Although many perceive boxing to be quite a brutal and dangerous sport medical evidence has shown that compared to other contact sports boxing is relatively safe. As with all contact sports there are risks of injury with some more common than others depending on the type of sport. With boxing the focus is fist fighting wearing boxing gloves where blows are focused at the upper body and head. Naturally, this can lead to injury but rarely is there severe lasting damage. Along with bruising to the face, hands and ribs.
This guide is aimed at the professional and amateur boxer and it explains each of these injuries with tips on diagnosis, prevention and recovery.
1. Boxer’s Fracture
A ‘boxer’s fracture’ is a break in the hand at the “neck” (just below the knuckle) of either the fourth or fifth metacarpal (ring or little finger). It gets its name because this injury commonly occurs when punching an immovable object with a closed fist. However, some doctors may also include fractures to the second and third metacarpal.
Symptoms of boxer’s fracture
- Instant pain coupled with hand swelling
- An area on the hand which is tender to the touch
- Difficulty moving the affected fingers
- Discolouration of the skin and/or bruising
Interesting Fact: Boxer’s fracture occurs in about 20% of patients that punch a hard object.
What can you do to prevent boxer’s fracture?
For boxers learning to punch correctly is the key to safe long term healthy hands. Bone density is another key factor and as we age the body will naturally decrease in size and strength so a healthy active lifestyle with adequate dairy products or calcium supplements will help.
What should you do if you suffer from boxer’s fracture?
Immediately look to seek medical attention where an X-Ray can confirm the diagnosis. If the bone is still aligned then the finger may be immobilised within a cast or a splint to allow the bone to heal. If the bone is misaligned then the finger may need to be set and held in place with pins which requires surgery.
Patients can expect healing time to take between six to 10 weeks but this is quite often determined by age and sport. For swelling and pain ice therapy can be used in the form of a cold compress coupled with elevation.
The long term prognosis of ‘boxer’s fracture’ is good although one may suffer a slight decrease in grip strength, but this is not clinically significantly. To promote finger strength and dexterity products such as hand strengtheners and hand therapy balls are recommended.
2. Carpal Bossing
Carpal bossing is the name given to a condition which causes a lump on the back of the hand at the junction of the long finger bones and the small wrist bones. Arthritis as a result of the thinning of the articular cartilage lining, encourages spurs of new bone which are produced as a natural response causing this prominence and swelling.
Interesting Fact: Carpal bossing is most often seen among adults age 20 to 40-years-old
What can you do to prevent carpal bossing?
Carpal bossing is typically caused after a knock to the back of the wrist so for a boxer technique and wearing the correct equipment is vital. There is no standard procedure for preventing carpal bossing other than taking care of yourself.
Respite is a key component of injury prevention, allowing the body to recover fully and rest between activities. Cold therapy or ice packs will help reduce inflammation and soreness after a workout. Lastly, always wear hand wraps and try wherever possible to use at least 16oz gloves during sparring sessions.
What should you do if you suffer from carpal bossing?
In the first instance treatment should start with non-operative options, activity modification can be an effective way to manage pain coupled with anti-inflammatory medication.
A wrist brace will also help during certain activities or a steroid injection may be recommended by a doctor. Surgery is rare but can be done under a local anaesthetic and usually takes between two to three hours. Success rates are as high as 85 per cent for good / excellent results with most patients having normal hand movement within a couple of days and returning to work within a week or so.
3. Cuts and Lacerations
What are cuts and lacerations?
Cuts (also known as lacerations) are when the skin splits and bleeds and are common place within boxing, usually occurring as a result of contact from an opponent’s’ glove or head. Rarely is this type of injury seen as enough to stop a bout on their own, but they can seriously impair a fighter’s ability to box. Generally, cuts themselves are not particularly problematic however deep tissue damage can mean a visit to the plastic surgeon.
During boxing, if bony prominence of a person’s’ brow takes the brunt of the damage, which in exceptional circumstances can lead to eye muscle damage, even after rest and recovery scar tissue can be a threat.
Interesting Fact: In the workplace around 30% of all injuries involve cuts or lacerations, most of which are to the hands or fingers.
What can you do to prevent cuts and lacerations?
As well as wearing protective headgear a boxer needs to rely on their own defensive skill to prevent damaging knocks to the face, where cuts and lacerations usually happen. Keeping the skin soft, smooth and supple will also help to maintain a healthy natural lustre – oils, lotions and body butters are ideal for this.
What should you do if you suffer from cuts and lacerations?
During a bout, cuts can be filled with petroleum jelly in order to prevent further bleeding, but post bout with a high risk of infection it is important to have the area cleaned and dressed appropriately.
If the wound has dead or damaged skin attached this may need to be removed or trimmed as it can form a breeding ground for bacteria. Large wounds will need to be closed with cohesive bandages, sports tape, medical glue or stitches. Massage therapy has been shown to be a very effective way of breaking down scar tissue and the adhesions which are produced as a result of injury.
4. Shoulder Dislocation
Shoulder dislocation is a common injury among boxers and participants of other contact sports which involve heavy knocks to the body. A dislocated shoulder is when the humerus bone (that’s the long upper section of the arm) has come away from the scapula (also known as the shoulder blade). This separation occurs at the glenohumeral joint.
It is characterised by pain in the shoulder, loss of moment in the shoulder, a change in the usual rounded appearance of the shoulder often replaced by a squared off look, and the sufferer protectively cradling their arm across their chest.
There are three variations of shoulder dislocation:
- Anterior is the most common with more than 95 per cent of dislocations categorised by forward separation of the humerus.
- Posterial dislocation is when the humerus is forced backwards. This form of dislocation can result from contact sports but is more common from seizures, electric shock or weakness in the rotator cuff muscles.
- Inferior dislocation is the rarest form of shoulder dislocation and is a result of hyperextension in the upper limb when it is under resistance. This type of injury can lead to ligament damage.
Interesting Fact: Out of all the joints in the body the shoulder joint has the greatest range of motion making it more prone to this type of injury.
What can you do to prevent shoulder dislocation?
As a boxer using the correct form is important. Over doing a movement or blocking incorrectly can lead to injury. Shoulder dislocation is however a risk with boxing and other contact sports because of the nature of these games. The best preventative measures are regular exercise with stretching at the beginning and end of workouts and conditioning.
What should you do if you suffer from shoulder dislocation?
Anterior dislocation is most common with boxers and is the easiest type of dislocation to recognise. This means they can be dealt with fast. As with all dislocations a sufferer should never attempt to set the joint back in place themself. This should only be done by a trained doctor.
After the shoulder has been set right rest is the next step on the road to recovery. Wearing a shoulder support or placing the arm in a sling for about two to three weeks will help to immobilise and protect the joint allowing it time to heal. Pain should be noticeably reduced when the joint is repositioned but any prolonged discomfort can be dealt with by applying an ice bag or cold compress to the affected area as needed.
After this period of rest rehabilitation exercising with a physio will help to restore movement and strength in the shoulder. Gradually building up strength in the arm and shoulder with resistance bands is a recommended treatment.
Concussion is a traumatic brain injury that results in a sudden but often short lived loss of mental function after a blow or other injury to the head. During a head injury that is severe enough to cause concussion the brain is moved out of its normal position disrupting electrical activity in the brain cells and the brain stops working properly for a short period.
The most common symptoms of concussion include headache, memory loss, disturbance in vision and confusion.
Interesting Fact: A professional boxer can land a punch speeds up to 20mph.
What can you do to prevent concussion?
In day to day life, concussion happens typically by accident and chance so there are no real preventative measures other than keep aware and safe. Work or physical activities such as cycling or working on a construction site, requires people to wear head protection so always follow safety protocol.
With boxing a risk of concussion is accepted with protective head gear a requirement of amateur boxing.
What should you do if you suffer from concussion?
An uncomplicated concussion may simply need time to heal but severe cases may take several days / weeks to heal due to the number of potential complications that may arise. A doctor should be contacted if the patient has been unconscious for more than a couple of minutes, if speech becomes slurred and if the patient vomits or begins to fit.
The only true way to recover from concussion is to rest and give your brain enough time to recuperate and heal. In order to do this, you’ll need to stay away from activity for some time, especially activity that involves contact. Most doctors suggest, at minimum of two weeks.
For more severe concussions:
- Apply ice to the head injury to help reduce swelling. Do not apply ice directly to your scalp as this could damage the skin. Instead, wrap the ice in a washcloth or towel. Apply the ice every two to four hours and leave in place for 20-30 minutes.
- Take paracetamol to control pain. Do not use the non-steroidal anti-inflammatory drug (NSAID) type of painkillers, such as ibuprofen or aspirin, as these can sometimes cause bleeding at the site of the injury.
- Take plenty of rest and, where possible, avoid stressful situations.
- Avoid drinking any alcohol or taking recreational drugs.
- Only return to work, college or school when you feel you have completely recovered.
- Only drive a car or ride a bike when you have completely recovered.
- Make sure you have someone to stay with you for the first 48 hours after the injury, in case you experience more serious follow-up symptoms.