In Response to: Use of Head Guards in AIBA Boxing Tournaments—A Cross-Sectional Observational Study

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Dear Editor-in-Chief:
I read with interest the cross-sectional observation study of Loosemore et al.1 I view the results with skepticism. There are lessons to be learned from professional boxing where head guards are not used. In professional boxing, every punch is thrown with the intent of knocking the opponent out. Concussions are common, and although it is easy to identify a concussion in a boxer who is knocked out, mild and moderate grades of concussion as when a boxer staggers and is wobbly on his legs after a hard punch to the head are not easy to identify even for an experienced ringside physician. While referees are closest to the action, I disagree they are “highly” trained to recognize a concussion. Most referees have no formal training in recognizing subtle signs in a concussed boxer. The statement that head guards by increasing the diameter and surface area of the head lead to increased rotational force and concussions is a hypothesis with no scientific validity. The statement that head guards increase the risk of blows to the head because the padding around the eyes limits a boxer peripheral vision has no scientific validity. It is akin to advising two-wheeler motorists not to wear helmets because it shall impair their peripheral vision making them more prone to an accident and head injury. It is a well-established fact that female and pediatric brains are more susceptible to concussions. Concussions are not rare in women boxers or young boxers. They just present differently. AIBA decision to end the use of head guards for all of their elite men's completion and to allow professional boxers to compete alongside amateur boxers at the Olympic Games in Rio has to be carefully weighed. In boxing, one punch can change everything. One punch can kill.
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