The Pathophysiology of Boxing Injuries

  • Michael Loosemore

Student thesis: Doctoral ThesisPhD


This thesis explores the prevalence, nature and pathogenesis of injuries in boxing. Following an introductory chapter and literature review (Chapters 1 and 2 respectively); Chapter 3 examines injuries in the GB boxing squad from 2005 to 2009. There were a total of 66 boxers on the squad during this period 61% were injured, a total of 297 injuries were recorded. The injury rate in competition was at least 460 times higher than in training, and most injuries were new rather than recurrent (246 v 51). The incidence of concussion is comparatively low compared to other studies in amateur boxing (5 in 5 years). Hand and wrist injuries were the most frequent (23.2%). Chapter 4 describes the nature of hand and wrist injuries in more detail. ‘Boxers’ knuckle’, skiers thumb, Bennett’s fracture and carpometacarpal instability were the most frequent hand and wrist injuries and also took the longest time to recover compared to all other hand and wrist injuries that occurred. These injuries occur significantly more frequently in competition than in training (347 injuries per 1,000 hours in competition less than 0.5 per 1000 hours in training). Chapter 5 describes efforts to identify and validate a means to measure the pressure at each knuckle, given that ‘boxers’ knuckle’ was found to be such a debilitating injury. This does differentiate between the proportion of knuckle impact forces (PKIF) displayed during punching and no punching but displays very poor test-re-test reliability. This method might allow the impact of changes in the hand wraps or the gloves to be measured. Chapters 6 and 7 deal with head injury in boxing. Head guards were removed from amateur boxers in 2013. The effect of this removal on boxers’ health was investigated by reviewing the number of bouts stopped due to blows to the head both with and without head guards (Chapter 6). To improve the quality of this analysis, an examination of video from championships with and without head guards (Chapter 7) was carried out. A significant decrease in observable signs of concussion (p<0.05) and a significant increase in cuts (p<0.001) was observed when the head guards were removed. This work will have implications for the protection of boxers’ hands and the use of head guards in other contact sports.
Date of Award1 Nov 2015
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorJames Bilzon (Supervisor)

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