Effects of bandaging techniques and shot types on wrist motion in boxing

Hand-Wrist injuries account for the highest number of injuries in Boxing. Bandaging of the hand-wrist region is a common and historic practice in this sport. However, there is no literature exploring the effect of bandaging techniques on wrist motion in boxing or other combat sports. This programme of research was aimed at improving the knowledge of wrist kinematics on impact in boxing through a rigorous scientific approach. Three novel studies were generated and published in peer-reviewed journals The first study describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in-vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. Two-dimensional kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with Visual 3D software. The electromagnetic tracking system agreed with the video-based system in both the surrogate (0.9). In the punch testing, the electromagnetic tracking system showed good reliability (ICCs >0.8) and substantial reliability (ICCs >0.6) for flexion-extension and radial-ulnar deviation angles respectively. The second study quantified wrist motion during in-vivo impact testing procedures for two types of shots, Jab (straight arm shot) and Hook (bent arm short), with 29 elite boxers. For both shots, flexion and ulnar deviation occurred concurrent on impact, with a mean and standard deviation of 9.3±1.9° and 4.7±1.2° respectively for Jab shots, and 5.5±1.1° and 3.3±1.1° respectively for Hook shots, supporting dart throwing motion at the wrist. For both Jab & Hook, wrist motion on impact occurred within >30% and >20% respectively of total available active range of motion, with wristangles greater in both flexion (t=9.0, p<0.001, d=1.7) and ulnar deviation (t=8.4, p<0.001, d=1.6) for Jab compared to Hook shots. The third study investigated the effects of bandaging techniques on wrist motion on impact during two shot types, Jab (straight arm shot) and Hook (bent arm short), in 18 elite male boxers wearing either bandage only or bandage plus tape. For both motions, a significant (p<0.001) interaction between bandage techniques and shot types, and significant (p<0.001) main effects for bandaging techniques (η2=0.580-0.729) and shot types (η2=0.165-0.280), were observed. For straight and bent arm shots, wrist motion on impact occurred within 50% and 40% respectively of total active wrist motion for bandage only compared to within 20% and 15% for bandage plus tape. Time to peak wrist angle on impact increased significantly (p<0.001) by 1.2-1.4 for both shot types when adding tape to bandage. The information from this programme of research contributes to knowledge through a better understanding of wrist kinematics on impact in boxing, useful towards both injury prevention and management strategies. Further, the methodology and knowledge discussed is applicable to wider clinical and scientific settings