Joining fight clubs, exercisers pack a punch

As the chief medical officer for the New York State Athletic Commission, Jordan oversees boxing for the state and "tries to make it as safe as possible" with medical screenings for all athletes and ringside medical assistance and supervision at all matches so that athletes can be pulled from competition when deemed necessary.

"When people are boxing for fitness, if they're not having any contact, I think it's safe," Jordan says. "If you're not hitting hard or trying to hurt the other person, it's probably OK. If you're actually doing forceful hits, there's a concern there."

Besides injuries to the head, there is also the risk of rib fractures and damage to internal organs such as the liver, spleen and kidneys, he notes.

When sparring, which is recommended only for more advanced boxers who've mastered their moves, participants are urged to wear protective gear, including gloves, headgear, mouthpieces and cups.

But headgear doesn't guarantee full protection, says Jordan. It protects against facial injuries but not necessarily against concussions, which are often caused by "rotational acceleration," such as when a blow to the chin spins the head back, he says. "The headgear doesn't prevent the rotation of the head."

You don't have to be knocked out to sustain a concussion, emphasizes Jordan. Other signs of a concussion include confusion, loss of memory, headache, agitation, difficulty concentrating and dizziness. All are red flags to seek medical attention.

For many people who box for fitness rather than sport, the bigger risk likely is an injury to the shoulder, elbow or wrist from improperly hitting a heavy bag, says Bryant of the American Council on Exercise. He recommends meeting with a qualified trainer who can teach how to properly execute boxing moves.

Although she works out at the House of Champions in Los Angeles, Rebekah Amirkhizi isn't worried about competition or concussions. She does boxing and kickboxing to get in shape and spend time with her husband and three kids, ages 17, 9 and 6.

When her middle child wanted to take karate a couple years ago, she signed him up at the facility, which offers a range of martial arts, and then the whole family got involved.

"It keeps us all together and affords us family time," says Amirkhizi, who's 44 and helps to manage an aircraft interior business from home.

"And when I'm having one of those days," she says, "hitting and kicking that bag is a really, really great way to relieve some stress."

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