiple bouts during a 7-day tournament display no evidence of cognitive dysfunction in the immediate postbout period.
There is concern over the potential for a high incidence of injury in boxing. This is despite a lack of prospective data evaluating the risk for modern day participants. Updated, reliable data with a focus on potential exposure to injury for both amateur and, especially, professional boxers is required.
To determine the epidemiology of injury and exposure of amateur and professional boxers in Victoria, Australia.
A prospective cohort study with one year follow up was carried out over 2004-2005. Thirty three amateur and 14 active professional boxers registered with either Boxing Victoria Inc (amateurs) or the Professional Boxing and Combat Sports Board of Victoria (professionals) volunteered. Exposure at training and competition was measured, and any injuries sustained during this participation were recorded.
Twenty one injuries were sustained by the cohort during the follow up period. Most were to the head region (71%; 95% confidence interval -3.7 to 89.4), with concussion being the most common (33%). An overall injury rate of 2.0 injuries per 1000 hours of boxing was calculated.
The high exposure experienced by the boxers (as a result of considerable training time) indicated that boxing has acute injury rates comparable to, and often lower than, those found in other contact and non-contact sports. Further, acute injuries during training appear to be less common and severe than those sustained in bouts.
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Counting Injuries Out of Boxing
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- J Ozanne-Smith
Scott I, Finch C, Ozanne-Smith J, et al. Counting Injuries Out of Boxing.
Melbourne: Monash University; 2001.
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Record of investigation into death -Ahmad Zia Popal
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