Why Parkinson’s was Muhammad Ali’s Greatest Battle
Muhammad Ali was, quite simply, the greatest heavyweight boxer of all time. For a glorious period in the 1960’s and 1970’s, Ali combined his skills in the ring with a knack for maximising publicity to be the most recognisable name on the planet.
His skills in the ring were often described as “highly unusual” for the time. In a sport dominated by lumbering and stocky heavyweights, Ali astonished viewers with his hand speed, fast feet, and incredible tenacity to take vicious beatings in the ring.
Ali achieved this tenacity through a merciless training regime, where he allowed sparring partners in training sessions to hit him in the head and body without offering any defence.
When Ali began displaying Parkinson’s symptoms towards the end of his boxing career, the head injuries he may have sustained in the ring, due to his fighting style and training regime, were often considered to be the cause.
Ali ended his boxing career at the age of 39, having lost only 5 bouts in an envious career that saw him deliver 37 knockout finishes and 56 wins for his enthralled fans.
Barely three years after leaving the ring, however, the boxer renowned for his ability to "float like a butterfly" was diagnosed with Parkinson's in 1984.
Head Injuries and Sportsmen
Recently, a light has been shone on how head injuries affect the brain health of sportsmen after news of 5 members of England’s winning squad of the 1966 Football World Cup being diagnosed with dementia.
In 2013, the National Football League or NFL entered into a mammoth $765 million settlement with a group of more than 4,500 former players who were suing on the grounds that the league misled them over the long-term dangers of head injuries.
Examinations conducted on the brains of former NFL players found that many showed evidence of chronic traumatic encephalopathy (CTE) – a progressive degenerative disease that links to such conditions as memory loss, depression, Parkinson’s, Alzheimer’s, Multiple Sclerosis, and Dementia.
The long list of boxers who have reportedly suffered brain damage includes some of history's legendary champions—from Joe Louis, who developed dementia symptoms, to Sugar Ray Robinson, who died with Alzheimer's.
Despite these connotations for head injuries, in Ali’s case, neurologists simply cannot definitively answer that this was the cause for his diagnosis.
Recently unearthed audiotapes of a young Ali’s voice have been thoroughly analyzed by speech experts, with a host of them concluding that Ali’s speech was slurring during his career, slowing by 26% from age 26 to 39.
In one of the most punishing bouts of his life at the age of 35, against heavy-hitter Earnie Shavers, Ali faced a total of 266 punches over 15 rounds. The analysis shows how Ali’s speech slowed by 16% in the aftermath of that fight.
Are Head Injuries Really To Blame?
A 2006 study into 93 pairs of twins, where one of them has Parkinson’s, is often cited as the strongest evidence pointing towards the effects of head trauma in people that went on to develop Parkinson’s. Researchers of that study believed that head injuries could be setting off “a degenerative cascade”.
Other researchers, however, believe that there needs to be a genetic predisposition for a Parkinson’s diagnosis, although almost all agree that those who suffer head trauma are more likely to face a diagnosis of Parkinson’s later in life.
The neurologist who diagnosed Ali, Dr. Stanley Fahn, was a director of the Center for Parkinson’s Disease and Other Movement Disorders at Columbia University.
Dr. Fahn said at the time of Ali's diagnosis, “There was some evidence that he had taken some hits to the head and so forth, so there was concern on my part that he might have what we call post-traumatic Parkinson's, or 'pugilistic parkinsonism,' from damage to the brain and the brain stem."
Pugilistic Parkinson's refers to Parkinson's caused by chronic traumatic brain injury. The rarity of observed cases means its existence remains unconfirmed, although some medical experts believe it to be a real variation.
Another potential pathway to Ali's Parkinson’s could be pesticides, with his exposure to them from his time training at a Pennsylvania farm he bought in the early-1970’s.
His oldest daughter, Maryum Ali, said this about the farm-based training facility - “He was exposed to a lot of pesticides at the Deer Lake training camp. My theory is that his Parkinson’s started with the pesticides and it possibly could have been drawn out by the head trauma.”
Ali after Parkinson's
Ali lost the greatest boxing match of all time in 1971 - the "Fight of the Century" - humbled by an imperious Joe Frazier. But Ali would never back down and in two subsequent rematches, he dominated Frazier to cement his position as the absolute greatest. That raw tenacity continued as Ali took on Parkinsonism.
Following his diagnosis, Muhammed Ali’s magnetic personality never waned, and he maintained his charming poise, despite living with the condition for 32 years.
Despite his God-like status, Ali did not go away and hide, lighting the Olympic Torch for the 1996 edition of the games in Atlanta in iconic fashion.
His legacy for Parkinson’s runs deeper, however, as he helped establish the Muhammad Ali Parkinson Center (MAPC) and Movement Disorder Clinic. He also created global awareness for the condition in a then-viral PSA ad with Michael J. Fox and by appearing before the U.S. Congress of Representatives.
Parkinson’s affected Ali’s speech tremendously and caused strong tremors in both hands. The fastest man heavyweight boxing had ever seen began to shuffle slowly, and his once astonishingly handsome and vibrant face became expressionless due to symptoms such as facial masking.
Ali also exhibited unnatural fatigue, with a propensity to nod off regularly, and sometimes in the middle of a conversation.
Ali’s struggles remind us that not even a world champion can triumph over an adversary that they cannot see and that the tide of Parkinsonism can overwhelm even the best of us.
His daughter, Maryum Ali, explains that her father also experienced the many ups and downs associated with the condition in a journey that mirrored many others: "He’s seen as Superman – this great boxer and activist,” she says. “But he went through the very human struggles that all people go through – denial, depression, isolation, not understanding, not wanting to take his medications. It took being proactive, being part of a large community and seeing someone else with Parkinson’s for him to understand that he had to deal with it. It took him a while to get to the point where he thought, ‘I have to deal with this the way I train for a fight; I have to be aggressive and proactive and exercise’. These are the stories I share to inspire people – even Muhammad Ali had a learning curve.”
One of Ali's favourite sayings towards the end of his life, whispered to his wife Lonnie, was “Never look back, only ahead.”
Sources: BBC press release dated November 4, 2020, “Dementia in Football”
The Guardian press release dated August 29, 2013, “NFL concussion lawsuits explained”
ESPN press release dated August 23, 2017, “Muhammad Ali exhibited slowed, slurred speech well before Parkinson's diagnosis”
Goldman, Samuel M., et al. "Head injury and Parkinson's disease risk in twins." Annals of neurology
Parkinson's Life press release dated April 8, 2021, "Even Muhammad Ali had a learning curve”