As of June 2001

Medical Examinations

Medical Advisor, Ring Physician / Physician - Procedures

1.   The Medical Advisor, Ring Physician or physician designated by the commission shall follow the procedures listed below:

(a)        An Initial Medical Examination shall be conducted by the commission Medical Advisor or a physician designated by the commission in accordance with the direction contained in paragraph 2 below prior to a boxer making application for a BOXING PASSPORT through his commission;

(b)      Annual Medical Examinations shall be conducted by the commission Medical Advisor or a physician designated by the commission in accordance with the direction contained in paragraph 2 below prior to the renewal of a boxer's license;

(c)        A Pre-Contest Medical Examination, an Immediate Pre-Fight Medical Check, and a Post-Medical Check of each boxer shall be conducted by the Ring Physician for each contest of exhibition; and

(d)      Boxers shall have an Annual Opthalmological Examination by a qualified ophthalmologist to detect and treat eye problems that could become more serious.

Initial and Annual Medical Examination Specifics

2.   The Initial and Annual Medial Examination shall include a most complete and detailed medical history and physical examination of the boxer, with special emphasis pertaining to his profession or sport, including:

(a)  Medical History:

(i) Family Medical History:

      Hereditary or familial diseases such as a history of epilepsy, tuberculosis, diabetes mellitus, and blood disorders should be medically assessed; and

(ii) Personal Medical History:

      The following conditions preclude boxing:

gross deformities and major operations (e.g. nephrectomy);

deaf mutes; and

a history of epilepsy or diabetes requiring insulin.

            Note also debilitating diseases, operations, deformities, allergies and concurrent maintenance medications.  A history of alcoholic intake and the use of drugs should be questioned in detail and carefully assessed;

(b)      Physical Examination:

      A complete physical examination shall be conducted.  In making a decision as to whether or not a boxer is fit to box, the following factors shall be strictly adhered to:

(i) Eyes:

The following conditions preclude boxing:

significant astigmatism, myopia greater than five (5) diopters or any variant of optic nerve degeneration;

- a (pre)retinal detachment, hemorrhage, or gross fundal pathology; and

- the wearing of spectacles or contact lenses in the ring.

Colour blindness or a squint (strabismus) are not precluded from boxing; provided there is no double vision complaint.  In the case of a squint or any questionable eye disorder, a certificate of approval for boxing competition should be obtained from an opthalmologist;

                       (ii)      Ears:

       The following conditions preclude from boxing:

- recurrent ear discharge and persistent tinnitus;

- bilateral deafness of chronic duration;

- deafness of recent onset until an investigation is completed; and

- deaf-mute condition.

                  Unilateral deafness of chronic duration does not preclude boxing;

(iii) Facial Deformity or Malfunction:

            Athletes with any facial bony configuration resulting in impaired breathing or inadequate retention of the mouthpiece shall not box;

(iv) Heart:

      An athlete with the following cardiac pathology shall not box:

-      ischemic heart disease;

-      rheumatic heart disease (active) with valvular pathology;

- certain cardiac arrhythmias (not benign);

-      right or left heart failure; and

- congenital heart disease, unless the defect has been rectified and the athlete has been certified "fit to box" by a cardiologist;

(v) Pulmonary:

       The following conditions preclude boxing:

-      a history of emphysema, recurrent bronchitis or bronchiectasis;

-      active tuberculosis or any neoplasm; and

-      a history of recurrent pulmonary fulminating infections and/or hemoptysis.

                   Inactive cured tuberculosis with restoration of normal lung function does not preclude boxing;

(vi) Central Nervous System:

       The following neurological medical states prelude boxing:

-      epilepsy, whether grand mal, petit mal or temporal lobe, or variant thereof;

-      recurrent dizzy spells (vertigo);

-     known space occupying lesions of the brain (e.g. cysts, tumors, hematomas, pneumatoccles);

-     cerebrovascular disease, cerebrovascular insufficiencies, or atrerio-venus malformations;

-      focal persistent leg and/or arm tremors;

- degenerative spinal cord disorders (e.g. ALS, multiple sclerosis);

-      spinal cord tumors or vascular malformations;

-      previous history of syphilis of the nervous system; and

-      any boxer with irregularity of the pupils or signs of locomotor impairment;

(vii) Musculskeletal and Joint Disorders:

Athletes with the following disorders shall not box:

      - degenerative disc disease of the spinal column – active;

-      bony tumors of the spinal column;

-      ankylosing spondylitis;

- diffuse or multifocal arthritic involvement of the joints, including the spinal column, hands, forearms, shoulders and legs;

-      myasthenia gravis;

-      muscular dystrophy;

-      active peripheral neuropathies; and

-      osteomalacia and osteoporosis.

            Poliomyelitis does not preclude boxing if resultant muscular involvement does not give disabling limb weakness, deformity or paralysis;

 (viii) Inguinal Hernia:

      A hernia, per se, does not preclude from boxing; provided that it does not protrude into the scrotum.  If exquisite tenderness exists, the athlete is precluded from boxing until the hernia is satisfactorily repaired.  Boxers with an inguinal hernia should be advised to consult their personal physician;

            (ix)      Abdominal:

                  Athletes with the following disorders shall not box:

                  -            certain forms of organomegaly (e.g. enlarged liver or spleen);

                  - active inflammatory visceral states (e.g. colitis, gastritis, pancreatitis, active hiatal hernia);

-      active gastric or duodenal ulcers;

-      persistent recurrent rectal bleeding;

-      jaundiced states; and

-      acute surgical abdomen.;

(x) GenitoUrinary:

       Regular routing and microscopic urinalysis shall be completed in all cases. The following preclude from boxing, unless allowed by a urologist:

-      chronic renal inflammations;

-      previous renal and/or urinary bladder neoplasms;

-      previous testicular neoplasms;

-      previous scrotal neoplasms;

-      presence of one kidney; and

-      undescended testicle, unless assessed by a physician or repaired;

            (xi) Endocrine:

                   The following states preclude boxing:

                  -                  thyroid dysfunction, if untreated;

      -      hypoglycemic attacks;

- pituitary and adrenal gland dysfunctions, if uncorrected; and

- diabetes, if untreated;

(xii) Dermatological:

       Systemic skim allergies or other Iesions should not preclude from boxing, unless the examining physician so decides;

(xiii)     Hematological and Lymphatic:

       History of persistent anemias, lymphomas, leukemias, thrombocytopenias, hemophilia, christmas disease, or any other blood clotting disorder precludes boxing;

(xiv)     Blood Pressure:

To be average for age.  Any boxer with a systolic pressure over one hundred fifty (150) or a diastolic pressure above ninety (90) is suspect and should have a special investigation;

(xv) Referral:

       In case of doubt in any particular defect, the need for a second opinion by referring the case to a consultant is indicated; and

(xvi) Weight Loss:

The Ring Physician shall pay particular attention to the presence of debilitating effects resulting from a strenuous weight loss program, both by foods or fluid reducing drugs, which might weaken the boxer to the extent he should be precluded from boxing in that particular event.

 Laboratory and Diagnostic Procedures

3.   The following laboratory and diagnostic procedures shall be carried out during the Initial and Annual Medical Examinations of an athlete:

(a)  chest x-ray;

(b)      complete blood picture and SMA 12/60 and a platelet count, INR and PTT;

(c)      complete urinalysis;

(d)      serological tests;

(e)  blood test for HIV (Human Immune Deficiency), HBC (Hepatitis "B") and HBC (Hepatitis "C");  Boxers who test positive for any of these tests will not be permitted to box; and

(f)   any other test or survey which might be indicated by the past or present condition of the athlete .

Laboratory Procedures – Pre-Contest Medical Examination

4.   Any or all of the laboratory procedures listed in paragraph (3) may be conducted at the Pre-Contest Medical Examination at the discretion of the attending physician.

Immediate Pre-Bout Medical Check

5.   The purpose of this medical check is to determine whether a boxer remains fit to box or has taken any substances that might endanger him or his opponent. These include:

(a)  alcohol; and/or

(b)  licit or illicit drugs.

      Any evidence that suggest a boxer is under the influence of such drugs shall preclude boxing and require immediate testing to determine the exact nature of the drugs suspected.

Post-Bout Medical Examination

6.   This examination should be carried out in accordance with the Post-Contest Medical Examination and Injury Report, with particular emphasis on any injury sustained.

Referees' and Judges' Medical

7.   A routine medical examination with particular emphasis on the standard of visual acuity required for the individual's particular duties.

Anti-Doping Tests

8.   Anti-doping tests may be conducted on a Champion and a Challenger both before and after a title contest, and for other contests when required by the commission. The commission shall designate a laboratory to conduct a urinalysis. The laboratory shall supply two (2) bottles for each boxer, which bottles shall contain urine samples taken in the presence of the boxer's manager and commission supervisor.  The bottles shall be numbered, sealed and signed by the boxer's manager and the commission supervisor. The designated laboratory shall then test the samples in bottles #1.  If a bottle is found to contain a positive sample, then bottle #2 shall be tested in the presence of the commission Medical Advisor and a representative of the boxer.  If bottle #1 is found to be negative, then bottle #2 will be destroyed.

 COMPLETION AND DISTRIBUTION OF MEDICAL DOCUMENTATION

Medical Examination Forms

9.   Medical examinations shall be recorded on the applicable forms as shown in Appendices "A-I", "A-2", and "A-3".  The commission Medical Advisor shall ensure that copies of all medical examination forms are distributed as follows:

(a)  one (1) copy retained by the attending physician;

(b)  one (1) copy retained by the commission;

(c)  one (1) copy forwarded to the Canadian Professional Boxing Federation; and

(d)  one (1) one copy forwarded to the National Data Bunk (when created).

FORBIDDEN ITEMS DURING A CONTEST

Forbidden Items

10.  The following items are forbidden and shall not be worn or applied during the weigh-in or a contest or exhibition:

(a)  General Items:

(i)       contact lenses;

(ii) spectacles;

(iii) dentures;

(iv) individual removable false teeth;

(v) rings;

(vi) watches, charms, bracelets, or necklaces of any description;

(vii) head bands and hair nets;

(viii) earrings;

(ix) hearing aids; and

(x) any plastic or metallic attachments to the trunks of a boxer; and

      (b)  Medical Items:

            (i)      any gauze, band-aides, dressings to the facial, scalp, neck, arms, back, or chest areas;

            (ii)      plaster or fibreglass casts;

(iii) butterfly or steristrip sutures on the facial, neck, ear, scalp, chest, arm or back areas;

(iv) suture material of any kind in the skin of a boxer's face, ears, neck, scalp or chest;

            (v)      sub-cuticular suture in the face, neck, ear or chest;

            (vi)     beards or facial hair of more than forty-eight (48) hours growth are not permitted.  (Note: a mustache is permitted; provided the ends do not extend below the upper lip and mouth area and the hairs are less than three-quarter (3/4) inches in length);

(vii) hair length of the frontal scalp area should not interfere with the vision of the boxer; if the examining physician feels that the frontal hair length poses a danger to the eyes and hence the vision of the boxer, the physician may order the frontal hair cut to a shorter length. If the posterior hair length is such that its swishing effect may harm a boxer's opponent, the physician may order the posterior hair to be knotted; and

(viii) "Collodion" and like substances are STRICTLY PROHIBITED before or during a contest on a boxer.

 MEDICAL PROCEDURE AFTER A KNOCKOUT FROM A BLOW TO THE HEAD

Medical Procedure

11.   The boxer should immediately be examined (preferably in the dressing room). He should be attended to in the dressing room until released by the physician.

       The boxer MUST BE EXAMINED AT THE CONCLUSION OF THE SHOW.  If at this time he shows a neurological deficit, he is to be sent with a note detailing his deficit and with another individual to the Emergency Room of the nearest hospital.  This is to be done as soon us the neurological deficit is detected, and not the next morning.

       If, however, the boxer shows a stable mental state with no neurological deficit, he may be sent home with an escort. The boxer shall not drive a vehicle himself.

       The boxer going home shall be provided with the "HEAD INJURY SHEET" (See Appendix "B" attached hereto) detailing the signs to watch for indicating a neurological deficit.

       At home, the boxer shall not ingest sedatives, tranquilizers or sleeping pills.  His diet should be restricted to clear fluids for eight (8) to twelve (12) hours after his injury.  Certain drugs may be used to relieve a headache on the advice of his physician.

      The boxer shall be seen the next day by a physician to ensure that the boxer has not shown a deterioration in his condition.

      The boxer shall be suspended from boxing or contact training for a sixty (60) day period, or such longer period us the attending physician may designate.

      All coaches (trainers) and referees and other boxing officials should familiarize themselves with the medical signs on the "Head Injury Sheet" so that they remain vigilant with respect to head injuries in a boxer.