The nation's leading organization of pediatricians is recommending that doctors "vigorously oppose" youth boxing because of the risk of head injuries like concussions, but trainers and boxing supporters say the benefits young people derive from the sport far outweigh the risks.

August 29, 2011


A pediatricians group is taking on youth-boxing injuries, but trainers and boxing supporters say the benefits young people derive from the sport far outweigh the risks.
Priscilla De Castro
By Carina Storrs
MONDAY, August 29, 2011 (Health.com) — Steven Galeano was a problem child. He couldn't stay out of fights and was "off the hook," his father Edwin recalls.

But then Steven decided he wanted to start boxing, like his brothers. For the last four years, he has been venting his anger and frustration on the heavy bag at John's Boxing Gym, in the Bronx, N.Y., rather than on other neighborhood kids.

"I [learned] how to control myself," Steven says. "If I have something on my mind, a little stress, I just take it out on the bag."

Along the way, he and his trainers also noticed that he has talent. He's now a ranked 12-year-old boxer in the U.S. and proud—"so far"—of what he's accomplished.

Boxing has turned Steven around, according to his father, but if the nation's leading organization of pediatricians has its way, Steven would trade in his boxing gloves for a basketball, tennis racket, or swim goggles.

Slideshow: How the young boxers at John's Boxing Gym stay healthy and confident

In a new policy statement published today in the journal Pediatrics, the American Academy of Pediatrics (AAP), along with the Canadian Paediatric Society (CPS), is recommending that doctors "vigorously oppose boxing for any child or adolescent" under the age of 19 because of the risk of concussions and other injuries, and instead steer kids toward non-collision sports.

"There's no reason why we as pediatricians should be condoning such a thing, when we know that the risk is not zero for these kids, and perhaps the damage may be more long lasting," says Claire LeBlanc, MD, the lead author of the statement and the chair of a CPS committee on sports medicine and active living.

The pediatricians based their recommendation, in part, on the number of boxing injuries recorded by U.S. and Canadian health officials. In 2003, for instance, there were roughly 14 boxing-related hospital visits for every 1,000 people between the ages of 12 and 34 who participate in the sport, according to data from the U.S. Consumer Product Safety Commission.

The main concern is serious head injuries among kids and teens. Young boxers have been known to suffer concussions, just like the pros, but the data on head injuries is scarce, Dr. LeBlanc says. The limited government records in the U.S. suggest that the rate of head injuries among 12- to 17-year-olds, as well as older boxers, is about 3 for every 1,000 participants.

Perhaps even more alarming to pediatricians is the creeping possibility, based on studies of professional boxers, that young boxers could develop chronic traumatic encephalopathy, a condition caused by repetitive blows to the head that can lead to dementia-like symptoms later in life.

"I think it's extremely important to continue to survey boxing as a sport until it shows evidence that it's not a danger," Dr. LeBlanc says.

Next page: Do the benefits of boxing outweigh the risks?

Though real, the safety risks enumerated by LeBlanc and her colleagues seem to be a world apart from the day-to-day experience of youth boxers and boxing trainers.

Minor injuries such as bloody noses, tennis elbow, and cuts are not uncommon, but thanks to protective headgear that covers most of the face and padded boxing gloves that absorb punches, serious injuries are highly unusual, says Joe DeGuardia, the owner of the Morris Park Boxing Club, in the Bronx.

Moreover, sparring makes up only a fraction of training. Young boxers spend most of their time stretching, conditioning, and practicing punch combinations outside the ring, where injuries are "very rare," says DeGuardia, who is also the president of the Boxing Promoters Association and has been training young boxers for more than two decades.

More to the point, DeGuardia adds, the benefits young people derive from boxing—such as confidence, motivation, physical fitness, and especially self-discipline—"certainly outweigh the risks."

In her corner, Dr. LeBlanc notes that safer sports can provide these benefits. Other solo pursuits such as long-distance cycling and triathlons also foster self-discipline and a work ethic without as much risk, she says, and underprivileged youth without access to such activities can get a lot of benefit from basketball.

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The AAP and CPS even consider collision sports like football and hockey that carry a risk of head injury and concussion to be fair game for kids, because unlike boxing they do not encourage intentional blows to the head.

"We disagree with sports that promote violence," Dr. LeBlanc says, noting that if boxing rules were changed to prohibit punching above the neck—as they were to protect the testicles, in 1938—pediatric organizations might rethink their opposition to the sport.

Youth-boxing supporters claim that the perception that boxing promotes violence is out of touch with the reality of neighborhoods like the South Bronx. On the contrary, they say, boxing can help reduce violence outside of the gym.

One of the main reasons that kids walk through the door of John's Boxing Gym is because they are getting picked on and want to protect themselves, says Pashk Gjini, 17, a manager at the gym. But most kids, like 12-year-old Steven, actually calm down when they start to train, he adds.

"They don't have to fight on the street and in school," Gjini says. "They're fighting here."

Another reason kids take up boxing is to get (or stay) in shape. At a time when school sports programs are being downsized and the rate of childhood obesity is about 17%, boxing offers a way to bring exercise back into some kids’ lives, supporters say.

Edwin, Steven's dad, first introduced Steven's older brother, Christopher, to boxing because he was overweight and not exercising. Christopher, now 18, eats salad instead of pizza every day and is a Golden Gloves amateur boxing champion.

"I was getting sick to see them just doing nothing," Edwin says. "Now they don't even have time for TV."

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