Punch Drunk Syndrome

[Nina Nutting]

So a thread on concussion got me thinking about this.  

Punch drunk syndrome, or dementia pugilistica, or boxer's syndrome is also called chronic traumatic encephalopathy (CTE). This condition is common among boxers. It is caused by head trauma and the condition typically develops about 16 years after the initial head injury.

Obviously I've heard of it in occurring in boxers, and in MMA, not really heard of it in MT though. Although I do know old western MT fighters who get headaches etc which is not a good sign. In Thailand I have met lots of old fighters,  many are alcoholics but never met anyone with any signs of brain injury, anyone know why this is?

Has anyone else heard anything? does it worry you? Do you think it will be an issue in the future?

 

[Kevin von Duuglas-Ittu]

Although I do know old western MT fighters who get headaches etc which is not a good sign. In Thailand I have met lots of old fighters,  many are alcoholics but never met anyone with any signs of brain injury, anyone know why this is?

 

I was just asking Sylvie how many Thais we've met that seemed a little punch drunk. Only about 3, and we've been exposed to a lot of ex-fighters. One was actually primarily a boxer (lower level WBC title), one a middling long term Thai fighter, and one a big name former big time Thai boxer (but who had fought in the west as well, and also in other martial art tournaments). That's not a lot ex-Thai fighters.

There are two big reasons I can think of. 5 Round fights are much shorter than most boxing matches, and because there are so many weapons and the nature of Thai aesthetics, the head is not targeted in the same way. Almost all strikes are to the head in boxing. Body shots are mostly designed to get to the head. But in Muay Thai there are lots of ways to score other than hitting the head. And even most elbow strikes are meant to cut rather than bludgeon.

Another factor is training. From what I've read concussion syndrome is more closely related to the repeated smaller blows that occur in training, and not so much in single big shots in a fight. Boxing training (often with head gear which does not really protect against concussive force) often involves sitting in the pocket and taking lots of deflected blows (blocked or partially slipped). Thais don't really train like this. They do spar hard at times, but it isn't lots and lots of head-hunting sparring.

[radarjam]

This had me thinking for a very long time and I wonder if some of you can add on to this (which relates this post as well) 

I have read some articles [in Boxing] and heard debates about the use of protection [headgear] during sparring and matches. Research has it that there are no "good evidence" that the use of headgear does not prevent head concussions, but could only reduce facial lacerations/cosmetic issues. And unfortunately I have read that it only increases trauma to the brain a whole lot more than "not wearing it" 

Personally, I do own a headgear but I only find it nuisance while training or sparring because it limits by vision. Not only that, I also found that my head ache's more when I get punched on the head; the force feels rather heavier than not wearing head protection. 

During training or matches - The way that western boxing and kickboxing works for points and appeal is the fighter doing whole lot more if you were to "aim for the head" and intend to KO your opponent ASAP. However in Muay Thai (I'm just re-iterating what Kevin said in the above) the scoring is different. 

You know what's interesting lol? Speaking of the use of headgear, I'm not sure if any of you recall this but recently in the Rio 2016 Olympics, boxers no longer use a head gear during matches. Due to basically in the above. However, female fighters were required to have it on. Here's an excerpt from this article: 

As of right now the AIBA’s ban on headgear in amateur fights and at this summer’s upcoming Olympics only extends as far as male heads. For now women fighters will continue to fistfight the old-fashioned way: with a giant, blinding delusion fastened to their vulnerable heads.

The ABIA’s reasoning, according to group President Ching-Kuo Wu, is simple: There just hasn’t been as much research done on the effects of headgear for women boxers as for men. "We have to do this step by step,” Wu said. “Once everything is proved ... then we can start to have some test and consider it in future for women."

http://fightland.vice.com/blog/male-olympic-boxers-will-no-longer-wear-ridiculous-and-dangerous-headgear

Why is that? Is it because females are not as strong as men [to do KO to the head] thus, keeping that clunky headgear protects us from trauma? I'm a little concerned by that retrospective study. In my opinion, I still think that headgear is a no-no (for me anyways) 

[Joseph Arthur De Gonzo]

I would think it is just because, regardless of security, the Olympics and sports in general are still very misogynistic. I can't see any other reason that, women are more fragile and that women with cuts and bruises is not feminine, is not okay.

It is the same reasons, I believe, women in hockey are not allowed to hit and get hit. I remember watching the last winter Olympics women hockey games and not believing the commentators saying stuff like : "well they are going way too rough, they need to calm down, this is lack of sportsmanship, this is not elegant" and other BS like that. The exact same thing would have happened in men hockey and the commentator would have say: "well that a good clean hit, good intensity". Discouraging.  As if women were not able to hit and get it in Hockey just as men do.

Anyway, can't think of another reason.

[Fighting Frog]

Crumbs, when I was a kid and played hockey (not ice hockey - the game on a grass field) at school all the people who taught it said that the most terrifying hockey they ever saw was schoolgirl hockey; not the boys! Back then the rules for boys and girls were slightly different (I'm not sure in what way, and I don't think there is any difference now) and we girls sneered at the boys because they would wear shin pads. We never did; only the goalie was padded up.

[Kaitlin Rose Young]

I agree with Kevin - the body takes a lot more of the abuse in MT, where the majority of blows are aimed at the head in boxing. The few pro boxing gyms I've visited seem to exclusively conduct very hard sparring sessions, so even when not fighting they are taking a significant amount of abuse - probably amplified by the inclusion of headgear. A heavier head creates a greater whiplash effect, which creates more trauma to the brain, etc. 

To take it a step further, the research suggests that concussion risk also has to do with neck to head circumference. If your neck is smaller in relation to your skull, it has a harder time slowing acceleration of the head due to an impact. Increasing neck circumference protects against traumatic brain injury. The amount of time spent clinching develops muscles in and around the neck like nothing else. (Everyone who trains has had that lovely first experience where you can hardly look up for a few days after the first hard clinching session.  :pinch:) There is also an emphasis on strengthening the neck and jaw by biting down on a rope and lifting a weight of some kind with your neck in traditional Thai-style training. Out of all sports, Muay Thai necks have to be up there with the strongest!

Edited to add: I bet Muay Thai fighters in the west traditionally do not spend as much time clinching and strengthening their necks, and probably more time hard sparring, which may have something to do with the differences noticed by the OP. 

Side note: My mom had an interesting discussion about this with one of the neurologists she works with at the hospital. He seemed to think athletes in every contact sport, especially kids and teens, should be doing these exercises. 

Wrestlers are another group that spends a lot of time conditioning their neck, and usually in MMA they are very difficult to knock out. I wonder if they have different rates of CTE as well?

It would be interesting to see some research on neck to head ratios in Muay Thai vs other concussive sports. I suspect it is much closer in the average nak muay than it is in the average boxer. In terms of sheer number of fights, it is amazing that you don't meet more retired MT fighters who are obviously punchy.