Zoe Mundell
Injury & Rehab

Common Injuries in Combat Sports and How to Avoid them

By Zoe Mundell
M,Ost, DPO,
ND Principal Osteopath & Director of New Body Osteopathy.
February 2019


In close contact sports such as boxing and mixed martial arts, injuries can be common place and often result from force applied to or from your opponent but what about injuries commonly sustained through training, which ones are common, how should you avoid them and most importantly, what should you do if you get injured.

The most common areas to injure are the shoulders, hands and wrists. The repetitive punches that a fighter throws during training sessions can lead to injuries of the shoulder involving muscles, ligaments and tendons. Ignoring the pain or “fighting through” a shoulder injury and treating it as second nature to your sport can lead to further degeneration of the injured tissues. There are two main categories of shoulder problems; those caused by the instability or dislocation of one or more of the joints of the shoulder or impingement, the result of excessive rubbing of the shoulder muscle against the top part of the shoulder joint.

Shoulder impingements usually occur when the axis of rotation which the arms bone moves through in the socket is altered (for example the arm is only moving in the anterior part of the socket, because the boxer has poor posture or an imbalance in their shoulder muscles). Repetitive strain injuries can occur if the boxer has poor rotation through the back and pelvis. It is important when punching to ‘load’ the punch through the whole spine, having good rotation allows the power to travel up the body from the legs and hips, through the shoulder to the arm. Try standing still and just moving your arm to execute a punch, without loading your body, the power produced will be comparatively minimal. Good hip and spinal rotation are important movements for all combat fighters.

While impingement issues plague boxers, the most common types of shoulder injuries are due to instability or weakness of the muscles that compose the rotator cuff. These muscles are responsible for keeping your upper arm bone in the socket as you move your arm. With missed punches, the ball of your shoulder joint may slip partially out of the socket — subluxing, or completely out of place — dislocating.  It is there for not only important to keep the big muscles of your upper body strong but also the smaller intrinsic shoulder muscles to maintain its stability.

With any contact fighting sport, hand injuries are not that uncommon, even with protective gear. If improper fighting techniques are used, the bones and ligaments of the hands and wrists are susceptible to breaks, tears, and fractures. The most common hand injury seen in boxing and UFC sparring is the boxer’s fracture. This is a break of the long bone (metacarpal) in the 2nd or 3rd finger and may occur through repetitive impact on a fixed object. Normally, if a fist is made properly and strikes are done correctly, the force of the impact should be distributed across the hands to the wrist and arm evenly. The force should typically come from the second and third knuckles with proper form. With improper form, the force of the impact may come through the fourth and fifth knuckles; the result in the force of the impact not distributing well into the wrist and arm may cause the bones in the hand to buckle and ultimately fracture. This usually requires rest and a cast to heal completely. A ligament or cartilage tear is also a common hand ailment for boxers and other types of professional fighters. If the hand or wrist is flexed when a punch is thrown the ligament or cartilage can easily tear away from the bones. This is painful but does not usually require a cast and will resolve with rest and physical treatment.

So when you are training take advantage of the professional’s advice and always use good technique. Never go into combat without wrapping the hands and wrists correctly and wearing appropriately sized gloves. Ensure you are not only strong in your upper body, but that you have good shoulder mechanics by strengthening your smaller rotator cuff muscles to prevent muscle imbalance and injuries. Consider the flexibility AND mobility of your spine and pelvis as a means to gaining more power to execute your punches and if you do get injured, don’t ignore it and train through, get professional advice. Treating an injury in the early stages is much easier and will have far less impact on your training.

Scapular retractions: Gentle drop your torso by allowing your shoulder blades to squeeze together. At the bottom of the movement push upwards using your arms to separate the shoulder blades as wide as you can without rounding your upper back, hold for 5 seconds then repeat. 2 x 15 reps.

Scapular retractions

Scapular strengthening: push back against the wall. Hold the contraction for 5 seconds, and relax. repeat 2 x 15 reps.

Scapular strengthening

External rotations with band or cable: Tuck your elbow in, keeping it next to your body, and move your hand outwards away from your stomach, using the band for resistance. This is an important exercise to strengthen the rotator cuff muscles. repeat 2 x15 reps.

External rotations with band or cable

Decline Cable Pull: Hold the handle of the cable above shoulder level (or fix a band), pull the cable backwards inline with the other arm, squeeze the shoulder blade backwards at the end of the movement. Control the return of the cable to the start position. repeat 2 x 15 reps.

Decline Cable Pull