Kickboxing Joints

In this issue of International Kickboxer I am going to discuss how kickboxing affects our joints, what we can do to look after them, and joint injuries that I commonly see and treat in kickboxing.

We can divide kickboxing joint injuries into two groups; chronic, or overuse injuries — which we commonly see as a result of training, such as impact or twisting injuries that occur in fighting and sparring.

As doctors, we tend to think pessimistically about injuries and we always have in mind the worst case scenario. In the case of joints, the worst that can happen is osteoarthritis (OA). This is where the joint has worn out. The protective cartilage that separates the bones has been destroyed by years of overuse, leading to bone on bone. It is debilitating. It affects mobility and causes pain, classically even pain in bed at night.

I bet you are wondering what this is doing in a sports magazine — you are too young to worry about OA. Well, I am already organising hip and knee joint replacements for kickboxers younger than myself. We are going through health revolutions at the moment. One is that we are all living much longer. When I was a med student we were told that a man could expect to live to 72. Now it is 83. At least 20 per cent of readers will make it to be 100. And if you play active sport you are more likely to live to a ripe old age. But our joints are wearing out between the age of 50 to 70 and some sportsmen are needing joint replacements in their 40s.

The second revolution is that a lot more people are aware of the health benefits of exercise, especially in middle age, so we have a lot more active people overusing their joints, especially with high impact activities (such as running and skipping).

We are living longer and our joints are wearing out sooner.

We are all aware of the short term benefits of kickboxing training such as fun, fitness, excitement, challenge and social. It is important in our training not to lose sight of the long term benefits of living longer and healthier.

The two main joints that are affected by OA in kickboxers are the knee and hip. I believe that exercises that predispose to this most are the high impact exercises such as running and skipping. The impact to the joint can be mitigated by running in good runners that are not too old. They can often be improved by using a high quality insole such as ‘Lightfeet’. Impact during skipping can be minimised by using jigsaw mats.

The good news is that working the hanging bags is no problem for the joints. I much prefer this to practicing kicks in the air. I believe repeatedly doing high kicks in the air, as is popular in taekwondo classes, is damaging to the hip joint in the long term. Many of the taekwondo experts have hip joint replacements at a young age. Using a bike or crosstrainer is probably good for you. So is exercising in water. I am a big fan of shadow sparring in water.

If you are starting to get joint pain, it is probably worth taking some preventative medicine such as glucosamine sulphate. I believe glucosamine hydrochloride does not work.

The most spectacular joint injury that I commonly see in kickboxing fighting is the dislocated shoulder. This is a medical emergency. Not only is it usually very painful, but it is also potentially damaging for the long term health of the joint. For this reason it is important to put the joint back in as quickly as possible. This can be done by lifting the arm above the shoulder while pulling on it. If the joint has been out for a while it can be very hard to put back in, especially in a strong fighter with muscular shoulders, because the muscles go into spasm. In this situation, painkillers are needed. I have found that the Penthrox Inhaler is wonderful in this situation. This is the green tube that you may have seen used in ambulances. The patient sucks on it to breath in the pain killing gas. It is fast and very safe. It is also short acting so the patient recovers fast afterwards.

An injury that we do not see as often nowadays is ‘skiers thumb’. This is caused by the thumb being bent backwards if you catch the thumb against your opponent’s elbow while punching. Most modern gloves have the thumb attached to the body of the glove to prevent this injury. You should only use gloves like this.

Ankle joint injuries are quite common in kickboxing. They are usually caused by ‘going over’ on the ankle and produce a tear of the ligament on the outside of the ankle, or lateral ankle ligament strain. The more severe injuries can be treated with immobilisation in a CAM walker, which is big boot, like a ski boot, which completely stops the ankle from moving. I have found this radically reduces the time it takes for the ankle to heal. The other thing that is important in ankle recovery is rehab balance exercises. This can be done by practicing balancing on the injured leg while doing multiple kicks in the air with the other leg, without putting it down.

Elbow joints are commonly injured through hyper extending while doing a straight jab. This usually affects the left. Sometimes a piece of bone is broken off it and ends up inside the joint. This causes a jamming sensation when you fully extend the elbow. It is very annoying. Unlike a strain of the joint with bone bruising, which can be similar, a bone chip does not go away. You need to see a doctor to get an X-ray or CT scan. The solution is usually a quick arthroscopic operation. This is very easy and leads to a rapid return of function, but the operation is expensive. For this reason, please have private health insurance, especially if you are fighting in competition. You are competing in a full contact sport and so it is well worth while having insurance. Many kickboxing injury repairs would have to wait years on a public hospital waiting list. The busy public system simply will not see your return to your sport or job as an emergency so you could have to wait ages, and you will be very frustrated. IK

DR PETER LEWIS

Dr Lewis is internationally recognised as a medical authority in the martial arts field. He has also been studying and teaching martial arts for 34 years.

Dr Lewis is best known as a ringside physician. He is often seen on televised shows in many countries. He has worked in 28 cities internationally, 22 of these on World title standard events. He has performed every ringside role, including doctor, referee, judge, rules co-ordinator, timekeeper, commentator, ringside announcer, matchmaker, trainer, cornerman, cutsman and has competed in karate, taekwondo and kung fu. He has had the pleasure and honour of looking after some of the most important fights and fighters in history.

Dr Lewis is also well known as an international lecturer and writer on martial arts medicine. He has consulted at ReCreation Medical Centre for 24 years.

He has also recently established a new clinic at Malvern Martial Arts, which is especially for martial artists. Dr Lewis works with a team including a nurse, physio, chiro, podiatrist, psychologist, exercise physiologist, dietician and masseurs who all have extensive experience in martial arts.

Contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it