" I have been feeding the faith, I have been starving the doubt so there’s no doubt in my mind that I can’t win this fight "

- The late Marvellous Marvin Haggler

Marvellous Marvin Haggler Boxing Opponent - Combat Sports Chiro

In recent times the scientific process has paved for a greater understanding of medical conditions and risks in all sports including combat sports.1 Whilst the breadth of understanding is not as comprehensive as other sports (i.e., full contact team sports like football) key areas of interest in combat sports have emerged i.e., linear peak head force, vestibular function and ocular function.2, 3, 4 These areas of interest are centred around the athletes well-being during their competition life and life after sport participation. In the context of the athletes sporting career this 'athlete well-being' idea is scientifically termed as ‘athlete availability’.

Athlete availability is defined as the maintenance of athlete health to maintain or preserve higher frequency and quality of sporting participation (competitive bouts and training).5 This idea of athlete availability has emerged over time, from the progression from ancient boxing (8th century BC) to modern day boxing.6 A comparison between these two sports demonstrates the different attitudes associated to athlete health and well-being (see table 1).

Timer Icon

Time Period

Fighting Icon

Ancient ‘Amateur/sport’ Boxing

Boxing Ring Icon

Current Amateur Boxing


Unlimited time limit

4 – 12 rounds of 3 minutes


Ox-hide leather gloves

8 or 10 oz synthetic gloves

Prize money

Winning agreements (i.e., lifetime of food)



No global organization


Fight style

More strategic clinching (wrestling)

Little strategic clinching (wrestling)

Table 1: Ancient vs Modern Amateur Boxing6

An early catalyst for athlete well-being succession occurred with the development and use of The Marques of Queensbury rules of 1867. These rules improved athlete safety during the predeceasing years of modern amateur and professional boxing.7 After this initial contribution for athlete safety, a greater priority was placed on understanding the injury risk factors that have since influenced smaller athlete safety changes since the 1860's. This early investigation into athlete safety and boxing injuries occurred in a time of research uncertainty. In the modern era this certainty has progressed into the academia surrounding boxing. The interest behind this boxing injury risk investigation positively reinforces this historical trend to better athlete wellbeing.  In 2023 the most recent and concerning injury related to boxing are mild-traumatic brain injury or, concussions (see blog).

Boxing Practice - Combat Sports Chiro

In a recent paper I published with support from Macquarie University, we investigate the mortality rate in Australian boxing. In short, there were 163 boxing-related fatalities in Australia during 1832 to 2020, including 122 (74.8%) professional and 40 (24.5%) amateur athletes. The most common causes of death were traumatic brain injury (n = 121; 74.2%) and cardiac arrest (n = 11;6.7%). Of note is the 74% brain predilection in mortality suggests that brain health is a key area of interest for future investigation and intervention.8

The mortality burden associated with the brain should invoke discussion of brain health practices amongst boxing athletes. Good brain health habits will prolong an athletes competition life and improve out-of-the-ring quality of life. These discussions should include ideas related to frequency and quality of sparring participations in the training and competition setting, and preventative measures. One protective measure exists in the form of neck strengthening and stiffness. A lot of the symptoms associated with early career boxers can occur from neck related issues, i.e., headaches, dizziness, insomnia etc. Adequate neck protocols paired with good sleep hygiene will greatly improve athlete availability. Additionally, the identification of concussions are crucial, with mechanistic research identifying 'second impact syndrome' as a potential cause behind prolonged concussion recovery. That is, not treating the initial concussion correctly and incurring a additional concussion (i.e., two concussions within a 4 week period).

At the CombatSportsChiro, we intend to discuss these topics of discussion in various blog posts and treatment/therapy recommendations to help educate the members of the boxing and greater combat sports communities.

Plus Icon
Click Here To View References

1. International Olympic Committee Injury andIllness Epidemiology Consensus Group, Bahr R, Clarsen B, Derman W, Dvorak J,Emery CA, Finch CF, Hägglund M, Junge A, Kemp S, Khan KM. International OlympicCommittee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sports 2020 (including the STROBEextension for sports injury and illness surveillance (STROBE-SIIS)).Orthopaedic journal of sports medicine. 2020 Feb 14;8(2):2325967120902908.

2. Krabben K, Mann DL, van Helden A, Kalisvaart Y,Fortin-Guichard D, van der Kamp J, Savelsbergh GJ. Getting a grip on theresilience to blur: The impact of simulated vision loss on a visually guidedcombat sports interaction. Psychology of Sport and Exercise. 2021 Jul1;55:101941.

3 .Lota KS,Malliaropoulos N, Blach W, Kamitani T, Ikumi A, Korakakis V, Maffulli N.Rotational head acceleration and traumatic brain injury in combat sports: asystematic review. British medical bulletin. 2022 Mar;141(1):33-46.

4. Andrii C, MarinaK, Ruslan A, Ivan S, Andrii H. The Impact of Training Load on the State of theVestibular System of Athletes specializing in Hand-to-Hand Combat. Journal ofPhysical Education & Sport. 2020 May 1;20(3).

5.Wicker P,Dallmeyer S, Breuer C. Elite athlete well-being: the role of socioeconomic factors and comparisons with the resident population. Journal of SportManagement. 2020 May 21;34(4):341-53.

6. Poliakoff MB. Combat Sports in the AncientWorld; Competition, Violence and Culture (Sport and History Series). Sport Encyclopedia of Ancient History. Yale University Press. 1987.

7. Jako P. Safety measures in amateur boxing. Br JSports Med 2002;36(6):394-395.

8. Alevras AJ,Fuller JT, Mitchell R, Lystad RP. Boxing-related fatalities in Australia: a retrospective analysis of news media reports. Journal of science and medicine in sport. 2022 Jan 1;25(1):25-30.

Follow Our Instagram