In the United States, approximately 1.5 million to 2 million persons practice the martial arts. It is the general belief that martial arts are safe, with little thought given to the physical forces involved. Some enthusiasts gravitate to the martial arts to learn self-defense, whereas others participate to improve cardiovascular fitness, flexibility, and self-esteem. Some join for the structured exercise programs, whereas others desire the artistic expression or have a need to compete. Injuries involve the head and neck region, trunk, and extremities. Soft tissue trauma, hematomas, and lacerations are some of the most common injuries. Occasionally fractures occur, most often involving the hands and digits. The neurosurgical literature indicates that wearing headgear increases the shearing injury to nerve fibers and neurons in the brain in proportion to the degree of acceleration to the head. Three case presentations illustrate death resulting from anterior chest trauma.

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