AuthorSam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia). A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009. As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 13 – General management principles

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While the management of hand and wrist injuries will depend on the specific injury, there are some basic management principles that will apply to most cases.  The first is one of specific load management. Most injuries will require a degree of off-loading/de-loading. For fractures, this de-loading will be in the form of immobilisation and often surgical intervention. For joint sprains, we usually...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 9 – Finger Dislocations

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Dislocation of the proximal interphalangeal joint (closest joint of the finger) is also very common. Dorsal (to the back) dislocation may lead to volar plate and ligament damage, and therefore requires proper diagnosis and follow up. If the dislocation is stable, only buddy taping (where the 2 fingers are taped together) is required, followed by early mobilization to avoid stiffening of the joint...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 8 – Finger Fractures

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Fractures of the fingers are more common in combat sports where a full boxing glove is not worn (karate, taekwondo, MMA, etc.) and are also common in grappling. The type of management will depend on the location of the fracture.  Fractures of the proximal and middle phalanges (the closest and middle bones of the finger) are often accompanied by avulsion (where a fragment of bone is pulled away by...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 7 – TFCC injury

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The triangular fibrocartilage complex (TFCC) consists of a cartilaginous disc that lies between the ulnar and the triquetrum and lunate bones, the ulnar meniscus, the sheath of the extensor carpi ulnaris (one of the muscles responsible for extending and ulnar deviating the wrist), and several ligaments of the wrist and hand. The complex is loaded in movements that involve axial compression in a...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 6 – Thumb ligament injury

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  A common joint injury observed in boxing is a tear of the ulnar collateral ligament (ULC) of the 1st ray metacarpophalangeal joint, the ligament that lies on the inside of the thumb (1). This ligament is often damaged when the thumb is caught and bent back during punching or defending. This is commonly referred to as a “skiers thumb” (when occurring acutely), or a “gatekeepers thumb” (when...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 5 – Bennett’s Fracture

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A Bennett’s fracture refers to a fracture of the base of the 1st metacarpal, the long bone that articulates with the thumb. As this is an intra-articular (occurring within the joint capsule), the injury often involves damage to the structures around the adjacent joint and the adjacent bone (the trapezium) (1). This injury typically occurs with excessive axial compression (compression down the...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 4 – Carpal Bossing Carpal bossing refers to disruption of the carpometacarpal joint (the joints between the second row of wrist bones and the long bones in the hand). This injury is typically caused by axial loading of the metacarpal bones. The joints of the wrist are very precise, like a lock and key, and excessive load in even...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 3 – The Boxer’s Fracture

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The boxer’s fracture is a fracture of the 5th metatarsal (little finger side). As this is obviously not the target area of contact with a punch, this injury is often caused by suboptimal punching technique. In a typical punch, the knuckles of the 2nd and 3rd rays should make contact, allowing for a smooth transfer of force across the joint. However, when contact is made with the 4th or 5th rays...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 2 – The Boxer’s Knuckle

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The boxer’s knuckle refers to an injury to the extensor mechanism of the fingers (the musculo-tendinous unit that allows the finger to extend) and is one of the more serious musculoskeletal injuries in boxing. During a punch, the metacarpophalangeal joint (the joint of the knuckle) is rapidly forced into flexion, stretching the surrounding soft tissue to its maximum tolerance. Over time this may...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 1

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Due to the frequency of hand contact, the impact with which this contact occurs and the complexity of the region, injuries to the hand and wrist are by far the most documented injuries in striking combat athletes. The impact related to punching results in a positive remodelling of bone and soft tissue over time, causing the tissues to become stronger and more resilient. We refer to this process...

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