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Rate ePoster

Musculoskeletal and Sports Medicine

Concussion Incidence in Bare-Knuckle Fighting: Quantification and Sex-Based Analysis

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 8
Has Audio

    Poster Presenter(s)

  • Alexander Sklyar, MS4

    Medical Student
    University of Central Florida College of Medicine
    Kissimmee, Florida

    • Co-Author(s)

  • ET

    Eric Twohey, MD

    Sports Medicine Fellow
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

  • GV

    George Velasco, MD

    Assistant Professor of Medicine and Medical Education
    Icahn School of Medicine at Mount Sinai
    New York City, New York

  • Donald A. Muzzi, MD

    Physician
    Sarasota Memorial Hospital & BKFC Chief Medical Officer
    Sarasota, Florida

Disclosure(s):
Alexander Sklyar, MS4: No financial relationships to disclose
Donald A. Muzzi, MD: No relevant disclosure to display
Background and/or Objectives: To quantify the incidence of concussions in bare-knuckle fighting and examine whether sex influences concussion risk.

Design: Prospective cohort study.

Setting : Bare Knuckle Fighting Championship (BKFC) Squared Circle.

Participants : A total of 1062 bare-knuckle fighters (965 male, 97 female) who competed in BKFC events and underwent King-Devick (KD) testing were included.

Interventions: No interventions were performed. Fighter data, including concussion assessments, were collected prospectively after each event and stored in a continuously updated database for analysis.

Main Outcome Measures: The primary outcome was concussion incidence stratified by sex. Statistical analysis was performed using Fisher’s Exact Test to assess differences in concussion rates between male and female fighters.

Results: Among 1062 fighters analyzed, 51 (4.80%) sustained concussions, all of whom were male (5.28% of male fighters). None of the 97 female fighters sustained a concussion. Fisher’s Exact Test demonstrated a statistically significant difference in concussion rates between male and female fighters (p = 0.0067).

Conclusions: Despite concerns about the dangers of bare-knuckle fighting, our findings reveal a relatively low overall concussion rate in bare-knuckle fighters. Most strikingly, no female fighters in our dataset sustained a documented concussion. These findings challenge conventional assumptions about concussion risk in bare-knuckle combat sports. Further investigation into potential protective factors for female fighters—whether physiological, biomechanical, or strategic—is warranted and could have significant implications for fighter safety, training protocols, and concussion prevention in combat sports.