Hard hitting facts on headgear
Neurologist reports evidence suggests protective gear can reduce risk of brain injury
Boxing Canada, the International Boxing Association and the International Olympic Committee have all stated that removing padded headgear reduces the risk of concussions for male boxers.
The evidence they have produced to back up those statements, however, is far less clear-cut and, in some cases, even suggests the opposite: Claim: Concussions decreased by more than 40 per cent when head guards were removed, according to International Boxing Association (AIBA) research published online in the Clinical Journal of Sports Medicine. Fact check: This research didn’t track concussions; it used referee stoppages in the ring due to head blows as evidence of possible concussions.
One component compared two different types of boxing — Olympicstyle (three, three-minute rounds) with headgear and the more professional World Series Boxing (five, three-minute rounds) without headgear. They based their data on rounds even though there can only be one stoppage per bout. Once the data is corrected to calculate outcomes based on bouts rather than rounds, the difference in stoppages goes from 43 per cent to 2 per cent.
The study’s authors tepidly conclude “removing head guards may reduce the already small risk of acute brain injury in boxing.” Claim: Concussions tripled when head guards became mandatory according to a 2013 study published in British Journal of Sports Medicine. Fact check: The study looked at 59 years of rule changes in amateur boxing and the effect on boxers’ health. Referee stoppages due to head blows did rise when headgear was first introduced in1984, but have since dropped to levels below the pre-headgear era. The study also found a significant reduction in knockouts with the combination of head guards and computer punch-count scoring — both of which AIBA has now removed.
“It is a concern that the recent rule changes will be a backward step in athletes’ health safety,” the researchers state. Claim: The Zurich Consensus statement on concussion in sport — “the gold standard in prevention” — supports AIBA’s decision to remove head guards. Fact check: Speaking broadly about all sports, they say “there is no good clinical evidence that currently avail- able protective equipment will prevent concussion,” but they don’t tell sports to toss their helmets and headgear; they urge sport-specific studies.
The lead author of the consensus, Paul McCrory, a neurologist and sports expert in traumatic brain injury and concussions, subsequently wrote an editorial in the British Journal of Sports Medicine criticizing AIBA for its moves to professionalize the sport and its lack of engagement with mainstream international concussion groups to develop guidelines to protect athletes.
“What little published evidence exists actually supports helmets as a means of reducing impact to the brain and presumably brain injury resulting from boxing.” Claim: Before approving the removal of headgear for boxers in Rio, the International Olympic Committee’s executive board reviewed medical and technical data, including a biomechanics analysis, showing reduced concussions without headgear. Fact check: The IOC-funded biomechanics analysis concluded the opposite.
“The data support the opinion that current AIBA head guards can play an important role in reducing the risk of concussion and superficial injury in boxing competition and training.”
Australian experts in biomechanics used punch machines to test boxing headgear at multiple angles and forces and found it was particularly effective in reducing the impact force of mid-range punches. With lighter punches, the gloves absorb most of the impact and with the heavy hits a boxer might be concussed or injured even with the head guard, they found.
“The test results do not show that head guards will increase the risk of head and brain injury.” Claim: The American Academy of Neurologists says there is “no proof of protection against concussion by head guard use.” Fact check: The neurologists did not say headgear should be removed from boxing; they said that even with it, brain damage can still occur.
“Sports that include intentional trauma to the brain (including boxing mixed martial arts, and extreme fighting) are a serious threat to the neurological function of those who engage in them. Formal studies have shown that even with protective headgear, measurable, persistent damage to the brain occurs.”
They recommend sports reduce direct blows to the head, provide participants with formal neurologic examinations, including brain imaging, and eliminate all blows to the head for participants under 16.