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14 NOVEMBER 2018


The Ultimate Question: Spit or Swallow?

By Flip Homansky MD

I am frequently asked what is the best replacement fluid during fights. The answer is that the type of fluid is less important than actually getting your fighter to come in well hydrated and to drink enough of anything to prevent dehydration. Boxing has historically treated water as simply something to rinse the mouthpiece with. The water bottle seems to be used mainly to drench the fighter. I don’t care how much is poured over a kid’s head - he can’t absorb it through his skin.

I watch in wonderment as a small lake forms in each corner. I do believe that I have actually seen wooden stools warp from the inundation. After this proper drenching, the boxer very carefully washes his mouth out and daintily spits in the general vicinity of the spit bucket.

An average size male body contains 50 quarts of water, and can lose 1-2 quarts per hour. This corresponds to 2-4 lbs. of weight loss and each pound is about 450 ml, or 15 fluid ounces. Dehydration can occur rapidly, and the reason this is important is that performance suffers just as rapidly! Thermoregulation is the body’s ability to regulate heat exchange. This ability is dependent on an individual staying well hydrated. If your core (internal) temperature rises, you will no longer be able to compete at a peak level. This is the main point of this story....

each quart of fluid lost = your heart rate increases by 8 beats

cardiac output declines by 1 liter/min

core temperature rises by 0.3 degrees

osmolality increases

1% dehydrated - performance begins suffering

4% dehydrated - performance cut by 20 to 30%

5 to 6% - loss of further thermoregulation, weakness and fatigue

7% - collapse

The key is to stay hydrated and never get behind the curve. Go into the bout in as perfect fluid and electrolyte balance as possible. If you have lost a great deal of weight and “dried out” for the weigh-in, then this is almost impossible. Remember that! You should consume at least 17 ounces of water before any strenuous exercise. Drink especially between each round, and after the fight. I believe drinking anything is more important than what you drink. Water is fine.

I have no problem if you want to drink electrolyte solutions like Gatorade or Pedialyte, but I don’t feel they are necessary in boxing. These commercial products contain predominantly water combined with electrolytes and carbohydrates. Carbohydrates are known to slow the rate of gastric emptying. This will decrease the rate of absorption of water from the gut. Carbohydrate ingestion clearly improves performance in events lasting longer than 90 minutes (Coggan and Coyle; Exercise,Sports Science Review-volume19, 1991). Our longest matches are only 36 minutes of actual activity.

What our boxers need is to come into the contest well hydrated and to replace the fluids they lose during the match. I don’t believe electrolytes during that short period are relevant, but shouldn’t hurt. Carbs may indeed slow down our ability to use the water we drink. If the fighter is to use Gatorade, then I would dilute it with water. The temperature should be slightly cool, not warm or icy.

A fighter must train his body to accept this regimen. Never force someone to drink during a contest if he hasn’t been doing this in training, and especially during sparring. Periods of intensive training that last over an hour will benefit from electrolyte replacement.

I hope the above has convinced you that it is almost always better to swallow...

{This was first presented at the IPRO Officials Seminar in Seattle 8/17/02}


Dr. Flip Homansky is the current Vice-Chairman of the Nevada State Athletic Commission (NSAC). For over twenty years, he served as Chairman of the Medical Advisory Board and Chief Ringside Physician for the NSAC.

Dr. Flip Homansky practices in Las Vegas, Nevada, where he had been a licensed ringside physician and Chairman of the Medical Advisory Board for the Nevada State Athletic Commission for over twenty years. His medical specialty is in the field of Emergency Medicine. Dr. Homansky was appointed by Nevada’s Governor, Kenny C. Guinn, in 2000, to serve as a Commissioner of the Nevada State Athletic Commission. Although he is currently Vice-Chairman of the Nevada State Athletic Commission, all of the views, opinions, and/or recommendations contained herein are solely his own and do not necessary 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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