From Punch Drunk to CTE: A Deeper Look into CTE in Boxing

Sugar Ray Robinson at the Uptown Gym. Source: Charles Payne

Chronic traumatic encephalopathy is a progressive and fatal brain disease that is oftentimes associated with traumatic brain injuries. These could be recurring concussions or hard hits to the head.

The current widespread awareness of CTE can mainly be attributed to Dr. Bennet Omalu. He first found the link between contact sports and brain injuries in 2002 after citing his findings on NFL Hall of Fame center, Mike Webster.

Since then, Dr. Omalu and his team have been able to discover treatments and diagnose the disease. Omalu was the first medical professional to find the correlation in other sports other than boxing.

In 1928, pathologist Harrison Martland discovered that following blows to the head and face during fights, fighters would appear to be in an altered state after the fight ended and took up to two hours to fully recover.

However, what followed would truly be the starting point of CTE in the MMA world.

Martland found that even years after fighters quit boxing, they exhibited tremors and short-term memory loss. He said that those who truly experienced the worst of the symptoms were those who spent significant time in the ring taking blow after blow.

The term “concussion” was coined in the 10th century by a Persian doctor, Rhazes ,according to

Pubmed. By the 19th century, concussions were classified as traumatic brain injuries or TBI.

The link was clear: Violent contact sports cause brain injuries.

The numbers are staggering. According to the Association of Neurological Surgeons, 90% of boxers will have some form of a concussion over the course of their careers.

According to Business Insider in 2017, there are currently 20,000 active professional boxers. 18,000 of them will have at least one concussion..

After receiving their first concussion, a fighter is one to two times more likely to have another one. Those odds increase to two to four times after the second one, according to Revere Health.

So, what does this mean for fighters?

Take boxing legend Muhammed Ali, for example. Ali died in June 2016 due to Parkinson’s Syndrome. The difference between Parkinson’s Disease and the former is huge according to Mike Silver in his review of “Damage: The Untold Story of Brain Trauma In Boxing.”

“Ali actually suffered from Parkinson’s syndrome, which is destruction by trauma to the same parts of the brain that are destroyed by someone who develops Parkinson’s disease,” said Silver. “It is not the same as Parkinson’s disease and has a different cause.”

However, some are skeptical as to what actually led to Ali’s eventual passing.

According to the book's author, Tris Dixon, in his interview with Dr. Robert Cantu, one of the world’s most renowned brain surgeons and head of the NFL Head, Neck and Spine Committee, says that CTE is the cause.

“CTE is a highly serious issue itself, but it could also be an accelerant to other neurological illnesses,” said Cantu. “Of the great fighters who died and were diagnosed with dementia, Parkinson’s, ALS, or Alzheimer’s over the years, there is not only a chance that it was just CTE misdiagnosed, but it could have triggered different medical problems.”

Cantu goes on to say that those fighters who had died with those diseases had gotten them almost two decades sooner than normal.

So where do combat sports go from here?

In May 2021, UFC revealed their first concussion protocol guidelines, according to ESPN writer, Mark Raimondi.

Raimondi states that the 484-page document is a similar version of the NFL protocol guidelines for brain injuries. However, it seems combat sports has done their due diligence on a very important topic to keep fighters healthy and safe.

There is still work to be done to make sure that fighters are protected and supported at all levels. It is encouraging that one of the biggest fighting conglomerates has recognized an issue and taken strides to combat CTE.