The introduction of the UK-wide Concussion Guidelines for Grassroots Sport in April 2023 marked a significant step forward in ensuring athlete safety by providing clear protocols for identifying, managing, and preventing concussions. This initiative prioritises removing participants from play if there is any doubt of injury, focusing on immediate care and gradual recovery to minimise long-term risks. While these guidelines focus on acute concussions, growing concerns about the cumulative effects of sub-concussive impacts — repeated, low-level brain traumas without immediate symptoms — are emerging as a critical issue.
Scientific evidence shows that even low-force impacts can have long-term consequences, particularly for children:
* Repeated sub-concussive impacts—low-force hits that don't cause immediate symptoms—can result in structural and functional changes in the brain. These changes include alterations in brain anatomy and impaired cognitive function, even in the absence of a diagnosed concussion. https://www.thieme-connect.de/.../html/10.1055/a-2342-3604
* Sub-concussive hits can interfere with GABA (gamma-aminobutyric acid) signalling pathways in the brain. This disruption can lead to motor control and memory impairments, impacting coordination and cognitive functions. https://www.frontiersin.org/.../10.../fnhum.2019.00294/full
* Children's brains, which are still developing, are particularly vulnerable to these impacts. Sub-concussive hits during critical growth phases can impair cognitive, emotional, and motor development, with potential long-term consequences like memory issues, mood disorders, and neurodegenerative conditions later in life. https://www.americanbrainfoundation.org/concussions-in
The human brain continues developing into the mid-20s, with the prefrontal cortex — responsible for decision-making and impulse control — maturing last. Disruptions during this period can cause permanent impairments. Even if children don't show signs of injury after small head impacts, these hits can quietly add up and harm brain development. This is why reducing exposure to head impacts, especially for children, is so important. The American Brain Foundation's conclusions on the effects of repetitive sub-concussive impacts are supported by several key pieces of evidence:
* Breakdown of the Blood-Brain Barrier: Repetitive sub-concussive hits can compromise the blood-brain barrier, a protective shield that prevents harmful substances from entering the brain. This breakdown can lead to various neurological issues.
* Cumulative Brain Damage: Studies indicate that even in the absence of immediate symptoms, repeated minor head impacts can cause cumulative damage to the brain, potentially leading to long-term cognitive and neurological impairments.
* Increased Risk of Chronic Traumatic Encephalopathy (CTE): Research has linked repetitive sub-concussive head impacts to the development of CTE, a progressive neurodegenerative disease characterised by symptoms such as memory loss, mood disorders, and cognitive decline.
These findings underscore the importance of minimising repetitive head impacts, especially in children and adolescents, to protect long-term brain health.
On the UK domestic competition scene, children as young as 9 often compete in multiple bouts per event, sometimes every other weekend. In continuous divisions these bouts frequently involve toe-to-toe exchanges with limited defensive skills, particularly in novice and younger age groups. Starting competition early increases the number of head impacts over time. The long-term effects of such exposure may not be evident for decades but could include:
* Memory loss
* Impaired judgment
* Mood disorders
* Neurodegenerative conditions like Chronic Traumatic Encephalopathy (CTE)
Sub-concussive impacts in light-contact sparring are a particular concern. Unlike Ringsports, the perception is that there is less danger, and this typically means a less regulated approach in terms of medical checks & weight control, number of categories an athlete can enter and therefore the number of fights someone can have at any given event. However, experience and a small review of online footage show that the number of hits to the head in light-contact disciplines is much greater than in full contact. This number increases exponentially as the level of experience reduces i.e. fighters in novice divisions get hit the most. In a small pilot study I carried out at the 2025 Kickboxing GB nationals, I came to the conclusion that even our elite athletes will on average receive between 5-7 sub-concussive hits to the head every round. When you consider how many fights our children have at any one event, the figures are alarming.
As a coach I have implemented a number of mitigation strategies to reduce the risk to our children:
1. Delay competitive sparring in continuous format: Introduce competitive sparring in divisions such as Light Contact and Kick Light only when athletes demonstrate advanced skills in distance control and evasion, i.e. don’t enter them in novice or even intermediate divisions because, by definition, they don’t have the skills necessary to reduce head trauma.
2. Safe Practise Policy: In addition to the safe practise policies already in place for Kickboxing GB member clubs, we have added the additional mitigations.
* Limit the number of sparring sessions per week, ensuring at least 24 hours of recovery between sessions.
* Avoid sparring for 24-48 hours after competitions, in line with the “If in doubt, sit them out” protocol.
* In training encourage cleaner sparring with mandatory breaks (e.g. step back after every three strikes).
* Consider a progressive approach to the introduction of sparring e.g. body contact only in the early novice stage, as skill develops introduce headshots with punches only, then at advanced levels introduce head kicks, finally introduction to competitive sparring.
* During sparring sessions keep the contact light. It is worth noting that research shows that whilst heavier gloves reduce superficial damage, they do not reduce brain acceleration within the skull and instead can increase rotational forces and therefore are not safer for concussion prevention. The advice therefore is to wear 10oz gloves and spar with control i.e. reduce the contact levels.
3. We now use the SportSmart app for injury and concussion management. - What is SportSmart? It’s a FREE easy-to-use injury-and concussion-management app developed by Podium Analytics to support schools, grassroots sports clubs and coaches. It enables users to log and monitor injuries, run a built-in head-injury assessment tool aligned with UK concussion guidelines, manage return-to-play processes and generate dashboards showing injury trends. It also connects coaches, teachers, parents and players to help share relevant player-care information across organisations, with the aim of improving safety, reducing risk and keeping athletes healthier and playing longer.
What are the longer term risks to our athletes if we continue to ignore the evidence…
* Chronic Traumatic Encephalopathy (CTE): Linked to repeated head trauma, even at low levels. Symptoms may include memory loss, depression, and progressive cognitive decline.
* Structural Brain Changes: Sub-concussive impacts can cause white matter damage and brain shrinkage over time, affecting memory and decision-making.
* Cognitive Decline: Increased risk of early-onset Alzheimer’s and other dementias.
* Second Impact Syndrome (SIS): A rare but catastrophic condition where a second injury occurs before full recovery from a previous trauma which in a worse-case scenario can result in the death of the athlete.
* Mental Health Issues: Links to mood disorders such as depression and aggression, even without visible neurological damage.
The risks of sub-concussive impacts in kickboxing cannot be ignored. The cumulative effect of repeated blows, even in light-contact disciplines, poses serious long-term risks to athletes' neurological health. My advice to all coaches and clubs is to educate yourself and take action where you can:
1. Review current practices and conduct risk assessments.
2. Take steps to reduce head impacts in training and competition.
3. Ensure the safety and long-term health of athletes remains the highest priority.
4. Ensure you are aware of and follow the UK’s concussion protocols for grassroots sports.
The Sport and Recreation Alliance and the Government published the first UK-wide Concussion Guidelines for Grassroots Sport in April 2023.
This is scary information for any parent to hear and the natural reaction is either denial or don’t talk about it because “it will kill the sport”. This is flawed thinking. Like the NFL, Football, Boxing and Rugby, we must recognise the research and address the risks.
The physical and mental health benefits of being active in the martial arts far outweighs the risks highlighted above. However we must also recognise that these risks do exist and that by addressing these issues proactively, we can ensure kickboxing remains a safe and enjoyable sport for all participants, particularly our children.