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. 

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