By Boxing Bob Newman
Day 4 of the 36th annual IBF convention in n Macau, China opened with the medical seminar at 9 a.m. In the Lotus Room at the Wynn Palace hotel. The Referees Seminar followed after a lunch break.
Dr. Rick Weinstein welcomed the delegates to the medical seminar, featuring four esteemed ringside physicians- Dr. Massimiliano Bianco from Italy, Dr. Domenic Coletta, Jr. from NJ/NY, Dr. Paul Wallace from the California State Athletic Commission and Weinstein himself, NY.
Dr. Bianco opened with a talk titled “Sudden Cardiac Death In The Ring.”
A video clip of the tragic Hank Gathers (Loyola Marymount University) collapse and death, on the basketball court during an NCAA basketball game in 1990 opened the presentation. While this was a stark image with which to open a lecture, the point hit home- sudden cardiac death doesn’t just happen to unhealthy individuals. It can happen to any level of athlete as well.
Bianco emphasized that certain conditions must be present, often predisposing factors are key. Some factors include coronary artery anomalies or hypertrophic cardiomyopathy, or hidden conditions such as myocraditis.
Bianco stressed that sudden cardiac death happening during exercise is statistically higher under vigorous conditions. However, freak accidents such as “commotio cordis,” can occur. The prime example which has been seen largely in America is an athlete getting struck in the chest with a baseball in just the right spot.
However, another example of this phenomena was seen in a video showing a seemingly harmless karate spar where one competitor took a kick to the chest. After being struck, the competitors retook their starting positions, but the kick recipient collapsed in delayed fashion, to the floor.
Bianco stressed that pre-competition screening in the form of patient cardiac history, family history and EKGs can be helpful.
Dr. Domenic Coletta, Jr. gave a talk entitled “Traumatic Brain Injury In Boxing And Mixed Martial Arts.” Coletta, Jr. started with a differentiation between Acute Traumatic Brain Injury (TBI) and Chronic TBI.
Acute TBI is further subdivided into Diffuse and Focal. Diffuse comes in the form of the knockout in the ring for example. Focal specifies the injury such as subdural or epidural hemorrhages. Three points to look for include:
cognitive, behavioral or physical changes. To better recognize these changes, having a baseline measurement is extremely helpful. Coletta, Jr. noted that MRI scanning is more helpful in pre-screening whereas CT scans are more beneficial post competition.
Second Impact Syndrome was discussed as a common problem in boxing, as well as American Football. In such cases, a fighter or other athlete, suffers a second injury before fully recovering from their previous concussion/injury.
Moving on to Chronic TBI, Coletta, Jr. explained the connection to Pugilistica Dementia, aka “Punch Drunk.” It’s estimated that 15%-40% of boxers are affected. The symptoms resemble Parkinson’s and or Alzheimer’s diseases. Risk factors in boxers for Chronic TBI include:
- 150 bouts
- Number of K.O.s experienced
- Duration of career, 10 years
- Fight frequency
- Age of retirement
- APOE e4 genotype (proteins linked to Alzheimer’s)
Management of Chronic TBI includes supportive care and meds for treatment and care of Parkinson’s and Alzheimer’s.
Dr. Rick Weinstein gave a talk entitled “The Knockout Punch.” Weinstein broke down the factors that contribute to the knockout as well as the basic punches in boxing.
Mass Acceleration is the main factor contributing to the knockout opined Weinstein. The mass in boxing not only comes from the overall weight of the boxer, but more importantly the fist and weight of glove itself. While a fist of one size in a larger glove will diffuse the impact over a larger area, that same fist will do more damage in a smaller glove as the contact area will be more concentrated while absorbing the same force.
Other factors contribute to the force of the punch, including body mechanics- the use of legs and core muscles.
Weinstein also focused on the treatment of the knocked out fighter in the ring. Being an orthopedic surgeon, Weinstein stressed immobilization of the neck of the stricken fighter.
Dr. Paul Wallace of the California State Athletic Commission delivered a talk entitled “Weight Cutting And Dehydration In Boxing.”
A study from California that came out this year regarding cutting weight and the subsequent re-hydration before fight time. The study showed examples of post-weigh-in weight gains of greater than 10% of the contracted weight. The most extreme case was regarding the Shawn Porter and Yordenis Ugas welterweight title fight. Porter gained a massive 19.2% of his body weight after re-hydration and came into the ring at 166 lbs.- a super middleweight!
Wallace looked at contributing factors to this problem including matchmaking. Possible control measures could include increasing fines and strict discouragement of poor weight control practices.
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The afternoon session was the Referees Seminar conducted by Chris Flores and Ernie Sharif. Flores conducted the first session dealing with:
- Current state of instant replay
- Knockdown or slip?
- Knocked or pushed out of ring?
- Behind the head bows
- Knocked down or held up by ropes
Sharif picked up the second session with the topics of:
- World title fight- what call do you make?
- Injury-when should a fight be stopped?
- How many fouls are too many?
- Long count
This seminar generated by far the most interaction with the assembly. Many refs in attendance had contrasting opinions on the scenarios shown on video, which made for lively, if not, long-running discussions.
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