Boxing is a fighting sport which has been popular since its inception. According to Arnold and Holland, the earliest form of boxing can be traced to the ancient Olympics while the modern form of boxing started in England in the year 1681 (Perkins et al. 9). This sport requires offensive and defensive strategies to win against an opponent. Over time, boxing rules were also improved to promote safety. Similar to other sports, boxing has two levels: amateur and professional boxing. Amateur and professional boxing differ in terms of safety gear and equipment (Heilbronner et al. 11). This research paper explored existing evidence on the benefits and negative effects of boxing in general.
One of the benefits of boxing would be the improvement of an individual’s overall physique. Similar to other sports, boxing results to an enhanced physique due to demanding physical training. Also, healthy dietary habits are strictly enforced which results to this overall improvement. Blonstein found that after two years of boxing training, an average increase of two inches in height and seven pounds in weight were observed among boys (207).
Boxing can also help people suffering from obesity. In a study conducted by Cheema et al., boxing training was used in a high-intensity level training program to test its effectiveness against obesity. Participants were subjected to twelve weeks of either boxing training or brisk walking. It was found that boxing training was able to lower body fat percentage significantly. Waist circumference, body mass, and body mass index were all significantly decreased after the training. Overall, boxing training was found to be more effective in lowering body fat than brisk walking alone. Although this study was able to demonstrate an important benefit of boxing, the researchers did not include a control group, group without exercise, and the study has a small sample size; this are essential since it can help remove doubts on the accuracy of the results, as well as bias in results. (1-3, 5-6). In a similar trend, Shultz et al. also revealed lower visceral fat thickness in participants after boxing training in a separate study (751, 753). According to Blonstein, psychological benefits can also be obtained from boxing. Boys who undergo boxing training become more self-confident and well-disciplined. Introverted boys become extroverted due to a boost in self-esteem (207). Furthermore, according to DiDomenico, boxing can positively build an individual’s traits and character (Perkins et al. 16). Boxing also helps people channel aggression into a productive activity. Blonstein argued that aggression is natural and instinctive, thus it should not be repressed or ignored. Boxing can therefore be used as strategy to release emotional build-up, including aggression (207). Some research studies have also explored the potential of boxing training as part of the therapy for patients with Parkinson’s disease. Combs subjected Parkinson’s patients, aged 51-77 years old, to boxing training sessions for 36 weeks. Mobility tests were conducted every 4 weeks. It was found that the patients demonstrated improvements in gait and mobility as early as the 12th week of boxing training. Patients with mild Parkinsons also improved more quickly than individuals with moderate and severe Parkinson’s, suggesting that the latter can still significantly improve with longer durations of boxing sessions. This study demonstrated that boxing is a promising supplement to the currently existing treatments and therapies for Parkinsons disease (132-141).
Overall, all of these benefits have led to the rising trend of including non-contact boxing in physical fitness training. The positive effects derived from research studies discussed above are typically achieved in non-contact boxing. In an actual boxing sport competition, contact boxing, physical injuries are quite common. Bledsoe et al. found that for professional boxing matches that occurred in Nevada (September 2001 to March 2003), 51% of injuries are facial lacerations. Other injuries include hand injury (17%), eye injury (14%), and nose injury (5%) (994). Available research studies are mostly focused on long-term effects of boxing-related injuries.
Traumatic brain injury is the primary cause of death in sport-related injuries (“Sports-related Head Injury”). Serious brain injury starts with head trauma. Over the years, research studies found that increased exposure to boxing-related head trauma is highly associated with lower volumes of certain brain regions (Bernick and Banks 3-4). This result suggests that head trauma (resulting from boxing) have the capacity to impair the normal function and integrity of the brain. Blonstein and Clarke described a case wherein a boxer suffered from headaches and amnesia after a boxing match, even without a knock-out. There was also a case wherein the boxer fell unconscious briefly during the match and became forgetful as the day progressed (363).
Through improvements in research, researchers were able to determine specific characteristics of nervous system-related injuries due to boxing. Heilbronner et al. discussed boxing-related neurological injuries; there are currently three types: acute neurologic injury, persistent groggy state, post-concussion syndrome, and chronic traumatic encephalopathy (also referred to as CTE, punch-drunk syndrome, chronic traumatic brain injury [CTBI], or dementia pugilistica). Acute neurologic injury is the loss of consciousness typically resulting from knock-outs during the match. Individuals with ost-concussion syndrome complain of headaches, dizziness and memory problems during or after the match. Chronic exposure to head or cerebral trauma commonly causes CTE. An individual may experience impairment in speech, motor skills, cognition; and changes in behavior (12-13). Additionally, some boxers may be at higher risk for CTE due to apolipoprotein E (APOE). APOE-e4 is highly associated with Alzheimer’s disease and is considered as its genetic risk factor according to the study of Roses et al. (qtd in. Heilbronner et al. 13).
The study of Neselius et al. further supported the existence of adverse effects of head trauma in Olympic boxing. Changes in cerebrospinal fluid (CSF) biomarkers (which has deviated from the normal levels) suggest minor nervous system injuries. Repeated head trauma can therefore result to CTE since it was observed that persistent head trauma prevents CSF biomarkers from returning to normal levels (1, 7). In a similar study, Zetterberg et al. discovered high levels of neuronal and axonal injury (also measured using biomarkers for neuronal injury) in amateur boxers even after three months of rest. Boxers who received more blows to the head showed higher neuronal injury compared to other boxers who had lower hits (1277) In addition, CTE was observed to induce pituitary damage in retired amateur boxers. The researchers therefore subjected the boxers to growth hormone replacement therapy for six months and found that GH therapy can improve growth hormone level but cannot restore it to normal level (Tanriverdi et al. 111-113).
Unfortunately, in addition to serious injuries, boxers are highly susceptible to the risk of death. Researchers were able to record 923 deaths of professional boxers and 293 amateur boxers from 1890 to 2007. Ninety-one percent were deaths from boxing competitions. Acute subdural hematoma is the most common cause of death (Perkins et al. 11). Researchers emphasized that the severity of injuries may differ between amateur and professional boxing. This may be due to the fact that amateur boxing generally makes use of safety gear and also have few rounds compared to the professional level (Heilbronner et al. 13; Jordan 179).
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