The Lessons of the Derek Boogaard Tragedy: Could This Be a Problem In Boxing?
by Waldo Rastel on Dec 7, 2011 10:00 PM EST
in Boxing Commentary & Opinion
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PrintI don't know about you guys but I'm also a big fan of hockey. An absolutely fantastic article by John Branch in the New York Times caught my eye. It's the story of enforcer Derek Boogaard. For those who don't know, enforcers in hockey are there to protect the stars of the team and to get in fights with members of the other team. Fighting is significantly less frowned upon in hockey than other sports and it is even encouraged at certain points.
Derek's story is a tragic one, where the lethal mixture of Oxycotin and alcohol ended his life at the young age of 28. However, his story does not stop there. In the video here, his family remembers his last couple of fights and they point out things that did not seem right.
In Derek's last fight, he gets thrown to the ice face first which leads to a concussion. This concussion would be the last of many. During his career, Derek admitted to "getting his bell rung" upwards of 10 times. Concussions have recently been in the spotlight for hockey with arguably the best player in the world Sidney Crosby suffering from symptoms for over a year. Derek's death led to an investigation by the Center for the Study of Traumatic Encephalopathy where they found that Derek had brain degeneration. Likely his chronic traumatic encephalopathy was caused by the many fights that he had in his hockey career, and by "getting his bell rung" repeatedly.
Naturally, this led me to thinking about boxing. I hope that you watch the video posted, and keep saying to yourself "Is this happening in boxing?'
Over an amateur and professional career, how many times would a typical boxer "get his bell rung?" Is that indicative of a concussion and is there any way to test for concussions? Now it is generally thought that fighters who get counted out from a knock down have suffered a concussion. This most likely happened to Ricky Hatton against Manny Pacquiao. However, someone can suffer a concussion and still function after a short recovery period. Is this what we see when a fighter gets his legs back?
A recent report by Di Russo in Psychophysiology found that boxers who had been boxing for an extended period of time had slower reaction times than non-athletes. Also there was a correlation between reaction time and length of boxing career, which means that boxers more susceptible to injury are less likely to avoid being punched in the face. Evidence also suggests that the loss in function is likely due to the accumulation of blows to the head. Meaning that a "warrior" is likely to have brain problems whereas a "cutie" should have significantly less impairment, just based on styles.
Is it the responsibility of boxing organizations to save the boxers from themselves? The libertarian side would suggest that people who get hit in the face for a living should be responsible for knowing the consequences of going into such a sport. The humanitarian side would suggest that watching one person inflict brain damage on another person is sick and shouldn't be a sport. These would be the two extreme views -- the answer being somewhere in the middle.
My personal view is that concussion testing should be mandatory after every single bout. After a boxer has sustained a certain number of concussions, the boxer should be forced into retirement. We have seen too many boxers develop Parkinson's Disease and Pugilistic Dementia. The boxing community needs to look at the current state of boxing science and make an informed decision. The ideal solution would allow great boxing to happen but severely limit the amount of post-career brain trauma. What would be your ideal solution for this problem?
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Fighting is significantly less frowned upon in hockey than other sports and it is even encouraged at certain points.
now that explains my question on why there are lots of fighting associated in hockey related news..
It’s actually an old joke from the 50’s re barnburner fights:" I went to see a boxing match, and a hockey game broke out!" , w
When we were kids, if my brother and I couldn’t find a boxing match on at the regular time, we’d settle for hockey, because we knew there’d be a fight. Possibly even a small, on court riot, complete with full use of hockey sticks as clubs. My Dad came home and found us watching hockey one time, and asked us how come, and when we told him he died laughing, told my Ma, “they know the joke and I haven’t even told it too them yet.”
There is no safety in numbers, or in anything else--James Thurber, 1939
how about the Nevada M.R.I. pre-fight scan test policy?
i think it is effective in preventing brain related problems with boxers.. I just don’t know with other places and countries if they do such test…. I’m sure there is no such meticulous test for boxers here in my country..
There is no such policy in Nevada.
According to the policies listed in their webpage an MRI is only required prior to getting a boxing license, and only if the fighter doesn’t already had one done before. There are no guidelines (at least not listed in the webpage) that indicate how old that MRI has to be, so in theory if a fighter had one say two years ago and submit that to renew his license this year he in theory should not need a new one.
With the technology available they should require periodic year round scans from the fighters to track changes that might take place between fights, and they should expand the required scans to include functional scans, since right now they only require (when they actually require them) scans that detect morphological changes in the brain. Particularly in parkinson’s disease research in the average population, it has been shown that functional changes usually precede morphological changes in the brain, so they would be better at assessing who should be retired for his own good.
Neurology has a variety of exams that could be implemented in order to track the amount of neurological damage inflicted on a particular fighter. I know that the WBC forces a fighter to undergo a neurological exam if a fighter is over 35 or is in “heightened danger” whatever that means. It is not difficult or expensive to track brain damage. However, it would mean that fighters will probably retire earlier and commissions will stand to lose money. Therefore, it will never happen, which is the sad state of affairs in boxing right now.
"The bell that tolls for all in boxing belongs to a cash register."
-Bob Verdi
You are correct that there are a whole series of exams that can be used to assess brain damage, and that most of them are pretty cheap and rather easy to implement. The problem with all of these types of exams is that most of these exams are physical exams, meaning the person has to perform a certain task like memorizing a set of words and then repeating them, or perform a certain manual task, in order to measure the respone time, etc. There’s tons of tests of this kind used to assess brain damage for the general public. For boxer’s I have not checked what the WBC has, but the CSAC has a nice detailed one in their website that the physician follows. What they have is not that different from what a physician would do if a random person is suspected of having suffered brain damage either through disease or injury.
With regards to boxing my beef with these types of tests is that they are all after the fact tests, meaning that if you can detect someone has brain damage because they fail a physical test its pretty much too late for the person. To make an analogy, it would be like waiting for a person to look like a walking skeleton with pneumonia before being able to tell he/she has AIDS. Currently the best way to detect brain damage before physical manifestations are evident is through imaging. A CT scan is better than nothing, and an MRI is better than a CT scan, and at least what some of the latest research has shown is that functional MRIs can detect the earliest stages of some brain conditions like parkinsons. With the idea being to detect who will suffer the disease as soon as possible in order to start the best treatment. As for your last statement I agree with you that that is how things are right now and it’s not likely to change in the near futrure, but I guess the hopeful in me does believe that it will change one day, I just don’t know when.
Not all of the tests are after the fact tests. Apparently there is a blood test that can be used to measure brain damage probably through some blood borne protein.
There is a way to measure a specific neuro protein through a lumbar puncture. This protein increases as the damage to the brain increases. Therefore if you take a pre-boxing baseline and measure this protein continuously, you could stop boxers from sustaining the level of brain damage seen with Parkinsons and Dementia.
"The bell that tolls for all in boxing belongs to a cash register."
-Bob Verdi
Yeah, I’m aware not all tests are motor task type of tests, although clinically, those (motor tests) are the standard to the best of my knowledge. Biomarker tests are still experimental and not commonly available (same way with fMRI for this purpose) although they do have shown promising results. Blood tests in particular have not been that great result wise. Tests looking at biomarkers from cerebrospinal fluid (the lumbar puncture you talk about) have shown more promise. Alpha-synuclein, amyloid-Beta, and Tau are three of the proteins that have been most looked at in Parkinsons and dementia studies and they do appear to show changes in the milder stages of the conditions prior to the person exhibiting motor changes.
So either through that or through more comprehensive imaging (the advantage I’d give to imaging is that it is non-invasive and doing the additional tests is super easy if you already have a scanner, while for lab tests introducing new tests is not as straight forward, but then I’m biased toward imaging), or ideally through both, a lot more could be done to prevent boxers from getting undue damage.
The problem is a balance between non-invasive procedures that require large instruments and simple procedures like a lumbar puncture which is invasive and painful but could be analyzed at any lab. Imaging needs to be cheaper, more prevalent, and more detailed for it to be utilized in a large scale fashion like boxing. I love imaging because of the principles behind it, but the university research needs to get industrialized and more widespread before I would want to put all the eggs in that basket. A dual approach would be good as well. Use something like the unreliable blood tests to raise a flag and mandate more testing.
"The bell that tolls for all in boxing belongs to a cash register."
-Bob Verdi
We could allow fighters to use Erytheroprotien.
It helps prevent and heal neurological damage. Otherwise, getting punched in the head will never be safe. Strict NFL type neurological testing will only shorten guys careers. Can we keep fighters from themselves? Are we within our rights as a society to do so? Perhaps letting them know that their mental capacity is deteriorating at a dangerous rate is necessary, but do we tell them when it’s time to stop?
I like that you didn’t take the extreme point of view on either side. You are right, the truth is somewhere in the middle.
But, I do think it’s in the commission’s best interest to protect fighters from themselves. Athletes are really proud, like a pitcher who says he can pitch to the next guy even though he has nothing left, a boxer who gets hit hard will try to get back at the guy without thinking of his own well being.
Ideally the managers, promoters, trainers and fighters work with doctors both outside of the ring as far as testing goes, and contracts would be created before fights where a doctor could step in to protect a boxer from himself during a fight. How far this line is will be really really blurred because boxing is a sport where you are beating a guys brain in.
State (or federal and local) commissions have zero role in boxing anywhere in my ideal world.
by BangBangLampley on Dec 7, 2011 11:05 PM EST reply actions
One problem is that doctors are marginalized in the sport as it currently stands. Hell many people blame the doctor for a quick stoppage in the Cotto-Margarito fight. There really does need to be independent oversight of this aspect of boxing. Everyone else has too much money and time invested to act in an objective manner.
"The bell that tolls for all in boxing belongs to a cash register."
-Bob Verdi
by Waldo Rastel on Dec 7, 2011 11:44 PM EST up reply actions
Doctors, by necessity, are going to marginalized in a sport where your goal is to incapacitate your opponent by (usually) punching them in the brain until they can’t go on.
I’d love to see independent (as realistically independent as possible) oversight of boxing that worked to protect the fighters but we will never have that with state commissions if that is what you are aiming for. The complete structure of boxing needs to change to have that happen. State commissions would need to be replaced with something like the professional sports leagues use to guarantee fair officiating, safety, and the integrity of their sport and league.
Of course this costs money, and I’m sure promoters and managers, while they don’t love this aspect entirely they do love that it is paid for by taxpayers. It’s kind of like why boxing is stuck in the rut of being on PPV and premium cable which limits it’s exposure greatly in the United States. Short term gains at the sacrifice of sustained long term growth. It takes risk taking and investments to make real changes. I really don’t see that coming any time soon.
by BangBangLampley on Dec 7, 2011 11:59 PM EST up reply actions
The professional sports leagues protect their own interests just as bad or worse. They’ve been in total denial of US football brain injuries for decades. It’s much worse than boxing for long-term brain damage, NOBODY wants to go there.
There is no safety in numbers, or in anything else--James Thurber, 1939
Box is tough sport
Russian boxer Roman Simakov dies in hospital after collapsing in ring. He died overnight of brain injuries in a Yekaterinburg hospital, after KO by Sergei Kovalev.
If boxing wants to get serious about concussions, they can study the model football is using………this is a “hot” topic in football.
But I’l lsay this……….. it’s hard to protect those who don’t want to be protected.. As the gentleman stated in last part of the video……it’s a question of "trading money for brain cells"…………..and I’d be willing to bet most would take the money.
This is particularly true among those who go to boxing
Ross Perot’s kids might not make that trade, but some poor kid growing up on the streets of Michigan or the Phillipines probably would. And the latter are those who go into boxing.
by journeyintosound on Dec 8, 2011 1:53 PM EST up reply actions
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