Boxing, MMA and Spinal Injuries
While it is well known that boxers can suffer brain injuries from repetitive contact, spine injuries can also occur during the boxing match.
For boxers who develop neck pain after a match, often times, it is attributed to sprains and strains of the neck. But if there is no rapid resolution of symptoms, a screening x-ray can be helpful in identifying a potential instability condition such as Os Odontoideum.
Os Odontoideum is the term used to describe a non-union of the C1-C2 anterior bodies. Normally, during fetal development, these bones naturally fuse togethe to form the axis of the spine. The axis allow the head to rotate around the neck, without causing a dislocation, While it is still not completely known how these Os Odontoideum develop, theories include a congenital (you were born like that) basis, or secondary to a fracture of the C1 and C2 areas during early childhood.
For people who have an Os Odontoideum, they are susceptible to developing a castastrophic neurologic injury secondary to potential instability of the spine. For Boxers, the forces delivered to the head can cause a prior asymptomatic problem to become dramatically evident. Not too long ago, some debated whether boxers should have screening of the neck.
For boxers with normal spine anatomy, there are still concerns regarding the forces impacted on the skull, and potential to cause injury to the ligaments and disks of the spine (especially the neck). While the use of gloves and head gear can dampen the forces experienced by the structures, the forces generated can be significant enough to cause structural injury to the spine.
Most Ring Side Physicians are trained to look for neurologic changes of the boxers. While often times, the changes are secondary to brain concussion, the physicians must always consider a spinal cause of complaints.
This past Saturday, we watched a fight between Floyd Mayweather and Conor McGregor. While the fighters put on a great match, the forces applied to their spines were significant.
- Bartsch AJ, Benzel EC, Miele VJ, Morr DR, Prakash V. Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data. J Neurosurg. 2012 May;116(5):1070-80. PubMed PMID: 22313361