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Returning to the golden age of boxing
  1. Paul McCrory1,
  2. Éanna Falvey2,
  3. Michael Turner3
  1. 1Florey Neurosciences Institutes, University of Melbourne and the Australian Centre for Research Into Sports Injury Prevention, Monash University, Melbourne, Australia
  2. 2Consultant Sports Physician, Sports Surgery Clinic, Dublin, Ireland
  3. 3Chief Medical Adviser, British Horseracing Authority, London, UK
  1. Correspondence to Paul McCrory, Florey Neurosciences Institutes, University of Melbourne and the Australian Centre for Research Into Sports Injury Prevention, Monash University, Melbourne 3010, Australia; paulmccr{at}bigpond.net.au

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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 at 32 kph (20 mph). Super-heavyweight amateur boxers by comparison averaged 4345 N of impact force from their punches.4 5 These differences have been used to justify the continuing ban on professional boxers in Olympic competition, which is reserved for amateur boxers.

In 1984, helmets were introduced for amateur boxers at the LA Olympic Games in an effort to increase participant safety. Previously, they had been used in amateur boxing in Canada since 1971. There is limited experimental evidence demonstrating that boxing helmets do in fact reduce the impact force to the head and brain particularly when combined with larger gloves (amateur boxers use 10 oz gloves vs 6–8 oz. in professional competition).6 7 It is also recognised that head guards reduce facial cuts and ear injury by up to 90%.8 There are issues however with head guards insofar as they obscure peripheral vision placing a boxer at increased risk of an unsuspecting blow. It is important to recognise however that even with helmets in place, amateur boxers still have the potential to suffer significant brain injury ranging from intracranial trauma to changes in brain cellular biomarkers postfight.9

Recent move towards professionalism in Olympic boxing

Over the past 5 years, the International Amateur Boxing Association (AIBA), which oversees Olympic competition, has been moving towards professional-style boxing. In large part, this derives from a longstanding desire for AIBA to be the overarching body governing all forms of boxing worldwide and to be responsible for a boxer's entire boxing career. This governing body will also manage the marketing, image, commercialisation and funding of boxing in order to sustain the sport in the longer term.

In 2010, AIBA started the World Series of Boxing (WSB), which established a team-based competition in which amateur boxers are able to receive payment as professionals and yet retain their amateur status for the purpose of Olympic Games selection. This competition is performed with professional type rules without head guards or vests, with professional-style scoring, a limited-weight categorisation, three judges and one referee and one supervisor. The style promoted is more akin to professional-less emphasis on points scoring and aggression being rewarded. For the WSB's second season, a new format has been introduced. The schedule is based around a new intercontinental league divided into two world groups with an initial competitive round followed by a playoff system.

In 2013, AIBA has announced further plans to launch the Professional Boxing program (APB), which will be designed to provide another opportunity for amateur boxers worldwide, to move into the professional ranks and yet still have the opportunity to participate in the Olympic Games, starting in the Summer Games in Rio de Janeiro in 2016. At present, professional boxers cannot participate in the Olympic Games although in the new competition structure, current professional boxers will be allowed to join the APB under certain terms and conditions and up to 20% of the total pool of boxers may be drawn from current professional ranks. APB will have two core programmes – an Individual Ranking Competition (similar to current professional boxing) and a worldwide national representative competition involving teams and individuals.

Why fight without headgear?

Amateur boxers in these new competitions will fight without headgear. The categories that will have to continue to use headgear will be women, youth and juniors. No rationale is provided for this distinction as to why some groups will wear helmets and some not. It is inevitable that the removal of headgear goes with the more aggressive style of boxing as seen in professional fighting. This in turn will mean more injuries to participants that seem to go against the Olympic ideal of amateurs striving for athletic greatness rather than the rewards of the prize ring. There is a long and proud tradition of great boxers such as Cassius Clay, George Foreman, Joe Frazier, Vladimir Klitschko, Lennox Lewis, Floyd Patterson, Oscar de la Hoya, and many others who have been Olympic gold medalists fighting as amateurs and who have then gone on to successful professional careers.

Although other Olympic sports such as tennis and basketball (and golf from 2016) have opened up their competition to professional athletes, no other sport has the same risk of serious injury difference between the amateur and professional levels of competition. At Olympic level, the addition of professional and semiprofessional participants to the boxing competition may improve the spectacle from an audience standpoint but at what cost to safety?

As discussed above, what little published evidence exists actually supports helmets as a means of reducing impact to the brain and presumably brain injury resulting from boxing. Rather than fundamentally changing the amateur rules and possibly increasing injury risk by discarding helmets, it would seem more appropriate to encourage and publish independent research into the protective effects of helmets, gloves, mouth guards and rule changes in line with the developments in other sports before a change is made. Furthermore, it is a great pity that AIBA has not demonstrated ongoing engagement with the mainstream international sports concussion groups (eg, the CISG group)10 developing guidelines and recommendations for sport to protect athletes. These groups would welcome the input and expertise from sports such boxing that have much to contribute.

Although the overall aim of the new focus by AIBA to amalgamate the various types of boxing under a single jurisdiction is praiseworthy; why AIBA sanctioned boxing would want to move towards a professional model of boxing with the likely higher acute injury rates (eg, concussion) seems intuitively counterproductive. At the very time that increased media and medical scrutiny of high-risk sports (with the potential for brain injury) exists and the increasing litigation and regulation for injured athletes, this move makes little sense.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.