Study – More Head Injuries Documented From Wrestling than Boxing and Martial Arts

Adding to this site’s archives of combative sports safety studies, a study was recently published in the Clinical Journal of Sports Medicine noting that more cases of mild traumatic brain injury were noted from participation in wrestling than in boxing or other martial arts.

In the recent study, titled “Incidence of Combat Sport-Related Mild Traumatic Brain Injuries Presenting to the Emergency Department From 2012 to 2016” the authors reviewed US emergency department records over a 5 year period linking documented mild traumatic brain injuries to the reported cause.  The data revealed that “a significantly larger proportion” of mild traumatic brain injuries were related to wrestling, compared with boxing and other martial arts.

The full abstract reads as follows:



We sought to investigate the incidence and characteristics of traumatic brain injuries [mild traumatic brain injury (MTBI)] presenting to the emergency department as a result of boxing, wrestling, and martial arts (MA).


Retrospective cross-sectional study of MTBI in combat sport athletes who were evaluated in emergency departments in the United States.


Patient data were taken from the National Electronic Injury Surveillance System.


All patients with MTBI from 2012 to 2016, which occurred during participation in boxing, MA, or wrestling.



Main Outcome Measures:

The incidence of combat sport-related MTBI presenting to emergency departments in the United States.


The mean annual incidence of MTBI due to wrestling was significantly larger (269.3 per 100 000 person-years) than boxing (85.6 per 100 000 person-years) and MA (61.0 per 100 000 person-years) (P < 0.01). The average age at injury was significantly lower for wrestling compared with boxing and MA (15.0 years [SD ± 3.9] vs 21.7 years [SD ± 8.2] vs 19.9 years [SD ± 10.5]; P < 0.01). A significantly larger proportion of MTBIs (95.3%; P < 0.01) in patients younger than 20 years were related to wrestling, compared with boxing (55.8%) and MA (54.1%). Most patients with combat sport-related MTBIs were treated and discharged (96.3%), with only 1.7% of patients being admitted and 0.6% of patients being held for observation.


Combat sports athletes are at high risk of sustaining an MTBI. Such athletes presenting to the emergency department for combat sport-related MTBI were more likely to be male and younger than 20 years. Of these athletes, wrestlers experience the highest incidence of MTBI-related emergency department visits.

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