Boxers Knuckle

What is Boxers Knuckle

Boxers knuckle is an injury to an extensor tendon. The extensor tendons are located on the back of the hand. They help the fingers to extend. They also help to protect the finger bones and joints.
Boxers knuckle develops if the layer of tissue that lies over these tendons becomes damaged and causes a tendon to move out of position. Boxer’s knuckle often affects the first knuckle of the middle finger.

What are the causes?

This condition is caused by direct or repeated injury (trauma) to a knuckle. If often happens during activities such boxing or martial arts.

What increases the risk?

This condition is more likely to develop in:

  • People who participate in hitting or fighting sports, such as boxing and martial arts.
  • People who play contact sports, such as football and rugby.
  • People who have poor strength and flexibility.
  • People who have injured a knuckle.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain and swelling over the injured knuckle.
  • Difficulty straightening the affected finger.
  • Delay when you try to straighten the affected finger.
  • Tenderness when you touch the injured knuckle.
  • Abnormal movement of the affected tendon when you open and close your hand.

How is this diagnosed?

This condition is diagnosed with a physical exam. Sometimes, X-rays are taken to check for additional problems, such as a fracture or cyst in the bone under the injured area.

How is this treated?

This condition may be treated with:

  • Ice applied to the affected area.
  • Medicines for pain.
  • Placing the hand in a cast or splint to keep the injured joint from moving while the tendon heals.
  • Surgery to repair the injured tendon or tissue. This may be done in severe cases.

Follow these instructions at home:

If you have a cast:

  • Do notstick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
  • Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do notapply lotion to the skin underneath the cast.
  • Keep the cast clean and dry.

If you have a splint:

  • Wear it as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint if your fingers become numb and tingle, or if they turn cold and blue.
  • Keep the splint clean and dry.


  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
  • If your health care provider approves bathing and showering, cover the cast or splint with a watertight plastic bag to protect it from water. Do notlet the cast or splint get wet.

Managing pain, stiffness, and swelling

  • If directed, apply ice to the injured area.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.


  • Do notdrive or operate heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a cast or splint on your hand.

General instructions

  • Do notput pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Do notuse any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your pain gets worse.
  • You hand tingles or feels numb.
  • Your hand becomes discolored.

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