Kayfabe is alive in Japan and wrestling, to most people, is seen as a sport. Athletes are expected to give very physical performances in NJPW because it's what the Japanese audience demands. This is indisputable, as NJPW is the number one promotion in Japan in terms of fan interest by a factor of at least 3 times. Fan interest, of course, being most reliably measured by attendance.
Basically, Japanese pro wrestling is everything anti-smarks wish American wrestling still was. Kayfabe lives, it's treated with respect like a sport 99% of the time (the 1% being Yano/Funky Weapon matches), and it's actually violent. And if you're one of those people that goes "THAT'S NOT SAFE, THEY'RE GONNA GET HURT", you're just a massive fucking pussy ass bitch that would've cried at Roman gladiatorial shows instead of embracing the carnal desire that stirs within the loins of all humankind: to see fucking blood.
