Epidemiology of boxing injuries in the Olympic Games: prospective injury surveillance at three consecutive events

Introduction: Boxing is a full-contact combat sport that has been part of the modern Olympic Games program since 1904. The objectives of this study were to determine the incidence, pattern, and severity of injuries, and to identify potential risk factors for injury, among male boxing athletes competing in the Olympic Games.

Methods: Injury data were obtained from prospective injury surveillance at three consecutive Olympic Games (i.e. Beijing 2008, London 2012, and Rio 2016), while exposure data were obtained from publicly available tournament draw sheets. Injuries were diagnosed by on-site sports medicine personnel. Injury incidence rates were calculated per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME) and presented with 95% confidence intervals (CI). Subgroups were compared by calculating their injury incidence rate ratios (RR) with 95%CI.

Results: A total of 114 injuries, 1486 athlete-exposures, and 12,498 min of exposure were recorded. The overall IIRAE and IIRME were 76.7 (95%CI: 63.3–92.2) and 9.1 (95%CI: 7.5–11.0), respectively. The most frequently injured anatomical region were the head (65%) and upper limb (21%). The most common types of injury were laceration/abrasion (44%) and contusion (18%), while concussion accounted for 7% of injuries. One fifth (21%) of injuries were considered to be moderate or severe (i.e. resulting in more than 1 week lost from participation in training or competition). The risk of injury was more than three times greater for defeated athletes compared to winners (RRME 3.2 [95%CI: 95%CI: 2.1–4.9]). The injury incidence rate appeared to increase with weight; however, the injury incidence rates for middleweight and heavyweight divisions were not significantly different from that of lightweight divisions (RRME 1.08 [95%CI: 0.70–1.68] and RRME 1.52 [95%CI: 0.94–2.44], respectively).

Discussion: Our findings indicate that there is a substantial injury problem among male boxing athletes competing in the Olympic Games. Because injuries have a detrimental impact on athletic success, injury prevention should be a priority for maximising athletic performance.