Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Boxing Injuries

What are Boxing Injuries?

Boxing is a combat sport with a high incidence of impact injuries. Since the sport involves competitors striking each other, moving quickly, and engaging with each other in short, high-energy bursts, the types of injuries that may occur to a boxer can vary greatly.

Boxing injuries can be classified as acute, chronic, or overuse. The frequency of traumatic injuries is relatively high in boxers. These injuries usually involve the hand and the wrist which make frequent, high impact, often unpredictable contact with the opponent. Common boxing injuries affect the soft tissues, bones, and joints of the hands and wrist.

Overuse injuries may affect the hands and arms due to the constant and continuous movements on the platform. Fatigue and conditioning besides skill are factors to include in training the entire kinetic chain from the ground up.

Some studies have revealed that the improvement of the boxing techniques has a positive impact on the reduction of boxing injuries, however hitting a moving target makes correct technique extremely difficult in real time.

Characteristics and Clinical Presentation of Boxing Injuries

Boxing injuries are considered part of the practice of this sport. The clinical presentation will depend on factors such as the area affected, the severity of the injury, and specifics of the injury and history of prior injury.

Some of the most common injuries seen in boxers are fractures of the metacarpals, Boxer’s fracture, Carpal bossing, carpal metacarpal fracture with and without subluxation, and extensor aponeurosis and metacarpophalangeal joint capsular tears.

Bennett’s Fracture is an injury involving the base of the first metacarpal bone extending into the carpometacarpal joint. As an intra-articular fracture, it is the most common fracture of the thumb and is typically associated with subluxation or dislocation of the carpometacarpal joint.

Carpal instability is a condition in which the athlete may injury themselves by falling onto an outstretched hand which results in a distortion of the alignment of the wrist bones. There is a high potential for the patient to develop arthritis when carpal ligament tears or fractures are involved.

Distal Radius Fracture is an injury indicating a break in the radius within inches of the wrist joint. A number of Distal Radius Fracture variations exist, dictated by the force of the injury and state of the broken bone. This depends on whether or not the fracture extends in the wrist joint or if the broken piece of bone moves out of its original place.

Extensor Carpi Ulnaris Tendinitis is a condition involving inflammation of the tendon running along the back and ulnar side of the wrist. Repetitive action from mechanically incorrect positions contribute to this condition and can strain the ECU tendon to the point of tenderness or tearing.

Perilunate dislocation involves traumatic rupture of the radioscaphocapitate, scapholunate interosseous, and lunotriquetral interosseous ligaments. It may also involve fractures of the radial styloid, the scaphoid, the trapezium, the capitate, and the triquetrum with dorsal or volar perilunate dislocation.

Boxer’s Fracture is another frequent injury due to the nature of the sport. It usually occurs when a person punches a hard object. It is characterized by a fracture of the fourth or fifth metacarpal. The symptoms of this type of fracture include swollen hand, deformity, a painful area, difficult movement of the fingers on the affected hand, the presence of hematoma and or discoloration of the skin.

Boxer’s Knuckle is an injury to the structures of the first knuckle of a finger, also known as the metacarpophalangeal joints (MPJ). This injury may involve the skin, extensor tendon, ligaments, joint cartilage, and the bone of the metacarpal head. Repeated impact to the extensor tendon over the knuckles can cause Hypertrophic Interstitial Tendinosis, or HIT Syndrome.

Boxer’s Wrist may refer to a variety of injuries, commonly including damage to the 5th metacarpal-hamate joint, or the 2nd and 3rd carpometacarpal joints. This injury is sustained during high-impact activities with excessive force or by not wearing proper safety equipment.

Carpal Bossing is an injury with a high incidence. This pathology produces a lump on the back of the hand at the junction of the long and index finger metacarpal bones and the wrist carpal bones. The boxer usually develops arthritis and joint ligamentous laxity secondary to the continuous trauma and the overproduction of bone tissue secondary to the injury.

Treatment Options

The best option in case of acute injury should be to judiciously apply the R.I.C.E principle. Some additional treatments that may be used include splinting with the aim to immobilize the area, taking prescription or over-the-counter pain medication, in addition to cleaning and treating any abrasions and lacerations of the skin.

In cases where a boxer has sustained a serious injury, an orthopedic hand and wrist surgeon may recommend a surgical procedure to help repair damaged structures and optimize strength, mobility, and function.

If You Believe You Have a Boxing Injury, Contact HandSport Surgery Institute

Please contact us as soon as possible to schedule an appointment with our talented team. People who have been hurt while boxing should be evaluated to try and prevent further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.