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 want to allow the joint area to settle, before loading back up, whereas for a less severe boxer’s knuckle, we can often modify the force in the specific area with padding etc. to allow the athlete to continue training. 

Some of the ways in which we can change the relative loading is by adjusting the volume, frequency, duration of training, as well as using softer surfaces, such as heavier gloves, water bags, paddles instead of focus mitts, etc. If an injury is particularly sensitive to a certain punch (wrist with hooks/uppercuts) then we may have to limit the type of techniques that the athlete is using. 

Glove maintenance is another important factor, particularly with knuckle injuries. Athletes should ensure that they are using high quality gloves, with sufficient protection around the knuckle. If the knuckle area of a glove is worn, then the gloves should be replaced. 

Athletes should pay attention to hand-wrapping techniques, and may need to alter their wrapping technique to provide stability around specific areas. 

Finally, if there are technique issues that may have predisposed an athlete to injury, then these should be addressed between athlete, coach and medical practitioner working together as a team to optimise function and health.

In the final post in this series, we will discuss some options for specific strengthening around the wrist and hand. 

About the author

Sam 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.

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By Sam Gilbert