Boxing

==Health concerns==
{{see also|Dementia pugilistica|The distance (boxing)#Distance change criticisms}}
Knocking a person unconscious or even causing a [[concussion]] may cause permanent [[brain damage]].<ref>{{cite web|url=http://news.bbc.co.uk/1/hi/health/medical_notes/363957.stm|archive-url=https://web.archive.org/web/20020918102719/http://news.bbc.co.uk/1/hi/health/medical_notes/363957.stm|url-status=dead|archive-date=18 September 2002|title=Boxing: The health risks|access-date=6 May 2010}}</ref> There is no clear division between the force required to knock a person out and the force likely to kill a person.<ref>{{cite journal |last1=Carter |first1=Neil |date=June 2006 |title=Better and Safer Boxing: Ringside and Boardroom Medical Control of Boxing Careers in the Twentieth Century |url=https://www.dora.dmu.ac.uk/xmlui/handle/2086/4437 |access-date=22 September 2014 |hdl-access=free |website=Dora.dmu.ac.uk |hdl=2086/4437 |archive-date=4 November 2021 |archive-url=https://web.archive.org/web/20211104165151/https://dora.dmu.ac.uk/xmlui/handle/2086/4437 |url-status=dead }}</ref> Additionally, contact sports, especially combat sports, are directly related to a brain disease called [[chronic traumatic encephalopathy]], abbreviated as CTE. This disease begins to develop during the life of the athlete, and continues to develop even after sports activity has ceased.

In March 1981, neurosurgeon Fred Sonstein sought to use CAT scans in an attempt to track the degeneration of boxers' cognitive functions after seeing the decline of [[Bennie Briscoe]].<ref>{{cite news |date=24 March 1981|title=Sports People: Inside boxer's head|work=The Philadelphia Inquirer|location=Philadelphia, Pennsylvania |page=2D}}</ref> From 1980 to 2007, more than 200 amateur boxers, professional boxers and [[Toughman Contest|Toughman]] fighters died due to ring or training injuries.<ref>Svinth, Joseph R. [http://ejmas.com/jcs/jcsart_svinth_a_0700.htm "Death Under the Spotlight"] ''Electronic Journals of Martial Arts and Sciences'', Accessed 25 November 2007</ref> In 1983, editorials in the ''Journal of the [[American Medical Association]]'' called for a ban on boxing.<ref>John Noble Wilford (14 January 1983). "Physicians' Journal Calls for a Ban on Boxing". The New York Times. pp. A1, A23. Editorials in today's issue of the Journal of the American Medical Association urged the banning of boxing in light of new evidence suggesting the chronic brain damage was prevalent among fighters ... New evidence of the correlation between boxing and brain damage was reported in the journal by a team of Ohio doctors, led by Dr. [[Ronald J. Ross]], a radiologist in Mayfield Heights, Ohio ... [The AMA] concluded that for the time being [banning boxing] 'is not a realistic solution.' Instead, urging stricter medical supervision of the sport, it recommended establishment of a National Registry of Boxers ... Another recommendation was that all states provide for a ringside physician who would be 'authorized to stop any bout'.</ref> The editor, George Lundberg, called boxing an "obscenity" that "should not be sanctioned by any civilized society".<ref>{{cite journal |last=Lundberg |first=George D. |title= Boxing should be banned in civilized countries |volume=249 |issue=2 |journal=Journal of the American Medical Association |year= 1983 |pages= 249–250 |publisher=Jama.jamanetwork.com|doi=10.1001/jama.1983.03330260068037 }}</ref> Since then, the British,<ref>[http://www.bma.org.uk/health_promotion_ethics/sports_exercise/BoxingPU.jsp BMA.org.uk] {{webarchive |url=https://web.archive.org/web/20110208211719/http://www.bma.org.uk/health_promotion_ethics/sports_exercise/BoxingPU.jsp |date=8 February 2011 }}</ref> Canadian<ref>{{cite web|url=https://www.cbc.ca/sports/cma-wants-to-ban-boxing-1.223547 |title=CMA wants to ban boxing |date=19 December 2000 |publisher=CBC Sports}}</ref> and Australian<ref>{{cite web|author=Australian Medical Association |url=https://ama.com.au/ |title=CMA.ca |publisher=Ama.com.au |access-date=18 May 2012}}</ref> Medical Associations have called for bans on boxing.

Supporters of the ban state that boxing is the only sport where hurting the other athlete is the goal. Bill O'Neill, boxing spokesman for the [[British Medical Association]], has supported the BMA's proposed ban on boxing: "It is the only sport where the intention is to inflict serious injury on your opponent, and we feel that we must have a total ban on boxing."<ref>{{cite news|url=http://news.bbc.co.uk/2/hi/uk_news/87267.stm |title=UK &#124; BMA renews call for boxing ban |publisher=[[BBC News]] |date=1998-05-03 |access-date=2016-06-23}}</ref> Opponents respond that such a position is misguided opinion, stating that amateur boxing is scored solely according to total connecting blows with no award for "injury". They observe that many skilled professional boxers have had rewarding careers without inflicting injury on opponents by accumulating scoring blows and avoiding punches winning rounds scored 10–9 by the [[10-point must system]], and they note that there are many other sports where concussions are much more prevalent.{{Citation needed|date=February 2022}} However, the data shows that the concussion rate in boxing is the highest of all contact sports.<ref>{{Cite journal|last1=Tommasone|first1=Beth A|last2=Valovich McLeod|first2=Tamara C|date=2006|title=Contact Sport Concussion Incidence|journal=Journal of Athletic Training|volume=41|issue=4|pages=470–472|issn=1062-6050|pmc=1748409|pmid=17273475}}</ref><ref>{{Cite journal |last1=Zazryn |first1=Tsharni R. |last2=McCrory |first2=Paul R. |last3=Cameron |first3=Peter A. |date=February 2009 |title=Neurologic Injuries in Boxing and Other Combat Sports |journal=Physical Medicine and Rehabilitation Clinics of North America |language=en |volume=20 |issue=1 |pages=227–239 |doi=10.1016/j.pmr.2008.10.004|pmid=19084773 }}</ref><ref>{{Cite web|title=Sports Concussion Statistics {{!}} HCC- Best Anti Concussion Helmets & Devices|url=https://headcasecompany.com/concussion_info/stats_on_concussions_sports|access-date=2022-02-18|website=headcasecompany.com}}</ref> In addition, repetitive and subconcussive blows to the head, and not just concussions, cause CTE,<ref>{{Cite journal |last=Castellani |first=Rudy J. |date=June 2015 |title=Chronic traumatic encephalopathy: A paradigm in search of evidence? |journal=Laboratory Investigation |language=en |volume=95 |issue=6 |pages=576–584 |doi=10.1038/labinvest.2015.54 |pmid=25867769 |doi-access=free}}</ref><ref>{{Cite journal |last=Ridler |first=Charlotte |date=April 2017 |title=New insights into the long-term effects of mild brain injury |journal=Nature Reviews Neurology |language=en |volume=13 |issue=4 |page=195 |doi=10.1038/nrneurol.2017.32 |pmid=28257129 |doi-access=free}}</ref><ref>{{Cite journal |last1=Tagge |first1=Chad A |last2=Fisher |first2=Andrew M |last3=Minaeva |first3=Olga V |last4=Gaudreau-Balderrama |first4=Amanda |last5=Moncaster |first5=Juliet A |last6=Zhang |first6=Xiao-Lei |last7=Wojnarowicz |first7=Mark W |last8=Casey |first8=Noel |last9=Lu |first9=Haiyan |last10=Kokiko-Cochran |first10=Olga N |last11=Saman |first11=Sudad |last12=Ericsson |first12=Maria |last13=Onos |first13=Kristen D |last14=Veksler |first14=Ronel |last15=Senatorov |first15=Vladimir V |date=February 2018 |title=Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model |journal=Brain |language=en |volume=141 |issue=2 |pages=422–458 |doi=10.1093/brain/awx350 |pmc=5837414 |pmid=29360998 |doi-access=free}}</ref><ref>{{Cite journal |last1=Montenigro |first1=Philip H |last2=Baugh |first2=Christine M |last3=Daneshvar |first3=Daniel H |last4=Mez |first4=Jesse |last5=Budson |first5=Andrew E |last6=Au |first6=Rhoda |last7=Katz |first7=Douglas I |last8=Cantu |first8=Robert C |last9=Stern |first9=Robert A |date=October 2014 |title=Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome |journal=Alzheimer's Research & Therapy |language=en |volume=6 |issue=5–8 |pages=68 |doi=10.1186/s13195-014-0068-z |pmc=4288217 |pmid=25580160 |doi-access=free}}</ref><ref>{{Cite journal |last1=Johnson |first1=Brian |last2=Neuberger |first2=Thomas |last3=Gay |first3=Michael |last4=Hallett |first4=Mark |last5=Slobounov |first5=Semyon |date=December 2014 |title=Effects of Subconcussive Head Trauma on the Default Mode Network of the Brain |journal=Journal of Neurotrauma |language=en |volume=31 |issue=23 |pages=1907–1913 |doi=10.1089/neu.2014.3415 |pmc=4238241 |pmid=25010992}}</ref><ref>{{Cite journal |last1=Di Virgilio |first1=Thomas G. |last2=Ietswaart |first2=Magdalena |last3=Wilson |first3=Lindsay |last4=Donaldson |first4=David I. |last5=Hunter |first5=Angus M. |date=10 September 2019 |title=Understanding the Consequences of Repetitive Subconcussive Head Impacts in Sport: Brain Changes and Dampened Motor Control Are Seen After Boxing Practice |journal=Frontiers in Human Neuroscience |volume=13 |page=294 |doi=10.3389/fnhum.2019.00294 |pmid=31551732 |pmc=6746992 |doi-access=free}}</ref> and the evidence indicates that brain damage and the effects of CTE are more severe in boxing.<ref>{{Cite journal |last1=McKee |first1=Ann C. |last2=Cantu |first2=Robert C. |last3=Nowinski |first3=Christopher J. |last4=Hedley-Whyte |first4=E. Tessa |last5=Gavett |first5=Brandon E. |last6=Budson |first6=Andrew E. |last7=Santini |first7=Veronica E. |last8=Lee |first8=Hyo-Soon |last9=Kubilus |first9=Caroline A. |last10=Stern |first10=Robert A. |date=July 2009 |title=Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury |journal=Journal of Neuropathology and Experimental Neurology |volume=68 |issue=7 |pages=709–735 |doi=10.1097/NEN.0b013e3181a9d503 |issn=0022-3069 |pmc=2945234 |pmid=19535999 |doi-access=free}}</ref><ref>{{Cite journal|last1=Safinia|first1=Cyrus|last2=Bershad|first2=Eric M.|last3=Clark|first3=H. Brent|last4=SantaCruz|first4=Karen|last5=Alakbarova|first5=Naila|last6=Suarez|first6=Jose I.|last7=Divani|first7=Afshin A.|date=October 2016|title=Chronic Traumatic Encephalopathy in Athletes Involved with High-impact Sports|journal=Journal of Vascular and Interventional Neurology|volume=9|issue=2|pages=34–48|issn=1941-5893|pmc=5094259|pmid=27829969}}</ref><ref>{{Cite journal |last1=Viano |first1=David C. |last2=Casson |first2=Ira R. |last3=Pellman |first3=Elliot J. |last4=Bir |first4=Cynthia A. |last5=Zhang |first5=Liying |last6=Sherman |first6=Donald C. |last7=Boitano |first7=Marilyn A. |date=December 2005 |title=Concussion in Professional Football: Comparison with Boxing Head Impacts—Part 10 |journal=Neurosurgery |language=en |volume=57 |issue=6 |pages=1154–1172 |doi=10.1227/01.neu.0000187541.87937.d9 |pmid=16331164|s2cid=45425906 }}</ref><ref>{{Cite book|last=Castellani|first=Rudy J.|url=https://books.google.com/books?id=ZHGazQEACAAJ|title=Handbook of Traumatic Brain Injury and Neurodegeneration|date=2020-04-24|publisher=IOS Press, Incorporated|isbn=978-1-64368-064-4|language=en}}</ref><ref>{{Cite web|last=EMagraken|date=2017-04-11|title=Study – Why are CTE Symptoms Worse for Boxers vs. Other Athletes?|url=https://combatsportslaw.com/2017/04/11/study-why-are-cte-symptoms-worse-for-boxers-vs-other-athletes/|access-date=2022-02-18|website=Combat Sports Law|language=en}}</ref><ref>{{Cite web|last=Bissell|first=Tim|date=2019-07-03|title=Largest CTE study to date finds evidence of disease in 6% of all test subjects, over 28% in former boxers|url=https://www.bloodyelbow.com/2019/7/3/20677705/largest-cte-study-evidence-disease-6-all-test-subjects-over-28-former-boxers-boxing-mma-health-news|access-date=2022-02-18|website=Bloody Elbow|language=en}}</ref>

In 2007, one study of amateur boxers showed that protective headgear did not prevent brain damage,<ref>{{cite journal| url=https://www.newscientist.com/article/mg19426023.000-amateur-boxers-suffer-brain-damage-too.html| title=Amateur boxers suffer brain damage too| date=8 May 2007| journal=New Scientist| issue=2602 | page=4}}</ref> and another found that amateur boxers faced a high risk of brain damage.<ref name="amatneuro">{{cite news| title=Does Amateur Boxing Cause Brain Damage?| date=2 May 2007| url=http://www.aan.com/press/index.cfm?fuseaction=release.view&release=470| work=American Academy of Neurology| url-status=dead| archive-url=https://web.archive.org/web/20070627065134/http://www.aan.com/press/index.cfm?fuseaction=release.view&release=470| archive-date=27 June 2007}}</ref> The Gothenburg study analyzed temporary levels of neurofilament light in cerebral spinal fluid which they conclude is evidence of damage, even though the levels soon subside. More comprehensive studies of neurological function on larger samples performed by Johns Hopkins University in 1994 and accident rates analyzed by [[National Safety Council]] in 2017 show amateur boxing is a comparatively safe sport due to the regulations of amateur boxing and a greater control of the athletes,<ref>{{Cite journal|last1=Stewart|first1=W. F.|last2=Gordon|first2=B.|last3=Selnes|first3=O.|last4=Bandeen-Roche|first4=K.|last5=Zeger|first5=S.|last6=Tusa|first6=R. J.|last7=Celentano|first7=D. D.|last8=Shechter|first8=A.|last9=Liberman|first9=J.|date=1994-03-15|title=Prospective study of central nervous system function in amateur boxers in the United States|journal=American Journal of Epidemiology|volume=139|issue=6|pages=573–588|issn=0002-9262|pmid=8172169|doi=10.1093/oxfordjournals.aje.a117047}}</ref> although the studies did not focus on CTE or its long-term effects. In addition, a good training methodology and short career can reduce the effects of brain damage.<ref>{{Cite journal |last1=McCrory |first1=Paul |last2=Zazryn |first2=Tsharni |last3=Cameron |first3=Peter |date=2007 |title=The Evidence for Chronic Traumatic Encephalopathy in Boxing |journal=Sports Medicine |language=en |volume=37 |issue=6 |pages=467–476 |doi=10.2165/00007256-200737060-00001|pmid=17503873 |pmc=2465459 }}</ref>

In 1997, the American Association of Professional Ringside Physicians was established to create medical protocols through research and education to prevent injuries in boxing.<ref>{{cite web |url=http://www.aaprp.org/ |title=American Association of Professional Ringside Physicians |publisher=Aaprp.org |date=17 September 2011 |access-date=18 May 2012 |archive-url=https://web.archive.org/web/20100211135806/http://www.aaprp.org/ |archive-date=11 February 2010 |url-status=dead }}</ref><ref>Hauser, Thomas. [http://www.secondsout.com/usa/colhauser.cfm?ccs=208&cs=15463 "Medical Issues and the AAPRP"] {{Webarchive|url=https://web.archive.org/web/20080210010515/http://www.secondsout.com/usa/colhauser.cfm?ccs=208&cs=15463 |date=10 February 2008 }} SecondsOut.com, Accessed 25 November 2007</ref>

Professional boxing is forbidden in Iceland,<ref>{{cite news|url=https://www.economist.com/news/international/21639526-more-countries-are-allowing-professional-boxing-despite-risks-bouncing-back|title=Bouncing back|newspaper=The Economist|date=15 January 2015}}</ref> Iran and North Korea. It was banned in Sweden until 2007 when the ban was lifted but strict restrictions, including four three-minute rounds for fights, were imposed.<ref>{{cite news| url=http://news.bbc.co.uk/2/hi/europe/6237978.stm | publisher=BBC News| first=Jim | last=Fish | title=Boxers bounce back in Sweden | date=26 June 2007}}</ref> Boxing was banned in [[Albania]] from 1965 until the [[Fall of communism in Albania|fall of Communism in 1991]]. Norway legalized professional boxing in December 2014.<ref>{{Cite journal|last1=Rudd|first1=S.|last2=Hodge|first2=J.|last3=Finley|first3=R.|last4=Lewis|first4=P.|last5=Wang|first5=M.|date=2016|title=Should We Ban Boxing?|journal=British Medical Journal |volume=352|via=ProQuest}}</ref>

The International Boxing Association (AIBA) restricted the use of head guards for senior males after 2013.<ref>{{Cite web |date=2019-02-14 |title=Why head-guards in boxing isn't always best ? |url=https://www.mskhealthcare.co.uk/is-wearing-head-guards-in-boxing-safe |access-date=2022-11-24 |website=www.mskhealthcare.co.uk |language=en |archive-date=6 March 2023 |archive-url=https://web.archive.org/web/20230306015858/https://www.mskhealthcare.co.uk/is-wearing-head-guards-in-boxing-safe |url-status=dead }}</ref><ref>{{Cite web |date=2013-03-23 |title=Olympic boxing drops headgear, tweaks scoring |url=https://www.espn.com/olympics/story/_/id/9087686/olympic-boxing-drops-head-guards-changes-scoring-system |access-date=2022-11-24 |website=ESPN.com |language=en}}</ref> A literature review study analyses present knowledge about protecting headgear and injury prevention in boxing to determine if injury risks associated with not head guard usage increased. The research of the reviewed literature indicates that head guards cover well against lacerations and skull fractures. Therefore, AIBA's decision to terminate the head guard must be considered cautiously, and injury rates among (male) boxers should be continuously evaluated.<ref>{{Cite journal |last1=Tjønndal |first1=Anne |last2=Haudenhuyse |first2=Reinhard |last3=de Geus |first3=Bas |last4=Buyse |first4=Luk |date=2022-03-04 |title=Concussions, cuts and cracked bones: A systematic literature review on protective headgear and head injury prevention in Olympic boxing |journal=European Journal of Sport Science |volume=22 |issue=3 |pages=447–459 |doi=10.1080/17461391.2021.1872711 |issn=1746-1391 |pmid=33607924|s2cid=231970408 |doi-access=free }}</ref>

=== Possible health benefits ===
{{More citations needed section|date=March 2021}}
Like other active and dynamic sports, boxing may be argued to provide some general health benefits, such as fat burning, increased muscle tone, strong bones and ligaments, cardiovascular fitness, muscular endurance, improved core stability, co-ordination and body awareness, strength and power, stress relief and self-esteem.