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Boxing and Martial Arts

In boxing, the aim is to inflict punishment by landing blows to the head and upper body. It is no wonder that boxers have a high injury rate.

Amateur and recreational boxers fight with different objectives than do professionals. In professional boxing, meting out punishment is part of the game. The point of amateur boxing is to outbox your opponent with a minimum of injuries. Recreational boxers are looking to improve their conditioning and coordination with a full-body workout.

In addition, amateur and recreational boxers use more protective equipment. They are required to wear headgear; larger, more heavily padded gloves; and a mouthpiece. These devices are all intended to soften the force of a blow to the head.

Also, an amateur or recreational bout is shorter than a professional bout. Amateurs and recreational boxers fight 3 two-minute rounds. Limiting the bout to six minutes virtually eliminates the fatigue factor for well-trained fighters. Professionals fight 12 three-minute rounds. Many serious injuries and most boxing-related deaths come about late in fights, so amateur fights are much safer.

Despite these precautions, many types of injuries occur even among amateur boxers.


A knockout is, by definition, a concussion. Any boxer who is "out on his feet" has suffered a concussion. If you have been knocked out, you should be examined carefully by a neurologist. A professional boxer who has been knocked out is required to wait three to six months, depending on where the fight took place, before he can fight again.

Cumulative head trauma is another problem. Repeated blows to the head can cause the brain to rock against the side of the skull. This kills brain cells due to bleeding in the brain and leads to small areas of scarring. The result is the "punch-drunk" syndrome, where the boxer's loss of brain tissue is sufficient to interfere with his mental function. Most professional boxers who have fought more than 50 times, even though they may show no outward signs of brain damage, have inhibited thinking ability and may suffer from headaches, blurred vision, or memory loss.

Some studies suggest that the neurological problems of amateur boxers are less dramatic because of stricter precautionary measures, such as mandatory headgear, limited bouts, and premature stopping of fights.

The most severe head injury is a brain hemorrhage from a violent blow to the head, which can result in paralysis or death. These are rare among amateur boxers, except for those who don't wear headgear.


The nose is a prominent, unprotected target. Consequently, almost every boxer, if he fights long enough, will suffer a broken nose.

Ice down a broken nose to limit the swelling and bruising, and get to a physician, who will set it. You should not box again until the fractured bone heals, which takes about eight weeks.


A contusion or black eye from a blow to the head can cause bleeding into the eyelids. Treat a black eye with intermittent icing until the bruise disappears. Unless you have a vision problem, you don't need to see a doctor.

However, scrapes and cuts of the cornea, which are usually caused by loose laces on the boxing glove or the opponent's thumb, are serious. All injuries to the eye itself should be seen by a doctor. Thumbless gloves are an attempt to cut down on this injury, but they are not very popular among boxers.

The most common serious eye injury among boxers is a detached retina. This is the injury suffered by world champion "Sugar" Ray Leonard. This injury requires surgical repair, and the victim should refrain from fighting. "Sugar" Ray, however, returned to professional boxing, knowing that he risked blindness every time he fought.

A boxer may also fracture the bony structure (orbit) around the eye, which is called a blow-out fracture. This calls for medical treatment, which may include surgery.


The cheekbone can break from a hard blow. This fracture should be iced down until it can be treated by a doctor. Surgery to elevate a depressed cheekbone may be necessary.


A mouthpiece helps to protect against, but can't prevent, a broken jaw. You can determine whether you have a broken jaw by trying to clench your teeth. If you can't clench them, or if your teeth feel out of alignment, your jaw is probably broken.

A broken jaw must be wired shut to heal. In many sports you can compete with your jaw wired shut for protection. This is not the case in boxing, since wiring cannot protect your jaw from another blow. In addition a boxer is likely to lose weight from the liquid diet required for someone whose jaw is wired shut.


A glancing blow of the glove can cause a deep facial cut and quickly end a fight. That's why a good cut man is so highly regarded among professionals. You can put petroleum jelly on your face in between rounds to keep your opponent's gloves from tearing your skin.

When you suffer a cut, apply pressure to stop the bleeding. Then treat it with an antiseptic ointment and a bandage. Wait until it heals completely before you return to the ring.

If you get a bruise, ice it down intermittently. Wait until the color disappears before you fight again.


If you don't wear headgear, as you should, then a blow to the ear can cause bleeding in the ear. If you don't go to a doctor to have it drained, the blood can form a hard mass, resulting in what is called a cauliflower ear.

The pressure of a fist against an exposed ear may also rupture an eardrum. If you have problems with your hearing, see an ear, nose, and throat specialist. Once your eardrum has been punctured, hearing loss will occur. However, over time and with no further injury, the eardrum itself may heal.


Shoulder injuries are not uncommon among boxers. A muscle can tear from the rapid deceleration of the shoulder as a blow lands against an opponent's body. The arm stops more suddenly than the shoulder, and this can tear the shoulder muscles or the rotator cuff muscles inside the shoulder joint.

Treat a torn shoulder muscle by resting it until the pain disappears, and ice it intermittently during this time. Then stretch and strengthen the muscle as it heals.


Rib separations are fairly common among boxers. The front end of the rib is connected to the breastbone by a piece of cartilage, and this cartilage can be torn from a sharp blow or series of blows to the rib.

A rib can actually break from a hard blow. This injury is more dangerous than a separated rib because the broken rib can become displaced and puncture a lung.

It can sometimes be difficult to tell whether a painful rib is separated or broken, so you need to get an x-ray. Either injury is treated with rest (about six weeks) and a rib belt. Once the pain is gone, you should not put on your boxing gloves again until an x-ray shows that the rib has healed completely.


The spleen sits under the left rib cage. This soft organ is prone to injury from a sharp strike, such as an uppercut to the left ribs.

A ruptured spleen bleeds profusely and may cause death if it is not removed rapidly and the bleeding stopped. If it is at all damaged, the spleen must be removed. Since the spleen has no vital function, it's possible to live without one.

Even if it doesn't rupture immediately, a spleen that is bruised by a light blow during sparring may rupture later on. Therefore any spleen injury must be examined by a doctor. If the x-ray scan reveals that the spleen has been seriously bruised, it will need to be rescanned to verify that it has healed adequately for you to return to the ring.


The liver sits under the right rib cage. Although the liver is stronger than the spleen, a blow to the right ribs can tear its surface. Surgery may be needed to repair the tear and stop the bleeding or to remove part of the liver, if the damage is severe. Any suspected liver damage should be seen by a doctor immediately.


The stomach and intestines may be injured by heavy blows to the abdomen. Bruising these organs can cause bleeding in the lining around the stomach or intestine. See a doctor immediately if you suspect internal bleeding.

A blow to the solar plexus, which is a nerve center in the abdomen, is responsible for many a knockout. The blow puts the solar plexus temporarily out of service, short-circuiting the nervous system. Usually, nerve function is restored within a few minutes. If this happens to you while sparring, rest until you feel normal and then pick up where you left off.


A boxer may sprain his wrist ligaments from hitting an opponent or the heavy bag. If you sprain your wrist, rest it for two to three weeks, or longer if it remains painful. Ice it intermittently during this time. You may also need to have it splinted by a doctor to allow the ligaments to heal, which takes about three weeks. To rehabilitate and strengthen your wrist, do the Wrist Curl, Reverse Wrist Curl, Roll-Up, and Ball Squeeze exercises found in Chapter 8.

The small bones of the wrist may slide out of place if the ligaments holding them together are partially torn. This partial dislocation, which often is the result of constantly hitting the heavy bag, causes pain at the base of the hand when you hit. New training techniques have moved away from punching the heavy bag, which doesn't give at all when your fist hits it. This is a serious injury that requires surgical repair.


Injuries occur to the hitter as well as to the "hittee." Boxers almost always have sore hands, and broken bones in the hand are quite common. The metacarpal bones, which are the long bones in the palm of the hand that form the knuckles with the fingers, can break from the force of a blow on the knuckle.

Most commonly, boxers break the fourth and fifth metacarpals; consequently, these are known as "boxer's fractures." These fractures must be set, casted, and rested for at least eight weeks.


Whenever I would see a boxer doing roadwork in army boots, I cringed. The heavy boots with no arches gave no support to the boxer as he ran mile after mile. It took me years of haranguing to convince fight promoter Lou Duva to put his fighters, including a young Evander Holyfield, into running shoes for their long workouts. Evander obviously learned his lesson about good training. For his first heavyweight championship bout, he used such unconventional conditioning methods as aerobics, yoga, flexibility exercises, and heavy weight training.

Boxers have traditionally trained incorrectly. They do long miles of daily roadwork, and although running long distances is good for building up cardiovascular conditioning, boxing is basically a burst activity. You go full out in two- to three-minute spurts, and then rest for one minute. You don't fight in one long, continuous segment, and you shouldn't train that way.

A boxer needs interval training consisting of two- to three-minute bursts of activity, with one minute of rest in between, to simulate a fight and improve his anaerobic conditioning. He should get his aerobic conditioning up first by running long distances and then begin interval training, running sprints, just as for any burst activity sport.

Many boxers work long, frequent sessions with the heavy bag to increase their punching power. As a result they may punch harder, but they also are likely to injure their hands and wrists. Instead of punching the heavy bag, a boxer should spend more time in the weight room.


Any recreational boxer who spars is subject to the injuries that have been described so far. Even recreational boxers who don't spar may suffer the same hand, wrist, and shoulder problems from hitting practice.

More women are turning to boxing workouts as part of an overall fitness program and for cross-training purposes. A boxing workout provides both physical and health benefits, particularly cardiovascular improvement. Boxing works the muscles of both the upper and the lower body and improves balance, agility, and hand-eye coordination.

Boxing develops quickness and stamina, and it strengthens the upper body without building big, bulky muscles. Look at a typical boxer. He isn't muscle-bound; he has a lean, well-proportioned torso. In addition to increasing strength and endurance, boxing is also a good way to relieve stress.

Boxing-based training programs are popping up at health clubs and spas across the country. They incorporate the techniques used by amateur and professional boxers into safe, well-rounded exercise programs. These typically include skipping rope, punching a speed bag and a heavy bag, shadowboxing, and doing sit-ups, all under the guidance of a trainer. Participants may also go a few rounds in the ring, throwing combinations of punches into the trainer's oversized, padded gloves.

Boxing gyms used to be men's clubs, but now women are being encouraged to join. Don't expect the same fancy facilities that a health club has; these gyms still have a no-nonsense atmosphere. Contact your state athletic commission for a list of licensed gyms. Then contact a local gym and ask about the availability of trainers. You will probably have to pay a small fee to join the gym and an hourly rate to the trainer for individual sessions. The gym should provide all the equipment. All you need bring is a T-shirt, shorts, and a pair of athletic shoes with good side-to-side stability.

Your local college may offer a boxing class that allows you to spar against classmates. Classes usually consist of a warmup such as calisthenics, work on the light and heavy bags, rope jumping, shadowboxing, and sit-ups, as well as short bouts followed by a warmdown and stretching period.


There are literally hundreds of types of martial arts. All of them depend on speed, balance, and leverage rather than brute strength.

Like boxing, the martial arts offer the advantage of working your upper body as well as your lower body. You usually work your way through meditation, stretching exercises, and then punching, kicking, and blocking at various speeds, as if you were shadowboxing.

The martial arts are good conditioning activities that help you build strength, increase muscle tone and flexibility, and improve your balance. In addition, you are likely to lose weight and relax your body while acquiring good self-defense skills.

To find a martial arts school, look in the Yellow Pages. Then go watch some classes and find out what skills each teacher emphasizes so that you choose a style that suits you.

All of the boxing injuries listed in this chapter are also seen in the martial arts, and they can be severe, since participants typically wear no headgear. In addition, injuries occur to the lower body because the feet also are used as weapons.


Hand injuries in the martial arts differ slightly from those in boxing because blows are delivered with the side of the hand as well as with a closed fist. Fractures commonly occur in the fifth metacarpal, the bone behind the little finger. These fractures, just as in boxing, need to be casted for four to six weeks. You will probably need to wait at least eight weeks before you can start hitting with the hand again.


All of the ligament and cartilage injuries described in Chapter 11 occur in the martial arts. Anything but the most superficial knee injury should be seen by a doctor.

Runner's knee is very common in the martial arts because of the characteristic bent-knee stance and rapid, forceful kicks. This movement causes the same stress as the frog kick in the breast stroke detailed in Chapter 28.

The proper treatment is to correct the foot position to ease the stress on the knee. The problem is that most martial arts are done barefoot. Wearing an arch or orthotic in your shoe in daily life will allow your knee pain to subside so that you can function on the mat without a shoe.


Toes are broken more than occasionally in the martial arts. The usual treatment for a broken toe is to ice it until the pain is gone and then to buddy-tape it to the toe next to it, with gauze between the two toes so that the skin doesn't rub.

The big toe doesn't buddy-tape well and may require medical treatment. This may include realigning the broken bone and keeping weight off the toe for three to four weeks.

How to Improve Your Skills

The first thing both boxers and martial artists need to work on is coordination. Both hand-eye and hand-foot coordination are essential. If you don't have good coordination, these are probably not good sports for you.

Hand-eye coordination can be improved by one of the training programs developed by sports optometrists and now used by the U.S. Olympic team. These techniques increase your peripheral vision so that you can see over a wider range and decrease your hand's response time to a visual stimulus. This allows a boxer or martial artist to see a punch coming in time to stop it before it lands. It also means that if you spot an opening, you can respond to it more quickly than your opponent can defend against your attack. Ask your optometrist about these special eye-training programs.

Shadowboxing, particularly in front of a mirror so that you can inspect your stance, will certainly help a boxer's hand-foot coordination. The same goes for martial artists, who should practice punches and kicks in front of a mirror.

Often a fighter gets hurt because he's off balance after he throws a punch or kick and he can't recover to defend himself. Training on a biome-chanical ankle platform stabilizer (BAPS) board and a side-ski machine can improve your balance. A BAPS board is a large, flat board balanced on a hemisphere. When you stand on the platform, it can tip to any side. The object is to stay balanced as you move about on the board. A side-ski machine allows you to move your weight from side to side as you balance yourself, approximating the motion of downhill skiing.

Boxers have long avoided working with weights out of fear of becoming muscle-bound. Today's weight-training techniques, and Evander Holyfield's success, have dispelled this outdated notion. Full range-of-motion weight lifting, followed by full-body stretching after a workout, can increase your strength without shortening your muscles. And you won't lose any punching speed. Almost every sport now uses weight training. Boxers and martial artists certainly could benefit from it as well.

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