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The Silent Enemy

 #31


Chronic Traumatic Encephalopathy – The Silent Enemy of Combat Sports Professionals


By Dr Paul Martin (HonDSc), WKA World Vice President



Professional combat sports inspire admiration — strength, precision, courage, and remarkable discipline are the hallmarks of champions in the ring and the cage.

Yet behind the medals and spotlight lies a different reality — a silent, insidious enemy: chronic traumatic encephalopathy, or CTE.

This neurological condition has increasingly entered public discussion, particularly following numerous reports of its occurrence among retired athletes from boxing, MMA, and kickboxing. While symptoms may not surface until years after retirement, the effects on a fighter’s life can be devastating.

What is Chronic Traumatic Encephalopathy?

Chronic traumatic encephalopathy (CTE) is a progressive brain disease caused by repeated head trauma, even when not every impact results in a concussion.

Micro-traumas sustained with each blow accumulate over time, leading to the degeneration of brain tissue and the build-up of abnormal tau protein, which disrupts neuronal function. This process results in behavioral changes, memory impairment, depression, and, in advanced stages, dementia.

Who is Most at Risk?

Combat sports athletes who have spent years training and competing at a professional or semi-professional level are at high risk, especially:

  • Boxers (hence the historical term “dementia pugilistica”)

  • Kickboxers

  • MMA fighters

  • Muay Thai and Savate practitioners

  • Sparring partners are exposed to hundreds of contact sessions per year

What’s alarming is that CTE can develop even without obvious knockouts. Regular, repeated exposure to blows to the head — in both fights and training — is enough to cause damage.

Symptoms of Chronic Traumatic Encephalopathy

Symptoms develop slowly, often many years after the end of an athletic career. Early signs may be mistaken for burnout, stress, or depression. Common symptoms include:

  • Short-term memory problems

  • Difficulty concentrating and disorientation

  • Mood disorders, impulsivity, and aggression

  • Paranoid thoughts and anxiety

  • Sleep disturbances

  • Suicidal ideation

  • Dementia (in later stages)

Some cases have also reported links to neurodegenerative diseases such as Parkinson’s or ALS.

Diagnosis and Testing

CTE cannot be definitively diagnosed in a living person. A confirmed diagnosis is currently only possible post-mortem through examination of brain tissue.

However, modern imaging and neuropsychological testing can suggest developing neurological changes. Diagnostic tools include:

  • MRI (Magnetic Resonance Imaging)

  • PET (Positron Emission Tomography)

  • EEG (Electroencephalogram)

  • Cognitive and emotional function assessments

Treatment and Prevention

There is no known cure for CTE — brain damage is permanent. Treatment focuses on slowing symptom progression and improving quality of life.

Possible Interventions:

  • Symptomatic medication (e.g., antidepressants, mood stabilizers)

  • Psychotherapy

  • Occupational therapy

  • Adapted physical activity

  • Avoidance of further head trauma

  • Neurological and psychiatric support

Prevention is key:

  • Limiting full-contact sparring

  • Using advanced protective gear

  • Educating coaches and athletes

  • Regular neurological check-ups

  • Early retirement when symptoms appear

Real-Life Examples – The Dark Side of the Ring

CTE cases among athletes are becoming more well-known through the media and scientific research. Notable figures include:

  • Muhammad Ali – suffered from Parkinsonism linked to brain trauma over his career

  • Chris Benoit (WWE) – a tragic story of aggression and suicide, later confirmed to involve CTE

  • Jerry Quarry – a renowned boxer of the 1970s who died with dementia at age 53

CTE is now a growing concern in the kickboxing and MMA world as well, with increased awareness among doctors and sports organizations.

Responsibility of Organizations and the Sporting Community

As the World Kickboxing and Karate Association (WKA), we treat the topic of CTE with the utmost seriousness.

We actively educate coaches, promoters, and athletes in:

  • Monitoring psychological and neurological health

  • Implementing safer training protocols

  • Reducing unnecessary contact sparring

  • Establishing support systems for post-career athletes

We cannot change the past — but we can shape the future.

Conclusion

Chronic traumatic encephalopathy is a real threat to athletes involved in full-contact sports. While strength and determination are key in the ring, protecting neurological health beyond the ring is just as vital.

There is no shame in stepping back. No defeat in listening to your body.
Sometimes, the most significant victory is preserving clarity of mind and emotional stability for years to come.

If you are a coach, athlete, or a family member of someone training in combat sports, don’t ignore the signs.

Educate. Respond. Support

It might save a life.

This article is for informational purposes only and does not replace consultation with a neurologist.








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