Punching Out Parkinson's: Boxing Training Improves Symptoms

For many years, there has been widespread speculation that boxing caused or contributed to the late heavyweight champion Muhammad Ali's long battle with Parkinson's disease. After all, head trauma is known to increase the risk of Parkinson's, a chronic and progressive movement disorder that affects an estimated 7 to 10 million people around the world, according to the Parkinson's Disease Foundation. So it may come as a surprise to discover that boxing training is now being used as a form of therapy for people who already have Parkinson's.

The trend started after former Indiana prosecutor Scott Newman, who was diagnosed with early-onset Parkinson's at age 40, began training one-on-one with a boxing coach and noticed dramatic improvements in his physical health, agility and daily functioning. In 2006, Newman founded Rock Steady Boxing, a program that uses modified professional boxing techniques to help people with Parkinson's in Indianapolis. Since then, the program has spread to more than 150 gyms around the country.

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A neurodegenerative disorder, Parkinson's is caused by the death or deterioration of brain cells that produce dopamine, a neurotransmitter (aka brain chemical) that helps regulate movement, coordination and emotional responses. This can lead to motor symptoms such as tremors, slowness of movement (or bradykinesia), muscle rigidity or stiffness, postural instability or impaired balance or coordination, and problems with speech, as well as nonmotor symptoms such as loss of smell, sleep disturbances and mood disorders.

"The boxing we're talking about is not what Muhammad Ali did -- this is noncontact boxing; [the participants with Parkinson's] are not fighting each other or getting hit in the head," notes Dr. Danny Bega, an assistant professor of neurology at the Northwestern University Feinberg School of Medicine in Chicago and the lead investigator of a study with Parkinson's patients and Rock Steady Windy City. Instead, they learn how to throw a variety of punches and hit heavy bags. They work on developing fancy footwork for balance and agility. They hit the mitts of an instructor (who won't hit back) with different punches to improve their coordination. They yell and count their punches to strengthen their voices. They stretch to counter muscle rigidity. And they jump rope and do core exercises and circuit weight training to strengthen their muscles.

In short, they perform a variety of movements in different planes of motion. The quick bursts of movement involved in the footwork and punching increase the muscles' firing ability throughout the body, Bega notes. As a result, participants improve their strength, power, agility, speed, balance and postural stability, hand-eye coordination and reaction time. The ultimate goal: to manage symptoms and improve quality of life for people with Parkinson's.

"By forcing the body to do movements the brain can't control, boxing challenges the brain to create new circuits, which leads to neuroplasticity," the brain's ability to rewire and reorganize itself by forming new neural connections, explains Roberta Marongiu, an assistant professor of neuroscience at Weill Cornell Medicine in New York City. This way, "neurons can reconnect to each other and control movement through an alternate pathway," adds Marongiu, co-founder of stoPD, a bicoastal organization that incorporates boxing, voice work and meditation in programs for people with Parkinson's.

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In a 2013 study involving 31 adults with Parkinson's, researchers from the University of Indianapolis compared the effects of two to three 90-minute sessions per week of boxing training or traditional exercise (stretching, aerobics and resistance workouts). After 12 weeks, those in the boxing group gained significant improvements in their walking speed and endurance, but the traditional exercise group didn't (they did, however, gain greater confidence with their balance). A small 2011 study by the same researchers found that boxing training helped people with Parkinson's improve their balance, gait, activities of daily living and quality of life after 36 weeks. "We hope we're slowing progression of the disease," says lead author Stephanie Combs-Miller, an associate professor of physical therapy and director of research at the College of Health Sciences at the University of Indianapolis. "In a two-year study, we found that they didn't get worse, which is positive considering it's a progressive disorder."

Steve Gilbert, now 70, was diagnosed with Parkinson's in 2004 and began boxing at Rock Steady Boxing in Indianapolis in 2007. "I never considered myself an athlete as a young person," Gilbert says, "but [through boxing] I learned how to think like an athlete. I ended up in better shape physically, emotionally and spiritually than before I had Parkinson's." In recent years, Gilbert has taken up running, climbed mountains and gained more stamina for everyday life. "I never would have walked into a boxing gym if I didn't have Parkinson's," he says. "So many of the good things I've enjoyed in the last 10 years of my life stem from that gym."

Boxing also enhances participants' overall feelings of wellness and boosts their moods. During aerobic exercise, especially a high-intensity activity like boxing, feel-good brain chemicals like endorphins and dopamine are released. Plus, "there is something about punching the heavy bag that makes you feel empowered, because you're taking control and action," Marongiu says.

In some programs, participants even have their own boxing nicknames: At Rock Steady Boxing Windy City, a neurophysicist is known as Big Bang. Among his fighting companions are Hurricane Hannah, Boom Boom and Big Thunder. "Everybody picks their own nickname -- once they put the gloves on, they take on a new persona, a new mentality that it's fighting time," says Eric Johnson, co-founder and head coach of Rock Steady Boxing Windy City. "It gives them a sense that they can beat this thing and push the envelope with what they can do, that this disease doesn't have to own them."

A positive side effect of these boxing programs: a strong sense of community often develops over time. "The camaraderie is worth almost as much as the physical part -- it becomes a support group," says Paula Tomlin, 59, who has been going to Rock Steady Boxing in Indianapolis for 10 years. Tomlin was diagnosed with Parkinson's in 2001 and participates in the program three times a week. "It pushed me to do more than I thought I could, which gave me physical and mental confidence," she says.

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Best of all, people of any age or stage of the disease can participate because the boxing training is tailored to each individual's needs and abilities. If you have Parkinson's and you're interested in boxing training to improve your symptoms and daily functioning, talk to your doctor before you do it, Bega urges. If someone has serious balance challenges, he or she may need to participate in a chair to avoid a risk of falling (some participants are in wheelchairs). "If you have blood pressure instability, you may get lightheaded and dizzy with boxing; you may need to modify your medications," he adds.

One way or another, most people with Parkinson's can participate, experts say, and it's worth a try because the benefits pack a powerful punch "from a physical standpoint as well as an emotional standpoint," Bega says. "There's interplay between the mind and body -- when one gets healthier, the other gets healthier. Realizing you can learn and do something this challenging after this diagnosis is really empowering."

Stacey Colino is a freelance Health + Wellness reporter at U.S. News. You can connect with her on LinkedIn or email her at staceycolino@gmail.com.