Martial Arts Head Injuries, CTE, and How Integrative Chiropractic Care Helps

 

Martial arts offer discipline, strength, and confidence—but they also bring a real risk of head injuries. Even when a fighter doesn’t get knocked out, repeated blows to the head can quietly damage the brain and nerves over time. That hidden damage can show up years later as memory problems, mood changes, or even degenerative brain disease like chronic traumatic encephalopathy (CTE).PMC+1

At the same time, recovery is not hopeless. Integrative chiropractic care—especially when it combines spinal adjustments, neurological rehab, and functional medicine—may help fighters improve balance, reduce symptoms, and support the brain’s ability to rewire itself after injury.Synergy Chiropractic+1

This article explains, in clear language:

• What happens to a martial artist’s brain and nerves after head trauma

• Why sub-concussive hits still matter, even without a diagnosed concussion

• The short- and long-term symptoms to watch for

• How integrative chiropractic care can support healing and neuroplasticity

Why Martial Artists Face Unique Brain and Nerve Risks

Martial arts like boxing, kickboxing, Muay Thai, MMA, taekwondo, and karate often involve repeated strikes to the head. Even when rules and referees try to protect fighters, the basic goal is still to land powerful blows or submit an opponent.

Studies on combat sports show:

• CTE was first recognized in boxers (“punch-drunk” syndrome) and has now been linked to other fighters, including mixed martial artists.PMC+1

• In the Professional Fighters’ Brain Health Study, active professional fighters with more bouts and more head trauma had smaller brain volumes and slower processing speed.British Journal of Sports Medicine

• Research in MMA athletes shows that repeated mild traumatic brain injuries (mTBIs) and head impacts are tied to worse cognitive function over time.PMC+1

MMA and other striking arts combine punches, kicks, elbows, knees, and sometimes ground-and-pound. That means more angles and more chances for both big concussive blows and smaller, repeated hits that add up.e-Journal of Education+1

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What Happens in the Brain During a Head Impact

When a fighter takes a hard shot to the head, the brain rapidly moves and twists inside the skull. This can:

• Stretch and damage long nerve fibers (axons)

• Disrupt blood vessels and the blood–brain barrier

• Trigger chemical changes and inflammation

Even blows that do not cause a full loss of consciousness can still cause microscopic tearing of nerve tissue and metabolic stress.PMC+1

After a knockout (KO) or technical knockout (TKO), the damage can be greater. Studies of KO events in combat sports show the brain experiences high rotational forces that can disturb nerve signaling and set the stage for long-term problems.PMC

Over time, if these injuries keep happening, the brain may struggle to repair itself, especially if there is not enough rest between fights or sparring sessions.

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Sub-Concussive Blows: Hidden Damage Without a Classic Concussion

Many martial artists worry about “big” concussions—but sub-concussive hits may be just as important. These are impacts that:

• Don’t cause obvious concussion symptoms

• Don’t lead to a fight being stopped

• Still transfer force to the brain

Large studies in contact sports show that repeated head impacts, even without diagnosed concussions, are linked with brain changes and may increase the risk of CTE.Live Science+3CDC+3Boston University+3

For fighters, this means that years of hard sparring, drilling, and competition can:

• Slowly lower brain volume in key regions

• Alter white matter (the wiring that connects different brain areas)

• Reduce processing speed and reaction timeBritish Journal of Sports Medicine+1

The danger is that the damage is “silent” at first. A fighter may feel fine but be losing a little function year after year.

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Short-Term Symptoms After a Head Injury

After a hard head shot or a series of blows, martial artists can experience symptoms right away or within hours to days. Common short-term signs of mild TBI or concussion include:

• Headache or pressure in the head

• Confusion or feeling “foggy”

• Dizziness or balance problems

• Blurred or double vision

• Nausea or vomiting

• Sensitivity to light or sound

• Trouble concentrating or remembering what happenedMayo Clinic+3NICHD+3Mayo Clinic+3

Sometimes, symptoms show up later, after training or once the adrenaline wears off. Even a fighter who “shakes it off” may still have an injury that needs rest and medical supervision.

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Long-Term Brain Changes: Cognitive Decline and CTE

When head trauma continues over years, especially in professional fighters, the risk of long-term problems increases. Research shows:

• In professional fighters, more cumulative head trauma is linked to lower brain volumes and slower processing speed, even while they are still active.British Journal of Sports Medicine+1

• Retired fighters may show brain shrinkage patterns similar to degenerative diseases like Alzheimer’s or CTE.Practical Neurology+1

• MMA and boxing both carry risks, but at least one study reported that brain injury risk per event may be higher in MMA than in boxing, due to the way fights end and where strikes land.espn.com+1

CTE is a progressive condition linked with repeated head impacts. It is associated with abnormal tau protein buildup, nerve loss, and inflammation in the brain.Cleveland Clinic+2Mayo Clinic+2

Over time, CTE and other trauma-related brain changes can show up as:

• Memory loss

• Trouble with planning and decision-making

• Slowed thinking and reaction time

• Difficulty with attention and focus

• Parkinsonism-like symptoms in some athletesPMC+2ScienceDirect+2

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Emotional, Behavioral, and Physical Symptoms That Worsen Over Time

CTE and repeated brain trauma do not only affect thinking. They also impact how fighters feel and behave. Studies and reports of former combat athletes describe:

• Depression, anxiety, and mood swings

• Irritability, anger, or aggressive behavior

• Apathy or loss of motivation

• Impulsivity and poor judgment

• Sleep problems and chronic fatiguePMC+2Mayo Clinic+2

Many fighters also experience ongoing physical symptoms:

• Chronic headaches and migraines

• Dizziness or vertigo

• Neck pain and stiffness

• Balance problems and coordination issuesBrainFacts+2Mayo Clinic+2

This combination of emotional, cognitive, and physical changes can slowly erode quality of life—often while the person still looks “healthy” on the outside.

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Why Some Fighters Seem Fine—Until They Don’t

One of the most troubling parts of trauma-related brain disease is how long it can stay hidden. Several factors play a role:

• Brain reserve: Some people have more cognitive reserve and can compensate longer before symptoms show.

• Culture of toughness: Fighters are used to ignoring pain and may under-report symptoms.

• Delayed onset: CTE symptoms may appear years or decades after a fighter retires.Mayo Clinic+1

• Sub-concussive load: No single hit causes a dramatic change, but the total number of hits adds up.PMC+1

This is why a martial artist can compete for years with few obvious issues, then suddenly experience rapid decline in mood, memory, or behavior later in life.

Because these changes are gradual, early screening and multidisciplinary care—neurology, neuropsychology, physical medicine, and chiropractic—are extremely important.Mayo Clinic Health System+2Synergy Chiropractic+2

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Hidden Nerve Damage: What “Lower Brain Volume” Really Means

When studies talk about lower brain volumes, they are describing measurable shrinkage in parts of the brain on MRI. In fighters, volume loss has been seen in areas responsible for:

• Memory and learning

• Movement and coordination

• Emotional control and decision-makingBritish Journal of Sports Medicine+2Practical Neurology+2

This shrinkage often reflects nerve-cell loss or damage to the supporting structures around those neurons. At the microscopic level, repeated trauma can cause:

• Axonal injury (damage to the long “wires” of nerve cells)

• Disconnection between brain regions

• Chronic inflammation and abnormal protein buildupScienceDirect+2PMC+2

Functionally, that hidden nerve damage may look like:

• Slower reaction time in sparring

• Trouble multitasking or remembering combinations

• Feeling “off” or uncoordinated, especially when tired

• Greater risk of injury because timing and balance are slightly off

These changes are real, even when routine scans or quick exams look “normal.”

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Integrative Chiropractic Care: A Whole-Person Approach for Injured Fighters

Integrative chiropractic care combines traditional chiropractic adjustments with neurological rehab, exercise therapy, and sometimes nutritional or functional medicine support.

For martial artists with a history of head trauma, this type of care focuses on:

1. Spinal alignment, especially the upper neck

2. Nervous system regulation

3. Balance, eye, and movement training

4. Support for brain neuroplasticity and overall healingSynergy Chiropractic+2Mayo Clinic+2

Rather than replacing medical care, integrative chiropractic is usually part of a team approach that includes neurologists, primary care providers, and sometimes neuropsychologists and physical therapists.Mayo Clinic Health System+1

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How Correcting Spinal Misalignment May Help the Brain

The upper cervical spine (especially the atlas and axis—C1 and C2) sits right under the brainstem. If these vertebrae are misaligned after repeated whiplash, chokes, takedowns, or head kicks, they can affect:

• Blood flow through the vertebral arteries

• Cerebrospinal fluid (CSF) drainage

• Mechanical stress on the brainstem and cranial nervesSynergy Chiropractic

Integrative chiropractors, including Dr. Alexander Jimenez in El Paso, use gentle, image-guided adjustments to:

• Restore normal joint motion and alignment

• Reduce abnormal tension around the brainstem and upper spinal cord

• Improve proprioceptive input from neck joints (the “position sense” that feeds the balance centers of the brain)Synergy Chiropractic+1

By improving neck mechanics and nerve signaling, adjustments may help reduce:

• Post-traumatic headaches

• Neck pain and stiffness

• Dizziness and sense of imbalance

This does not “cure” CTE or erase all damage, but it may relieve mechanical stress and improve the way the nervous system functions day to day.Synergy Chiropractic

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Balance, Eye, and Movement Training to Support Neuroplasticity

Many fighters with head injuries report:

• Feeling unsteady on their feet

• Trouble tracking moving targets

• Motion sensitivity or feeling “spaced out” in crowds or bright gyms

These issues often come from dysfunction in the vestibular system, eye movement control, and cervical proprioception.Mayo Clinic+2BrainFacts+2

Integrative chiropractic care often includes:

• Vestibular rehab: Head and eye movement drills to recalibrate balance systems

• Oculomotor exercises: Smooth-pursuit and saccade training to improve eye tracking

• Proprioceptive work: Controlled neck and body movements to retrain how joints send information to the brain

• Gait and posture work: Training to normalize walking patterns and stance

Research suggests that repeated, targeted movement sends sensory input to the cerebellum and cortex, stimulating neuroplasticity—the brain’s ability to adapt and build new connections after injury.Synergy Chiropractic+1

Dr. Jimenez’s clinical model emphasizes movement-based therapy, spinal decompression, flexion–distraction, and soft-tissue treatment (such as Graston or Gua Sha) to reduce pain and improve spinal mechanics, which in turn supports more normal neural signaling.Synergy Chiropractic+1

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Supporting the Whole Fighter: Functional and Integrative Care

Brain and nerve health are not only about joints and muscles. Integrative chiropractic clinics, like those led by Dr. Jimenez, often combine:El Paso, TX Doctor Of Chiropractic+1

• Nutritional guidance to lower inflammation and support brain recovery (for example, omega-3 fats, colorful fruits and vegetables, and adequate protein)

• Sleep and stress support, since poor sleep can prolong post-concussion symptoms

• Strength and conditioning plans that avoid excessive head trauma while maintaining fitness

• Coordination with neurologists and imaging centers for advanced diagnostics (MRI, DTI, functional neuro testing, and biomarkers in some cases)

This team-based integrative approach is especially important for martial artists who want to keep training safely, adjust their style if needed, and protect long-term brain health.Synergy Chiropractic+1

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Practical Steps for Martial Artists After a Head Injury

If you are a martial artist or coach, consider these practical steps:

1. Take every head impact seriously.
   If there is confusion, memory loss, vomiting, severe headache, or difficulty standing, treat it as an emergency and seek urgent care.Mayo Clinic+1

2. Do not return to sparring or competition too soon.
   Guidelines strongly advise against going back into a fight or hard practice the same day after a suspected concussion.Mayo Clinic+1

3. Get a full evaluation.
   This may include:

   • Neurological exam

   • Imaging when appropriate

   • Neurocognitive testing

   • Balance and eye-tracking tests

4. Consider integrative chiropractic and rehab.
   A clinician experienced in TBI and combat sports—such as Dr. Jimenez and his team—can assess neck alignment, movement patterns, and nervous system function and build a customized rehab plan.Synergy Chiropractic+2Synergy Chiropractic+2

5. Monitor for delayed symptoms.
   Watch for changes in mood, memory, sleep, or behavior in the weeks and months after an injury. Early support is better than waiting until symptoms become severe.CDC+2Mayo Clinic+2

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When to Seek Emergency Care

Call emergency services or go to the ER right away after a head injury if you notice:

• Worsening or severe headache

• Repeated vomiting

• Seizures

• Unequal pupils

• Weakness or numbness in arms or legs

• Slurred speech, confusion, or behavior that is very unusual

• Trouble waking up or loss of consciousnessBrainFacts+2Mayo Clinic+2

Chiropractic and rehab care are not substitutes for emergency evaluation. They are part of recovery after life-threatening problems have been ruled out and the person is medically stable.

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Conclusion: Protecting the Brain While Protecting the Passion for Martial Arts

Martial arts will always involve risk. But understanding how head trauma affects the brain and nerves helps fighters make smarter choices about training volume, protective gear, and recovery.

The evidence is clear:

• Repeated head impacts—even when they do not cause a full concussion—can lead to lower brain volumes, slower processing, and higher risk of CTE and other neurodegenerative problems.Mayo Clinic+4British Journal of Sports Medicine+4PMC+4

• These injuries can show up as a mix of cognitive, emotional, and physical symptoms that often worsen over time.CDC+3PMC+3Cleveland Clinic+3

Integrative chiropractic care—like the approach used by Dr. Alexander Jimenez, DC, APRN, FNP-BC—works to:

• Realign the spine, especially the upper cervical region

• Improve brain–body communication

• Enhance balance, eye movements, and coordination

• Stimulate neuroplasticity through targeted movement and rehabilitation

• Support overall recovery with nutrition, lifestyle, and collaborative medical careSynergy Chiropractic+2Synergy Chiropractic+2

For martial artists, the goal is not just to fight well today, but to think clearly, move confidently, and live fully decades from now. Protecting the brain—and partnering with an integrative, neuroscience-informed chiropractor when injuries happen—can help make that possible.

References

Bernick, C., Banks, S. J., & others. (2013). What boxing tells us about repetitive head trauma and the brain. Cleveland Clinic Journal of Medicine, 80(3), 185–190. PMC

Bernick, C., Zetterberg, H., & others. (2015). The Professional Fighters’ Brain Health Study: Cognitive function, brain structure and exposure to repetitive head trauma. British Journal of Sports Medicine, 49(15), 1007–1011. British Journal of Sports Medicine

Centers for Disease Control and Prevention. (2024). About repeated head impacts. CDC

Cleveland Clinic. (n.d.). Effects in football and professional combat sports: Repetitive head trauma and brain health. Cleveland Clinic

Lim, L. J. H., Ho, C. S. H., & Ho, R. C. M. (2019). Dangers of mixed martial arts in the development of chronic traumatic encephalopathy. International Journal of Environmental Research and Public Health, 16(2), 254. PMC

Mańka-Malara, K., & others. (2022). Head trauma exposure in mixed martial arts: A narrative review. Journal of Clinical Medicine, 11(21), 6293. PMC

Mayo Clinic. (2024). Concussion – Symptoms and causes. Mayo Clinic

Mayo Clinic. (2025). Chronic traumatic encephalopathy – Symptoms and causes. Mayo Clinic

National Institute of Neurological Disorders and Stroke. (2025). Traumatic brain injury (TBI). NINDS

National Institute of Child Health and Human Development. (2020). What are common symptoms of traumatic brain injury (TBI)?. NICHD

Reis, H. (2020). Chiropractic and traumatic brain injuries: Consider all your holistic options.

Stern, R. A., & others. (2011). Long-term consequences of repetitive brain trauma. PM&R, 3(10 Suppl 2), S460–S467. ScienceDirect

U.S. Centers for Disease Control and Prevention. (2025). Symptoms of mild TBI and concussion. CDC

Verywell Health. (2024). How long do concussion symptoms last? Key signs to watch for. Verywell Health

World Federation of Neurology / BrainFacts.org. (n.d.). Traumatic brain injury. BrainFacts

Dr. Alexander Jimenez and Integrative Chiropractic Sources

El Paso Chiropractic / Synergy Chiropractic. (n.d.). Traumatic brain injury: Integrated chiropractic–neurological recovery. Synergy Chiropractic

Jimenez, A. (n.d.). Sports head injuries: Chiropractic’s role (articles section). El Paso, TX Doctor Of Chiropractic

Turnersville Chiropractic. (n.d.). Consider chiropractic care for mixed martial arts injuries.

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General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicine, as well as wellness, sensitive health issues, and functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and the jurisdiction in which they are licensed to practice. We utilize functional health and wellness protocols to treat and support care for musculoskeletal injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters and issues that directly or indirectly support our clinical scope of practice. Our office has made a reasonable effort to provide supportive citations and to identify relevant research studies that support our posts. We provide copies of supporting research studies upon request to regulatory boards and the public.

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900.

Dr. Alex Jimenez, DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

Email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*