**Boxer’s Fracture: A Judo Therapist’s Guide to Hand Healing**

A Boxer’s Fracture is a break at the neck of the fifth metacarpal—the bone just before the pinky knuckle. It's a frequent injury in Judo, often caused by poorly controlled punches, awkward ukemi (breakfalls), or even an opponent stepping directly on the hand during a match. Despite its name, this fracture isn’t limited to fighters in the boxing ring; Judokas encounter it more often than one might expect.

Recognizing the signs early is essential. Sharp pain and swelling over the pinky knuckle, along with a visibly flattened knuckle when making a fist, are clear indicators. You may also notice difficulty in gripping or finger flexion, and in some cases, the fingers might overlap awkwardly when making a fist. Even if the bone doesn’t appear to be displaced, tenderness along the bone or pain during grip are warning signs not to ignore. Left untreated, the injury can worsen and result in chronic problems.

Treatment begins with manual realignment, also known as reduction. If the bone fragment is angled, a trained Judo therapist can reposition it using gentle yet precise manipulation. The metacarpophalangeal (MP) joint is first flexed to 90 degrees to engage the collateral ligaments. Then, the therapist applies light traction and gradually guides the bone back into place from the palmar side. This technique may be repeated a few times while monitoring progress.

Once alignment is restored, immobilization is the next critical step. A molded aluminum splint is used to stabilize the hand, with the wrist held in about 20 degrees of extension. The MP joints are flexed between 40 to 70 degrees, and the PIP and DIP joints are kept slightly bent to preserve joint integrity and minimize stiffness. Buddy taping the injured finger to its neighbor adds extra support and reduces rotational strain.

The recovery phase involves wearing the splint for five to six weeks while monitoring for any abnormal swelling, numbness, or circulatory issues. Once the fracture has healed, gentle rehabilitation begins to restore grip strength and range of motion—key for returning to martial arts practice.

In Judo therapy, treating a Boxer’s Fracture goes far beyond setting bones. What may seem like a minor injury can cause significant long-term dysfunction if left unaddressed. Skilled Judo therapists are trained to identify even subtle signs of fracture and use techniques that are effective without relying on brute force. The ultimate goal is clear: restore function, prevent deformity, and safely return the athlete to the mat as quickly as possible.

2 Thumb MP Joint Dislocation

**Thumb MP Joint Dislocation: What You Need to Know**

A thumb MP (metacarpophalangeal) joint dislocation occurs when the joint at the base of the thumb becomes misaligned, typically due to a hard fall, a forceful grip, or an awkward bending motion. This injury is frequently seen in Judo but can also happen in everyday situations such as falling or catching a heavy object the wrong way. Most dislocations result from hyperextension, where the thumb is bent too far backward. This stretches or tears important stabilizing ligaments like the volar plate and collateral ligaments, often pushing the joint out of place and causing a dorsal dislocation.

When a dislocation occurs, common signs include a visibly bent or Z-shaped thumb, intense pain and swelling at the joint, limited or no movement in the thumb, and sometimes a gap or misalignment that can be felt. Some patients also report a clicking or grinding sensation when attempting to move the thumb.

Dorsal dislocations are the most common type, as they occur when the thumb is hyperextended backward. This motion tears the volar plate and allows the joint to shift dorsally, creating a "locked" position that typically cannot be self-corrected without professional intervention.

To reduce the dislocation, traction must be avoided—pulling the thumb can make it worse by trapping soft tissues inside the joint. Instead, the proper technique involves gently hyperextending the thumb to release any trapped tissues, applying pressure on the base of the thumb to guide the bones back into alignment, and then slowly flexing the joint into place. Once the joint is back in position, stability should be confirmed by testing the thumb’s movement.

After reduction, immobilization is essential. A molded aluminum splint should be used to keep the thumb slightly flexed at around 20 to 30 degrees. Wrapping the thumb with a Bakusui-tai bandage provides added support, and suspending the arm with a triangular bandage helps prevent swelling and the buildup of scar tissue. Immobilization is typically maintained for two to three weeks, with regular follow-up assessments to monitor progress.

Once the splint is removed, rehabilitation begins. Early mobility exercises are important to regain flexibility, followed by strength training using grip balls, resistance bands, and pinch exercises. Proprioception training helps restore thumb control and joint awareness. Finally, a gradual return to Judo practice starts with light gripping exercises using a Gi, progressing to full training once strength and stability have returned.

The typical recovery timeline involves three weeks of immobilization, followed by one week of light movement and strengthening. By week five or six, progressive training can resume, and from week six onward, most individuals can return fully to sports. With the right care and rehabilitation plan, complete recovery is achievable, allowing the thumb to return to full strength and function.

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