Whether we agree or disagree with boxing as a sport, it remains a popular participation sport worldwide. The safety of participants, both in the short- and long-term creates strong opinions on both sides of the debate and calls to ban the sport continue. Published systematic reviews have thoroughly reviewed the scientific evidence for the health effects of boxing participation and found no strong evidence for an association between amateur boxing and chronic traumatic brain injury1 whereas a small but significant proportion of professional boxers appear to suffer from this problem.2 The cause for these changes are complex.

Amateur boxing is a different sport from professional boxing for a number of reasons, including in the motivation to participate, different rules and equipment, but, most importantly, there is greater injury exposure in professional boxers (longer bouts, greater boxing experience, increased sparring, smaller and lighter gloves, greater scoring reward for punches that visibly hurt an opponent, longer careers often after an amateur career). A knockout is a rare event in amateur boxing for example, world amateur championships 2001 – 6 knockouts in a total of 366 bouts. Highlighting these differences are studies showing that a single punch from a professional heavyweight boxing champion can deliver an impact force of up to 6320 N (0.63 ton).3 For comparison, an equivalent blow would be delivered by a padded wooden mallet with a mass of 6 kg (13 lbs) if swung …