Boxing Amateur

Should amateur boxers be concerned about long term brain injury? According to an article published in the British Medical Journal (BMJ) the association between amateur boxing and chronic traumatic brain injury is not significant; researchers say it is currently not possible to come to a decisive conclusion.

The authors explain that in the case of professional boxing the risk of long term brain injury is much clearer. However, this does not mean that the safety of amateur boxing should not continue to be questioned.

If the British Medical Association had its way, both professional and amateur boxing would be banned. However, no recent studies have been carried out to evaluate the dangers in amateur boxing. Therefore, Dr Mike Loosemore, Lead Sports Physician, Olympic Medical Institute, Northwick Park Hospital, Harrow, UK, and a team of sports doctors and clinical academics looked at the evidence to decide whether the amateur sport might lead to chronic traumatic brain injury.

36 observational studies were identified – all of them focusing on amateur boxing and its potential link to chronic traumatic brain injury. In order to minimize bias, the researchers took into account study design and quality. Their definition of chronic traumatic brain injury included any abnormality in neurological examination, psychometric testing, brain imaging, or electroencephalography.

15 of all the studies came to the conclusion that abnormalities took place. However, the researchers commented that the quality of proof was generally poor.

The studies deemed to be of the best quality – the ones that included psychometric tests – concluded that there were no long-term effects of boxing on the function of the brain. Of 17 better quality studies, just four identified indications of chronic traumatic brain injury in a small proportion of boxers in their studies.

Six of the studies used magnetic resonance imaging. Just one of them found an abnormality – one boxer had a cyst – which could have been congenital. MRI (magnetic resonance imaging) is normally considered as the best way of determining subtle damage and degenerative change in the brain.

Studies with positive findings were, in general, of bad design and quality.

The authors explain that amateur boxing is becoming more popular. They stress that their aim in this review is neither to support nor oppose the sport. They conclude that the evidence as such is not strong enough to link amateur boxing with chronic traumatic brain injury.

Accompanying Editorial:
Paul McCrory, a neurologist and sports doctor, University of Melbourne, believes that as modern amateur boxers have shorter careers than their peers years ago, and reduced exposure to repetitive head trauma, the chances of this condition developing are fairly slim.

“Amateur boxing and risk of chronic traumatic brain injury: a systematic review of observational studies”
BMJ Online First
“Editorial: Boxing and the risk of chronic brain injury”
BMJ Online First

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• Do you like being a tough guy?
• And do you go to a boxing club to show after that how hard you hit when you’re pissed off?
• Well, you’d better find out that you will become like Muhammad Ali, even if you do not step on a professional arena.

A new Swedish research shows that blows to the head in amateur boxing provoke severe brain damage. “Despite the high prevalence of brain damage as a result of professional boxing, until now there has been little information on the possible risks for brain injury in amateur
boxing,” said study author Dr. Max Hietala, with Sahlgrenska University Hospital, Goteborg.

The researchers employed lumbar puncture to see if there were higher amounts of biochemical markers pointing to brain injury in the cerebrospinal fluid (CSF) of 14 amateur boxers. The fighters were checked after a fight and a second time three months after a pause without boxing. 10 healthy men that did not practice box were used for control.

The research team detected in the CSF high amounts of neuronal and glial markers showing brain damage after the fight. Neurofilament light (NFL), a marker for neuronal damage, was four fold higher in boxers in the first 10 days following the fight compared to control subjects.

These high marker amounts turned back to normal only after the three months pause. These abnormal levels following a boxing match were much higher among those amateur fighters who had received over 15 high impact hits to the head.

This category was found to present 7-8 times more NFL-levels post fight than their own levels after the three-months pause. “Repeated hits to the head are potentially damaging to the central nervous system, and our results suggest CSF-analysis could be used for medical counseling of athletes after boxing or head injury,” said Hietala.

When the same analyses were made on soccer players, who head the ball repeatedly from long and high goal kicks, there were no raised levels of brain trauma markers in cerebrospinal fluid. “This data shows headings in soccer is not associated with any neurochemical evidence of brain damage,” said Hietala.

Pierce Egan, the famed 19th-century boxing journalist who coined the term “sweet science,” wrote that “Drummers and boxers, to acquire excellence, must begin young.”

It is as if the fates conspired to push 22-year-old Deontay Wilder toward pugilism just to prove Egan wrong. The 6-foot-7 heavyweight, whose bronze medal on Friday kept alive the U.S. streak of winning a boxing medal in every Olympics in which it competed, never meant to be a boxer. Not like his USA Boxing teammates, all of whom were ducking and diving by age 12.

Wilder grew up as a basketball player in Tuscaloosa, Ala. He was in his freshman year playing at Shelton Community College when his girlfriend became pregnant. It wasn’t by design. An early ultrasound showed that Wilder’s daughter would be born with spina bifida.

“Our hearts dropped,” Wilder said. “Doctors gave us the choice to terminate the pregnancy, but after a while I just said, it really doesn’t matter, this is my little girl.”

Wilder dropped out of school and found work at Red Lobster and driving a Budweiser truck so he could support his daughter and shuttle her to doctors and hospitals to fix her clubbed feet. But there was a hole in his heart where basketball had been, and with team sports out of the question, boxing was something that offered a flexible schedule. Thus, 3-year-old Naieya Wilder helped keep the U.S. medal streak alive by turning her daddy to boxing. “She’s healthy and smart,” Wilder said, proudly.

For the first time in 20 years, USA Boxing established a residence program and required Olympic boxers to live in Colorado Springs beginning last September, a response to America’s dearth of boxing gold in recent Olympics after a gilded history. Wilder, with his coach’s blessing, seized the opportunity to “play catch up,” he says, with intensive training.

But other team members resented being plucked from their long-time coaches. David Ali, father of 20-year-old lightweight Sadam Ali, who lost his opening bout, said before the Olympics that Sadam “could have gotten better training [at home in New York]. He has two trainers here.”

Light welterweight Javier Molina, 18, who lost his first fight at the Olympics, said that the residence program “takes me out of my comfort zone. The only thing I like is I get to know the other Olympians, but I don’t know if that’ll help me. This isn’t like a basketball team.” Molina said that while the USA Boxing coaches are very good coaches, Roberto Luna, the man who has coached him since he was eight, “knows my weaknesses.”

It didn’t help that some of the coaches were loath to part with their prized pupils, and many continued to exert influence from afar by email and phone. Wilder’s coach, Jay Deas, bought into the idea that Wilder needed to make up for lost time, and “did not interfere,” says USA Boxing coach Dan Campbell. “Other coaches didn’t want to cooperate.”

In the broader view, though, Egan had a point about experience. This U.S. team was extremely young, with an average age just older than 20, and only one returning Olympian, world champion flyweight Rau’shee Warren, who lost his opening bout.

Wilder could use more amateur bouts to hone his skills, but his punishing power — in a test prior to the Olympics, his jab measured stronger than all but one other U.S. boxer’s power punch — may ensure this is his last Olympics. Wilder said he’s already gotten calls from promoters. In other countries, so-called amateurs enjoy great financial support.

“International boxers, like Cubans, they get paid to stay amateur; we don’t get paid to stay,” said Ali, the first Olympic team member since Riddick Bowe in 1988 to hail from New York City, where boxing gyms have dwindled from a high of 150 in the mid-1980s to 50. “So we go for it once, and turn pro.”

To the detriment of both amateur and professional boxing.

Many people believe that boxing is dead because of the rise of MMA, and while that may be true there will always be those amateurs who continue to keep the sport alive with some highlight reel knockouts of their own.  After all, who needs a ring or octagon when you can put on a show in the comfort of your own living room.

These two guys put the gloves on and decided to get a couple of swings in there with their friends watching.  They touch gloves and right away the mayhem begins.  With their fists swinging wildly, both guys get in some devastating shots before the final blow is landed.

It was the type of blow you would expect to see delivered from a giant heavyweight fighter, or perhaps even the right hand of Dan Henderson.

This is without a doubt one of the better amateur boxing matches I have witnessed as there could have been at least two or three knockouts prior to the punch that ended it.  It was a great finishing shot, but I am not sure what was more enjoyable to watch; the knockout, or the reaction of those in the room, including the male who delivered it.

One thing about amateur boxing is the ringside doctors tend to be amateurs as well.

During a General Assembly, The Pan American Sports Organization (PASO) and its President, Mario Vazquez Rana, announced the inclusion of Women Boxing in the 2011 Guadalajara Pan American Games, a request made by the President of the American Boxing Confederation, Bienvenido Solano.

In the same way, it was announced the broad interest for women’s boxing to be able to demonstrate their skills and abilities in the Pan American Games. This discipline was accepted under the same conditions that the IOC did for the upcoming 2012 Olympic Games.

The weight categories for women’s competitions will be 51kgs, 60kgs and 75kgs, which will have 7 competitors per weight, a total of 21 boxers. This will be reduced from the men quota of 125 boxers.

The women’s qualification procedure for this event has not yet been announced.  The PanAmerican Games are scheduled for October 13-30, 2011.  The men’s boxing events are currently scheduled for October 21-29.

This edition of articles emphasizes safety concerns, and is in honor of the late award winning actress, Natasha Richardson, who recently died from what initially appeared to be a minor blow to her head in a skiing accident, and to her surviving husband actor Liam Neeson who as a teenager was the youth heavyweight amateur boxing champion of Northern Ireland:

The standing count can serve as a means for the referee to assess the condition of the boxer’s situation in the ring.  This tool of the referee is readily available and is routinely initiated as a result of a blow or from a series of blows.  These eight seconds give the referee an up close opportunity to evaluate and focus on the boxer.  While the referee is administering the eight count, the referee has plenty of time to assess the boxer’s physical condition by assessing his/her: stance, muscle tone, and the eyes.  Within those precious eight seconds, the referee determines if the boxer is capable to continue, or if the bout should be stopped.  At the end of those eight seconds, the referee should either command the bout to continue, or stop it.  Compliments of Ray Silvas, Vice-Chair AIBA R/J Commission; past Technical Committee Chair and National COO of USA Boxing.

Second impact syndrome. Referees who have issued RSC-Hs and who have signed a restriction Affidavit and/or those Officials who perform practice judging, and/or who referee sparring in the gyms should pay particular attention.  All the guidelines focus on the question of when is it safe for the boxer to return to competition after suffering a concussion.  Several serious risks are associated with a premature return to boxing.  The most serious is the second impact syndrome.  This syndrome was first described in 1973 and it occurs in athletes that return to competition before the symptoms of the first concussion have completely resolved.  A second blow to the head, even a minor one, can result in loss of auto regulation of the brain blood supply.  This in turn can result in brain injury and possible death.  All coaches and boxers should also be made aware of this risk.  Many injuries usually can occur in unsupervised sparring sessions.  Therefore, close supervision during sparring sessions should be given to the boxers at all times.  If there are any questions, it is always better to keep the boxer from any further competition/sparring until a physician examines that person.  Compliments of Robert Voy, MD, LBC 49 Nevada ringside physician; past member AIBA medical commission; and past President of USA Boxing