Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data

Laboratory investigation

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In spite of ample literature pointing to rotational and combined impact dosage being key contributors to head and neck injury, boxing and mixed martial arts (MMA) padding is still designed to primarily reduce cranium linear acceleration. The objects of this study were to quantify preliminary linear and rotational head impact dosage for selected boxing and MMA padding in response to hook punches; compute theoretical skull, brain, and neck injury risk metrics; and statistically compare the protective effect of various glove and head padding conditions.


An instrumented Hybrid III 50th percentile anthropomorphic test device (ATD) was struck in 54 pendulum impacts replicating hook punches at low (27–29 J) and high (54–58 J) energy. Five padding combinations were examined: unpadded (control), MMA glove–unpadded head, boxing glove–unpadded head, unpadded pendulum–boxing headgear, and boxing glove–boxing headgear. A total of 17 injury risk parameters were measured or calculated.


All padding conditions reduced linear impact dosage. Other parameters significantly decreased, significantly increased, or were unaffected depending on padding condition. Of real-world conditions (MMA glove–bare head, boxing glove–bare head, and boxing glove–headgear), the boxing glove–headgear condition showed the most meaningful reduction in most of the parameters. In equivalent impacts, the MMA glove–bare head condition induced higher rotational dosage than the boxing glove–bare head condition. Finite element analysis indicated a risk of brain strain injury in spite of significant reduction of linear impact dosage.


In the replicated hook punch impacts, all padding conditions reduced linear but not rotational impact dosage. Head and neck dosage theoretically accumulates fastest in MMA and boxing bouts without use of protective headgear. The boxing glove–headgear condition provided the best overall reduction in impact dosage. More work is needed to develop improved protective padding to minimize linear and rotational impact dosage and develop next-generation standards for head and neck injury risk.

Abbreviations used in this paper:ATD = anthropomorphic test device; CSDM05 = cumulative strain damage measure at the 0.05 level; DDM = dilatational damage measure; GAMBIT = Generalized Acceleration Model for Brain Injury Threshold; GSI = Gadd Severity Index; HIC = Head Injury Criterion; HIP = head impact power; MMA = mixed martial arts; RMDM = relative motion damage measure; SIMon = Simulated Injury Monitor; wPCS = weighted principle component score.

Article Information

Address correspondence to: Adam J. Bartsch, Ph.D., Cleveland Clinic Spine Research Laboratory, Luth2-C, 1730 West 25th Street, Cleveland, Ohio 44113. email:

Please include this information when citing this paper: published online February 7, 2012; DOI: 10.3171/2011.12.JNS111478.

© AANS, except where prohibited by US copyright law.



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    Photograph demonstrating the unpadded (control) impact condition.

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    Photograph showing the bare pendulum–headgear condition.

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    Photograph of the MMA glove–bare head condition.

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    Photograph showing the boxing glove–bare head condition.

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    Photograph demonstrating the boxing glove–headgear condition (high-energy trial only).

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    Graphs illustrating the linear acceleration in the high-energy (upper) and low-energy (lower) trials.

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    Graphs showing the angular velocity in the high-energy (upper) and low-energy (lower) trials.

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    Graphs demonstrating the angular acceleration in the high-energy (upper) and low-energy (lower) trials.

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    Graphs illustrating the impact force in the high-energy (upper) and low-energy (lower) trials.

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    Representative frame from the SIMon computational simulation results displaying pressure isosurfaces within the brain from boxing glove–bare head impacts.



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