Boxing, Mixed Martial Arts and TBI: Take Care of Yourself

By Dr. James Bender, psychologist, and a Level I Combatives instructor, amateur-mixed martial arts fighter, and former Army officer. He writes a monthly post for the DCoE Blog, Frontline Psych with Doc Bender on issues related to deployment and being in the military.

As a former Army officer and current amateur boxer, I was very happy to hear that the U.S. Army won the Armed Forces Boxing Championship, beating tough Navy, Air Force and Marine Corps teams. The next step is competing in the 2010 U.S. National Boxing Championships July 12-17 at the U.S. Olympic Training Center in Colorado Springs, Colo.

Boxing and mixed martial arts (MMA) are hot sports right now.  I remember Fort Benning, Ga. practically shutting down so everyone could watch UFC 100 at the local Benning Brew Pub.  MMA is equally popular at other bases and with the other military branches.  Plus, there’s a significant overlap between MMA, the Modern Army Combatives Program (MACP) and the Marine Corps Martial Arts Program (MCMAP).  For many servicemembers, this is more than a sport; it’s a military specialty and sometimes a matter of life and death.



On the left, Dr. James Bender, Level I Combatives instructor, amateur mixed martial arts fighter, and former Army officer, spars with a traing partner

Unfortunately, if you’re going to have any kind of realistic training in combatives or MMA, head injuries (including concussions) are going to happen. DCoE works hard to put out guidelines for doctors to use when treating concussions. Much has been learned during the past 10 years and some of the new information is disproving some of the old information.  It would take a small library to cover all the information about concussions (also called mild traumatic brain injury, or mTBI), but here are a few main points you should know about mTBI as it relates to boxing and MMA:

  • You don’t have to be knocked unconscious to have a mTBI. Some other signs of mTBI are a period of memory loss, feeling woozy or dazed, confusion or disorientation.
  • Amateur boxers, who train less intensely and sustain fewer head blows are less at risk for incurring permanent brain damage than pros. However, effects of repeated concussions may result in changes within the brain. Resting and preventing further injury following a concussion is important to brain recovery.
  • While mouthguards are very good at protecting teeth, they have not been proven to protect the brain or prevent concussions thus far.
  • If you do experience a mTBI while training, your doctor will advise you to rest, with emphasis on sleep and abstaining from alcohol (which is a brain toxin). Before returning to boxing or MMA, be certain that you no longer have any symptoms, such as headaches, dizziness, trouble sleeping or nausea. If you begin exercising and experience these symptoms, immediately stop and contact your doctor.
  • Most people with mTBI have normal brain scans. That’s why your doctor may not order a brain scan for you if you suffer a mTBI.
  • Finally, you should know that most people who sustain a mTBI recover completely.

Boxing and MMA are great sports that get you in fantastic physical condition, relate to the military’s mission and sometimes have direct battlefield uses.  Just be smart with your training; your brain and body will hold up just fine.

Thanks for your service, and please post any questions that you have.

JB

*Be sure to check out Dr. Bender’s previous DoD Live post About Your Brain, for more information about traumatic brain injuries

*For more posts on psychological health and traumatic brain injury, check out the DCoE Blog

Check out these other posts:

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  • http://www.mmajudo.net/fedor-emelianenko.php Fedor Emelianenko

    very good post… :) I believe that the popularity of MMA will rise even more, maybe it would be great to try to organize the MMA championship of Armed Forces. The US Army fighters should just use the MACP training and they can be very successful…as for the training, this is still an issue due to necessity to train as real as possible, but no real solution yet…

  • http://www.guardkit.co.uk Guard

    It’s true that mouthguards are good at protecting teeth and they have not been proven to protect the brain or prevent concussions thus far. So there is no proof that there is a definite relationship between mouthguards and cerebral concussion. Mouthguards, until proven different, are primarily for the reduction of orofacial injury.

    • jennifer.cragg

      Thanks for visiting DoDLive.mil and for posting your comment. I have forwarded your comment to the Defense Centers of Excellence. V/r, LT Jennifer Cragg

  • Adam Boyd

    As an Army officer (level II certified in the Modern Army Combatives Program (MACP)), I wholeheartedly agree that Combatives, Boxing, and MMA are some of the best physical training methods, in or out of the military. However, with all the attention placed on mTBI in recent years, I wonder if/when the military will add even more restrictions to realistic combatives training. On that note, I have one question: what have studies shown with regards to effectiveness of the headgear worn in boxing in mitigating mTBI? Personally, I would think that headgear has somewhat minimal effect, since mTBI is more from concussive impact. I would be interested to hear your take. Thanks for the interesting post.

    • jennifer.cragg

      Adam, thanks for posting your comment on DoDlive.mil with regard to the blog posting referencing Mixed Martial Arts, Boxing and TBI. I have forwarded your question to the author of the post. V/r, LT Jennifer Cragg

    • jennifer.cragg

      Adam, please find listed below a comment response from Dr. James Bender:

      You’re absolutely right; mild TBI, or concussion, is typically caused by some sort of impact that causes the head to suddenly accelerate and/or decelerate. Usually, the punch or kick is merely the cause of the head movement. With this acceleration/deceleration, the brain literally moves around inside the skull, twisting and hitting the inside of the skull. Sometimes, the area of the brain opposite the blow will get injured when the brain strikes the inside of the skull. This is called a contra-coup injury.

      I looked pretty hard at the scientific literature and found some conflicting information about headgear and TBI. There was a letter printed in a 1982 issue of the British Medical Journal saying that headgear actually increases the risk of TBI. It says that the extra weight of the headgear gives the skull more momentum, therefore allowing it to swing faster and further, increasing the potential brain damage. I don’t put a lot of stock in that letter because 1) it was not a scientific study, just someone giving his opinion and 2) it was 28 years ago, long before breakthroughs in brain scans and measuring equipment gave us a better idea of what goes on inside and outside the head.

      In 2006, a few bioengineers at Wayne State University had 27 amateur boxers throw a hook with their dominant hand at a dummy. The boxers punched the dummy when it did and when it did not have headgear on. Sensors measured head acceleration and punch force. The researchers found that headgear significantly decreased both punch force and head movement, thus reducing the risk of injury.

      Anecdotally, a lot of boxers complain that headgear affects their peripheral vision, making them more likely to get hit. I couldn’t find any study that looked at that but I think that would largely depend on the person and the brand of headgear. Also, almost everyone agrees that headgear protects boxers from getting cut.

      So, headgear likely offers some protection against TBI sustained while boxing, but is certainly no guarantee against injury. Thanks for your question and for your service.

    • Jennifer Cragg

      Adam, please find listed below a comment response from Dr. James Bender:

      You’re absolutely right; mild TBI, or concussion, is typically caused by some sort of impact that causes the head to suddenly accelerate and/or decelerate. Usually, the punch or kick is merely the cause of the head movement. With this acceleration/deceleration, the brain literally moves around inside the skull, twisting and hitting the inside of the skull. Sometimes, the area of the brain opposite the blow will get injured when the brain strikes the inside of the skull. This is called a contra-coup injury.

      I looked pretty hard at the scientific literature and found some conflicting information about headgear and TBI. There was a letter printed in a 1982 issue of the British Medical Journal saying that headgear actually increases the risk of TBI. It says that the extra weight of the headgear gives the skull more momentum, therefore allowing it to swing faster and further, increasing the potential brain damage. I don’t put a lot of stock in that letter because 1) it was not a scientific study, just someone giving his opinion and 2) it was 28 years ago, long before breakthroughs in brain scans and measuring equipment gave us a better idea of what goes on inside and outside the head.

      In 2006, a few bioengineers at Wayne State University had 27 amateur boxers throw a hook with their dominant hand at a dummy. The boxers punched the dummy when it did and when it did not have headgear on. Sensors measured head acceleration and punch force. The researchers found that headgear significantly decreased both punch force and head movement, thus reducing the risk of injury.

      Anecdotally, a lot of boxers complain that headgear affects their peripheral vision, making them more likely to get hit. I couldn’t find any study that looked at that but I think that would largely depend on the person and the brand of headgear. Also, almost everyone agrees that headgear protects boxers from getting cut.

      So, headgear likely offers some protection against TBI sustained while boxing, but is certainly no guarantee against injury. Thanks for your question and for your service.