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Observed but overlooked (possible) concussions in slap fighting - a video analysis study
Yavuz Lima1, Levend Karaçoban2, Yasin Atay3
1Cerrahpasa Faculty of Medicine, Department of Sports Medicine, İstanbul University-Cerrahpasa, İstanbul, Turkey.
Brain Injury
|February 16, 2026
Summary
This study found that many slap fighting concussions were not properly assessed, leading to continued fights. Referees and physicians need better training to identify concussion signs and prevent athletes from returning to competition.
Area of Science:
- Sports Medicine
- Neurology
- Combat Sports Research
Background:
- Existing research on slap fighting primarily focuses on concussion frequency and visible injury indicators.
- There is limited understanding of concussion incidence and assessment protocols within the sport.
Purpose of the Study:
- To investigate the occurrence of possible concussions in male slap fighting.
- To analyze the assessments of these concussions by referees and ringside physicians.
Main Methods:
- Video analysis of male slap fights conducted between January 2023 and August 2025.
- Independent coding by two investigators focusing on visible concussion signs, referee, and ringside physician actions.
Main Results:
- 231 possible concussions were identified across 164 fights.
- Motor incoordination was the most common visible sign (40.1%).
- Over 55% of concussions assessed by referees allowed fight continuation; ringside physician assessments also frequently permitted continuation, with both assessments being brief.
Conclusions:
- Referees and ringside physicians require structured training to identify concussion signs, especially motor incoordination.
- All suspected concussion cases must be medically evaluated and withheld from further competition to ensure athlete safety.
