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COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 14 – Hand and Wrist Strengthening 

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Grip strength was discussed in part 11, and if there are deficiencies here then they should be addressed. The power grip can be trained with a simple gripper, and if an adjustable gripper is available, this can allow for a more incremental progression of load. Using a thicker grip, such as a towel, or a fat gripz handle, while performing traditional resistance training exercises can also be...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 12 – Load Tolerance Assessment 

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Another useful test for wrist and hand injuries is a measurement of load tolerance. In the general population we typically measure the load taken through the palm, however with combat athletes, we also need to measure the amount of pressure tolerated through a fist.  A simple, low-tech way of assessing this is with the use of an analogue scale. With the scales placed on a bench or table, and...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 11 – Grip Assessment

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Grip strength is an important functional measure in both diagnosis and evaluation of progress. A 10% difference in grip strength between sides is within the limits of normal, however more than a 20% difference between sides may indicate either a strength deficiency that could have contributed to the development of the injury, or more commonly a loss of strength secondary to the injury. A 50% or...

COMMON HAND AND WRIST INJURIES IN STRIKING SPORTS – PART 10 – Wrist ROM assessment

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Special tests for hand and wrist injuries will be specific to the injured area. However all hand and wrist injuries will likely require assessment of range of motion. One of the common methods of measuring joint range of motion is with the use of a goniometer. However, whilst this may be optimal for larger joints such as the knee, because of the small size and intricacy of the wrist, as well as...

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 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...

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