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I'm not asking for medical advice, I'm just asking this out of sheer curiosity:

To me it seems that kickboxing is the best kind of workout I could get, nothing else gets me in shape quite as quickly and as well. But as a noncompetitive kickboxer, I've always wondered what doctors would say about the potential for braindamage with kickboxing.

I mean, is it something that always occurs, or is it incidental? Sometimes when I'm hit well (about 2 - 3 times every training), I see stars and feel a little lightheaded. I've always wondered what's actually going on in my body when that happens. I mean, most sports tend to damage you a little, but in the long run the gains are worth it and you heal from the damage. Or is the damage you do to yourself with kickboxing beyond healing (and if so, is there a point of no return)?

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Great question. I gave it a shot, but I hope we get someone with extensive kickboxing and/or relevant medical experience to weigh in with some facts. –  Dave Liepmann May 23 '12 at 16:14
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you see stars and feel light headed 2-3 times per training session? that's bad. those are both pretty good signs that your brains rattled, and getting damaged. Do you wear head gear and 16 oz gloves when you spar? –  Patricia May 24 '12 at 13:18
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Why don't you just stop getting hit in the head? It's not kickboxing that's bad for you, it's getting hit hard in the head. And that's bad for you regardless of what you train. –  Trevoke May 25 '12 at 23:41
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@Trevoke While that might be a lot of contact (even for kickboxing), it's not so simple to "just stop getting hit in the head" if training hard in a sparring-oriented head-hitting art. –  Dave Liepmann May 28 '12 at 1:17
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@Trevoke, because I'm not a pro yet. Which is the reason why I'm training (and thus why I'm getting hit a lot). You don't get started in kickboxing and immediately learn how to avoid all of the blows they throw at you. That's impossible for a beginner like me when fighting a more trained opponent. –  user474 May 28 '12 at 12:25

5 Answers 5

up vote 15 down vote accepted

I don't think the science is settled to a degree where we can give a solid answer, or make too many specific conclusions. Disclaimer: I'm not a kickboxer, and I haven't studied the subject deeply.

Dementia pugilistica

Getting hit in the head is not good for your brain. Getting hit a lot in the head is very bad for your brain. That's true regardless of dosage, but large, repeated doses of getting hit in the head over long periods of time are particularly problematic.

Medicine has known about the brain damage from boxing and kickboxing for a long time. We have a name for it:

Dementia pugilistica...[is a] variant of chronic traumatic encephalopathy... Symptoms and signs of [dementia pugilistica] develop progressively over a long latent period sometimes amounting to decades, with the average time of onset being about 12 to 16 years after the start of a career in boxing. The condition is thought to affect around 15% to 20% of professional boxers.

I would argue that there are probably a lot of people with minor brain damage that doesn't rise to the level of dementia pugilistica. That damage might be insignificant, but it exists. This is backed up by more recent studies, as reported in the LA Times:

A yearlong study of boxers' and mixed martial-arts fighters' brain activity has found those who fight for more than six years begin to experience damage and those who fight longer than 12 years expose themselves to an even greater decline each time they return to the ring.

Mitigation

The degree of brain damage depends greatly on how you train. Competing seriously is definitely a different animal from training hard, and training hard is different again from training casually. Getting your bell rung is a minor concussion, make no mistake, and those are no good. But in terms of serious damage, I bet a lot of people get a handful of minor concussions spread out over a few years of training and don't suffer any major brain damage. Taking three or four ring fights a year, and the training that requires, would probably mean a greater degree of brain damage. (Not debilitating in every case by any means, but it's certainly present.) Doing this for several years would in most cases cause noticeable problems.

Reading up on the signs of concussions is extremely informative. Staying out of hard training after a serious or moderate concussion is definitely a good idea. It would be a good idea for boxing and kickboxing coaches (in addition to grappling and field sports coaches) to adopt a concussion-recognition protocol. The King-Devick test has been shown to work well for boxing and MMA:

The King-Devick (K-D) test is based on measurement of the speed of rapid number naming (reading aloud single-digit numbers from 3 test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the K-D test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts fighters.

In particular, getting knocked out or losing the match were predictors of damage:

Those with loss of consciousness showed the greatest worsening from prefight to postfight. Worse postfight K-D scores and greater worsening of scores correlated well with postfight MACE scores.

So work on your slipping and defense!

It is also probably a good idea to get regular MRIs or other brain tests done, if you continue to train over several years. As noted in the LA Times article, this is already enforced by boxing commissions.

But in the end, hard training is not knitting class. The risks of learning to hit and get hit can be mitigated through careful control in sparring and diligent use of equipment (and recognizing the limitations thereof), but at some point you're going to get concussed.

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I would speculate that the damage in boxing is worse than kickboxing, because you receive many more head blows in boxing, and head blows in kickboxing are more likely to produce a fight-ending knockout/down due to lighter gloves and/or the blow being a kick. –  slugster May 24 '12 at 9:54
    
So basically what I'm getting from all of this, is that because you can't avoid getting hit as a beginner, kickboxing is always bad for your brain. And getting better will probably mean you'll get hit less often, but every hit is still bad for you nonetheless. So basically, kickboxing is always bad for your brain, it's just a matter of how bad, and you're better off pursuing a career in jogging (or something) if you want to keep your brain in tip-top condition whilst trying to get your body in shape. –  user474 May 28 '12 at 12:27
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@Samuel Yes, but please keep the doses mentioned in mind. Every hard head impact is bad for your brain, but so is a night of binge drinking, and serious damage has been shown to start at six years of hard, competitive training. –  Dave Liepmann May 28 '12 at 14:51
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@SirProgrammer I am not trying to say all kickboxing is bad. There's a lot more nuance to the issue. A simplified version of my view is closer to this: Getting hit in the head is a little bad, getting hit in the head hard enough to be concussed is bad, getting concussions frequently is very bad, getting concussions frequently for many years is SUPER BAD. –  Dave Liepmann Jul 11 '12 at 13:18
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@SirProgrammer - Kickboxing is not bad, nor is boxing. Head trauma is bad, as dave said. It's just a little more likely to occur in martial arts, it's the nature of the beast. If you don't spar or do competition fighting, then you're probably no likelier to suffer a traumatic head injury than someone that does kick box aerobics. Even light head contact can be ok, as the brain has a decent cushioning system. It's the brain impacting the skull or neural fibers tearing in the brainstem that cause the problems. My worst (only) knockout I ever suffered was playing flag football. –  JohnP Jul 12 '12 at 20:20

The biggest risk with concussions is getting a second one shortly after the first. For competetive boxers and kickboxers, this means the 10 count and standing 8 count are sentencing them to long term brain damage. If you're training casually, wearing very good headgear (Winning FG-2900 if you can afford it, Rival d3o would seem to be a good second choice) and a very good mouthguard (custom made for boxing) will help. Also, if you get hit once and see stars - call your sparring off right away, and don't finish the round. You'd want to not do any further sparring for at least 2 weeks.

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Yes this, a million times this; moreover, as I unfortunately learned YOU MUST TRUST THOSE AROUND YOU TO STOP THE FIGHT FOR YOU. I was in the unfortunate situation of seeing stars sparring a few years ago, and while I know this means stop immediately, my brain had forgot and said I was fine when asked. My memory's not been all the same since the 3rd time I saw stars that night, I couldn't sleep for a week. –  Jimmy Hoffa Jul 14 '12 at 23:42
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To note, I had seen stars fighting maybe 3 times in my life before that night (and none sense), so it doesn't take a lot of dings to do the job, difference was each of the previous times I had someone there who told me I was done for 2 weeks. –  Jimmy Hoffa Jul 14 '12 at 23:43

I also think it's worth mentioning that if you are a beginner then you should either, not be sparring until you learn proper technique, tactics, and defense, or spar with someone of your same level. Frankly, as a kickboxer, if you are sparring with someone who rings your bell two or three times each session, then you are sparring with someone who is too far beyond your level. It's one thing for your coach to toughen you up--that's part of the process--it's another thing for them to put you up with an opponent who is going to hurt you. Think about that and whether your coach is making good choices.

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Honestly, I'd rather see beginning sparrers squared up with my most experienced black belts. The black belts should have enough control to not knock their opponent silly, and be able to give them openings for them to take advantage of. They can also evade the attacks, and can teach control and focus. I always watch VERY closely when my beginning sparrers get matched together, simply because they haven't learned control to a great extent yet, and their techniques tend to be wilder and more uncontrolled as a general rule. –  JohnP Jul 27 '12 at 20:39
    
@JohnP, Yeah I agree, usually sparring with other beginners means a lot of uncontrolled and unpredictable movements, which increases the risk of injury. I think the problem is also partially that all the schools in my district are pretty ghetto, and the trainers aren't really too concencerned with beginners. Consequentially there isn't really a lot of coaching for beginners, and they're left to find everything out themselves. I haven't been able to find a better gym yet, which sucks. –  user474 Jul 30 '12 at 7:19
    
@Samuel - Honestly, I would stop boxing until you can find a better gym. No boxing is better than seeing stars three times a session. Just look at all the pro athletes with post concussion syndrome and other problems. –  JohnP Jul 30 '12 at 13:48

Interesting question... just the other night there was a segment on brain injury on local TV ( not sure if you'd be able to see it or not... http://tvnz.co.nz/sunday-news/research-reveals-damage-football-video-4894963 )

basically it was saying that any concussion is BAD, but even more minor hits can cause injury.
It can the manifest itself in many ways later in life, like higher rates of depression.

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What is a concussion?

In the last few years we've gotten a lot more info on them, and literally, they are brain damage. What makes them especially dangerous is that concussions can be extremely unpredictable in terms of cause to effect - sure, getting hit harder in the head is worse, but sometimes lighter hits can cause severe concussions or heavier hits not one at all.

Concussions build up over your lifetime. Earlier concussions make later ones worse and more damaging. Receiving a second concussion while still under the effects of a first one can literally kill you. (High school football deaths are mostly from this.)

The only way to avoid concussions is don't hit your head at all.

That said, you can do a few things if you're going to be in an activity where these happen.

  1. Wear headgear, use gloves. Preferably, go light. Really preferably, don't hit each other in the head and train well to take falls. Obviously, this runs counter to a lot of self defense training and sports, so you have to figure out where on the scale you want to be and how many head shots and how hard is going to be necessary for you to develop and keep your skills and conditioning.

  2. Strengthen your neck muscles. The stronger your neck, the better you can take those shots because you'll have better stabilizer muscles. You can still roll with punches, you just don't want the whiplash effect happening. Stats show sports you wouldn't necessarily think of as being that brutal to the head having high rates of concussions (soccer, volleyball), primarily because they don't do a lot of strength training for the neck and supporting muscles.

  3. Learn what the signs of a concussion are. Don't ignore them. Don't try to tough it out.

When do you have a concussion?

The old way of recognizing a concussion was to ask people things like - "How many fingers am I holding up?" "Who is the President?" "What is your name?" These are valid in the loosest sense - if you lose the ability to visually focus, if you cannot remember things (including short term memory loss - "What were you doing 2 minutes ago?"), you have a concussion.

Do you have a headache? Do you feel nauseous? Do you feel dizzy? Does light seem too bright? Do you slur your speech or mix up your words? You also have a concussion.

If someone's eyes look in different directions, or the pupils do not match in size, there is a concussion. If you shine a light in their eyes and they don't react, there's a concussion.

Sports teams now have a computerized word test they run people through while they're healthy and after they take a hit, run them through again - if they drop below a certain performance level, this indicates a concussion as well.

What do you do if you have a concussion?

If you have a headache that seems to be getting worse? Go to the hospital RIGHT AWAY. The worst case scenario is internal brain swelling/bleeding. People who die from concussions typically die 30 minutes to a few hours after taking the hit, as their brain slowly swells and crushes itself inside their skull.

If not, the answer is it's time for you to stop training. Take a rest. Go home.

Now comes the other unfun part of recovering from a concussion. You're looking at 3-10 days of recovery IF you rest. Rest means:

  1. Don't take any other head hits
  2. Try to engage your brain as little as possible - no reading, no studying, no figuring out the tough problem at work...

Non-rest can increase your concussion recovery time to months.

The concussion has damaged the neural connections in your brain, and you basically are stuck letting your brain connect things around again, starting from the most basic autonomic processes. Things like "pupils focus like this", "We control our tongue and mouth using these neural connections", etc. Trying to read or intake heavy information ends up causing the brain to prioritize high level processes and leaves the low level ones unrepaired.

Wow that sounds totally unreasonable!

Yep! The brain is not well designed to take hits. It helps if you remember that for most of human evolution we weren't designed to last quite as long as we do these days, nor did we need to do much more than organize hunting food or gathering it as a social group.

It's up to you to decide for your own health how much risks you want to take with head shots and how you want to train around that.

You can see a lot of traditional martial arts where sparring only involves body and leg shots. That's an adaptation, but not necessarily as good for self defense. You can also see arts where people do controlled drills most of the time, and only once in a while break out the head gear and go with any force. That's more useful. It really depends on what risks you plan on taking for you.

Just be aware - muscle heals easiest, bone heals ok, joints heal hard, the brain barely heals.

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