Boxing for fitness has become a popular exercise in the active community however like any new activity the body will take time to adapt, so how can we protect ourselves from becoming injured? 
Common hand injuries seen in boxers often affect the knuckles, the thumb or the carpo-metacarpal joints (joints in the hand where the long bones of the hand (metacarpals) join with the smaller bones of the wrist/hand (carpals)). Stability of the wrist and hand during impact plays an essential part in injury prevention. 
Strengthening the muscles which prevent the wrist flexing or deviating on impact (moment at which the glove makes contact with the bag) is a great way to condition the hand and wrist for impact. These exercises can be done by moving the hand and wrist through all ranges of movement using the resistance of dumbells or elastic bands.  
Other types of conditioning exercises are suggested below. 
- Reverse dumbell curls (dumbell curl performed with palms facing down) while trying to maintain the wrist in a neutral position is particularly useful as it 
allows the muscle to stabilise the wrist against gravity, which is the same action that is required for wrist stability on impact. 
- Rotation of the forearm from the palm up to palm down position while holding a hammer is beneficial for both the wrist and elbow joints. 
- Band exercises for the thumb will strengthen the smaller and larger muscles that control the thumb. 
- Shoulder and trunk stability exercises using a wall or floor in press up or plank positions can help improve muscle control in all areas of the body.  
The use of neoprene wrist/hand/thumb supports or wrapping the hand as you would for competitive boxing can also add an extra layer of protection for the wrist and hand. To protect your knuckles select boxing gloves that have sufficient padding so that you are unable to feel your knuckles when pushing through the glove. 
(see Ian Gatt's excellent demonstration on utube 
Finally as often mentioned in my blogs load and load intensity should be gradually increased, using water bags initially before using boxing bags can be a nice way to transition into a boxing class. Also gradually increasing the amount of punches by no more than 10% a week should give soft tissue sufficient time to adapt.  


Craig Fowlie 

Craig is a highly specialized physiotherapist with post graduate qualifications in Acupuncture and Sports and Exercise Medicine. 
He has worked with Professional Rugby sides in New Zealand and has assisted Great Britain Table Tennis at the World Team Championships and Olympic Qualifiers in Qatar and Germany. He is a consultant for the Governments Talented Athlete Scholarship Scheme and has published and presented research in the Journal of Physiotherapy and the Chartered Society of Physiotherapy Annual Conference. 
Outside of work he enjoys participating socially in triathlon and running. 
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