Expert: Jack Rose - 3/5/2010

Question
Hi, I apologize for the long question up front, but would really appreciate any insight you might have if you can take the time to read.  I wanted to be as specific as possible to avoid generalization of hand pain.  I'm not looking to re-learn how to throw any punches.  I just want to know if you've heard of anything similar to my injury in any other boxers, and if they have been diagnosed & fixed.  I am 29, have been boxing competitively as an amateur for about 5 years off and on.  I am very fundamentally sound, having been taught how to box about 15 years ago by my father who fought many amateur fights, for State Police, Navy, & pro.  I then had a different coach for my competitive career, who worked more fundamentals with me, so it's not like I learned bad fundamentals from my father, and have bad habits from a young age.  

Off and on competing myself, I am a personal trainer & boxing instructor as my career.  About 3 months ago, I was doing medium contact sparring with a student, and I threw a left hook to the body (not very hard - maybe it didn't land flush - but not anywhere near hard enough that i would think could injure me), but immediately on landing, a shooting pain like I've never felt, shot through my hand.  I had to toss my glove off, and was jumping up and down like my hand exploded.  I've broken my left hand 3 times, and the pain never came close to this.  But moments after the initial shooting pain, no real pain at all.  

I rested for a few days, then tried hitting the heavy bag, and the shooting pain was back with a slightly hard left hook.  Weeks, months following this, I could feel mild pain on certain movements at work & training clients, and i could mildly recreate some pain by making a fist, tilting my fist toward my thumb side (radial deviation), and compressing as if landing a punch at an angle.  So the pain is deep where carpals between index & thumb are.  I got 2 x-rays, both were said to show no fracture, AND a contrast MRI which showed no soft tissue tears.  I just got a cortisone shot today, and no relief yet.  The hand specialist was pretty much stumped, as none of his ROM tests nor direct pressure on the site produced any pain.  

Im very frustrated.  I know that I have pretty small bone structure for my size 6'1" - 178lb, and i have been told that my left hook is really hard.  So i feel like a lot of force gets transmitted through skinny wrists and small bones in a fairly thin hand, and i'll probably always be prone to hand injury because of this combined with punching power, but this pain is enough to make me unable to compete, or even spar at a high level, so i want it remedied.  Should i splint it for a while to give it complete rest, or is some undetectable by xray & MRI damage done that wont be fixed unless i quit throwing hard left hooks?  The hand specialist didnt offer any suggestions...  I just want to know if this injury is common to any other boxers you know or have trained, and if anyone has had it diagnosed. Thanks a lot for your time. -Kevin

Answer
Kevin,

These types of injuries are very common in boxing. Normally I would think you had a tear in the tendon but that would have show up on the MRI. So I'm curious why they didn't discuss nerve damage with you.

I would talk with your doctor about the possibility of a EMG or a Nerve Conduction Study. MRI's and Xrays don't show nerve damage and the pain sounds like the shooting pain associated with nerve damage.

Just a thought.

Hopefully he will send you to a specialist.

Good Luck