10th August 23

Understanding the Risk of Boxing Injuries to the Shoulder

Anthony Joshua is back in action this weekend and with it, seems to come a sudden interest in the sport.

In light of Joshua’s upcoming fight, we find it opportune to delve deeper into the often-unseen aspects of the sport.

Boxing, beyond the glitz and glamour of media coverage, demands rigorous training, disciplined lifestyle choices, and a relentless pursuit of physical and mental fortitude.

These are the elements that shape a boxer’s career, far removed from the spectacle of the ring.

A boxers training camp leading into the fight can be brutal. As physiotherapists, we often work with them in the lead up to a fight – and one of the most common boxing injuries that we see is in the shoulder.

Shoulder injuries in boxing are alarmingly common, often causing significant setbacks for boxers, both professional and amateur.

As these athletes extensively utilize their upper body, particularly their shoulders, they are invariably susceptible to a range of shoulder-related injuries.

Shoulder Injuries in Boxing – An Overview

Common Types of Shoulder Injuries in Boxing

Boxers are prone to a variety of shoulder injuries due to the intensive and repetitive movements involved in the sport. These injuries can be categorized into three primary types:

Rotator Cuff Injuries:

The rotator cuff, a group of muscles and tendons surrounding the shoulder joint and upper arm bone (humerus), is frequently injured in boxing. Rotator cuff injuries can range from mild strains to complete shoulder rotator cuff tears, often resulting from the repetitive motion of throwing punches. Boxers may experience shoulder pain, weakness, and limited mobility in their shoulder. Rotator cuff injuries occur when the load through the tendon increases above the level of tolerance (or strength) of the tendon.

Shoulder Impingement Syndrome:

This condition occurs when the shoulder blade puts pressure on the soft tissues underneath, often due to repetitive overhead movements such as those in boxing. Symptoms include chronic shoulder pain and a limited range of motion.

Glenohumeral Joint Injuries:

The glenohumeral joint, where the upper arm bone meets the shoulder blade, is a common site of injury. Injuries here can include a sudden traumatic incident such as dislocations (where the humerus comes out of the shoulder socket), a torn labrum, or joint instability. These injuries might lead to persistent shoulder pain and decreased athletic performance.

Shoulder joint injuries, if left untreated, can cause long-term damage and hinder a boxer’s career. Therefore, understanding these risks and focusing on proper technique, preventive exercises, and timely treatment are crucial in the sport of boxing.

Connection to Boxing Training, Techniques, or Moves That May Lead to These Injuries

The intensity and repetitive nature of boxing training contribute significantly to the high incidence of shoulder injuries in the sport. Let’s delve deeper into few aspects:

Punching Techniques:

The sheer volume of punches thrown by a boxer during training and matches puts a significant strain on the shoulder joint, especially the rotator cuff. Rotator cuff injuries occur when bad punching technique, such as overextending the arm or throwing punches from awkward angles, occurs over a period of time and this can exacerbate the risk of shoulder rotator cuff tears.

Defensive Movements:

Defensive techniques such as ducking and weaving require swift, sudden movements that can lead to shoulder impingement of the rotator cuff muscles over time. These rapid changes in direction can cause the shoulder blade to pinch the soft tissues underneath.

Workout Routines:

Many boxers incorporate strength training into their routine to increase power. However, improper lifting techniques or overtraining can lead to glenohumeral joint injuries. For instance, overhead lifts can cause excessive stress on the upper arm bone and the shoulder joint, leading to instability or even dislocations.

Inadequate Warm-ups and Cool-downs:

Skipping or rushing through warm-ups and cool-downs can significantly increase the susceptibility to all types of shoulder injuries. Muscles and tendons need to be properly warmed up before training to increase their flexibility and blood flow. Similarly, cool-down exercises aid in muscle recovery and decrease post-exercise stiffness.

Understanding these training-related risks and promoting proper technique, appropriate workout routines, and adequate pre and post-exercise routines can play a critical role in those experiencing shoulder pain in boxing.

The Boxing World’s Response to Shoulder Injuries

Preventative Measures to Reduce Shoulder Injuries in Boxing

Recognizing the high prevalence of shoulder injuries in the sport, the boxing world has initiated several preventative measures to safeguard boxers from such risks.

These strategies encompass various elements of a boxer’s training regimen, aiming to fortify the entire shoulder strength and resilience.

Proper Punching Technique:

Coaches place significant emphasis on teaching proper punching technique from the get-go. This focus ensures that boxers throw punches in a manner that minimizes shoulder strain on the shoulder socket. The sport has also witnessed a rising trend of incorporating video analysis to minutely observe and correct boxers’ techniques.

Strength and Conditioning Training

Specific exercises designed to strengthen the shoulder muscles and increase joint stability have become a staple in boxers’ workout routines. These exercises, such as resistance band workouts or rotational shoulder strengthening, aim to fortify the shoulder and upper arm against the rigors of the sport.

Emphasis on Warm-ups and Cool-downs:

Boxing training now places a high priority on thorough warm-ups and cool-downs, recognizing their critical role in injury prevention. Programs often incorporate dynamic stretching, light cardio, and mobility exercises during warmup and static stretching during cool-downs – which majorly reduces the risk of a sudden traumatic incident.

Regular Physiotherapy Sessions:

Regular check-ups with physiotherapists and sports medicine professionals are encouraged in the boxing world. Injuries tend to be easier to treat when picked up early. These sessions aid in early detection of potential issues, allowing for timely intervention and treatment.

Rest and Recovery:

Understanding the importance of rest in an athlete’s regimen, rest periods are now embedded into training schedules to ensure muscles have adequate time to recover and rebuild. Tendons develop microtears from overuse, so it is critical that they are well rested when possible.

Through these comprehensive preventative measures, the boxing world aims to decrease the likelihood of shoulder joint injuries, enabling athletes to sustain their performance while prioritizing their health.

In our practice, we work closely with renowned boxing coach Ben Davison, and we have implemented these preventative measures successfully with many of his boxers, including Josh Taylor, Leigh Wood, Pat McCormack, and Shabaz Masoud, to reduce the risk of common injuries.

For instance, Shabaz places a significant emphasis on technique. He works with Ben and a team of trainers and analysts to refine his punches and defensive movements, using video analysis to identify and rectify any nuances that may put extra strain on his shoulder joint.

Their training consistently focuses on strength and conditioning training of the rotator cuff and upper arm muscles, incorporating specific shoulder-strengthening exercises into their regime to increase their shoulder stability.

Shabaz Masoud regularly consults with our physiotherapists to monitor his entire shoulder health and catch any potential issues early on.

Furthermore, he ensures to incorporate adequate rest periods into his training schedule to allow his rotator cuff muscles ample time to recover.

By integrating these proactive measures into their training programs, these boxers have managed to stay at the top of their performance while minimizing the risk of shoulder injuries and experiencing shoulder pain.

Case Study – Shabaz Masoud – WBA Intercontinental Champion

Shabaz Masoud, the WBA Intercontinental Champion, serves as a prime example of successful collaboration with our physiotherapists.

The main objectives were improving his shoulder external rotation and internal rotation range of motion, enhancing rotator cuff strength for better stability and power, and preventing tissue degradation.

Masoud worked closely with our team of physiotherapists on a comprehensive program designed specifically to enhance his shoulder mobility and rotator cuff strength.

This program incorporated a range of upper arm exercises and stretches that targeted the muscles surrounding the shoulder joint, gradually increasing his range of motion without compromising stability or risking injury ro the rotator cuff.

His commitment to the program resulted in an improved ability to execute his punches and defensive techniques more efficiently and accurately, avoiding any common injuries along the way.

Our physiotherapists also focused on strengthening Masoud’s rotator cuff muscles to bolster shoulder stability and enhance power in his punches.

They introduced a regime of resistance exercises and weight training to increase muscle strength and endurance over time.

This systematic and targeted approach allowed Masoud to deliver more robust and powerful punches without overstraining his rotator cuff.

In addition to movement and strength exercises, our team utilized innovative therapies such as shockwave therapy and cryoultrasound to maintain the integrity of Masoud’s shoulder tissues.

Shockwave therapy helped stimulate the body’s natural healing processes, promoting faster recovery and reducing the risk of chronic injuries, typically tears of the rotator cuff.

On the other hand, cryoultrasound, a technique combining ultrasound’s therapeutic benefits with the application of cold, helped to manage inflammation, ease pain, and prevent tissue degradation.

Injuries tend to occur when tissue is overloaded and inflamed, and so this prevented painful conditions associated with degradation of the tissue such as subacromial bursitis.

This multi-faceted approach to training and rehabilitation ensured that Masoud could continue performing at his peak while minimizing the risk of serious shoulder injuries or upper arm issues.

His case aptly demonstrates the effectiveness of targeted physiotherapy interventions in enhancing athletic performance and injury prevention.

Masoud has recently signed a multi-fight deal with Matchroom Boxing and is one of the countries most exciting prospects with a record of 11-0 (4KOs). Thankfully, many boxers are now taking this approach to injury prevention.


In conclusion, understanding and preventing upper arm and shoulder injuries in boxing is of paramount importance for the longevity and success of an athlete’s career.

The rigorous demands of the sport necessitate a preventative approach, focused on correct technique, strength and conditioning training, thorough warm-ups and cool-downs, regular physiotherapy sessions, and enough time to properly rest and recovery.

Our work with top-tier boxers such as Shabaz Masoud highlights the effectiveness of these measures.

By integrating these strategies into their training, boxers can optimize performance and minimize the risk of upper arm and shoulder injuries, ensuring they can continue to thrill fans and excel in their careers for as long as possible.