Head Trauma in Martial Arts: The Case for Chiropractic

Head Trauma in Martial Arts: Improving Balance, CSF Flow, and Neuroplasticity

If a martial artist gets hit in the head—even if it’s “just” a hard sparring shot and not a full concussion—their brain can be affected in ways that build up over time. Repeated blows can alter the structure and function of the brain, as well as the way a fighter feels and behaves, years later. PMC+2PMC+2

This article explains how head impacts in martial arts and mixed martial arts (MMA) can lead to short-term symptoms, long-term cognitive decline, and conditions like Chronic Traumatic Encephalopathy (CTE). It also explains how integrative chiropractic care—similar to the approach used by Dr. Alexander Jimenez, DC, APRN, FNP-BC—may support brain and spine recovery as part of a comprehensive medical plan. El Paso, TX Doctor Of Chiropractic+2Synergy Chiropractic+2

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What happens in the brain when a fighter takes a hit?

A traumatic brain injury (TBI) happens when a sudden blow, jolt, or strike to the head or body causes the brain to move inside the skull. NINDS+1 In martial arts, this can come from:

• Punches, elbows, or kicks to the head

• Takedowns that whip the head back

• Knees or head clashes in the clinch

• Hard landings on the mat

When the head snaps or twists:

• The brain slams or shifts against the inside of the skull.

• Nerve fibers (axons) can stretch and shear.

• Brain cells are stressed by chemical changes and inflammation. PMC+1

Sometimes this causes a concussion, which is a mild TBI. Other times, the hit is sub-concussive—not strong enough to cause obvious symptoms, but still stressful for the brain. Researchers now know that repeated sub-concussive blows can be harmful, especially when they add up over years of training and competition. PMC+1

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Sub-concussive blows: why “small” hits still matter

Many fighters worry about knockouts (KOs), but the real danger may come from the total number of hits the brain takes over a career.

Studies of active professional fighters show that:

• Greater exposure to repetitive head trauma is linked to smaller brain volumes in areas like the thalamus and caudate.

• Fighters who experience more head impacts often exhibit slower processing speeds and weaker cognitive skills. PMC+2PMC+2

Research in MMA specifically has found:

• MMA carries a high risk of head trauma, with many fights ending in KOs or technical KOs after repeated strikes to the head. ESPN.com+2CBS News+2

• Reviews of the literature show a clear connection between MMA head injuries and problems with attention, memory, and executive function. PubMed+1

• Repeated mild TBIs and sub-concussive blows are a known pathway toward chronic brain changes, including CTE. PMC+2PMC+2

Recent work reported in Nature and summarized in popular science outlets suggests that years of repeated head impacts can cause loss of brain cells and brain inflammation even before classic CTE protein changes fully appear—and this can happen even when concussions are never officially diagnosed. Live Science+1

For martial artists who spar often, this means that the total number of rounds, years, and impacts matters—sometimes more than any single “big hit.”

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CTE: the long-term risk of repeated head impacts

Chronic Traumatic Encephalopathy (CTE) is a progressive brain disease linked to repeated head impacts, including both concussive and sub-concussive blows. PMC+2PMC+2

Key points about CTE:

• It is a neurodegenerative condition—that means it slowly damages and kills brain cells over time.

• CTE involves a buildup of abnormal tau protein around small blood vessels in areas of the brain that take the most mechanical stress. PMC+1

• It has been identified in boxers, football players, and other athletes involved in contact sports—and more recently, in MMA fighters and practitioners of other combat sports. PMC+2PMC+2

Common symptoms described in CTE and related chronic head trauma include:

• Memory problems and mental “slowness”

• Trouble making decisions or planning

• Mood changes (irritability, depression, anxiety)

• Impulsivity or poor judgment

• Problems with balance, walking, or coordination PMC+2PMC+2

Some long-term fighter studies have shown that as fighters age and accumulate more ring or cage time, their cognitive testing scores decline, particularly in areas such as speed, attention, and executive function. PMC+2PMC+2

Not every martial artist with head trauma will develop CTE, and experts still debate who is most at risk. But most agree that repeated head impacts raise the odds of serious long-term brain problems, especially when athletes do not get enough rest, recovery, and monitoring. PMC+2PubMed+2

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Short-term symptoms that martial artists may notice

Even a “mild” head injury can cause symptoms that change how a fighter feels, moves, and thinks. Major brain health organizations describe common symptoms after TBI and concussion, including: NINDS+2BrainFacts+2

Physical signs

• Headache or pressure in the head

• Dizziness or feeling off-balance

• Nausea or vomiting

• Blurred or double vision

• Sensitivity to light or noise

• Fatigue or “low energy”

Cognitive signs

• Confusion or feeling “foggy”

• Slow thinking or trouble following instructions

• Memory problems (especially for recent events)

• Trouble focusing during drills or games

Emotional and sleep-related symptoms

• Irritability, anxiety, or depression

• Panic attacks in some cases

• Sleeping more or less than usual, or having trouble falling asleep Rezon+2Apex Brain Centers+2

Importantly, loss of consciousness is not required for a concussion. The Rezon combat sports brain-injury guide notes that being “knocked out” happens in less than 10% of concussions. Rezon+1

In a martial arts setting, this means a fighter can:

• Never be knocked out

• Take many hard shots in sparring or competition

• Still develop short-term symptoms and long-term risks

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How repeated head injuries affect life outside the gym

Over time, repeated head trauma doesn’t just affect performance—it can affect everyday life.

Studies in fighters and other contact-sport athletes have linked chronic head trauma to:

• Declining memory and processing speed

• Difficulty learning new information

• Changes in personality, including anger or apathy

• Higher rates of depression and anxiety ResearchGate+3PMC+3PMC+3

Martial artists often take pride in their discipline and mental toughness. That can make it harder to admit that something is wrong, even when:

• Friends notice that they repeat questions.

• Training partners see them lose balance in drills

• Loved ones see mood swings or withdrawal

Some research suggests that combat sports can also benefit mental health when training is well-managed, structured, and supportive. PubMed+1 The problem is not martial arts itself, but unchecked head trauma, poor recovery, and lack of long-term brain-health planning.

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Where integrative chiropractic care fits in (and where it does not)

Before talking about chiropractic care, it is important to be clear:

Chiropractic care does not replace emergency or medical care for TBI. Any fighter with red-flag symptoms—worsening headache, repeated vomiting, seizures, slurred speech, unequal pupils, or confusion that gets worse—needs immediate medical evaluation.NINDS+1

Once a fighter has been medically cleared and is in the recovery phase, integrative chiropractic care can become a supportive part of a comprehensive team approach that may include neurologists, primary care providers, physical therapists, and mental health professionals. Synergy Chiropractic+4Carr Chiropractic Clinic+4Calibration Brain & Body+4

Many chiropractic and integrative clinics now work specifically with concussion and TBI patients, focusing on:

• The spine–brain connection

• Balance and posture

• Nerve function and pain

• Lifestyle, sleep, and stress

Clinicians like Dr. Alexander Jimenez in El Paso describe a whole-body approach that looks beyond symptoms to underlying spinal and neuromusculoskeletal dysfunction while coordinating with medical providers when needed. elpasobackclinic.com+3Synergy Chiropractic+3El Paso, TX Doctor Of Chiropractic+3

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How an integrative chiropractor evaluates a martial artist after head trauma

An integrative chiropractic exam for a fighter with a history of head impacts may include: elpasobackclinic.com+3Carr Chiropractic Clinic+3Calibration Brain & Body+3

1. Detailed history

   • Number of fights and years of training

   • History of knockouts, TKOs, “flash KOs,” and hard sparring sessions

   • Current symptoms: headaches, dizziness, brain fog, neck pain, visual problems, mood changes

   • Sleep quality, stress level, and prior injuries

2. Spine and posture assessment

   • Alignment of the cervical spine (neck), thoracic spine, and jaw

   • Posture in standing, walking, and fighting stances

   • Muscle imbalances and tightness, especially in the neck and upper back

3. Neurological and balance testing

   • Eye movements and tracking

   • Simple cognitive and coordination tests

   • Static and dynamic balance (single-leg stance, tandem stance, etc.)

4. Imaging and referrals when needed

   • If there are “red flag” neurological signs, significant cognitive decline, or alarming findings, the chiropractor may refer the fighter for an MRI, CT scan, or neuropsychological testing and coordinate with neurologists or other specialists. NINDS+2commondataelements.ninds.nih.gov+2

This integrative mindset prioritizes safety first, then utilizes chiropractic tools to support healing once serious medical issues have been addressed.

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How chiropractic adjustments may support the spine–brain connection

Many TBI-focused chiropractic and functional clinics emphasize the impact of cervical spine alignment on brain function. Apex Chiropractic+2Calibration Brain & Body+2

After a head or neck trauma, fighters often develop:

• Restricted motion in the upper cervical joints

• Muscle guarding and spasm along the neck and upper back

• Subtle shifts in head and neck posture that affect balance and eye position

Chiropractic adjustments and gentle mobilization aim to:

• Realign vertebrae to improve mechanical function

• Reduce joint irritation that can drive pain signals

• Decrease muscle tension by normalizing joint motion

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Some providers also suggest that restoring normal cervical alignment may improve cerebrospinal fluid (CSF) flow and blood flow around the brain and spinal cord, which could support healing; however, more research is still needed in this specific area. Apex Chiropractic+2Apex Chiropractic+2

Dr. Jimenez’s clinical content similarly highlights the goal of improving spinal mobility, optimizing nervous system communication, and easing post-TBI headaches, neck pain, and balance problems to support the brain’s recovery environment. Synergy Chiropractic+3Synergy Chiropractic+3Synergy Chiropractic+3

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Supporting balance, proprioception, and posture

Head injuries frequently disrupt balance and body awareness. Fighters may feel:

• Unsteady when changing levels

• Off-balance when turning, shooting, or spinning

• “Disconnected” from their usual timing and distance control

Integrative chiropractic practices often combine spinal care with vestibular and balance training, such as: El Paso, TX Health Coach Clinic+4Carr Chiropractic Clinic+4Calibration Brain & Body+4

• Gaze-stabilization exercises (keeping eyes fixed on a target while moving the head)

• Balance drills on stable and unstable surfaces

• Coordination training that pairs head motion with footwork

• Postural retraining to bring the head, shoulders, and pelvis into better alignment

These exercises aim to:

• Retrain the brain to process head-position and body-position signals

• Reduce dizziness and motion sensitivity

• Improve reaction time and control in sport and daily life

This type of multimodal care aligns with Dr. Jimenez’s emphasis on posture, spinal alignment, and neuromuscular control when treating TBI-related balance issues in athletes and accident victims. El Paso, TX Doctor Of Chiropractic+2Synergy Chiropractic+2

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Encouraging brain neuroplasticity

One hopeful part of the TBI story is neuroplasticity—the brain’s ability to reorganize and build new connections. After an injury, the nervous system can sometimes “rewire” itself when given the right inputs and enough time.

Some chiropractic and functional neurology approaches use:

• Targeted adjustments to normalize sensory input from the spine and joints

• Eye-movement and coordination drills are tied to specific brain regions

• Cognitive challenges during physical tasks (for example, memory games while doing balance work) Apex Brain Centers+3Calibration Brain & Body+3Apex Chiropractic+3

Clinics like Apex Chiropractic and others serving TBI patients report improvements in:

• Prefrontal functions (attention, decision-making, emotional control)

• Headache frequency and intensity

• Overall quality of life when chiropractic care is integrated with other therapies. Apex Chiropractic+2Apex Chiropractic+2

Dr. Jimenez’s integrative work in El Paso follows a similar principle—combining spinal adjustments, soft-tissue therapy, exercise, and lifestyle coaching to provide the brain and body with repeated, meaningful signals for healing and retraining. Synergy Chiropractic+3El Paso, TX Doctor Of Chiropractic+3Synergy Chiropractic+3

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Pain relief and muscle recovery for fighters

Head injuries are almost always tied to neck and upper-back trauma. Clinically, many martial artists show:

• Tight, overworked neck muscles

• Trigger points in the shoulders and jaw

• Guarded, stiff movement patterns

Chiropractic care and soft-tissue methods—including myofascial release, instrument-assisted techniques, and stretching—can:

• Reduce muscle tension and pain

• Improve range of motion

• Make it easier to tolerate vestibular and strength exercises needed for brain recovery Calibration Brain & Body+2pushasrx.com+2

For fighters, less pain often means better sleep, better mood, and more consistent follow-through with rehab.

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Lifestyle, mood, and brain-healthy habits

Recovery from martial arts–related head injury is not just about the spine or the brain—it is about the entire lifestyle around them.

Brain-injury experts and integrative providers emphasize: Synergy Chiropractic+3NINDS+3NINDS+3

• Sleep: Deep, regular sleep supports brain repair and clears waste products.

• Nutrition: Consuming an anti-inflammatory, nutrient-dense diet (rich in fruits, vegetables, lean protein, and healthy fats) helps reduce systemic inflammation and supports recovery.

• Stress management: Mind-body practices, counseling, and social support reduce stress hormones that can slow healing.

• Mental-health care: Depression, anxiety, and irritability are common after TBI and in athletes with years of head impacts—referrals to mental-health professionals are essential when symptoms are present. Rezon+2PubMed+2

Dr. Jimenez’s clinical content frequently highlights these lifestyle pillars, integrating nutritional counseling, exercise guidance, and collaborative care with other specialists to create a whole-person recovery plan for athletes and accident patients. elpasobackclinic.com+3El Paso, TX Doctor Of Chiropractic+3Synergy Chiropractic+3

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Practical safety steps for martial artists and coaches

Even with good care options, prevention and smart training decisions are the most powerful tools martial artists have.

Based on current research and expert guidance, important steps include: Calibration Brain & Body+5ESPN.com+5https://www.wndu.com+5

1. Take all hits to the head seriously

   • Do not ignore dizziness, confusion, or vision changes after a strike or takedown.

   • Stop training and get evaluated if symptoms appear.

2. Limit hard sparring

   • Use drills and technical sparring more often than full-power rounds.

   • Track the number of hard sessions per week and per camp.

3. Follow strict return-to-fight rules after KO/TKO

   • Respect medical suspensions and recommended rest periods.

   • Gradually return through light movement, then non-contact drills, then controlled sparring.

4. Get baseline and follow-up brain testing when possible

   • Neurocognitive tests and balance assessments can show changes over time.

   • This data helps athletes and coaches make informed choices about their careers.

5. Build a multidisciplinary care team

   • Primary-care doctor or sports physician

   • Neurologist or concussion specialist when needed

   • Integrative chiropractor (like Dr. Jimenez) for spine and neuromusculoskeletal care

   • Physical therapist or vestibular rehab specialist

   • Mental-health support

6. Think long-term

   • Sense of identity, relationships, and life after fighting are just as important as wins.

   • Protecting the brain today protects thinking, mood, and independence later in life.

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Bringing it all together

For martial artists, head impacts are a real part of training and competition—but so are knowledge, choice, and care. Research shows that repeated concussive and sub-concussive blows can shrink and slow the brain, raising the risk of cognitive decline and diseases like CTE. Live Science+3PMC+3PMC+3

At the same time, integrative chiropractic care—especially when combined with medical oversight, rehabilitation, and mental-health support—can help fighters:

• Realign and stabilize the spine

• Improve balance, posture, and coordination

• Enhance nervous-system function

• Support neuroplasticity, CSF flow, and overall recovery environment

Clinicians such as Dr. Alexander Jimenez, DC, APRN, FNP-BC, demonstrate how a whole-body, spine-focused, and neurologically informed approach can provide martial artists with a better chance to heal, train wisely, and protect their future brain health. Synergy Chiropractic+3El Paso, TX Doctor Of Chiropractic+3Synergy Chiropractic+3

The key message: head injuries in martial arts must be respected, not feared. When fighters, coaches, and healthcare teams work together, it is possible to honor the art, enjoy the sport, and still protect the brain.

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References

Apex Chiropractic. (2022, August 18). 3 benefits of chiropractic care following a traumatic brain injury. Apex Chiropractic. https://apexchiroco.com/auto-injury/3-benefits-of-chiropractic-care-following-a-traumatic-brain-injury/

Apex Chiropractic. (2022, December 19). How chiropractic care can treat a traumatic brain injury. Apex Chiropractic. https://apexchiroco.com/updates/how-chiropractic-care-can-treat-a-traumatic-brain-injury/

Bernick, C., Banks, S., Shin, W., et al. (2015). Repeated head trauma is associated with smaller thalamic volumes and slower processing speed in fighters. Neurology. https://pmc.ncbi.nlm.nih.gov/articles/PMC4518758/

Brain Injury and Combat Sports – Rezon. (2025, August 16). Brain injury in combat sports. Rezon. https://www.rezonwear.com/halos/brain-injury/combat-sports/

Carr Chiropractic Clinic. (2023). The role of chiropractic care in concussion management. https://www.carrchiropracticclinic.com/the-role-of-chiropractic-care-in-concussion-management/

Calibration Chiropractic & Functional Health. (2024, August 21). How can integrative chiropractic care help with traumatic brain injuries? https://calibrationmansfield.com/how-can-integrative-chiropractic-care-help-with-traumatic-brain-injuries/

de Brito, M. A., et al. (2025). Long-term cognitive decline in MMA fighters: A two-year follow-up study. International Journal of Environmental Research and Public Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC12294694/

Gardner, A., Iverson, G. L., & McCrory, P. (2014). Chronic traumatic encephalopathy in sport: A systematic review. British Journal of Sports Medicine, 48(2), 84–90. https://pubmed.ncbi.nlm.nih.gov/23803602/

Hamdan, J. L. (2022). A brief descriptive outline of the rules of mixed martial arts and concussion in MMA. Journal of Exercise Rehabilitation. https://www.e-jer.org/journal/view.php?number=2013600936

Lim, L. J. H., Ho, R. C. M., & Ho, C. S. H. (2019). Dangers of mixed martial arts in the development of chronic traumatic encephalopathy. International Journal of Environmental Research and Public Health, 16(2), 254. https://pmc.ncbi.nlm.nih.gov/articles/PMC6352039/

Mańka-Malara, K., et al. (2022). Head trauma exposure in mixed martial arts. International Journal of Environmental Research and Public Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC9603147/

McKee, A. C., Stern, R. A., Nowinski, C. J., et al. (2013). Repetitive head impacts and chronic traumatic encephalopathy. Brain Pathology, 23(3), 350–364. https://pmc.ncbi.nlm.nih.gov/articles/PMC5028120/

National Institute of Neurological Disorders and Stroke. (2025, July 21). Traumatic brain injury (TBI). NINDS. https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi

National Institutes of Health. (2020). Traumatic brain injury: Hope through research. NINDS. https://www.ninds.nih.gov/sites/default/files/migrate-documents/traumatic_brain_injury_htr_february_2020_508c_1.pdf

New York Times / The Athletic. (2020, June 4). MMA fighters’ brain health: CTE is a reality. https://www.nytimes.com/athletic/1854544/2020/06/04/mma-fighters-brain-health-cte-is-reality/

New York Times / The Athletic. (2020, September 18). Explained: What happens to a fighter’s brain after suffering a KO? https://www.nytimes.com/athletic/2074911/2020/09/18/explained-what-happens-to-a-fighters-brain-after-suffering-a-ko/

Saulle, M., & Greenwald, B. D. (2012). Chronic traumatic encephalopathy: A review. Rehabilitation Research and Practice. https://pmc.ncbi.nlm.nih.gov/articles/PMC3337491/

Schlegel, P., Novotny, M., Valis, M., & Klimova, B. (2021). Head injury in mixed martial arts: A review of epidemiology, affected brain structures and risks of cognitive decline. The Physician and Sportsmedicine, 49(4), 371–380. https://pubmed.ncbi.nlm.nih.gov/33538222/

Stein, T. D., Alvarez, V. E., & McKee, A. C. (2015). Concussion in chronic traumatic encephalopathy. Handbook of Clinical Neurology, 127, 489–509. https://pmc.ncbi.nlm.nih.gov/articles/PMC4633042/

Turnersville Chiropractic. (n.d.). Consider chiropractic care for mixed martial arts injuries. https://www.turnersvillechiropractic.com/blog/80501-consider-chiropractic-care-for-mixed-martial-arts-injuries

UFC/Cleveland Clinic coverage. (2014, March 28). Study: MMA brain injury risk higher than boxing. ESPN / CBS. https://www.espn.com/mma/story/_/id/10690370/study-shows-mma-brain-injury-risk-higher-boxing

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Dr. Alexander Jimenez – clinical and integrative perspectives

Dr. Alexander Jimenez. (n.d.). Sports head injuries: Chiropractic’s role. DrAlexJimenez.com. https://dralexjimenez.com/sports-head-injuries-chiropractics-role/

El Paso Chiropractic (Synergy Health Solutions). (2025). El Paso chiropractic care for traumatic brain injury recovery. ElPasoChiropractic.com. https://elpasochiropractic.com/f/el-paso-chiropractic-care-for-traumatic-brain-injury-recovery

El Paso Chiropractic (Synergy Health Solutions). (2025). Chiropractic care for TBI recovery after car accidents in El Paso. https://elpasochiropractic.com/f/chiropractic-care-for-tbi-recovery-after-car-accidents-in-el-paso

El Paso Back Clinic. (2025). Detecting hidden traumatic brain injury symptoms. ElPasoBackClinic.com. https://elpasobackclinic.com/detecting-hidden-traumatic-brain-injury-symptoms/

HealthCoach Clinic. (2025). Head injuries can trigger sciatica symptoms. HealthCoach.Clinic. https://healthcoach.clinic/head-injuries-can-trigger-sciatica-symptoms/

Northwestern Health Sciences University. (n.d.). Chiropractic and traumatic brain injuries. NWHealth.edu. https://www.nwhealth.edu/news/reis-writes-for-chiropractic-economics-chiropractic-and-traumatic-brain-injuries/

YouTube / Apex Chiropractic. (n.d.). Chiropractor Boulder | Traumatic brain injury recovery [Video]. YouTube. https://www.youtube.com/watch?v=Fc5Tva2Z7BU