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Doctors' Groups Say Teens Shouldn't Box
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New Policy Statement Warns That Youngsters Face Special Risks of Brain Injury
By Kathleen Doheny
Reviewed by Laura J. Martin, MD
Aug. 29, 2011 -- Teens and boxing are a bad combination, doctors say.
The risk of brain and other injuries during boxing makes the sport too risky, according to a new policy statement by U.S. and Canadian pediatrician groups.
The statement urges doctors to ''vigorously oppose boxing for any child or adolescent.''
"Children and adolescents should not be participating in boxing because of the risk of head and facial injuries," says statement co-author Laura Purcell, MD. Purcell is a pediatric sports medicine doctor for the Canadian Paediatric Society.
Children's brains are more vulnerable to concussion, the doctors say. Recovery takes longer in kids.
There may also be long-term consequences. "We don't know what the long-term effects are, particularly with amateur boxing," Purcell tells WebMD.
The statement from the Canadian Paediatric Society and the American Academy of Pediatrics is published in Pediatrics. It updates a statement from 1997 issued by the U.S. doctors. This is the first time the Canadian group has addressed boxing, Purcell says.
Educating Parents About Boxing Risks
The new statement, like the earlier one, asks pediatricians to oppose youth boxing, to educate their patients, and to suggest other sports.
The new policy statement also urges doctors to talk about boxing hazards with parents, teachers, and coaches.
It asks that boxing organizations "ensure that appropriate medical care is provided for children and adolescents who choose to participate in boxing." Ideally, the statement says, that would include medical coverage at events, medical exams before boxing, regular testing to rule out neurological problems, and eye exams.
"Most of the organizations do have doctors affiliated with them," Purcell tells WebMD. However, she says, she is not certain if they all meet the other recommendations.
Risks of Amateur Boxing
In amateur boxing, participants ages 11 and above win points for scoring ''clean blows to the head and body above the belt," according to the policy statement.
A match goes three or four rounds, each about two minutes.
Brain injury is the most significant risk linked to boxing, the doctors' groups say. More than half of the injuries in boxing matches are concussions, research shows.
One study found that 13% of amateur matches ended because of concussions.
"There is no evidence that headgear prevents concussions," Purcell tells WebMD.
Injury to the face and neck also occur.
The practice of ''making weight" -- ensuring that a teen or child can compete in a specific weight class -- could encourage unhealthy habits such as fluid restriction, the doctors say.
Of several combat sports, boxing has the highest likelihood of injury resulting in hospitalization, according to a Canadian database. It looked at the years 1990 to 2007. It found that 4.8% of the admissions involved boxing, compared to about 3% for wrestling and karate.
USA Boxing Perspective
USA Boxing, the national governing body of amateur boxing, took issue with the new policy statement. More than 18,000 children under age 19 were registered in 2008 with USA Boxing.
In a statement, Anthony Bartkowski, executive director of USA Boxing, says, "The sport of boxing and the training that accompanies it provide valuable traits to all those who participate in a supervised and registered program.''
Safety is the first priority, he says. "USA Boxing focuses great efforts on ensuring that young boxers are highly supervised by their coaches at all times, and that headgear is always worn during sparring and competition.''
The skills learned, he says, prepare boxers for challenges. He says the positives outweigh the potential risks.
SOURCES: Laura Purcell, MD, pediatric sports medicine physician, Canadian Paediatric Society, Ottawa.Anthony Bartkowski, executive director, USA Boxing.Purcell, L. Pediatrics, September 2011; vol 128: pp 617-623. ©2011 WebMD, LLC. All Rights Reserved.