yeah, the combination of genuinely beautiful and valuable tradition and sport can also make for really complicated situations and feelings. something like making the dohyo a flat surface just on the ground would pretty much objectively make the sport safer and reduce injuries for athletes, but i can't really see myself supporting that idea.
and yeah i think the sport being an expression of machismo and toughness is also valuable. hopefully, that can be maintained while having better ways of dealing with injuries, or without the hazing and abuse that was (and probably still is to an extent) common in stables. a sport like rugby is still able to maintain that image while introducing pretty robust head injury protocols.
frankly, it would be good to have someone nearby who could treat gyoji, judges, or even spectators as well.