The Theory of the Sweet Science
The Theory of the Sweet Science
In the ninth round, he started a right hand and I reached over to catch it. When I opened my glove it wasn’t there and I heard the referee say: ´Four. I thought to myself, Man, he’s startin’ awful high. — Sugar Ray Robinson
In 1928 an American pathologist wrote a paper entitled "Punch Drunk" in which he drew attention to a condition that was largely unknown back then;
"Many cases remain mild, but in severe cases there many develop a peculiar tilting of the head, a marked dragging of one or both legs, a staggering, propulsive gait with the facial characteristics of the Parkinsonian syndrome, or backward swaying of the body, tremors, vertigo, or deafness. Finally marked mental deterioration may set in necessitating commitment to an asylum."
Despite rules and regulation boxing is a hurting business. In essence it’s about hitting and not being hit. In spirit it could be said to be a conversation with the self. Inflicting damage on your opponent is deliberate and that is what distinguishes it from other sports, it’s what makes boxing so controversial and polarizing and as a result, deaths in the ring and some of the more serious injuries that are sustained by willing participants are deemed by many who don’t understand the motivations of fighters and the allure of boxing to be completely unnecessary and avoidable.
In 1985 Atha et al measured punches delivered by the then heavy weight champion Frank Bruno. Using an instrumented ballistic pendulum they observed forces of approximately 500kgs (1100 pounds). Clearly with such violent velocities and capabilities at hand, particulary in the heavyweight divisions, the 12 rules devised by the Marquess of Queensberry will not, and probably were not intended to prevent brain injuries and death. Surely the extensive body count made evident by The Manuel Velazquez Fatality Collection would be testament to that. In order to gain a more thorough understanding of Newton’s third law of motion and how it applies to force production - click here
As a trainer or boxer there are a few medical terms that are worth having rudimentary knowledge of. Typically the most serious boxing injuries are those caused by a blow or a series of blows to the head. When injuries are deemed serious enough they go under the relatively broad expression of Traumatic Brain Injury or TBI for short. The most common of the more severe head injuries are concussion and subdural-hematoma which is basically bleeding inside the skull due to ruptured or severed arteries. For a more thorough and medically qualified explanation of what a subdural-hemetoma is, view the video below. Boxing statistics indicate approximately a 6% rate of knockouts and 1 TBI per 12 rounds of competition (Brain Injury Resource Foundation 2009)
This phenomenon occurs when the brain swells catastrophically after even a mild blow, with debilitating or even lethal results. As the name suggests, this is caused by a second blow to a person’s head who has already suffered a recent head injury or head knock and there hasn’t been sufficent time for the first injury to heal. If you’re a trainer, it behooves you to know what your boxers have been up to outside of training. Any head knocks sustained in recreational activities can be prove deadly when that boxer has to step inside the ring.
Occurs when the head is hit (e.g. by a punch to the head) and accelerated in the opposite direction from the incoming blow which then causes the brain to collide with the inside of the skull where the knock occurred, this then sends a percussion wave to the opposite side of the skull. The first impact causes the coup injury whilst the second force causes the contrecoup (pronounced “con-tra- koo”) injury.
Modern advancements have brought about the X-ray and more recently magnetic resonance imaging or MRI which allows us to see structures within the brain. These tools can show intracranial bleeding quite well. What they cannot show is the phenomenon known as axonal shearing. Left is a diagram of motor neuron. When axonal shearing takes place the axon is severed and the cell dies. Given that each neuron communicates with approximately 50,000 other cells this of course has a detrimental effect on the interconnectedness of the brain. When enough of the brain cells die this can present itself with a change in behavior, coordination and impaired spatial awareness.
This video demonstrates axonal shear injury with 2D/3D Medical Animation.
Touched on above are the more severe head injuries that can be acquired by combatants. Other injuries that are present include cuts, bruises, broken teeth, broken or cracked ribs, internal bleeding, and damage to internal organs.
Serious injuries of the eye may occur in boxing, including injuries of the eyelids, cornea, anterior chamber, lens and retina. Neck injuries in boxing may be serious but are not common. Injuries of the nose and ears and fractures of the bones of the striking fist are common. Other injuries include disturbance of hearing and of the balance mechanism of the ear, cranial and peripheral nerve inpry and contusions of the kidney. Protective equipment in boxing may not reduce the risk of brain injury, but properly designed equipment may reduce superficial inpry. (National Health and Medical Research Council – NHMRC - Boxing Injuries)
A study of professional boxing in the state of Nevada USA from September 2001 through to march 2003 found an overall incidence rate to be 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%).(Bledsoe, Gregory H. MD, MPH; Li, Guohua MD, DRPH; Levy, Fred MD, JD - 2005)
Dr Margaret Goodman who is a very experienced ring side physician gave these comments in an interview with the Sweet Science in relation to head gear and ways to help prevent brain injury when boxing.
"Studies have shown that. Headgear can actually contribute to brain injuries, because of the weight it adds on the head. It is one of the things that can cause concussions or cause injuries to the brain and can definitely contribute to knockouts. What happens with headgear, especially in training and in the gyms, fighters start to sweat into it, it becomes heavier and actually creates kind of like a fulcrum, where blows become more easily felt."
.....There are better ways to prevent damage to the brain and there are a lot of things the fighter can do to prevent that and a lot of that comes from their training regimen, their strength, their nutrition, strong neck muscles, a good mouthpiece, a good chin tuck. There are a lot of things that someone can control that can help prevent head injuries. If you look at fighters, how many minutes is the fighter in his career really spend in a fight? Not that many when compared to the hours and hours, days and months and years of them training in the gym. But getting hit in the head during training doesn’t make it easier for you to get hit in the head during an actual fight.
Admittedly, changes to the rules in Amateur boxing over the decades (listed below) and according to BJM have made it much safer than in the distant past.
Neurology.org cites a paper entitled "The management of concussion in sports" which promotes the benefits of a grading scale in sport medicine to help determine the severity of concussions, hopefully this knowledge once applied enmass, can help prevent cases of second impact syndrome or similar.
The Ali Act amended the Professional Boxing Safety Act of 1996 to improve the safety and welfare of professional boxers and to ensure that promoters were truthful in their financial dealings with them. A boxing commission should, upon issuing an identification card to a boxer, make an appropriate health and safety disclosure to that boxer, including the risks associated with boxing (in particular, the risk and frequency of brain injury and the advisability that a boxer periodically undergo medical procedures designed to detect brain injury).
In elite professional ranks of boxing there lie hidden under the penumbra of the glamour - some very serious problems. In the past, mismatches and corrupt organizers who tempted and then stewarded broke, semi-retired boxers with pre-existing head injuries for a re-entry to the ring, all in the hopes for a quick pay day have had deadly consequences. The worst effects of repeated head trauma often don’t show themselves until long after the boxer has retired. The other negative situation that can exist is having boxers who don’t have any real talent for the game punching on long after they should. More can be read on this subject: Stiffs to Superstars: A boxing hierarch.
In amateur boxing it’s incompetence on the part of inadequately qualified trainers who throw their ill prepared fighters into the ring. Skeeter McClure who is a former gold medal winner of the 1960 Olympic games had a visceral and valid retort to a journalist he was speaking with at an amateur boxing event, "There are five ways to keep a left jab from landing," McClure whispered, "and these kids don't know a single one."
This interview with Henry Cooper echoed the same sentiments.
" ...you watch trainers now, and they only do one thing. They're saying to their fighter: 'Come forward, come forward.' They're just telling fighters to go forward all the time, and half the time the fighter's just walking into punches and taking them twice as hard.
At best, fighters who aren’t properly prepared both psychologically and physically can be turned off boxing altogether or worse, be very seriously injured or killed. One of the more recent cases of an amateur death in the ring was that of Becky Zerlentes, the fatal punch can be seen on you tube.. The tragedy in the US between the fire department and police, touted as Gun’s Vs Hoses. The event resulted in a former war veteran come police officer and father of one collapse and die just hours after his charity bout.
Boxing sits in an awkward middle ground, it’s actually between a sport and a form of combat (like war) and in unfortunate cases, whether by design or accident, it does cross that line at times. Either way you frame it, it is a very serious business that has been cleverly marketed as a 'sport'. Most people in the know, know it’s anything but. Mike Tyson pointed out this fact himself in this Time Magazine article. It is not a sport to Tyson. He goes on to say, "I don't like sports; they're social events."
Boxing for some, particulary those who are marginalised provides a way out of poverty. And as long as there are fit, agile and willing participants who need a mechanism to direct and concentrate their energies, boxing will make a place for itself, even in a modern society. The reality is that boxing for now remains herewith, the least that can be done is sensible and proper management of the risk that rides with it.
