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Martial Arts and Kickboxing Injuries
Guest Editor, Dr. Alan Ng
1994 World Kyuk Too Ki Heavyweight Bare Knuckle Champion
Second Degree Black Belt Enshin Karate
First Degree Black Belt Shidokan Karate With
the new popularity of athletic activities involving the martial arts, a
variety of injuries will occur that are not seen with mainstream
athletics. The diversity of the martial arts can be broken down into
two different types of training. The traditional martial artist or
kickboxer's training will involve a series of activities. A training
session will involve stretching, basic techniques and combinations, bag
and/or pad training, forms or kata, and finally sparring. A new type of
training has become very popular in today's society is aerobic
kickboxing otherwise known as "tae Bo". This type of training or
exercise involves utilizing martial arts technique combined with
traditional aerobic exercises. A class of aerobic kickboxing will
combine stretching, basic techniques and combinations in an aerobic
type format. Training The
most important aspect of martial arts training or aerobic kickboxing
training is that the student or participant must stretch extensively
before a training session. By stretching the amount of minor soft
tissue injuries such as muscle strains, tendon strains will be
decreased. Stretching should be performed for a minimum of fifteen
minutes before performing any kicking or punching techniques. Injuries
that can occur vary from minor injuries to severe dehabilitating
injuries. When assessing aerobic kickboxing, injuries that occur are
generally minor. Common podiatric related injuries when performing
aerobic kickboxing are; plantar fasciitis, Achilles tendonitis,
seasmoiditis, ankle sprains. When looking at traditional martial arts
which involve striking pads, a heavy bag, and/or another student, the
injuries become more extensive. In addition to the injuries mentioned
above, traditional martial arts injuries include; fractures, hematomas,
and dislocation joints and tendons. Plantar fasciitis,
or plantar fascial injuries can occur when training due to the constant
pivoting and elevation of the foot while performing kicks. The
mechanics of performing a front or roundhouse type kick involves the
supporting leg to pivot on the ball of the foot, while the other leg is
in the air striking the target. The fascial injury can occur on the
supporting leg due the strain on the fascia, or a fascial injury can
occur to the striking leg due to the repetitive pushing off and
tightening of the fascia when beginning the kick, or when the kick is
concluding which causes the kicking foot return to the ground which
causes tightening of the fascia. The pain will be located at the inside
of the heel and at the bottom of the heel when this type of injury
occurs. Achilles tendonitis
is another common injury during martial arts training. The Achilles
tendon is involved bringing the foot into position for many of the
kicks, and is also responsible for the initiating motion when
performing a kick. Since the amount of kicks performed in a training
session can be over 500, an overuse injury to the Achilles tendon can
cause a tendonitis when training. Seasmoiditis,
is another type of repetitive motion related injury. When performing
kicks properly, the supporting foot is elevated onto its metatarsal
heads, which allows the supporting leg to pivot. The long bone behind
the big toe has two small round shaped bones underneath the head of
this bone. These bones can become irritated and inflamed and cause pain
just behind and under the big toe. As with many
other sports, ankle sprains are very common in martial arts training.
The abundance of side-to-side motion and one limb support while kicking
makes this injury a common one when training. Basic Treatment Recommendations With
the four injuries listed above, basic treatment of resting the injury,
icing the injury, and elevating the extremity should be performed. If
the conditions persist after a few days of rest, ice, and elevation,
further assessment should be performed by your podiatrist. Other Injuries With
the addition of contact activities in traditional martial arts,
fractures are common in the foot and ankle. Common types of fractures
while training are; digital fractures, and metatarsal fractures. With
these types of injuries, the pain is severe and often results in the
inability to bear weight on the limb. Swelling and bruising will often
accompany the fracture. If any injury is severe enough to hinder your
ability to walk, and a fracture is suspected, it is recommended that
you visit your podiatrist so x-rays of the area can be taken.
Hematoma formation may be the most common injury in the traditional
martial artist. Hematoma is caused when the foot or leg strikes the
target improperly or strikes a target which is not padded well. Objects
such as bony prominences, a hard heavy bag, or even sandbags. What
occurs is that by striking this object multiple vascular structures are
disrupted causing bleeding inside the foot or leg. This will cause the
foot to swell most commonly on the top of the foot, and the swelling
causes pressure on the nervous structures which will result in pain.
Hematomas can occur with or without fractures of the bones. The primary
treatment for this type of injury is again rest, ice, compression, and
elevation. It is very important thought to assess this injury properly.
If you notice that the toes are cold, and the pain is very severe you
must immediately have the injury assessed at a hospital or an urgent
care center. A condition called Compartment Syndrome can occur in this
area which if not treated immediately, can result in loss of your foot.
Dislocation of joints in martial arts will
involve the digits the majority of the time. With traditional martial
arts the training is performed without shoe gear. This allows the
digits to be exposed and vulnerable to dislocation. If a digit becomes
dislocated, see you podiatrist as soon as possible to avoid any
long-term complications in that digit. Tendon dislocation can
also occur as a result of martial arts training. The primary tendon
which can dislocate when training is the peroneal tendon which runs
just behind the fibula. Often times this injury is mistaken for an
ankle sprain. The characteristic of this injury is that the tendon
which is usually behind the fibula will pop around the outside of the
bone when the foot is pushed up. The injury will feel much like an
ankle sprain. If you notice the tendon displacing in this way, or you
notice that what you thought was an ankle sprain is not getting better
you should see your podiatrist for further evaluation. Conclusion Martial
arts is an excellent method of exercise and stress relief. As with any
type of exercise, injuries are a common occurrence. Being able to
identify the type of injury, and the proper treatment modality will
allow for a faster recovery and a faster return to activity.
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