An article was published in the latest edition of the South African Journal of Sports Medicine levying criticism at professional boxing’s lack of standardized protocols for athletes to return to training/competition after suffering concussive injury.
The article, authored by Dr. Sethi from the Department of Neurology, New York Presbyterian Hospital is titled “Post-concussion return to boxing protocol” and can be found here.
Dr. Sethi fairly points out that
“Immediately following a concussion, an athlete is usually advised physical and cognitive rest until post-concussion symptoms abate. The athlete then enters a stepwise return-to-play protocol. Premature return to play risks a second concussion, second impact syndrome, exacerbation and persistence of post-concussive symptoms. Various sports governing organisations such as the National Football League have developed postconcussion return to play protocols”
After noting professional boxing lacks a standardized protocol for return to sport following concussion Dr. Sethi proposes the following criteria to be adopted:
The following post-concussion return to boxing protocol is proposed based on evidence from other sports and clinical acumen:
Once the boxer is symptom free for at least 24 hours and a release has been signed by the treating physician, he/she can begin a graded return to boxing as detailed below.
Day 1: Light aerobic activity (walking or stationary bike for 10 minutes, no resistance training)
Day 2: Sport-specific activity (jumping rope, shadow boxing)
Day 3: Non-contact training drills (Skill drills-pad work, speed bag, heavy bag)
Day 4: Full-contact practice (sparring with head gear)
Day 5: Return to boxing (return to competitive boxing occurs when the period of mandatory medical suspension has expired)
Each of the above steps should take 24 hours so that a boxer would take approximately one week to progress through the full post-concussion protocol once they are asymptomatic at rest. If any post- concussion symptoms occur while in the stepwise return to boxing programme, then the boxer should be instructed to return to the previous asymptomatic level and try to progress again after a further 24-hour period of rest has passed.
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