sharp pain in middle knuckle when I touch it

Discussion in 'Standup Technique' started by Dayuum, Sep 19, 2010.

  1. Dayuum

    Dayuum Orange Belt

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    Was throwing some hooks on the heavy bag (With bag gloves on) and everything went fine. I took a break and noticed when I touched my middle knuckle I felt a sharp pain. It looks completely normal and I can make a fist without it hurting but when I throw a punch or touch it, I feel the sharp pain.

    Could it just be in the skin and not in the joint itself?
     
  2. Get some Grant Boxing gloves

    Gloves-grantboxing.com
     
  3. Soul Harvester

    Soul Harvester Banned Banned

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    You've probably damaged the tendon that runs across the top of the knuckle. I've done this numerous times to the point my tendon now doesn't track right and sits on the side of the knuckle. Hopefuly it's just bruised and there's no real damage.
     
  4. Bennosuke

    Bennosuke Blue Belt

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    You either have a non-extreme case of boxer's knuckle or some nerve impingement. Most likely boxer's knuckle. Is the knuckle swollen? It doesn't have to be. If over the next couple of days you can feel pain in the joint for no reason its nerve impingement. Otherwise boxer's knuckle. BK is damage to the fibrous sheath that holds your extensor tendons in place over the knuckle. The damage can be minor, can have some ripping of this sheath, or can be a full splitting of the sheath.

    In either case you should give your hand some time off. If when you make a fist, you can see the tendon move off the bone (sublux- you will know it if you see it), you need surgery ASAP as you have a severe case of BK. Probably not that bad though. I have boney hands and I get BK from time to time. I recommend using heavier gloves for bag work if you are using 12-14 oz. Also wrap your hands using the ribbon method, this will give the knuckles some extra padding.

    Hope this helps!
     
  5. Bennosuke

    Bennosuke Blue Belt

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    Soul Harvester- I don't mean to scare you, but you probably need surgery as that will not heal on its own and can completely f-k ur hand up when you are older. Most articles I've read and Orthos I know prescribe surgery if your tendon is subluxing.

    To give some credence to what I'm saying, I'm a medical student and I did my undergraduate thesis on hand injuries due to punching. If you want some articles about the injury and how it is treated just PM me.
     
    Last edited: Sep 19, 2010
  6. ECS123

    ECS123 Purple Belt

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    "Sharp pain?" See a doctor, better safe than sorry. Invest in a good quality pair of super bag gloves, and some 180" Mexican style handwraps. And, wear the handwraps every time your train.

    :icon_chee
     
  7. Soul Harvester

    Soul Harvester Banned Banned

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    I've already had it looked at by a specialist. They gave me the option to have it operated on but said they usually only recomend it in cases when you have lost mobility of the apendage, which I really have'nt, I just cant fully extend my finger. Some times it gets pretty sore when I'm sparring but the doc said he could'nt garauntee surgery would ever make that go away so I just deal with it.
     
  8. Bennosuke

    Bennosuke Blue Belt

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    If you can afford it, you may want to get a second opinion from a hand specialist.
     
  9. NickDowl

    NickDowl White Belt

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    Recently, I'd noticed a sharp pain in my middle knuckle on my left hand and thought that it might go away if I took some time off. Eventually, it did go away, however, when I continued to traumatize my hand with the heavy bag, the pain would return. I also experienced the weird leather-y sensation I have seen described on so many forums regarding this topic.

    Obviously, I am going to see a specialist about this as soon as I can and I am already prepping myself for the possibility of surgery as I am very anal about keeping my body in good working condition as I imagine most of the people who take part in martial arts.

    My tendon is "not tracking" and goes a little off to the side when I clench my fist so I was wondering if any of you had experienced this and would also like to know what the outcome was. Namely, if surgery was required, or if there was some other treatment that was non-invasive. I am guessing surgery is required since the problem lies in the mechanics of the tendons and is not merely a small contusion.

    Bennosuke, I would like to see those articles and have your insight especially since you have experience with this on a medical level, it would be much appreciated since I can't seem to get the problem out of my head at the moment.

    Cheers
     
  10. Fear

    Fear White Belt

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    Are you wearing wraps? and what bag gloves are you using?
     
  11. Bennosuke

    Bennosuke Blue Belt

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    Sorry I missed your post. I will get back to you this afternoon. I'm in lecture right now :redface:

    In general though. If the tendon is tracking off the head of the Metacarpal, also known as subluxing, surgery is required. Here's a list of a few good articles. I can't give you the actual papers, but if you go to your local university or library, you should be able to access most of these through PubMed or Google Scholar

    9. Melone Jr., Charles P., Daniel B. Polatsch, and Steven Bender. "Disabling Hand Injuries in Boxing: Boxer's Knuckle and Traumatic Carpal Boss." Clinical Sports Medicine (2009): 609-21. Print.
    10. Gambrell, Robert Chul. "Boxing: Medical Care in and Out of the Ring." Current Sports Medicine Reports 6 (2007): 317-21. Print.
    11. Hame, Sharon L., and Charles P. Melone Jr. "Boxer's Knuckle in the Professional Athlete." The American Journal of Sports Medicine 28.6 (2000): 879-82. Print.
    12. Hames, Sharon L., and Charles P. Melone Jr. "Boxer's Knuckle- Traumatic Disruption of the Extensor Hood." Hand Clinics 16.3 (2000): 375-80. Print.
    13. Bents, Robert T., John P. Metz, and Steven M. Topper. "Traumatic Extensor Tendon Dislocation in a Boxer: A Case Study." Medicine and Science in Sports and Exercise 35.10 (2003): 1645-647. Print.
     
    Last edited: Oct 7, 2010
  12. EasternWind

    EasternWind Blue Belt

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    This, I get hand injuries from time to time, but they are less severe because I make sure i wrap my hands everytime I do stand-up and try to use the most padded glove you can get.
     
  13. Bennosuke

    Bennosuke Blue Belt

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    Other experts in the field are/were Stracher and Posner, and you can look them up with the work Boxer's Knuckle. It is generally agreed upon that if there is just minor damage to the "extensorhood" of the knuckle, then non-invasive techniques such as splinting can be used to speed up recovery. However, if the damage to the hood is such that it ruptures, the tendon will slide out of position (almost always). If this happens, surgery is required.

    I would give you the actually articles, but I'm afraid its copyright infringement since you (or your local library ;) have to pay for the journal to get the article.
     

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