Combat sports

Combat sports involve close interaction with an opponent in a sport designed to produce victory by physical strength, power and technique. Combat sports include boxing, wrestling and the martial arts. These categories of combat sports are very different, and produce different injury patterns.

Boxing will produce hand and wrist injuries caused by the sudden impact of a clenched fist on an opponent's body. This may be a fracture in one of the bones of the hand, but is more usually a tear in the tendon and its supporting structures as it is stretched over the back of the hand. The underlying bone can stretch and tear the overlying tendinous structure on impact. These injuries often do not come to light until after a competitive fight or training session. Early investigation, often using ultrasound scanning, can identify these injuries whilst the outcome of treatment remains good.

Martial arts and wrestling involve more grappling and twisting of an opponent (and their clothing) than boxing. Different injury patterns occur. Injuries to the ligaments of the fingers and wrist are more common in these activities, and are frequently noticed at the time of injury. The strength of the attachment of a tendon to bone may be insufficient to counter the muscular pull experienced during the tight gripping of clothing. The tendon can be ripped from the bone, leaving a floppy joint. Splintage, or even surgery, may be necessary to restore the connection between muscle and bone.