Hand injury in Boxing

Abstract

In a contest the boxer uses his hands to attack and he scores points when he punches his opponent on the target area (the front of the body above the belt) using the knuckle part of the closed fist. When the punch is delivered the hand must be closed and he must not slap or strike his opponent with the side of the hand, the forearm, or the elbow, but he can use these parts of the upper limbs to. defend himself. Depending on the nature of the contest boxing gloves weighing eight or six ounces are used and the hands may be bandaged, a regulation gauze or light crepe bandage nine feet long must be used. Providing the boxer adheres to the rules and punches with the hand in the correct position it is seldom that the hand is injured. Most of the hand injuries in boxing are sustained during training sessions when the heavy punch bags are being used, and the hands are not properly supported with well fitting training mitts. Fig. 1. A closed fist showing prominence of head of middle metacarpal. Also shown are the extensors of the carpus (marked) at their insertion, a common site for swelling to occur. When the hand is closed to make a fist (Fig. 1) the head of the middle metacarpal projects beyond the rest and is liable to be traumatised; an enlarged bursa forms over the joint, the capsular tissues swell and an effusion forms in the joint. Once the bursa is present the hand must be rested, analgesic ointments can be applied, hot hand baths prescribed and all blows on the knuckle must be avoided. Cortisone injections are used and they may shorten the disability period, but I have found that if pain is relieved at an early stage the boxer will return too soon to his previous routine with the chance of early recurrence. Once upon a time boxers tried to toughen the skin of the hands by the use of brine, or alum hand baths, but I am not convinced that these were of any value; a much more rational approach is proper bandaging of the hands, proper maintenance of gloves and mitts and the delivery of the punch in the correct manner.