Sports Massage – Boxing

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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 will have 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 but certainly not as extreme as in Ancient Roman times wherein they used studded gloves and usually fought until it ended in death. When boxing first originated at the Olympic Games in the 7th century BC, opponents fought with strips of leather 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 the introduction of protective hand and headgear in amateur boxing, the sport has seen serious injury some of which have been lethal.

Boxing injuries can be divided into two different categories, acute trauma and those resulting from chronic repetitive microtrauma.  The majority of boxing injuries are the result of blows to the head which can result in the nerves in the brain being torn, blood clots forming or incurring a cumulative effect known as ‘punch drunk syndrome’ which can come on long after they have retired.  It is also known that boxers 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 the demands placed on the body.  When rehabilitating injuries in the acute stage the intention is to reduce acute inflammation and encourage tissue healing.  In the chronic, early and late sub-acute phase of injury soft tissue work is more appropriate.

The preceding case history is an actual client. Hispresentation is common wherein you are dealing with both the physical and psychological elements of rehabilitation.

Case History

A young talented boxer presented with persistent left shoulder pain. Despite making changes to his training and including stretches within 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, cuts and muscle strains.

He acquired this particular injury 6 months prior, justafter he had been signed up to start his professional career. At the time he was 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 and sparred 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 the left side. He discounted the severity of the injury yet he stopped the fight soon afterwards due to his inability to breath because of the pain.  He did not go to the hospital immediately but continued to train in the weeks and months following working through the pain. Understandably he protected the area and consequently his posture and movement changed to reflect this. He played down his difficulties as he had just been signed up and did not want to lose his chances of a career inboxing.  As his progression was slower than expected, and it was becoming evident that he was not moving correctly 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 of rehabilitation 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 came to see Clinical Massage Therapist.

Taking in to consideration his past history of injuries, and after 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 was clearly 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 was achieved 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 spaces allowing a greater freedom of movement. He was then able to breath easier and felt more at ease. Thus it removed the protective posture he had been assuming and his training reverted back to where it should have progressed months ago.The use of Muscle Energy Techniques also helped to re-establish proprioception into 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 thoracic spine. By explaining the relationship between the fracture and how it affected his 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 injured athlete and how this will affect whether they seek treatment or not.  In this particular instance he was very resistant in admitting he needed help simply because he was so very nervous about 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 is through educating your clients to understand the effects of massage, how it can help in the recovery and prevention of injury, thereby they will be able to reach their optimum training goals without interruption.  This will encourage them to trust you about their soft tissue concerns making for a more relevant treatment and successful outcome.

Research

Eleven years ago there was a study done on the effects of massage 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 effects of massage of the boxers perceived recovery, blood lactate removal and the effects on their repeated boxing performance.

They had eight amateur boxers complete two simulated boxing matches.  Their heart rates, bloodlactate and glucose levels were taken before the first round.  Between the two fights one group off our 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 taken again.  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 necessarily help an athlete to recover any faster in short term. Although the massage group did not perform at any higher standards than the passive rest group, the massage group did report a significantly higher increased perception of recovery than the passive rest group. Even in conventional medicine, the perceived 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 of the 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 Clinical Massage therapist (I usually refer to myself 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 effective outcome I adjust my approach according to the needs of my client.  Research needs to be done on such areas as to look at the effects massage has on the prevention of injuries, pain control, soft tissue rehabilitation, to but name a few, as well as the long and short term effects of soft tissue work.

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Posted on October 6, 2013, in Uncategorized and tagged , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

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