The Lancet Student

Reevaluating what is important: should contact sports involving the head undergo stricter regulations? By Maxwell Koobatian

This blog was submitted by TLS editor on 15th June 2012.
Tagged with Sports, Boxing, Injury

 When I read years ago that Muhammad Ali began to exhibit symptoms of Parkinson’s disease it was not a surprise to me there would be arguments linking his career as a boxer with his medical condition.  After all, boxers typically do not wear head gear while in the ring and over the years the ability to train fighters to hit harder, gain more weight, and maintain endurance has only become more effective. Unfortunately all of us are limited by our physiology. While our ability to throw a more powerful punch may improve, our ability to take a hit doesn’t.  The results are obvious; higher incidence of blindness, traumatic head injury, concussions, and death. Some countries (such as Norway, Cuba, Iran, North Korea, and Iceland) have banned the sport. Sweden is unique in reversing its ban in 2007, but only under strict restrictions, which includes four 3-minute rounds for fights. British, Canadian, as well as Australian Medical Associations have routinely called for bans on boxing.  Dr Bill O’Neil (a spokesman for the British Medical Association) has supported a ban on boxing stating "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."  While highly debatable, the consensus among the medical doctors in this debate is that the risk and apparent harm boxing has on its fighters is not worth the thrill of participation.

What I do find surprising is that similar arguments are being made and taking root with other sports calling for more strict regulations; arguments which I now believe are grounded on solid medical evidence. The sports in question are American football and Soccer. These two sports are arguably more popular than boxing; but what is not normally discussed is the harm done while participating in these sports.  Reports regarding soccer date back to the late 1980s when Dr. Tysvaer wrote an article stating “It is concluded that the atrophy probably was caused by repeated small head injuries during the football play, mainly in connection with heading the ball.” In 1995, a headline was run in the Los Angeles Times  “Hitting Soccer Ball With Head May Cause Impairment: Study finds that skilled players who take at least 10 head shots a game score lower on IQ test”. In the case of American football a more recent example is the case of Junior Seau; who like Dave Duerson ended his own life believing that his difficult life post-career was due to repeated blows to the head, and had requested to have his own brain examined.

These cases all raise very difficult questions and concerns for parents, athletes, and doctors.  With a sport such as boxing it is clearer that a risk is being run regarding the players' health; the sport is grounded on fighting. The same cannot be said for soccer which on the surface seems like a far milder and less dangerous sport. In the case of American football, helmets and padding are mandatory but do not appear to offset the intense physical damage done to the players over time potentially leading to brain damage and chronic pain.

Should heading the ball for example not be allowed in soccer? Should different rules be implemented in American football regarding tackling in an attempt to ensure the long term health of those who participate in the sport? The most difficult task would arguably be educating the public about the seriousness and potential risks associated with these various sports, especially with children and teenagers. And what should if any be the role of medical doctors if they routinely see children, and their parents express an interest in playing these sports or they treat patients as a direct result of participating in these sports?

1 comment

Mini on 23rd June 2012 10:55am

We enjoy watching these sports but we never try to find out the impact on the players...this is really an important matter that requires more attention!