Monday, February 16, 2009

Brain injuries in MMA and Boxing

Where is the headgear?
A while back we posted on whether headgear actually protected the fighter (see Does headgear protect your noggin?). To quote myself:
I don't believe that headgear does much to prevent damage to the brain. For the following reasons:
  1. A blow to the headgear still does to prevent the rapid acceleration of the brain inside the skull, and nothing to prevent the inevitable impact of the brain, possibly resulting in a concussion.
  2. Boxing-style headgear, to me, is more of a liability to the user because it ALWAY reduces peripheral vision. That results in more blows taken to the same head. Unintended consequence, to be sure, but a serious one. KOs happen all the time in amateur boxing, don't they?
Is there any benefit to headgear? Sure. I love it because I train on hard surfaces (floors or pavement) or uneven (grass), and I hate worrying about whether I'm going to smack my skull on something sharp or hard when I go down, even accidentally. Headgear is great to prevent that. Headgear also protects against cuts and abrasions to the skin. That's important when training for a fight because a cut could mean a postponement of cancellation of a bout. For most of us, a little cut just makes us look tougher on Monday when we go back to our geeky jobs.
To be sure there's slight reduction in the impact of a blow. I'd much rather take a Thai kick or overhand right to the headgear than my skull, but if I wear headgear I may never see it coming.
How-to-Box has a nice post addressing the same topic.
The argument against headgear is that it doesn't protect against knockouts, only cuts and scrapes.  While true, the amateur powers that be have made it pretty clear that isn't going to happen anytime soon.
There is a perception that headgear prevents brain injuries.  While not necessarily true, the perception is beneficial in helping parents get over the initial shock of young jimmy or suzie coming home and saying they want to start boxing.  The perception is that headgear somehow makes it safer.  In reality it's the rules and attention to safety amateur refs enforce. [Emphasis mine - TDA]
What stands out for me is that this is correct, the refs are the ones that protect the fighters, and prevent the injuries. In pro boxing, I’ve seen fighters sustain near-knockout shots for round after round, (sometimes multiple times a round!), and yet fights aren’t stopped because the recipient of those blows is both upright and fighting back. Yet, as any good fight fan knows, a fighter’s instinct, especially a veteran, is to show nothing to the crowd or referee that would indicate he’s hurt, and many have said later that they didn’t know what happened after round X, in other words they were fighting on instinct after a concussion.
MMA, in contrast, seems to me to be safer because of the quick action by referees when a fighter is stunned, whether on the ground or standing. This can lead to controversy, but, overall, it looks less damaging by stopping the action quickly. The addition of submission stoppages (in comparison to striking sports like boxing or kickboxing) also means that fights can stop sooner with less damage?
What say you?
For more information:
Striking Thoughts Head shots and tradition
TDA Headgear or mouthpieces
TDA Does headgear protect your noggin?
Boxing Damages Brain Despite Headgear Protection
TDA Stop hitting me so hard!
TDA Head Butts - use 'em or not?
TDA Hand Protection, What is the Cost?

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thefightgeek said...

I'm against head-gear!

I think intelligent training and responsible refs are the best means of limiting damage.

It annoys me that many amateur fight organizations are more concerned in the perception of safety in their sports than ACTUAL safety.

Good post, dude1

Cheers :)

BSM said...

I tend to think headgear is a good thing. Then again I might be wrong. If we bracket that debate out I do agree about MMA vs. boxing. In boxing the game is stand up and punch. There is no kicks or take downs so the competitors are one dimensional. (no fault of their own; it's the sport!)

MMA changes how the punches fit with the total package. It also changes how the refs act and the refs usually do act pretty darn quick to protect the fighters.


Anonymous said...

Good to see you back. I have never felt comfortable sparring with headgear. As you say, it obstructs vision, which i dont like. Good 16 oz gloves for full contact is good enough for me.

Anonymous said...

For about the past 10 years, there have been 0 fatalities in MMA vs about a half dozen per year in boxing. I heard that before that there was 1 MMA death in Russia or Ukraine in an unregulated fight.

BK Price said...


I don't completely agree with your assessment of headgear and its utility in mitigating head trauma. I do agree that its the rules and the referees that do the most to prevent unnecessary trauma.

Your point that head gear doesn't keep the brain inside the skull from jostling around is mostly accurate. However, the speed with which that brain is sloshing back and forth is reduced to some extent by the cushion/absorbtion/dissipation of the force over the headgear.

As the strike makes contact with the headgear, the headgear gives, absorbing some of the energy of the strike. What energy it is unable to absorb (because it is not thick enough or not designed sufficiently to dissipate over more area) is then absorbed by the head which in turn does not "give" and so simply snaps away from th energy. The brain inside, of course, sloshes back and forth causing the damage.

Without that headgear, 100% of the strike's energy would be transferred to the head. With the headgear, maybe 90-95% is transferred. Is that significant? In a full-contact match, probably not. You're still getting your bell rung.

In light/no-contact sparring or training, that 5-10% reduction may actually be sufficient since the originally energy you are receiving is much less. (Okay, so the math of using percentages doesn't work, but I don't know what the actual force absorption metric for headgear is...just that it reduces the same amount of force regardless of the strike's power, and that reduction vs. a light strike is therefore more effective.)

So, wrt your boxing, maybe headgear isn't that useful. In training, particularly TMA, I think its considerably more useful. And the idea of using a helmet (as Vu is likened to do) may do even less since the helmet itself doesn't give much to anything less than full impact with the pavement. So you get more jarring, not less from strikes. (Which is why Soldiers wearing Kevlar still suffer concussions from IED attacks even though they don't sustain any "injuries.")

Just my two cents.


John W. Zimmer said...

Hi Nathan,

I always opted to forgo the head gear so I could see the punches coming (and potentially get out of the way).

It is a tough thing to on the one hand like contact fighting and the other want to mitigate injuries. I heard about a study about some football players whose brains were studies post mortem. I found another study that dealt with brain injury. Paraphrasing both articles seem to say the brain being repetitively hard is bad and may lead to dementia later in life - kind of scary.

Good topic.


Colin Wee said...

I found once upon a time that when I reduced my gloves - from those bulky foam numbers to the thinner karate type, I was more inclined to control the strikes and to strike lighter - just because I could feel the feedback more accurately anyway. So didn't need to hit so hard. Partly this is so with headgear too - if you're wearing it in order to go for it, then the headgear is going to probably have a net effect that is detrimental for the participants.


Anonymous said...

I agree, that headgear is detrimental as you get hit more often. Nice big 16oz gloves, as someone mentioned are great.

you can really go for it and you're pretty well protected. It's a problem if the inexperienced person can't defend themselves properly, but then it's a case of respecting their ability and NOT battering them! Otherwise you run out of training partners pretty quick..... :(

Protection and safe training practices ensure you can go flat out, or close to it, thereby 'keeping it real', as far as possible. Otherwise we can get into the tippy tappy realm of points sparring which isn't close to real...

Neil R. Hall said...

I agree with the points you make. I also see that some younger students take an opponent wearing a headguard as permission to hit as hard as they like - they think that's safe because of the headguard.

Boxing Shop said...

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