13 April 2016

Why are we less tolerant of boxing injuries than in other sports?

British boxer Nick Blackwell has recovered from a medically induced coma after taking a beating for 10 rounds in his British middleweight title fight against Chris Eubank Junior. He is making a steady recovery but the calls to have the sport banned are ringing louder than ever. But the risk that comes with contact sport is one all professional sportsmen take. Why then are we seemingly more tolerant of severe injuries in other sports compared to boxing?

Boxing has, and always will have, its critics who state that the sport is too dangerous and barbaric for a civilised society. And yet, injuries abound in all contact sports. Is boxing really any more dangerous than other sports and if not, should our perceptions regarding this ancient code change?  Image by Peter Gordon

Boxing has, and always will have, its critics who state that the sport is too dangerous and barbaric for a civilised society. And yet, injuries abound in all contact sports. Is boxing really any more dangerous than other sports and if not, should our perceptions regarding this ancient code change? Image by Peter Gordon

British boxer Nick Blackwell is making a steady recovery after he was put in a medically induced coma after a title fight against Chris Eubank Jr on the 26th March. The fight lasted for 10 rounds before it was stopped and just minutes later Blackwell was on a stretcher and needed oxygen. Not long afterwards, he was diagnosed with bleeding on the brain and put into a coma.

It was, as boxing often is, brutal and some say that the referee, Victor Loughlin, should have stopped the fight sooner, despite there having been no knockdowns. The fight was largely one-sided and Peter Hamlyn, a neurosurgeon, told The Guardian that Blackwell had received “dozens and dozens” of “neuro-physically significant punches” in the fight while landing only two in return. He added, though, that it is “very tough to be in the ring under all that pressure trying to make instantaneous decisions”.

During the fight, Chris Eubank Sr, whose fight with Michael Watson back in 1991 ended with Watson confined to a wheelchair for many years, was heard giving instructions to his son just before the 10th round, saying: “You’re not going to take him out to the face, you’re going to take him out to the body.”

Eubank Sr, who manages his son's training, was also heard between the eighth and ninth round saying: “If the referee doesn’t stop it, then I don’t know what to tell you. But I will tell you this: if he doesn’t stop it and we keep beating him like this, he is getting hurt and, if it goes to a decision, why didn’t the referee stop the fight? I don’t get why.”

Blackwell was badly hurt. His eye had swollen to the size of a tennis ball and before the 10th round was due to end, the referee asked for ringside medical advice and was told the swelling was too debilitating to continue. Not long after the fight stopped, the boxer had to go to hospital.

Blackwell is not the first and will most likely not be the last to suffer a severe injury in the ring. Brain damage is an occupational hazard for a boxer, but boxing is one of the few contact sports, which raises the question: “Does a sport as brutal as boxing have a place in civilised society?”

This is not a new question. Back in 1986 that same question was the lead commentary article titled “On Boxing and Liberty” in the Journal of the American Medical Association, and there have been countless similar articles since.

The question only really crops up when something really terrible happens in the ring. Almost exactly a year ago, the death of a 23-year-old boxer prompted a call by the Queensland branch of the Australian Medical Association for the sport to be banned in Australia. Braydon Smith died two days after being admitted to hospital after he had lost a 10-round fight before collapsing. He was never knocked out and appeared fine, round after round.

Safety is often brought up as an argument against boxing and why it should be banned, but that argument is flimsy at best. In recent years, medical supervision in boxing has arguably been tightened more than in any other sport. Pre-participation screening is rigorous and involves a full physical as well as blood tests. Ringside care requires doctors trained in the management of unconscious boxers with resuscitation facilities and dedicated paramedical ambulances solely for the use of the boxer.

Sure, constantly pummelling somebody’s head isn’t exactly safe, but neither is crashing into somebody at high speed while wearing a helmet as the numerous lawsuits against the NFL will attest. Contact sports all carry a certain risk yet society seems to tolerate the risks that other sports hold far more than the risks of boxing.

Following the incident involving Smith, James Donnelly, a lecturer in Psychology, School of Health and Human Sciences, Southern Cross University, wrote in an article for The Conversation that a 2012 study from Victoria found that motor sports, fishing, equestrian activities and swimming all led to more deaths in a year than boxing.

Boxing didn’t even make the top 10 of deaths in sport. Another study found that motor vehicle accidents and falls were far more likely to kill people than boxing or any other sport for that matter. When it comes down just to traumatic injuries, especially to the head and face, these were found to be much more common in motor sports, cycling, skiing, hockey and equestrian activities.

In 2014, The American Association of Neurological Surgeons published similar findings. Cycling was at the top of the list of estimated head injuries treated in US hospital emergency rooms in 2009 both for adults and for children 14 and younger. Football and baseball were next. Boxing didn't feature.

That doesn't mean we should ignore the potential damage that can come as a result of boxing. The Journal of Combative Sport claims that from January 1960 to August 2011, there were 488 boxing-related deaths. The journal attributes 66 percent of these deaths to head, brain or neck injuries; one was attributed to a skull fracture.

Some ex-boxers are rendered immobile and require institutional care while others struggle with speech difficulty of varying degrees. Stiffness, unsteadiness and memory loss are also side-effects and some studies suggest that 15-40 percent of ex-boxers have been found to have symptoms of chronic brain injury. For most, the symptoms are mild to moderate. The occupational risks are very real, but that is the case with almost all sports.

Even heading a soccer ball has been shown to cause some damage. The intolerance of boxing injuries seem to be largely a moral debate.

The brutality of beating your opponent into a stupor is intolerable for many and challenges their own views on what constitutes civility. In a perfect world, boxing would not cause harm to the opponent and defenders of the sport will argue that it is all about skill and not brutal battery. Yet the morality question never seems to go away. In 1962, Sports Illustrated published an essay questioning the very same thing. Since we do not live in a perfect world, some of the sport’s opponents suggest that outright banning seems to be the best solution.

But that will do more harm than good. It will almost certainly not have an impact on the sport’s existence, only where it exists. Ban boxing and it goes underground where access to medical care is far more limited than when it is done openly in public. Rather than ban, considering ways to better manage the risk factors will be far better. While that might initially subdue the very reason some are drawn to the sport, it will perhaps make the risks a little bit more tolerable

This article first appeared on the Daily Maverick and has been published with permission.

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