THE FIGHT DOCTOR
improving a right hand, stamina and endurance are built through consistent training on a structured schedule – not just sparring. Maintaining shape between bouts and treating boxing as a career and not a hobby will help, but there’s more to it. Beyond the formidability of the person in the opposite corner, are there cognitive, central nervous system or mental factors that contribute to a fighter’s decline during a fight? In boxing, mental endurance is rarely discussed, but many experts would agree that boxing is 75% mental! A study published by Frontiers in Psychology in June 2025 states that “mental fatigue is a psychobiological state triggered by sustained mental effort. [...] It impairs sports performance across various disciplines.” It goes on to outline how brain endurance training can combine cognitive tasks along with physical exercise to create more resistance to mental fatigue.
system (CNS) fatigue as one of the most misunderstood topics in strength and conditioning. Exhaustion in the muscles themselves is called peripheral fatigue, while “CNS fatigue refers to a reduction in the voluntary activation of muscles that originate from the brain and spinal cord,” the authors note. “True CNS fatigue is characterized specifically by a reduced ability to voluntarily activate muscles despite the muscles themselves being capable of producing force.” In other words, your body might be ready to fight, but your brain has other plans. They explain that mechanisms contributing to CNS fatigue include: 1. Serotonin levels. Prolonged exercise increases the concentration of serotonin in the brain. This can make a fighter both more aware of how much effort they are expending while also making them not want to work so hard anymore.
within two or three days. In CNS fatigue, there may be impaired cognitive function, mood issues and reduced motivation in training along with decision-making mistakes. Experts say the solution for CNS fatigue lies in training your brain as you would a muscle. A boxer can perform reaction time drills to strengthen neural pathways. Meditation and deep breathing can calm the mind while reducing stress and enhancing focus, especially during a fight where there are a thousand distractions. Proper hydration and nutrition play a role for cognitive fitness in the ring and the gym. Both enhance mental clarity and reduce CNS fatigue. Our muscles rely on glycogen/carbohydrates, especially during long sparring sessions. Protein supports muscle recovery. Weight remains a big concern, but fats are a long-term energy source for endurance and stamina. Specific
nutrients like omega-3 fatty acids (occurring in flaxseeds and fish) and antioxidants like vitamins C and E protect the brain from stress, while B-vitamins support energy production in the brain. Dehydration reduces performance in all activities,
“Mental fitness means staying in the present and in the moment at all times. Each exercise demands that the athlete be fully engaged with the task.”
Perhaps we are too focused on the boxer’s response to head shots or muscle fatigue as the rounds pile up, and more emphasis should be placed on the mental aspects. Just like muscles fatigue, so does the
brain, and cognitive fatigue can certainly occur in a bout. It results in slower reaction time, diminished focus and poor decision-making. The first step is understanding what it is and recognizing the signs and symptoms. “Concentration and focus should be developed within the gym environment,” said former two-division titleholder and Hall of Famer Timothy Bradley. “Mental fitness means staying in the present and in the moment at all times. Each exercise demands that the athlete be fully engaged with the task. Over time, this focus becomes second nature. The foundation of this process begins with an athlete’s overall fitness level. A conditioned athlete can maintain focus longer than one who is unprepared. Keep in mind, fatigue can quickly diminish concentration and turn the most disciplined into cowards.” A March 2026 training guide for athletes published by PoinT GO Research covers the concept of central nervous
2. Dopamine levels. A reduction in dopamine in the brain slows reaction time and the ability to generate a high level of force. 3. Supraspinal fatigue. The brain’s motor area reduces output as a protective measure, limiting force before the muscles are completely depleted. As a strategy for success, it is important for a trainer/coach to recognize and differentiate if their fighter is exhibiting CNS as opposed to peripheral fatigue. I frequently worry about a boxer who blankly stares into space during the one- minute rest period versus one focused on their trainer’s instructions. In a 2020 Experimental Physiology study entitled “Endurance Exercise-Induced and Mental Fatigue and the Brain,” it was agreed that brain chemicals like those described above can directly impair endurance. Peripheral fatigue is localized to certain muscle groups and is followed by soreness or decreased range of motion and recovery
but especially in boxing. Simple strategies for recovery exist, like getting adequate sleep, which enables our brain to repair itself. Less stressful activities, including yoga and walking, can promote relaxation. Bottom line: Stamina, endurance and CNS fatigue don’t occur in a vacuum. They are equal factors that can make or break a win and influence a successful career. That applies to athletic endeavors beyond boxing as well. There’s a wealth of information to be found about this topic online, but when adopting recommendations that can affect your health, nothing can replace consulting with your own healthcare providers. Dr. Margaret Goodman is the former chief ringside physician for the Nevada State Athletic Commission and is the founder/president of the Voluntary Anti-Doping Association. She co-hosts the Fighter Health Podcast.
BRAIN FATIGUE AND ITS ROLE IN BOXING By Dr. Margaret Goodman
Moses Itauma’s muscles were clearly exhausted by fighting Filip Hrgovic, but what about his brain?
Endurance refers to how long he can sustain an effort over mounting rounds, though not necessarily at peak intensity. There are two types of endurance. Cardiovascular endurance is the ability of your heart, lungs and circulatory system to provide oxygen to your muscles over an extended period. Muscular endurance is the other side of that equation, referring to how well a muscle group can sustain force without fatiguing. The former would be developed by an activity such as running, while the latter would be developed by higher reps and lower load resistance. “Developed” is the key word. Just like
W hen fighters turn professional, they typically fight four- rounders. As their careers advance – hopefully successfully – they move up to six, eight and even 10-12 rounds. If we eliminate making weight as a factor, this success is not just a function of age,
ring maturity and capabilities, but also stamina and endurance. We frequently hear commentators observe that a fighter “has no legs left” or ask why they’re keeping their hands down. Is it due to lack of physical conditioning? Boxing stamina refers to the peak level of intensity to which a fighter can push himself before succumbing to fatigue.
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