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15 NOVEMBER 2018


PART II: I’M GONNA KNOCK YOU OUT… or am I? (Or when watching Tyson-Lewis this week what should they try to do…or avoid)

How can you prevent a knockout? By Margaret Goodman, MD

The same factors that prevent a knockout are really the same factors that can produce one. We will deal with these one by one.

ANATOMY/HEREDITY. This could easily be listed as “good luck.” To be fair, some people are predisposed to cerebral injuries. Heredity, family history, genetics, is each a factor. On the other side of the coin, if you have a family history of stroke, high blood pressure, aneurysm, vascular disease, Alzheimer’s Disease, or diabetes you may need careful evaluation before you embark on a boxing career or close follow-up after you start.

GOOD CHIN. Some fighters have a “glass jaw” and others don’t. This also relates to one’s anatomy and refers to when the boxer is hit square on the jaw. The force of the blow is transmitted to the Temporomandibular joint (TMJ) where the power temporarily disrupts cerebral circulation. Look at both Marco Antonio Barrera and Erik Morales. Each is never without a good chin tuck.

STRONG NECK MUSCLES. If I were a boxer, this would be one of the areas I would concentrate on most. This is one thing you can have control over. If you watch “Classic KOs” on ESPN, you can’t help but notice that what separates out the guy still standing from the guy on the ground is strong neck musculature. You don’t have to have a neck like a linebacker, but alternatively develop selective muscles alongside the neck will prevent your head from moving after getting hit. Bottom line, if you head doesn’t move with a punch, you can’t get KO’d. Look at Gatti, look at Foreman. I remember seeing Forman training by pulling a tractor behind him!

Bobby Stella, well-renowned Boxing Fitness Expert from “The Gym” in Las Vegas, Nevada, recommends a boxer begin with simple exercises while laying on a bench. For 1 ½ minutes each, do reps flat on the back, on the stomach, and on each side flexing and extending the neck in each position. This can even be done with head rotation. After some time, the trainer can place a towel around the boxer’s forehead and exert minor pressure as the boxer repeats the reps in each of these positions. Bobby adds that after four weeks weighted headgear is helpful. He recommends against boxers believing they need a muscle bound neck. Strength and endurance are tantamount to muscle size.

WELL-MADE MOUTHPIECE. Hopefully you saw our recent articles on Mouthguards written by expert Dentist, Dr.Timothy Reardon. The fighter losing his mouthpiece during a fight is often the same boxer that gets KO’d. Fighters typically forget its importance, buy a cheap one, never train enough with it in, and forget to have it made by a professional. This is such a simple thing, yet it is the last thing a boxer often thinks about. A well-made mouthpiece drastically increases jaw strength and it allows much of the force of a blow to be absorbed before it has the opportunity to disrupt brain function.

CHIN TUCK. If a fighter maintains a good chin, the chances of a KO are lessened. By keeping your chin up, you have a greater chance of allowing a rotatory/hyperextension blow to knock you out! An example would be how Rahman KO’d Lewis and Lewis, in turn, KO’d Rahman.

DRUGS/ALCOHOL/STEROIDS. (Please see Dr. Homansky’s article in our Safety Section). Each of these substances predisposes the brain directly or indirectly to damage. Occasional use can be as important as chronic/habitual use. In simpler terms, you don’t have to be “under the influence” at the time of a fight to have these substances predispose you to a blood clot in the brain.

HEADGEAR. Headgear comes in many shapes, sizes, weights, and makes. If used correctly it will protect against cuts. However, none on the market has proved to protect against brain damage. Be aware of that when you are an amateur or spar repeatedly in the gym. It is important for it to fit properly. Headgear that sits too low will force the fighter to train with his jaw up. This in turn will create a bad habit come fight time, so that the chin tuck becomes nonexistent. Furthermore, amateurs during a fight and professionals in the gym are constantly readjusting the headgear or pushing it up. This not only creates a bad head position, but forces their hands from being in the right place to either properly deliver or block a blow.

PREPAREDNESS. This includes so many things that boxers take for granted: a). Appropriate training regimens with an experienced trainer, b). Safe weight loss regimen, c). Avoiding dehydration, d). Good conditioning regimen. The boxer must listen to experts, but he has to also take responsibility for what his body can and cannot handle. If these factors are ignored, you can become a set-up for a KO. Instead, good strength and conditioning makes it easy to avoid punches in the first place.

GOOD GYM HABITS/HONORING SUSPENSIONS. (Please see article on Suspensions in our safety section. If you get knocked down or KO’d in the gym, you are a set-up for another especially if you haven’t taken enough rest. Don’t go into a fight, or back into the gym for that matter, when you have recently been KO’d/TKO’d. Your brain needs time to heal, and if you don’t take the time to rest you might as well hand your opponent the win


Dr. Margaret Goodman is a Ringside Physician and Chairman of the Medical Advisory Board of the Nevada State Athletic Commission.

Dr. Margaret Goodman practices in Las Vegas, Nevada, where she is a licensed ringside physician since 1994. Her medical specialty is in the field of Neurology. Dr. Goodman was appointed by Nevada’s Governor, Kenny C. Guinn, in September of 2001, to serve as Chairman of the Medical Advisory Board to the Nevada State Athletic Commission. Although she is Chairman of the Commission’s Medical Advisory Board, all of the views, opinions, and/or recommendations contained herein are solely her own and do not necessarily reflect those of Nevada’s Commission. All readers are strongly cautioned that the information contained herein is not intended to, and never should, substitute for the necessity of seeking the advice of a qualified medical professional whenever a boxer or his/her representatives have specific questions regarding the best course of action that a boxer should take. Furthermore, since it is possible that general information herein may pertain only to a law, regulation, rule or acceptable standard of practice for a particular jurisdiction, a boxer or his/her representatives must always inquire with the appropriate licensing jurisdiction to determine the applicable laws, regulations, rules, and acceptable standards of practice for each jurisdiction.

All readers are advised that the information herein is intended solely as a general reference source, and to the fullest extent permitted by law, the information is provided “AS IS” without any warranties of any kind, whether express or implied, including without limitation, warranties of merchantability, fitness for a particular purpose and non-infringement. No one may rely on the accuracy, integrity, quality or completeness of the general information herein. Accordingly, neither the authors, editors nor anyone else affiliated with this website may be held liable for damages of any kind whatsoever allegedly caused or resulting from any such claimed reliance.

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