PITTSBURGH, Sept 23 — Medical experts are raising alarms over the growing popularity of slap fighting, a combat sport that may be causing serious brain damage.

Competitors in slap fighting take turns striking each other’s faces with full-force, open-handed blows, unable to duck or defend themselves, according to a BBC report.

A study conducted by the Pittsburgh School of Medicine in the US, and published in Jama Surgery, analysed 78 matches involving 333 slaps and found that more than half the participants showed signs of concussion.

“While slap fighting might be entertaining to watch, as medical professionals, we found some aspects of the competitions to be quite concerning,” said lead authors Dr Raj Swaroop Lavadi and Dr Nitin Agarwal.

These experts stated that their study is the first to provide a quantifiable assessment of the potential dangers of the sport.

The study revealed that 78.6 per cent of contestants exhibited at least one visible concussion sign, such as impaired movement, motor incoordination, or blank stares.

It also identified 20 cases of “second impact syndrome,” where contestants displayed concussion symptoms after being struck multiple times in a single match.

Unlike other contact sports such as rugby or American football, slap fighting lacks concussion protocols or protective gear, heightening the risk of repeated head trauma.

Slap fighting gained mainstream attention in 2023 through the televised promotion Power Slap, which features matches streamed online and has attracted figures like Arnold Schwarzenegger and Logan Paul. The channel has 3.05 million subscribers at the time of writing.

Despite its growing audience, the sport has faced extensive criticism, with medical experts warning about the dangers of repeated blows to the head.

Repeated head injuries can lead to chronic traumatic encephalopathy (CTE), a degenerative brain disease linked to dementia and cognitive impairments.

Dr Joseph Maroon, a co-author of the study and developer of concussion protocols for US sports leagues, stated: ““The worst possible thing to do in terms of possibly incurring brain damage is to return to a contact sport before the brain has completely recovered... the brain is more susceptible to damage with a lesser force.”

He warned that the worst possible scenario is for an athlete to return to a contact sport before fully recovering from a concussion, increasing the risk of long-term brain damage.

The researchers called for greater monitoring of athletes and long-term follow-up to mitigate neurological harm, as well as the introduction of concussion protocols in slap fighting.

While the sport has millions of online viewers, the long-term consequences for participants could be severe without adequate safety measures in place.

Slap fighting has gained popularity in both the United States and the United Kingdom, with Liverpool set to host the first British Heavyweight Slap Fight Competition next month.

Competitors in slap fighting are prohibited from ducking or flinching and are judged on both the damage they inflict and their ability to withstand strikes.

In 2021, Polish slap fighter Artur Walczak suffered a fatal brain bleed after being knocked unconscious during a match, eventually dying from organ failure linked to his head injury.

Concussions occur when the brain is jolted inside the skull and can lead to symptoms such as headaches, confusion, and memory problems.

A single concussion may not cause permanent damage, but repeated blows can lead to CTE, which is associated with dementia and other long-term health issues.

Fifa and the World Health Organisation have launched a campaign to raise concussion awareness in sports, including football.

“Concussion is a brain injury and should always be taken seriously,” said Fifa president Gianni Infantino, stressing the importance of recognising and treating concussions properly to prioritise player safety.

Doctors have called for stricter regulations in slap fighting to protect participants from the potential long-term harm caused by repeated head trauma.