The Hidden Battle: Common Injuries in Combat Sports and the Vital Role of Physiotherapy

The Hidden Battle: Common Injuries in Combat Sports and the Vital Role of Physiotherapy

Common Injuries in Combat Sports:

1. Musculoskeletal Injuries

Musculoskeletal injuries are the most prevalent injuries in combat sports. According to research by

the American Orthopaedic Society for Sports Medicine, strains and sprains account for

approximately 32% of MMA injuries (AOSSM, 2024). These injuries typically result from the

explosive, multidirectional movements required in combat, especially during takedowns and

transitions. Knee ligament tears and ankle sprains occur frequently due to pivoting and kicking

motions. These injuries can significantly impact an athlete’s mobility and stability, making early

intervention crucial (AOSSM, 2024). Hip injuries are increasingly recognised among combat sports

athletes, particularly due to the dynamic movements involved in these disciplines. Common hip

injuries include Labral Tears, Femeroacetabular Impingement (FAI) and Hip Flexor Strains.

The hand is one of the most commonly injured areas in mixed martial arts (MMA), primarily due to

repetitive striking. A study analysing 408 MMA fights, reported an upper limb injury rate of 9.9 per

100 athletic exposures, with the hand being the most frequently injured location (6.61 per 100

exposures). Specific injuries include carpometacarpal (CMC) instability, boxer’s knuckle, and skier’s

thumb. These conditions often result from repetitive stress and impact during training and

competition (Fares et al., 2022).

Shoulder injuries are prevalent among combat sports athletes, particularly due to the demands of

striking and grappling. Rotator cuff tears and labral tears are common shoulder injuries in these

athletes, often resulting from repetitive overhead movements and direct trauma.

2. Fractures and Dislocations

Fractures, especially to the hands and wrists, are common due to frequent striking. Dislocations,

particularly of the shoulder and elbow, are often associated with submission holds and throws

(AOSSM, 2024).

3. Concussions and Head Trauma

Head injuries remain a critical concern in combat sports. Concussions can result from both direct

head strikes and whiplash-type movements. Over time, recurrent concussions may lead to chronic

traumatic encephalopathy (CTE), a progressive neurological disorder (Torres, 2018).

 

The Role of Physiotherapy in Combat Sports

Physiotherapy plays a crucial role in injury management and improving performance for combat

sports athletes.

1. Injury Assessment and Rehabilitation

Physiotherapists conduct detailed assessments and develop personalised rehabilitation plans. These

often include exercises to improve joint stability, mobility, and strength—critical for recovering

from injuries such as ACL tears or rotator cuff strains (AOSSM, 2024).

2. Manual Therapy Techniques

Manual therapy, including joint mobilisations, myofascial release, and soft tissue manipulation, can

significantly reduce pain and facilitate recovery. Trifecta Therapeutics (2023) reports that hands-on

techniques are especially effective in managing joint and soft tissue dysfunctions.

3. Neuromuscular Re-education

This approach focuses on retraining the body to use correct movement patterns, which can prevent

reinjury and enhance athletic performance. It’s especially relevant for post surgical rehabilitation of

the lower limbs, where impaired biomechanics often lead to recurring issues (Kaur & Singh, 2017).

4. Preventive Strategies/ Education

Physiotherapists also educate athletes on injury prevention, emphasising proper warm-up,

stretching, and strength training.

 

Conclusion

Combat sports athletes face a high risk of various injuries due to the physical intensity and

unpredictability of competition. Physiotherapy plays a pivotal role not just in injury recovery, but in

building resilience, enhancing performance, and extending athletic careers. A well-rounded

physiotherapy program should be considered an essential part of every combat athlete’s training

regimen.

 

References
American Orthopaedic Society for Sports Medicine (AOSSM), 2024. Mixed Martial Arts: Injury
Patterns, Trends, and Misconceptions. [online] Available at: https://www.sportsmed.org/
membership/sports-medicine-update/summer-2024/mixed-martial-arts-injury-patterns-trends-and-
misconceptions [Accessed 14 Apr. 2025].
Fares, M. Y., Baydoun, H., Elhassan, B., & Abboud, J. A. (2023). Upper limb injuries in mixed
martial arts. The Physician and sportsmedicine, 51(5), 434–441. https://doi.org/
10.1080/00913847.2022.2123257
Kaur, R. and Singh, J., 2017. Physiotherapy and martial arts. ResearchGate. [online] Available at:
https://www.researchgate.net/publication/319112469_Physiotherapy_and_martial_arts [Accessed
14 Apr. 2025].Torres, R., 2018. Mixed Martial Arts and the Risk of Concussion. Orlando Orthopaedic Center. [pdf]
Available at: https://www.orlandoortho.com/wp-content/uploads/2018/02/Torres-Mixede-Martial-
Arts-min.pdf [Accessed 14 Apr. 2025].
Trifecta Therapeutics, 2023. 5 Ways Physical Therapy Can Knock Out Injuries in Combat Athletes.
[online] Available at: https://www.trifectatherapeutics.com/blog/rehab-for-the-combat-athlete-5-
ways-pt-can-ko-injuries [Accessed 14 Apr. 2025].

Ganglions and Cysts

Ganglions and Cysts

What is a Ganglion?

A Ganglion is a cyst, which is a fluid filled sac that is often found on the hands and feet. It originates from a joint capsule or tendon. The cause of Ganglions is not known however could be a consequence of repetitive trauma or a single event.

What does it feel like?

A ganglion can cause some burning or tingling in the hands and feet. This is due to the sac impinging on a nerve. It may make shoes uncomfortable because if irritation against the ganglion.

Diagnosis

A Podiatrist can diagnose a Ganglion in the foot by palpating the area. It will usually move freely beneath the skin when palpated. If there is suspicion of an alternative diagnosis, then the podiatrist may request an x-ray or ultrasound to rule out other causes.

Treatment

If the cyst is causing no issues and the patient just wants clarification on the diagnosis, then the Podiatrist can monitor closely over time.

In the instance that the Ganglion is causing irritation then there are options such as:

-Shoe modifications

-Padding to offload the Cyst

-Insoles that are specific to the region and size of the cyst so that comfort can be achieved.

-Aspiration of the Ganglion can be completed, however often the cyst will return.

– Surgical removal can be completed when the previous treatments have been exhausted. Surgical removal reduces the chance of the Ganglion returning however there is still the possibility of its return.

To conclude, Ganglion cysts may come and go. If the mass is causing pain, there are treatments available to allow you to manage discomfort. See a Podiatrist to confirm a diagnosis and to create a treatment plan specific to you.

Morton’s Neuroma

Morton's Neuroma

What is Morton’s Neuroma?

Morton’s Neuroma is a thickening of the tissue that surrounds the nerve supplying the digits (toes). Patients commonly complain of a pain at the ball of the foot that feels like a stone or marble. The condition can cause nerve pain such as tingling, pins and needles or numbness.  This digital neuritis often occurs at the webspace between the third and fourth toes however can occur between any of the digits.

Who does it effect?

This condition can affect anyone, sprinters may experience it due to the compression of the nerve from pushing off at the start blocks.

Those wearing high heels can experience it, similarly due to the toes/forefoot position because of a heightened heel.

Tight, narrow shoes are a large factor contributing to the condition.

 

What else could it be?

-Stress fracture

– Capsulitis (aggravated joint capsule)

-Systemic causes such as Rheumatoid Arthritis

-Corn, Callus, Verruca.

-Foreign Body.

 

How can A Podiatrist Help?

A Podiatrist will analyse symptoms, medical history, footwear, activity changes and biomechanics. These factors alongside range of motion, mobility and strength tests will guide the Podiatrist to a diagnosis. Imaging such as x-ray can be used to rule out differential diagnosis such as fractures.

Treatment

Treatment can include footwear changes, Orthotic use, stretching and strengthening. Other treatments used for Morton’s neuroma include:

-Corticosteroid injections.

-Shockwave therapy.

-laser therapy.

-Foot and ankle mobilisations.

– Neurectomy (Surgery to remove the affected area of the nerve).

Wart is this on my foot? – Verruca Pedis

Wart is this on my foot? – Verruca Pedis

A plantar wart, also referred to as plantar verruca is a skin condition caused by the Human Papiloma Virus. This virus is very common, and presents on the feet. It infects the skin causing an abnormal reproduction of the skin’s appearance. Verrucas can be embarrassing for some however there is no need to be concerned as there are various treatments for Plantar verruca’s.

Verruca’s can be painful due to their raised appearance on the skin and are often surrounded by hyperkeratosis (callus). They often contain small black dots within them, these are small blood vessels. If you think you may have a verruca, it could be time to visit a Podiatrist.

 

What can Podiatrists do?

Podiatrists will assess the lesion to determine if it is verruca or something else like callus, or a foreign body. We will ask for a medical history so that we can determine the best treatment plan for you. Treatments can include debridement of the tissue and the use of chemicals such as silver nitrate, or salicylic acid. We can modify insoles and use padding to offload the Verruca so that you can stay active and pain free throughout treatment.  Verruca’s that don’t respond to these treatments may require further interventions such as Swift Microwave therapy or Faulkner’s needling.

What can you do?

Verruca is a virus that is transferable through direct contact or surfaces.  If you think you have a verruca it is important to wear socks around the house or public places to minimise the cross-contamination.

Rheumatoid Arthritis and your Feet​

Rheumatoid Arthritis and your Feet

Rheumatoid arthritis is a chronic autoimmune disease whereby your immune system begins to damage tissues such as cartilage and ligaments.   The condition affects the hands and feet most commonly. Females are 3 times more likely to develop this condition and the most common age category for developing it is between 40 and 60 years.

Symptoms can present as swelling and stiffness in the foot and ankle joints. Deformities such as bunions, hammer & Claw toes, pes planus (flat feet), can develop at a progressed stage of the condition.  These deformities can lead to increased pressure on aspects of the foot, causing callus buildup and possible breakdown of the tissues.

After a diagnosis of Rheumatoid Arthritis, treatment can commence in the form of medication known as disease modifying anti-rheumatic drugs (DMARDS) or non-steroidal anti-inflammatory drugs (NSAIDS) following assessment from a Rheumatologist.

A thorough assessment from our health professionals will determine the extent of deformity or progression of the disease. Treatments such as exercise therapy, Orthotic therapy and footwear modifications are excellent for slowing the progression and will often include softer materials that offload any deformities of the condition and to keep you comfortable and active.  

What does a Podiatrist do?

It is a common question and often a point of confusion as to what a podiatrist does, as far as treatment and scope of practice.

Most of our time is spent assessing, diagnosing, and treating lower limb conditions. In terms of our training most undergraduate programs are 4 years of full-time university with a focus on biochemistry, human biomechanics, anatomy and physiology, in addition to podiatry specific clinical practice and associated study.

We treat people of all ages, and a myriad of conditions. Basically anyone with feet! And this is what makes a day in the life of a podiatrist so diverse. In a single day, you could treat a person for heel pain, whilst later addressing ingrown toenails, providing intervention for an in-toeing child and screening for neuropathy and circulation in a diabetic patient.

No issue is too big or too small .

Below is a broad list of categories that a podiatrist treats.

Skin and nail care: When it comes to making sure your nails are healthy or free of fungus, corns/hard skin and callus are removed safely and painless, and addressing ingrown toenails, we are the people to see.

Orthotic therapy: Biomechanical and postural complaints such as flat or very high arched feet, in addition to optimising foot function can be addressed with orthotic therapy in the form of custom or pre-made dependant on the circumstances. They can be a very useful tool to unload injured tissues during an acute or chronic injury, or a way to reduce muscular and joint strain in active individuals with jobs or activities that place high demands on the lower limb.

Diabetes screening and management: Podiatrists play a vital role in screening for the effects of diabetes such as neuropathy and impaired circulation. Due to the increasing epidemic of diabetes and the burden it places of the health system, it is crucial to prevent complications related to diabetes. We ensure diabetic’s feet are in good condition to ensure long lasting mobility and prevent hospitalisations.

Footwear: A podiatrist is well positioned to provide advice on appropriate footwear for an individual based on their unique biomechanics, activities and occupation. Aside from the dynamic function of the foot, the size and shape of feet mean considerations for length and width and the shape of the outsole are important considerations. We have regular contact with leading footwear companies on the latest innovations and ranges that can suit a person’s foot, get the right fit and help with the particular issue, rather than worsen it.

Running and Gait Analysis: From simple gait retraining and analysis, it can help paint the overall picture of why someone might develop lower limb pain. It can also be useful to have a trained eye to assess running technique to optimise efficiency, reduce injury and facilitate improved performance.

Paediatric issues: We commonly see young children for postural concerns, ingrown nails, warts/verruca and in-toeing. Often a parent wants to be advised if their child is progressing and developing with a normal range and we can provide assessment to decide whether intervention is necessary. 

Aches and pains: If that niggling knee, hip or back pain is keeping you from staying active, we can assess if their is a contributing factor by evaluating your movement patterns, limb-length and gait cycle. We can help with a combination of assessment, and effective treatments. Life is too short to be in pain!

What do Michael Jordan, Tiger Woods and Arnold Schwarzenegger have in common? | We ask Dr Soroush Ebtash

At The Wellness Place, we have been looking after athletes day-in day-out. Some of these athletes have been seeking physiotherapy care and some have chosen to see our chiropractors. Traditionally, most athletes are used to seeing physios for their injuries, however sports chiropractic is fast becoming a growing area of speciality within the chiropractic profession. 

Many big names in sports such as Michael Jordan, Evander Holyfield, Tiger Woods, Arnold Schwarzenegger, Tom Brady, Joe Montana, Usain Bolt and many others have turned to chiropractic care as part of their routine care to enhance theirperformance. 

Even locally, you would be pleased to know that while Dr Soroush Ebtash looked after the WAIS cycling team, almost all athletes who received chiropractic care, scored their PB on the track. Similar impressive results were also noted when Dr Soroush Ebtash looked after the Swan DistrictsFootball Club over 8 years and the club recorded the lowest statistics of non-impact injury list in its history.

If you’re an athlete, you understand the importance of keeping your mind and body in tip-top shape with exercise, healthy foods and plenty of rest. However, some of these results above may be surprising to you.

If you wondered how athletes benefit from chiropractic care, here’s why:

Better mind-body awareness. By improving your neurological and musculoskeletal functionality, your body can perform to the best of its ability. This means proper, free-flowing signals between your brain and body.

Improved coordination. Cerebellum is the part of your brain which controls your coordination and It receives its input from different parts of your body. The joints in your spine and extremities are crucialto “feeding” your cerebellum. 

Your chiropractic adjustments provide your brain with the necessary input and information for it to perform optimally. Chiropractic is a completely natural solution to bringing your body into peak performance mode, which means you’re moving with ease exactly how your brain is telling you to.

Heightened flexibility. Proper movement on the field or the court can help prevent future injuries, keeping you in the game longer. Optimal movement is directly dependent on correct alignment. Your chiropractic adjustments ensure you are aligned and moving correctly and comfortably. 

Know an athlete that could benefit from our care? Give us a call on 08 9379 3838.