THE FIGHT DOCTOR HOW TO PREVENT A KNOCKOUT By Dr. Margaret Goodman W e all know a knockout when we see one, but what is the actual cause?
Most believe there is no such thing as a “glass jaw” that predisposes a fighter to a knockout.
knockout, there is a loss of consciousness that results from dysfunction of an area in the back of the brain called the Reticular Activating System (RAS). The RAS keeps you awake unless it is disrupted. Hence another reason “rabbit punches” to the back of the head are prohibited in boxing. This resultant loss of consciousness is also a protective mechanism so your brain can shut down and “reboot.” From a physiological perspective (and before you zone out from TMI), the nerve cell membrane covering the brain is subject to trauma with a knockout. Calcium flows into the nerve cells, which causes them to swell. Energy from your body is sent to help pump out the calcium in the nerve cells so you can return to baseline. Preventing susceptibility to a knockout is, in part, hereditary and dependent upon anatomy. Technically the skull’s thickness won’t prevent a knockout, but skull shape can slightly change the distribution of force. A more rounded skull can better deflect impact (like a helmet), but flatter areas like the jaw and temple are more vulnerable. A well-fitted mouthguard can cushion a blow to the chin or jaw that would otherwise be transmitted to the temporal bone and base of the skull. It helps to stabilize the jaw. Biting on a strong mouthpiece tenses the jaw and even some neck muscles, which may reduce the snap of the head and lessen KO susceptibility. Those old-fashioned “boil and bite” mouthpieces are essentially worthless except for perhaps protecting the teeth, but a mouthguard made by a dentist every six months, fitted to the fighter’s mouth, is crucial. Strong neck muscles are paramount to preventing a KO by also acting as a shock absorber and reducing acceleration. The neck muscles are not just ones along your cervical spine but include your trapezius and sternocleidomastoid (muscles along the sides of your neck). If your neck doesn’t move, it’s harder to rotate or hyperextend your head. Fighters with stronger neck muscles who undergo resistance training, along with the all-
important chin tuck, can better brace themselves against a punch. I remember videos of the great George Foreman training for a fight by pulling a tractor with a strap around his neck. Most believe there is no such thing as a “glass jaw” that predisposes a fighter to a knockout. It’s more likely multifactorial: not seeing a punch coming, no chin tuck and especially weak neck muscles. Simple progressive exercises (omitting the tractor) can really help. Below are some suggestions, but contact a strength and conditioning expert and your physician before proceeding. Dave “Scooter” Honig, famed conditioning expert and trainer of many world champions and celebrities, notes: “A strong neck reduces the risk of concussion and can improve the posture in clinches and add stability against strikes.” Honig recommends the following exercises: 1. Manual resistance by pushing your forehead into your hands forward and side to side. Three times a week, three sets of 30 seconds each. 2. Dynamic exercise: lying on your back on a bench with your head hanging off the end. In this instance, a light weight would be behind the head while flexing and returning your head to neutral. Do three sets of 10-20 reps each. 3. Seated on a bench, flexing and extending the neck with a five-pound plate attached to your head and hanging between your legs. The weight shouldn’t be too heavy, to avoid straining. 4. Utilizing a cable weight machine with light resistance, attach a towel to the cable and bite down on it. Then turn your head to the side so that the motion is raising the weight. After several repetitions, reverse and exercise in the opposite direction.
He also has his fighters strengthen their upper back with dumbbell shrugs and lat (latissimus dorsi) pulldowns. How can a fighter who has physically healed come back from the emotional and mental aspect of a knockout? There are many examples of a fighter who is “gun-shy” in their next fight after they’ve been knocked out. Self- doubt and fear of recurrence is normal. It’s important to meet what happened “head-on” (sorry for the pun) and recognize that it doesn’t define who they are as a fighter and instead view it as an opportunity to learn from what happened or what they did wrong, then make adjustments going forward. Sports psychologists would recommend mindfulness such as meditation to handle stress and anxiety. A strong support system from the fighter’s trainer and family is crucial, as is setting attainable goals to rebuild confidence. Dr. Carlos Alarid, a clinical psychologist with research emphasis on professional boxers, says, “It is understandable for a fighter to feel concerned about being knocked out again. If the boxer finds that their caution is affecting their performance or affecting their ability to ‘pull the trigger’ during a boxing match, it may be beneficial to consult with a sports psychologist to work out the mental kinks that may be preventing the boxer from being the fighter they are used to being. There are also online resources with keys to recovery.” Nothing can replace time in recovering from a knockout. Beyond staying out of the line of fire until cleared by medical professionals, each of us has our own timeline dependent on the factors above. Listening to your body and being in tune with how you feel can be as good as anything to prevent a recurrence when returning to competition.
Why do some fighters take a punch better than others? And is there a way to prevent one, other than a good defense? Your brain sits suspended in your skull, surrounded by cerebrospinal fluid that behaves as a shock absorber when the head is struck or hits a solid surface. An acceleration blow occurs when a punch propels the brain in the direction it was given. A deceleration blow occurs when the fighter hits the canvas or when the brain stops moving within the skull. Both types of shots can cause a KO. In a true
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