DEAR DOCTOR K:

My teenage son wants to box. Should I let him?

DEAR READER:

As much as I believe sports are great for kids, particularly teenagers, I think boxing is a bad idea. The American Academy of Pediatrics agrees. Last year the AAP released a statement strongly opposing boxing as a sport for children and teens.

Your son may argue that other sports, like football or ice hockey, can also cause injury. But boxing is a sport in which participants actually get points for hitting opponents in the head. That's dangerous. Blows to the head can cause head injuries, including concussions, which are the most common injury in boxing.

Because people typically recover full neurological function after a concussion, although it may take weeks or months, many doctors have long assumed that concussions don't cause permanent brain injury. However, over the past several decades we've learned otherwise. Being struck again in the head while recovering from a concussion can cause brain injury, even if the second blow doesn't cause an apparent change in brain function. So can repeated concussions, even if a person has recovered fully between concussions.

In fact, concussions can cause more damage to kids and teens than to adults. That's because their brains are still developing and are more vulnerable to injury. A young brain also takes longer to heal. Perhaps even more alarming, multiple concussions can lead to permanent brain injury.

Another concern about boxing is that athletes compete in "weight classes." This means that boxers are encouraged to lose weight before a match. Diuretics, laxatives and various ways to increase sweating are all common practices. This can be dangerous for a young athlete.

Playing sports is something we certainly want kids to do. But we want kids to be safe when they exercise. Exercise should prevent health problems, not cause them.

Many sports and activities allow children and teens to be active without encouraging blows to the head. Swimming, tennis, track, basketball and volleyball are all good options. Although baseball can cause head injury, particularly if a wild pitch hits the batter's head, the routine use of helmets offers considerable protection. Soccer and football are more likely than these sports to cause head injury, but not as likely as boxing.

If your son really wants a sport that involves hand-to-hand competition, other martial arts are a better alternative. If carefully supervised, many martial arts are safer than boxing.

If you do decide to let your son box, try to find a boxing group that provides medical care on site and at events. Your son should get a medical exam before he starts, and regular eye exams and tests of nerve and brain function as long as he continues. Make sure he always wears protective gear. Make certain he is carefully evaluated after any head injury, and enforce any restrictions the doctor places on his activity after such an injury.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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