Muhammad Ali was one of the greatest professional boxers of all time. However, his long career in the ring resulted in significant brain damage over time. Repeated hits to the head are known to cause various types of brain injuries, including chronic traumatic encephalopathy (CTE), which Ali suffered from. In this article, we will look at the key questions around Ali’s brain damage:
What is CTE?
CTE stands for chronic traumatic encephalopathy. It is a degenerative brain disease caused by repeated head injuries. In CTE, abnormal tau proteins accumulate in the brain, killing brain cells. The buildup of tau causes several cognitive, behavioral, and mood problems. Scientists believe CTE occurs in people who suffer repeated concussions or subconcussive hits to the head. subconcussive hits are hits that don’t cause full-blown concussion symptoms but still injure the brain.
What are the symptoms of CTE?
CTE symptoms include:
- Cognitive: Memory loss, confusion, impaired judgment
- Behavioral: Impulsivity, aggression, anger, violence
- Mood: Depression, anxiety, suicidal thoughts
- Motor: Difficulty with balance, tremors, difficulty speaking
Symptoms typically appear 8-10 years after repetitive head injuries. But symptoms often get worse over decades as the brain damage progresses. In the late stages, CTE can cause dementia.
How did Ali’s boxing career expose him to brain injury?
Boxing involves repeatedly being punched and struck in the head, which carry risks of concussions and subconcussive brain injuries. In his career spanning 21 years, Ali fought in 61 professional bouts against many top boxers. Getting hit thousands of times by powerful punches put Ali at high risk for long-term head trauma.
In particular, research suggests that the length of Ali’s career and number of fights contributed to his brain damage. One study found that professional boxers with over 100 fights have a high rate of CTE. Ali fought nearly double that number, taking more hits and increasing his risks. The fact that he fought until age 39 also exposed his brain to more trauma over decades.
When did Ali start showing symptoms?
Ali started showing possible symptoms in the 1970s, about a decade into his professional boxing career. His doctor at the time, Ferdie Pacheco, began noticing Ali slurring his speech and struggling with balance and physical coordination. Those are typical early signs of brain damage. Ali’s condition worsened through the remainder of his career.
After retiring in 1981 at age 39, Ali’s physical and mental health deteriorated. His motor functions declined and his speech became increasingly impaired. He also showed memory loss and signs of dementia. Ali first received a Parkinson’s disease diagnosis in 1984 at age 42. But many doctors believe his true condition was brain damage from boxing.
Extent of Ali’s Brain Damage
The full extent of Ali’s brain injuries became clear after his death. He passed away in 2016 at age 74 after struggling with symptoms for over three decades. An autopsy showed that Ali had extensive brain damage:
Evidence of CTE
Doctors diagnosed Ali with CTE stage 3-4 out of 4 stages. His brain showed substantial buildup of tau proteins plus significant loss of brain tissue. This extensive CTE likely caused many of Ali’s long-term cognitive, speech, and motor problems.
Other Brain Conditions
Besides CTE, the autopsy found other brain conditions related to head trauma:
- Leukoencephalopathy – Damage to white matter of the brain
- Parkinsonism – Loss of neurons, common in boxers
- Atrophy – Severe loss of brain volume
Combined, these disorders produced widespread, irreversible destruction across Ali’s brain as a result of the repeated head trauma.
Comparison to Healthy Brain
This image compares Ali’s brain to a normal healthy brain. The extensive dark areas show the severe brain atrophy and loss of tissue caused by the years of blows to his head.
Key Causes of Ali’s Brain Damage
While boxing was the predominant cause of Ali’s brain trauma, other factors also likely contributed:
Length of Boxing Career
Ali boxed professionally from age 18 to 39. Competing for over 20 years exposed him to more cumulative hits than shorter careers.
Number of Professional Fights
With 61 pro bouts, Ali exceeded the threshold linked to higher CTE risk. More fights meant taking more total punches over time.
Strong Opponents
Ali fought the top boxers of his era like Joe Frazier, George Foreman, and Sonny Liston. Hard punches from strong opponents increased chances of brain injury.
Fighting Style
Ali used an aggressive, attacking style where he took many punches to land his own. This left him more exposed to head shots than defensive styles.
Age of Onset
Ali first showed damage in his 30s, when the brain is still vulnerable. Starting boxing younger (18 years old) also increased his lifetime exposure.
Impact on Ali’s Life and Health
The brain damage Ali suffered from his boxing career profoundly impacted his life and health in many ways:
Speech and motor impairment
The cumulative hits led to worsening problems with slurred and slowed speech over decades. His motor functions also declined, affecting movement and coordination.
Cognitive decline
Ali exhibited memory loss and general cognitive decline as the injuries progressed. By the 2000s, he displayed symptoms of dementia.
Parkinson’s disease
Doctors diagnosed Ali with Parkinson’s in 1984. But this was likely CTE and related brain damage rather than true Parkinson’s.
Difficulty working and self-care
As Ali’s condition worsened, he had trouble doing everyday activities like dressing, feeding himself, and other basic self-care tasks. His injuries ended his public speaking career.
Emotional health
Ali struggled with frustration and some depression later in life as his brain function deteriorated. However, his positive spirit mostly persevered.
Early death
While the direct cause was respiratory issues, Ali’s brain damage contributed to his death at age 74. The average lifespan for men is about 76 years.
Could Ali’s Brain Damage Have Been Prevented or Reduced?
There are a few factors that may have helped prevent or reduce the extent of traumatic brain damage for Muhammad Ali:
Shorter boxing career
If Ali had retired earlier in life, he would have taken fewer total hits over a shorter period. This might have prevented some damage. Experts suggest retiring before age 28 optimizes brain health.
Fewer fights
Similarly, having fewer than 50 professional bouts could have reduced Ali’s risk and exposure. Fighting less frequently would give more recovery time.
Improved medical knowledge
Better understanding of head trauma in the 1960s and 1970s may have led to earlier interventions. However, research on CTE and related disorders was still in its infancy.
Better safety gear
Using more protective headgear may have cushioned some impact, although this only marginally limits damage. Safety gear is much improved today.
More proactive screening
Frequent cognitive and neurological tests may have caught problems sooner and led to earlier retirement. However, these practices were uncommon during Ali’s career.
Conclusion
Muhammad Ali had an extraordinarily long and intense boxing career during which he acquired severe brain damage, primarily in the form of CTE. The constant head strikes over two decades in the ring resulted in progressive neurological and cognitive decline. While some safety measures may have helped reduce the damage, the only definitive way to prevent it would have been avoiding pro boxing altogether or having a much shorter career. Ali’s tragic case shines a spotlight on the potential consequences of head trauma in high-impact sports.