Why Do People Keep Fighting After Getting Knocked Out? The Science Behind “Sleep-Fighting”
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A tense moment from an Elite Fighting Promotions event in Saratoga, photographed by John Murray of JMurrayAthletics, shows GAMMA regional commission officials and ringside medical staff providing immediate care to a fighter following a bout. The scene highlights the professionalism and safety measures present at modern mixed martial arts events.
If you watch reels on Instagram or YouTube, you may have seen clips of fighters who get knocked out, then wake up moments later trying to fight the referee. To some it looks fake, or like rage at the stoppage. The truth is more clinical: a blow to the head can temporarily shut down the parts of the brain that control conscious awareness while leaving lower motor circuits active. In this article we explain why people keep fighting after getting knocked out.
Yes — unconscious automatisms can trigger repetitive movements like striking; these are reflexive, not conscious.
Any loss of consciousness, even brief, meets the clinical definition of a concussion and requires medical evaluation.
Table of contents
What’s Actually Happening?
A knockout (KO) usually occurs when a strike—often to the jaw, temple, or side of the head—causes the brain to rotate rapidly inside the skull. That rotational acceleration can interrupt communication between the brainstem (which helps regulate wakefulness and automatic reflexes) and higher cortical centers responsible for conscious thought and voluntary control.
Put simply: the brain’s “mainboard” flickers. Sometimes the “off” state is partial — the fighter loses situational awareness but basic motor programs (stand, strike, clinch) still run. The result: automatic, involuntary movements that look intentional.
Common signs you’re seeing automatisms, not willful fighting:
- Shadow striking or throwing punches at an invisible opponent
- Standing up before full awareness returns
- Primitive posturing or stiffening driven by brainstem reflexes
These motions are reflexive, not conscious; the fighter often has no memory of the episode afterward.
How Often Does It Happen?
People Fighting after getting knocked out doesn’t often Happen, but often enough that most referees and ringside physicians have seen it at least once or twice.
In MMA or boxing, mild “flash knockouts” where a fighter drops and immediately rises occur in roughly 5–10% of knockdown events, though full-on “sleep-fighting” moments (swinging while unconscious) are rarer—perhaps 1–2% of bouts that end in KOs.
Every organization keeps its own data, but neurologically speaking, any episode involving loss of consciousness—no matter how brief—is considered a concussion. Treat every LOC like a serious injury.
What Refs Are Trained To Do
Referees are taught to recognize the difference between a fighter defending themselves intelligently versus moving reflexively. When a fighter:
- Falls without protecting their head,
- Doesn’t respond to commands,
- Or displays uncoordinated or automatic behavior,
The ref must stop the fight immediately. The danger is second-impact syndrome — another blow before the brain recovers, which can cause massive swelling and catastrophic outcomes.
Refs like Herb Dean and John McCarthy have spoken about the “1-second rule”: If a fighter looks “switched off” even momentarily, it’s over. It’s better to take criticism for stopping too early than to risk permanent neurological damage.
In Medical Terms
When a fighter is knocked out but keeps moving, they’ve experienced a brief loss of consciousness (LOC) due to diffuse axonal injury — a temporary disconnection between parts of the brain caused by rapid acceleration and deceleration. Essentially, the brain has been shaken so violently that neural pathways between the reticular activating system (which controls wakefulness) and the cerebral cortex (responsible for conscious control) momentarily stop working.
Pathology studies show rotational forces produce diffuse axonal injury—shearing of axons—that can account for transient loss of consciousness and impaired cortical signaling.”
Adams JH et al. — Diffuse axonal injury due to non-missile head injury (classic neuropathology work, 1982).
Mechanics of Why People Keep Fighting After Getting Knocked Out:
- Violent rotational forces can cause transient diffuse axonal injury: shearing forces briefly interrupt signaling between regions of the brain.
- The reticular activating system (the brain’s arousal center) can be transiently impaired, producing loss of consciousness.
- Deeper subcortical structures and spinal circuits remain active; they govern reflexes and ingrained motor patterns.
This state—incomplete cortical inhibition—means the higher brain is offline, but the lower brain structures and spinal cord remain active. Those deeper regions control reflexes and ingrained motor patterns, like covering up, punching, or trying to stand. The result is post-traumatic automatisms: repetitive, unconscious movements that look intentional but aren’t.
Medically, These Can Include:
- Transient amnesia — No memory for the seconds or minutes after impact.
- Confusional Arousal — When the cortex restarts, the fighter wakes dazed, with sensory inputs and adrenaline producing disorientation.
- Under older concussion grading systems, any LOC qualifies as a severe event (Grade 3); medically it demands removal from competition and a formal concussion evaluation.
“Concussive blows trigger a rapid neurometabolic cascade that temporarily disrupts cortical function while subcortical pathways remain active.”
Giza, C. C. & Hovda, D. A. — The New Neurometabolic Cascade of Concussion (2014 review).
During these few seconds, the fighter is operating on what neurologists call subcortical motor memory—essentially muscle memory and adrenaline taking over without conscious input. Their eyes may be open, their body may appear functional, but their conscious awareness is absent.
When the cortex “reboots,” they regain consciousness suddenly, often dazed and disoriented, unaware that the fight has already been stopped. This is sometimes followed by confusional arousal—a state where the brain is trying to reconcile conflicting sensory inputs while still flooded with adrenaline.
From a clinical perspective, this fits the definition of a Grade 3 concussion under older classification systems (any LOC, even brief). The danger is that the fighter, still on autopilot, might take further strikes before a referee or doctor can intervene, compounding the injury.
“Experts warn that a second impact before recovery can cause catastrophic cerebral swelling, which is why immediate stoppage and medical removal are essential after any loss of consciousness.”
May / StatPearls — Second-impact syndrome (review, StatPearls / NCBI Bookshelf, 2023).
Repeated episodes like this raise concern for cumulative traumatic encephalopathy (CTE)—chronic damage resulting from repeated subconcussive and concussive blows.
The Bottom Line
When a fighter gets back up and keeps swinging after being knocked out, it’s not grit—it’s their brain misfiring while rebooting. It’s rare but dangerous. The ref’s job is to override that primal instinct and protect them from themselves.
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