For the first time since boxing was introduced in 1904 women are competing in the Olympic Games in 2012. Both men’s and women’s events will have different weight categories. Men’s consist of 10 ranging from light Fly Weight (46-49 kg) to Super Heavy Weight (over 91 kg), the women’s have 3: Fly Weight (48-51 kg), Light Weight (57-60 kg) and Middle Weight (69-75 kg). The duration of the women’s and men’s bouts last 2 to 3 minutes long over 3 to 4 rounds respectively. Each event is run in a knockout format.
For the first time since boxing was introduced in 1904 womenare competing in the Olympic Games in 2012. Both men’s and women’s events willhave different weight categories. Men’s consist of 10 ranging from light FlyWeight (46-49 kg) to Super Heavy Weight (over 91 kg), the women’s have 3: FlyWeight (48-51 kg), Light Weight (57-60 kg) and Middle Weight (69-75 kg). The duration of the women’s and men’sbouts last 2 to 3 minutes long over 3 to 4 rounds respectively. Each event is run in a knockout format.
Boxing is still considered to be an extreme sport butcertainly not as extreme as in Ancient Roman times wherein they used studdedgloves and usually fought until it ended in death. When boxing first originatedat the Olympic Games in the 7th century BC, opponents fought with strips ofleather wrapped around their fists, this made for a much harder impact on thebody than what is now used with a padded gloved hand. Even with theintroduction of protective hand and headgear in amateur boxing, the sport hasseen serious injury some of which have been lethal.
Boxing injuries can be divided into two differentcategories, acute trauma and those resulting from chronic repetitivemicrotrauma. The majority ofboxing injuries are the result of blows to the head which can result in thenerves in the brain being torn, blood clots forming or incurring a cumulativeeffect known as ‘punch drunk syndrome’ which can come on long after they haveretired. It is also known thatboxers are more likely to suffer from Parkinson’s or Alzheimer’s Disease.Boxers still suffer with similar conditions as in other sports such as musclestrains, tendonitis and joint strains due to the repetitive nature and thedemands placed on the body. Whenrehabilitating injuries in the acute stage the intention is to reduce acuteinflammation and encourage tissue healing. In the chronic, early and late sub-acute phase of injurysoft tissue work is more appropriate.
The preceding case history is an actual client. Hispresentation is common wherein you are dealing with both the physical andpsychological elements of rehabilitation.
Case History
A young talented boxer presented with persistent leftshoulder pain. Despite making changes to his training and including stretcheswithin his routine, the achy, niggling discomfort would not shift. Frequently it would wake him up atnight and it never completely went away during the day. It was affecting his training andinterfering with his expected progression. His past general history consistedof injuries that are typical in boxing, such as broken bones, contusions, cutsand muscle strains.
He acquired this particular injury 6 months prior, justafter he had been signed up to start his professional career. At the time hewas very excited about the prospect of his future moving onto a new level andwas feeling on top of the world. Hence he did something out of character andsparred with a partner who was a more seasoned boxer in a heavier weightcategory. During the session he received a significant blow to the ribs on theleft side. He discounted the severity of the injury yet he stopped the fightsoon afterwards due to his inability to breath because of the pain. He did not go to the hospital immediatelybut continued to train in the weeks and months following working through thepain. Understandably he protected the area and consequently his posture andmovement changed to reflect this. He played down his difficulties as he hadjust been signed up and did not want to lose his chances of a career inboxing. As his progression wasslower than expected, and it was becoming evident that he was not movingcorrectly or as aggressively as he had in the past, his coach insisted he havean x-ray. It showed a poorlyhealed fracture on the 3rd & 4th ribs anteriorly. He then had a series of rehabilitation sessions to returnhim back to form. After 6 weeks ofrehabilitation he was discharged. Although it had improved his range of movement he was still hindered bya dull achy sensation at the top back area of his shoulder. It was for this that he originally cameto see me at the NLSSM Sport and Remedial Massage clinic.
Taking in to consideration his past history of injuries, andafter completing a thorough assessment of his range of movement in his shoulder,back and ribs, I felt it was appropriate to start work in the front close tothe fracture rather than focusing on the area of discomfort at the back. It wasclearly evident that there was scar tissue present and the ribs were no longerevenly spaced and moving as intended. Also his shoulder joint was not as stable as it should have been partlydue to his protective posture he had assumed. His serratus anterior had atrophied, and his scapula wastherefore not gliding over the ribs properly which led to a decrease of powerin that arm.
Over a series of treatment sessions a successful outcome wasachieved by using a combination of friction, soft tissue release, mobilitytechniques such as compression, vibration and rocking along with rhythmic breathing.This resulted in realigning the ribs, opening up the intercostal spacesallowing a greater freedom of movement. He was then able to breath easier andfelt more at ease. Thus it removed the protective posture he had been assumingand his training reverted back to where it should have progressed months ago.The use of Muscle Energy Techniques also helped to re-establish proprioceptioninto the muscles that had lost their power and strength.
The young athlete had not linked up the fracture to his shoulderpain as the fracture was anterior and the pain was posterior near the thoracicspine. By explaining the relationship between the fracture and how it affectedhis movement he began to understand the link between the body as a wholeinstead of looking at it in sections. Thus his workouts took on a new perspective as he began to relate thesame principle to his training sessions.
It is important to understand the psychology of an injuredathlete and how this will affect whether they seek treatment or not. In this particular instance he was veryresistant in admitting he needed help simply because he was so very nervousabout appearing to be “weak” and lose out on a chance of a lifetime. In Boxing,as in a great many sports, the appearance of weakness is not an option. It can be a challenge to work within asport that requires such a powerful and supreme presence. Therefore the carrot on the stick isthrough educating your clients to understand the effects of massage, how it canhelp in the recovery and prevention of injury, thereby they will be able toreach their optimum training goals without interruption. This will encourage them to trust youabout their soft tissue concerns making for a more relevant treatment andsuccessful outcome.
Research
Eleven years ago there was a study done on the effects ofmassage on the physiological restoration and the perceived recovery and sportsperformance of boxers (B. Hemmings, M. Smith, J. Graydon and R. Dyson). It’s aim was to investigate the effectsof massage of the boxers perceived recovery, blood lactate removal and theeffects on their repeated boxing performance.
They had eight amateur boxers complete two simulated boxingmatches. Their heart rates, bloodlactate and glucose levels were taken before the first round. Between the two fights one group offour boxers received a massage by a professional therapist and the other fourwere asked to rest for the same period of 20 minutes. After the massage treatmentor rest period and before starting the second round, the same tests were takenagain. At this time the boxerswere asked to evaluate their perceived recovery ratings. When the second round was complete, alltests were taken again.
The massage group did not perform any better in the secondround than did the passive rest intervention group. There was also no difference in the blood lactate or glucoselevels in the groups, which would indicate that massage does not necessarilyhelp an athlete to recover any faster in short term. Although the massage groupdid not perform at any higher standards than the passive rest group, themassage group did report a significantly higher increased perception ofrecovery than the passive rest group. Even in conventional medicine, theperceived effectiveness of a treatment has a significant role to play inachieving a positive outcome.
This short study highlights the need for more research to bedone in our profession. Most ofthe work I do and the results I have seen have been the result of regularsessions over a longer period of time, but I have also seen some significantchanges after just one session. As a remedial therapist (I usually refer tomyself as a soft tissue specialist) I have an extensive “bag of tricks” that Iuse. I do not rely on one method but in order to achieve the most effectiveoutcome I adjust my approach according to the needs of my client. Research needs to be done on such areasas to look at the effects massage has on the prevention of injuries, paincontrol, soft tissue rehabilitation, to but name a few, as well as the long andshort term effects of soft tissue work. If you are interested in doing research a good place to start is readingup on what has been done. Youmight already have an idea that has been forming in your mind, it would bevaluable to purchase a good book like Outcome-Based Massage from Evidence toPractice ISBN 13:9078-0-7817-6760-6 wherein it will show you how to adopt anevidence based approach to practice and demonstrate the outcomes that youachieve within your massage based interventions.
Terminology Corner
Below the belt is an imaginary line from the belly button tothe top of the hips. Under the rules a boxer is not supposed to hit below thisarea.
Mouse - A swelling on the face, forehead or head.
Punch-Drunk – Due to repeated blows to the head boxers candevelop Dementia Pugilistica, a neurological disorder. Symptoms include slurredspeech, dementia, dazedness, confusion and inappropriate behavior resemblingalcoholic intoxication.
Queer Street - When a boxer is dazed from getting hit hardon the head or has taken too many punches to the head.
Rabbit Punch – a potentially lethal blow to the back of thehead or neck. It is illegal in boxing since it can cause cervical vertebraedamage and subsequent spinal cord injury resulting in paralysis or death.
Technical Knockout (TKO) - A referee can stop a fight if hefeels that the boxer is unable to continue due to bad cuts or bruises or whenthey cannot defend themselves.
Further Information
www.uksport.gov.uk/sport/summer/boxing-amateur
www.gbboxing.org.uk
www.uksport.gov.uk
As well the following website offers free access to a large variety ofarticles and journals on a wide range of subjects. If you put your search in itneeds to include the words massage and benefits under articles rather thanjournals. http://www.ncbi.nlm.nih.gov
