Ban Boxing (and every other sport)!

Image: Andrzej Krauze - taken from New Scientist article

I have to say that I don't like professional boxing. Not to say I've never watched it, but it does make me uncomfortable. I've watched amateur boxing at the Olympics. They wear headgear and it seems more of a sport to me. It may be no safer than the pro side but at least it has the sheen of a points-based contest. As argued in this New Scientist article, head injuries are the aim of pro-boxing. I don't see how we can still justify it as entertainment. I'd get rid of it if I was in charge. You may be glad I'm not.

That leads to the question: What level of risk is acceptable in a sport, either to the competitor or others? I don't have the answer to that, but all sports should be trying to get the balance right between preserving the game and protecting those playing. No, 'they make loads of money' isn't justification for putting them at unnecessary risk.

Dave and I talked about this on the pod, but we came across some interesting articles and stories that you might want to read.

I'm obsessed with NFL (American Football) at the moment and we mentioned in Podcast 1 that we wanted to talk more about it so we got to it in Podcast 2. Head injuries have been big news in the NFL for some time. Over 3000 former NFL players sued the league in 2012 and a settlement was agreed in 2013 for $765m to provide medical care for those affected.

NFL involves HUGE guys tackling each other. All players must wear a helmet, but this can only help so much. There is now an initiative starting in schools called Heads Up Football that aims to teach kids proper tackling technique and reduce head and spinal injuries. When concussions do occur, the NFL has guidelines in place for the assessment of players and when to let them play again. This involves pre-season baseline testing and the presence of neurologists at every game. When players sustain a concussion, they should not play until they have fully recovered as the risk from second injuries is great.

The lawsuit above covered a few different types of head injury, but it seems that the main issue was CTE or chronic traumatic encephalopathy - a degenerative disorder related to repeated concussions. It's linked with movement disorders, personality changes, substance misuse and suicide. Clearly, even minor head injuries need to be taken seriously. As a vast money-making machine, the NFL is finally starting to take responsibility for reducing these injuries and protecting its employees.

Football (our football) is much earlier in this journey. It's a non-contact sport though, right? Well that's fine until a keeper wants to get a ball with his hands or body and an attacker wants to score with his legs. Petr Čech (Chelsea) suffered a depressed skull fracture in 2006 and has been wearing protective headgear since. Last year, Tottenham were criticized for letting their keeper Hugo Lloris play on after being rendered unconscious in a similar collision.

Partially in response to this incident, the Premier League introduced new guidelines prior to the start of the 2014-2015 season. These included giving doctors (who are employed by the team...) the power to remove players from the game, rather than leaving the decision to the team or player. Surely the Premier League can afford an independent doctor at a game to assess these things - armed with a rule that says, "If a player is knocked out, they are getting subbed off. I don't care if you've used all your subs, it's great when a defender has to get his gloves on."

Last week, the inadequacy of the current set-up was displayed again when another Chelsea keeper was knocked out. He was assessed by the club doctor and allowed to carry on but was subbed later when he felt unwell, with blood coming out of his ear. FIFA have supported the decision to keep on playing (caution - Daily Mail link) but I can't see how unconscious players should be allowed to wake up and carry on. It's not bravery or commitment, it's reckless and stupid.

I don't watch much rugby, but the RFU puts out this info sheet, which looks pretty good. it talks about the 4 R's when concussion is suspected (such as when a player has been knocked out):

Recognise

Remove

Recover

Return

If any one knows whether this works in practice, I'd be keen to hear.

The conflict between safety and spectacle is rarely more apparent than in motorsport. Fans want speed (and many will freely admit, crashes) but no-one wants to see drivers hurt. As the pinnacle of motorsport, Formula 1 has improved greatly from earlier decades, where death was an accepted and inevitable part of the season. There's not been a driver death in F1 since I was ten. Circuit design, improvements in protective equipment, car safety and rule changes have all helped reduce the risk. The lessons learnt in F1 have filtered down to lower formulae and to our road cars.

But any thoughts that F1 was now "safe" were shattered last weekend, when Jules Bianchi crashed into a recovery vehicle that was by the side of the track to move another stricken car. I had read that he had undergone surgery for a subdural haematoma (bleed on the brain) but I can't actually find confirmation of this now so sorry if that isn't the case. What has been said is that he's suffered a diffuse axonal injury, where rapid acceleration and deceleration causes damage to nerve cells due to shearing. This is a common but devastating consequence of severe head injury.

We'll be thinking of him and his family.

At this point I'd like to say that motor sport, at all levels, can only run because of the dedication of a legion of unpaid marshalls, who stand out in all weather to keep the racers safe. They are backed up by knowledgeable and passionate officials and an enthusiastic community of doctors and paramedics who are constantly trying to improve medical provision at these events. Here's some concussion guidelines for F1 and for loads of information about Medicine in Motor Sport, read that.

A HANS device and helmet

Will any good come from this? This accident occurred following a previous incident and the organizers have come under fire for not putting out a safety car to slow everyone down in wet conditions whilst the first car was recovered. There is a debate about closed cockpits in F1 (like a fighter-jet canopy to protect drivers' heads) but worry that fans won't like the look of it. Some fans will moan about every change in F1 but ultimately get used to it. We'll have to wait to see what lessons can be learned.

Ultimately, organizers should take all reasonable steps to protect their athletes. We, as fans and consumers, should accept changes to improve the safety of the sports we love.