Working as a Physiotherapist for 13 years and a being a martial artist for 25 years I’ve seen a few injuries along the way caused by poor striking technique. This is common in any martial art that has upper limb striking as part of its repertoire.

The most common injuries are cuts and abrasions but if we are really looking at upper limb injuries that stop people boxing and training they are usually of the:





The hand has its own unique “boxers fracture” and is susceptible due to the high force transmitted from the lower limb and trunk into the fist. The Metacarpal(bone between the wrist and fingers) on the outside of the hand is exceptionally vulnerable to a fracture as it is a small and only has a support on one side. This is the reason boxers wear wraps under their gloves. This support allows some element of protection to the hand.

Striking poorly and overusing the smaller knuckles of the hand can increase the risk of stress or a fracture to this area. This risk can be significantly reduced with good technique.


The wrist injuries usually come down to poor technique again I’m afraid. A good coach or trainer ensures you are striking with a strong and stable wrist. A bend at the wrist on impact can lead to trauma and injury to the ligaments and tendons of the wrist or in worst case even a fracture. Pain on the outer wrist can be trauma to the small pad that sits in-between the forearm and wrist called the TFCC for short


The elbow suffers if you miss the target causing hyperextension. This can be down to technique or a poorly placed pad from a sparring partner. Over locking or hyperextension can lead to posterior impingement of the elbow which in serious cases can require an operation. It pays to have a good trainer teaching you the basics and building your power from control. Overzealous training of boxing to build cardio can lead to these types of problems where technique comes second to the cardio element.


The other interesting injury I’ve come across more recently is tennis elbow and golfers elbow on the person holding the sparring mitts for prolonged periods as the elbow tendons have to work extremely hard in an inner range and take the impact of a punch and the flexors work to absorb and slow down the impact in outer range. This can affect you if working in pairs and long sessions without changing over. Trainers and coaches are especially vulnerable.


Shoulders also suffer from over extension of the elbow and missing a target repetitively. The shoulder is the most mobile and therefore unstable of all the bodies’ joints. The rotator cuff group of muscles have to work amazingly hard to control the shoulder joint with the power in a punch. Fatigue certainly plays it’s part in shoulder injuries. For instance, when you are tired and barely able to keep your hands up, the cuff still needs to control your punches and blocks.


Over fatigue leads to more punches that miss the target. This double jeopardy effect will place the cuff under significant stress and can lead to overuse and impingement type injuries.


Ido Portal, one of my movement idols has a great saying; “every time you specialise you compromise”. This is true of fighters who just focus on the Pec and Deltoid power. As a shoulder specialist physiotherapist I can assure you, it’s all in the Cuff, Scapula and Back. You need just as much control behind as you do in front to decelerate and control the shoulder and scapula.


Shoulder dislocation despite being widely reported as a common injury in boxers, is incredibly rare. The normal striking position of the arm is a stable position and I would suggest that those who are unfortunate enough to dislocate have had their arm placed in an abduction external rotation position (hands up position) or are hypermobile and prone to dislocation or have had previous dislocations and are susceptible


My advice is if you want to box, kick-box, or use boxing as a form of training then get a good coach who understands fighting. They will build you up slowly focusing on technique and power from the lower limb and trunk, teaching good arm placement and correct punching technique. This will not only keep your injuries down to a minimum but also teach you an effective strike. You never know when you might need it !!


Tony Gill