Child boxing: Concerns over repetitive head impacts on the developing brain and socio-ethical issues

Abstract

Training in boxing often starts early in expectation of attaining the athlete's full potential. Traditional Thai boxing (Muay Thai) has increasingly received international recognition. As part of the Muay Thai boxing industry, thousands of children from low-income families in Thailand start partaking in paid combat boxing competitions as early as four years of age, with only limited protective gear. Herein, we discuss a medical issue involving the potential harm of competitive boxing to children's brain health and a socio-ethical issue regarding the exploitation of underprivileged youths. Children are much less aware of the danger of head trauma than adults. Together with their head and neck anatomy, child boxers are at greater risk of sustaining repetitive head impacts than adult boxers. Repetitive head impacts on the developing brain may cause disturbances in brain development and, later in life, chronic traumatic encephalopathy. We propose practice-and policy-based implications in child protection. While society faces the dilemma of boxers' safety or spectators' entertainment, we call for a social norms campaign against child boxing in the gambling-related boxing industry. We advocate a ban on all combat boxing competitions for youths under 15 years of age. The rules of competitive boxing can be modified to ban blows to the head and neck. Finally, implementing safer forms of boxing into community programs can serve as an avenue to attain positive youth development.