September 12, 2012 by Melissa Ray
(Ding ding) “Round one…..”
I breathed deeply and stepped towards the centre of the ring. It was one of my earliest fights in England and my opponent was a popular local girl with vociferous support. I had trained hard for the bout. However, I lacked experience and had watched relatively few Muay Thai fights in person, relying instead on fight videos for inspiration. My opponent immediately started punching wildly—throwing big looping hooks.
Hold on—this isn’t what happens in the videos!
One problem with studying videos of professional fighters is it can leave you with unrealistic expectations of how your own fight will progress. In the bouts I had watched, especially those in Thailand, the boxers would start slowly—tentatively feeling each other out in the first round. I was foolishly unprepared for my opponent’s immediate onslaught—my guard low and insufficient. One of those big hooks connected with my left temple. And then the fight was over. It was less than a minute into the bout—probably even less than 30 seconds. I had—in boxing jargon—been “caught cold”. My memories of the event are patchy. I don’t recall experiencing any pain. I do remember my visual field gradually narrowing to darkness and the roar of the crowd petering out to silence. My next recollection is being in the changing rooms asking my trainer what happened. To this day I have no memory of the fight ending, congratulating my opponent, bowing and leaving the ring, and making my way backstage.
During the time I was training for that fight, my “day job” was studying for a PhD in Neuroscience (the study of the brain) at Newcastle University. Given my academic background, one question I am often asked is whether the risk of damage to the brain caused by blows to the head has ever caused me concern. Before I address Muay Thai’s possible detrimental effects, I’ll start by discussing its positive effects. Often likened to a game of chess (with violence), Muay Thai involves complex strategies for attack, defence and counter, and a range of techniques. Therefore, to train in Muay Thai is mentally as well as physically stimulating. When a person learns a new skill, this encourages the generation of new nerve connections in the brain. During repeated practice, such as training drills, these connections are strengthened. The brain also has a regulatory process in which unused nerve cells are eliminated; so any activity that stimulates and encourages learning is beneficial to brain cell maintenance and function. The phrase “use it or lose it” is one that applies to the brain as much as to the muscles. According to research, vigorous exercise promotes the growth and survival of cells in an area of the brain involved in learning and memory. Increased blood flow during exercise has further beneficial effects of promoting the transport of oxygen and nutrients to brain cells.
But what happens to these brain cells after a punch to the head? A boxer can be on the receiving end of different grades of blows. A knockout (KO) blow to the head is a fight-finishing strike—often associated with loss of consciousness caused by trauma following the sharp rotation of the skull. Memory loss and concussion are other adverse effects. Strikes to the head can be concussive without causing a KO and these are more difficult to recognize—symptoms of headache, confusion, memory loss, or dizziness might not appear until several hours after a bout. Repeated subconcussive blows—which can be sustained within a fight or during sparring—can also cause changes within the brain and loss of cells.
According to the regulations, after a KO loss, a boxer should be restricted from competing for at least 30 days. From what I have observed in Thailand, this rule is not strictly enforced, especially in the provinces. Financial considerations tend to take precedence over safety considerations—fighters may have families to feed or gyms have overheads to be paid. About 5 years ago, I spent time training in Chiang Mai and remember one teenage boy there fighting 4 times within a 10-day period, losing by KO on 2 occasions. After one of those KOs, he was back in the ring only 2 days later, going on to win the ensuing bout. While I admired his tenacity, I did wonder what level of damage might have been inflicted on his adolescent brain.
The long-term effects of Muay Thai on the brain are unclear. Research is lacking—certainly in English language—on former Muay Thai fighters and permanent damage that might have resulted from head trauma sustained during fights. Most existing studies on the subject were conducted on international rules boxers. Dementia pugilistica or “punch drunk syndrome” is a form of dementia associated with boxing, and characterized by loss of memory and concentration, problems with coordination, and depression. Although Parkinson’s disease, mainly associated with tremor and movement disorder, has a range of proposed triggers, it has been famously linked to head trauma in boxing legends Muhammad Ali and Freddie Roach. Both dementia pugilistica and Parkinson’s disease can be difficult to diagnose, especially in their early stages. Without suggesting that all former Thai boxers are prone to alcoholism or substance abuse, rumours abound concerning ex-fighters and whisky and “yaa baa” (methamphetamine) habits, and therefore the distinguishing of changes in mental, physical, or psychiatric function deriving from Muay Thai-related head injuries from those caused by alcohol or substance abuse would be extremely problematic.
The medical community has different views on whether the wearing of a head guard actually offers any protection against head trauma. Some scientists have suggested that amateur boxing is safer than professional boxing because of the wearing of protective headgear and lower rate of KOs. Others have speculated that the head guard only protects against cuts and facial swellings and does not prevent brain trauma. Research findings have also suggested that it is the repeated subconcussive blows—not the KO blows—that cause most damage to brain health. One study evaluated 42 professional boxers using tests of attention, concentration, and memory. Poor performance in these tests was associated with the number of rounds of sparring a boxer had completed (when they were wearing head guards), and not with age, fight record, or history of KO.
After more than 11 years in the sport and 40+ fights, it is clear that I have not been deterred from training Muay Thai, despite its risks. Even after the KO loss, my feelings were of embarrassment and disappointment in myself rather than any particular concern for my health. Risk of head injury is associated with many other sports (including cycling, football and rugby) and several daily life activities. In Thailand, riding a motorbike without a helmet carries a far greater potential risk to health than fighting Muay Thai. Those who are concerned about head trauma should not be put off from the sport. It is quite possible to train without head contact and receive the same health benefits. Fighting is another matter but perhaps the risk is part of what makes it so exciting?
I am interested in hearing your views on the subject. Have you ever worried about damaging your brain through Muay Thai? How many of you have been knocked out during a fight and what are your memories of the experience? What are your views on wearing protective headgear—should it be made compulsory or do you feel it would “water down” a fight and makes it less interesting? It will take years of research before we can have clear answers on the effects of Muay Thai on the brain. For now, I’m not worried. When I consider the positive effects Muay Thai has had on my life—physical fitness, challenges and achievements, unique experiences, and a great deal of pleasure—these far outweigh any potential risks in my opinion.