Update October 5, 2021 – Today the ABC Medical Committee released the below critical comments on the quality of regulation in BKB in the United States
ABC MEDICAL COMMITTEE Statement Regarding BARE KNUCKLE BOXING DEATH
Uncasville, CT – Bare Knuckle Boxing (BKB) has been gaining in popularity across parts of the United States. Since 2018, early injury studies in BKB have suggested a higher rate of minor hand fractures and lacerations, but less severe concussions. Nevertheless, athletes who compete in this sport are generally older (over 35 years old), have already fought in various other Mixed Martial Arts disciplines and tend to be at the tail end of their careers. Many of these competitors have been affiliated with other MMA organizations and have been subsequently released by these promotional companies due to many factors including (but not limited to) loss of skills, consecutive losses or injuries. Lastly, many of these fighters have not fought for extended periods of time. Therefore, the Association of Boxing Commission’s Medical Committee is especially concerned that athletes competing in BKB may be at higher risks for acute and chronic injuries due to these and other factors.
Disturbingly, and despite our recommendations, some jurisdictions regulating these events are still not following the minimum medical guidelines set forth by the Association of Boxing Commissions and Combative Sports (ABC) and the Association of Ringside Physicians (ARP). More concerning is the fact that many commissions still do not require any imaging studies (CT Scan or MRI Scan) in a sport where individuals are at risk for acute and chronic head injuries.
Given the limited data regarding the medical risks of BKB, the ABC medical committee implores commissions who are considering licensing these events to proceed with caution. Furthermore, we encourage those jurisdictions who are still deficient in these minimum medical recommendations and guidelines to immediately update and revise their requirements to include a CT scan, MRI scan and/or neurological clearance performed by a board certified neurologist prior to clearing a fighter to compete.
With the tragic news regarding the death of Justin Thornton and the limited medical data regarding short and long term injuries in BKB, the ABC medical Committee recommends enhanced screening of individuals considering participation in such events. During the 2021 ABC Conference, a Committee was formed to examine and make suggestions on safety regulations for Bare Knuckle Boxing
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In 2018 Wyoming became the first state to legalize Bare Knuckle Boxing. Several other jurisdictions quickly followed suit with Mississippi becoming one of the busier jurisdictions for the sport.
It is reported that Justin Thornton passed away following complications after a bout in the BKFC promotion which took place under the watch of Mississippi regulators. This is, to my knowledge, the first bare knuckle boxing death in any regulated jurisdiction.
The injury data to date for bare knuckle boxing is revealing a lower concussion rate than gloved boxing however combatants incur a high incidence of lacerations and broken hands.
Combat Sports Law 
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