Secrets To Treating Martial Arts Injuries

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This young tae kwon do athlete attempts to break a board by using a turn kick during a promotion test. If the student has not built up enough power, speed and accuracy to strike the board with the correct technique, there can be resulting trauma to the fo
Secrets To Treating Martial Arts Injuries
By Mark A. Caselli, DPM, and Edward C. Rzonca, DPM

   Both of these lacerations commonly occur when athletes kick the sparring bag or while they are sparring. While these lacerations usually do not result in any permanent disability, both these injuries are very painful and require podiatric intervention to excise the damaged nail plate. The athlete must also learn to dress the involved toe and apply protective padding to the toe to promote both healing and the ability to resume martial arts activities.

Key Pearls On Treating Sprains

   Ankle sprains occur most often in the martial arts during sparring when the student is changing positions rapidly. The most common type is the lateral ankle sprain. Sudden changes in direction during sparring can result in the student being caught off balance. A slow progression of training is essential to promote increased balance, flexibility and strength while reducing the risks of foot and ankle sprains. Pay careful attention to the sprain in order to rule out a fracture.

   Disability from an ankle sprain can last four months or more. It is essential that all ankle injuries be totally healed before permitting the martial arts athlete to return to rigorous activities such as performing difficult maneuvers or competitive sparring. The athlete should have a pain-free ankle, subtalar joint range of motion and be capable of walking and running without a limp. There should be equal and symmetrical ankle proprioception for both limbs. One can assess this by evaluating athletes as they hop on one leg. These athletes should also have symmetrical muscle strength in the three muscle compartments of both limbs. One can determine this via manual muscle testing.

   A common sprain to the foot is a hyperextension injury to the first MPJ. This sprain is usually the result of sparring and changing directions rapidly. The hallux becomes forcibly dorsiflexed while the athlete lunges forward to attack an opponent, resulting in a sprain of the first MPJ.

   While most of these injuries are mild, be aware there are severe cases in which the sesamoids may be partially or completely torn from their bed. A forced dorsiflexion of the proximal phalanx against the first metatarsal head may also result in a fleck of cartilage being shorn from the metatarsal head. The hyperextended first MPJ sprain can last up to four months or longer. During this time, one should follow initial immobilization with physical therapy as this is essential for maximum recovery.

Dr. Caselli (pictured) is a staff podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is also an Adjunct Professor at the New York College of Podiatric Medicine and is a Fellow of the American College of Sports Medicine.

Dr. Rzonca is a Staff Podiatrist at the VA Hudson Valley Health Care System, Montrose, N.Y. He is a Former Chairman of the Department of Orthopedic Sciences at the New York College of Podiatric Medicine. Dr. Rzonca is a black belt candidate in tae kwon do.


1. Caselli MA, Rzonca RC: Ankle Answers. OrthoKinetic Review 2002 April; 2(3): 22- 25
2. Fetto JF: Judo and Karate. In Fu FH, Stone DA (ed) Sports Injuries, Mechanisms, Prevention, Treatment (2nd Edition). Philadelphia, Lippincott Williams & Wilkins, 2001, pp 545-557
3. Muller-Rath R, Bolte S, Petersen P, Mommsen U: Injury profile in modern competitive karate--analysis of 1999 WKC-Karate World Championship Games in Bochum. Sportverletz Sportschaden 2000 Mar;14(1):20-24

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