Sport
Boxing is two activities. Boxing fitness (shadow boxing, bag and pad work, and boxercise-style classes) is hard interval exercise with no blows to the head. Competitive boxing adds sparring and bouts, and with them hand injuries and concussion. Either way, the work comes in short, very hard rounds, and the power behind a punch comes mostly from your legs and the turn of your body, not your arms.
This guide covers what boxing asks of your body, the injuries trained boxers get (hands first), England Boxing's rules on medicals, sparring and concussion, what's known about boxing and the brain, who shouldn't spar, and how strength and interval training improve punching. It covers amateur, club and fitness boxing, not professional licensing. There are two workouts with 3D demos: a boxing fitness session with no sparring, and a strength workout for boxers.
Boxing fitness, from shadow boxing to bag work, pad work and classes, involves no blows to the head. Competitive boxing adds sparring and bouts. England Boxing says that failing its medical "need not stop a boxer from continuing to get health benefits from boxing training", though it often means no sparring.
In the Great Britain amateur squad, the hand was the most injured part of the body, and the commonest hand and wrist injuries were boxer's knuckle and unstable joints at the base of the index and middle fingers.
In England Boxing's 2026 rule book, a knockout from blows to the head, or a concussion, means a 30-day suspension, a doctor's review before sparring again, and no bout before day 35 at 19 and over, or day 39 at 18 and under. Anyone else follows the UK grassroots guidelines: if in doubt, sit them out.
England Boxing won't pass anyone fit to box who has epilepsy, has had a stroke, a bleed in the brain or brain surgery, has a detached retina, or is pregnant, and no one under 10 may spar. Sparring needs a yearly medical and a qualified coach.
In trained boxers, stronger and more powerful legs, explosive upper-body strength and a faster turn of the trunk go with harder punches; maximal upper-body strength doesn't. These are associations, mostly in elite amateurs.
England Boxing's elite bouts are 3 rounds of 3 minutes with a minute's rest; youth bouts are 3 rounds of 2 or 3 minutes, and schools and junior bouts 3 rounds of 90 seconds. Elite amateurs make about 1.4 to 1.55 actions a second, including about 20 punches a minute.
In 10 highly trained Lithuanian amateurs, heart rate passed 93% of maximum in rounds 1 and 2 and 97% in round 3, blood lactate rose above 15 mmol/L, and about three-quarters of the energy came from aerobic metabolism. Reviews describe elite boxers as having high aerobic fitness and strong, powerful arms and legs.
The Compendium of Physical Activities rates boxing in a ring at 12.3 METs (multiples of your resting energy use), sparring at 7.8 and a simulated round at 9.3. Bag work is 5.8 METs at a steady pace, moderate exercise, rising to 10.8 at 180 punches a minute, which is vigorous. The UK's National Health Service (NHS) counts martial arts as vigorous, and short bursts of maximum effort with rest as very vigorous.
In 12 highly trained amateurs, knee strength went with the force pushed into the ground during a cross, and a faster turn of the body with a harder punch. In 15 elite Brazilian boxers, strength and power, especially in the legs, were closely linked with punch impact. A review concludes that lower-body strength and explosive strength in both the upper and lower body go with punch force, while upper-body maximal strength doesn't.
The knuckles, the joints at the base of the fingers, the thumbs and the wrists absorb every punch. The shoulders repeat thousands of punches and blocks, with the serratus anterior (the boxer's muscle) driving the shoulder blade forward. In sparring and bouts, the head and neck take blows.
Boxers compete in weight classes. Across 26 surveys of 3,994 combat sport athletes, most lost weight before competing, usually under 5% of body weight in the 7 to 14 days before, often starting as teenagers, and some used extreme methods. England Boxing's elite programme aims to keep weight "within safe boundaries for health and performance".
Studies count injuries per hour, per bout, per minute of competition or per fight, so their numbers can't be compared directly. Per hour, competition injures far more than training, though more injuries happen in training overall.
Boxer's knuckle is a tear in the hood of tissue that holds the finger tendon over the knuckle, usually the middle (61% of cases) or index finger. In 57 operated fingers in elite boxers, 98% returned to the same level of boxing, on average 8 months after surgery.
Instability of the carpometacarpal (CMC) joints, at the base of the index and middle fingers, was the other common diagnosis in elite boxers. It affected the rear hand in most cases, and 82% returned to the same level after fusion surgery, a median of 8 months later. A knuckle that stays swollen or painful after punching needs a hand specialist's view.
In an older series of 100 hand injuries in boxers, 39% were to the thumb, mostly from it being forced outwards. In US emergency departments, the hand accounted for 48% of boxing injuries to the arm, the wrist 19% and the shoulder 14%, and hand fractures were the commonest injury.
A break just below the little finger's knuckle (the boxer's fracture) usually comes from a punch, often an untrained one at something hard. Our broken hand, broken finger, scaphoid fracture, wrist sprain and wrist pain guides cover these.
Shoulder injuries were 14% of boxing injuries to the arm in US emergency data, and we found no boxing studies that measured them against hours of training. Our shoulder pain, shoulder impingement, rotator cuff tear and shoulder dislocation guides cover the common problems.
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Concussion was 12% of boxing injuries across 14 studies, and a third in one small group of Australian boxers. Fewer than 1 in 10 concussions involve being knocked out. The concussion section below says what to do.
Cuts and bruises are the commonest boxing injuries. In professional boxers in Victoria, Australia, between 1985 and 2001, 90% of injuries were to the head, neck and face, and nearly half were around the eyes. England Boxing won't pass anyone fit to box after a detached retina. Body blows can also injure ribs, and our rib injury and jaw pain guides cover those.
No trial has tested an injury prevention exercise programme in boxing. Prevention rests on the rules, the kit and how much head contact you take.
To spar or compete with England Boxing you need a medical, renewed every year, by an England Boxing doctor. There's a medical before every bout, a doctor at ringside and a medical after it. Boxers are matched by weight, age and experience, and under-18s need a parent's or guardian's permission.
Sparring is only for registered boxers with an in-date medical who aren't suspended, supervised by a fully licensed Level 2 coach, and never for anyone under 10. From June 2026, boxers need 30 days of active sparring before a first bout. The rule book recommends at most 10 contests a season for minors, 14 for schools and junior boxers, and 18 for youths and seniors.
In competition, everyone wears a gum shield, hand wraps and gloves of 10 oz (65 kg and under) or 12 oz (over 65 kg). Everyone except senior men wears a headguard.
One knockout from blows to the head, or a diagnosed concussion, means a 30-day suspension and then the concussion protocol below. Two within 3 months mean at least 30 days after the second, and three within 12 months mean a year. A sparring session stopped for blows to the head counts the same. Anyone under a medical restriction mustn't train or spar during it, and England Boxing says its medical sanctions should apply to all combat sports.
A review by hand surgeons says there is clear evidence that hand protection reduces the risk of hand injury, and that good technique and choosing what you hit help too. No trial has tested wraps, glove weights or hand conditioning. In 62 Greek boxers, bigger gloves for bag work went with more finger fractures and thumb injuries, which is an association: harder hitters may choose bigger gloves.
Our suggestion: wrap your hands and wear gloves for any bag or pad work, build up how hard and how long you hit over weeks, and get a knuckle checked if it stays swollen (editorial). Elite boxers' hand and wrist injuries happened mostly in competition, not training.
Headguards protect well against cuts and skull fractures. Whether they reduce concussion is uncertain: there are almost no trials, and few data from recreational boxing. The Association of Ringside Physicians recommends them in sparring to prevent cuts, but says they "should not be relied upon to reduce the risk of concussion", partly because people may take more risks in one.
In punch machine tests, an approved headguard roughly halved how fast the head spun. When elite men stopped wearing them in 2013, one study found fewer bouts stopped for blows to the head and more cuts; another found fewer standing counts but more bouts ending early in knockouts and stoppages. A review of 59 years of Olympic-style bouts found more stoppages for blows to the head after headguards became compulsory in 1984, and a 2023 review called reliable data on headguards limited. These observational results conflict.
Across sports, people without a mouthguard had more than twice the risk of mouth and face injuries, and the effect on concussion was small and uncertain. In collision sports, a later review found about a quarter fewer concussions with mouthguards. England Boxing requires one whenever boxers box.
In 22 cadets on a compulsory beginners' boxing course, mouthguard sensors recorded about 4 head impacts per sparring bout, most of them light to moderate. In a small study of competitive boxers, symptoms usually didn't change after sparring, but in about a quarter of sessions someone's symptoms rose noticeably.
Losing weight fast before competing is common in combat sports, and sometimes extreme. Our suggestion: box at a weight you can make with ordinary eating and training, and talk to your club about it (editorial).
Neck strengthening hasn't been studied in boxing, and in team sports its link with fewer concussions is very uncertain. There's no evidence for toughening the knuckles by hitting hard surfaces, and untrained punches at hard objects are how boxer's fractures happen.
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Punch force goes with lower-body maximal and explosive strength and with explosive upper-body strength, in elite amateurs mostly. The review behind this notes a lack of training trials and almost no research in women, so these are associations.
In 8 elite boxers, one week of three power sessions (jump squats, half squats and bench press at the load that gave each boxer their best power) raised punch impact by about 8%. In 8 experienced amateurs, 4 weeks of jumping and throwing with added weights didn't raise single-punch force but helped them keep punching hard over repeated efforts. Neither study had a control group.
In 18 experienced amateur boxers split into two groups of 9, adding 3 rounds of 14 all-out 3-second punching efforts on a bag, with 10 seconds' rest and a minute between rounds, 3 times a week for 4 weeks, improved upper-body aerobic power, punch force and how well they kept it up across rounds. The group that trained at low intensity didn't change. In 16 young boxers, 4 weeks of interval training improved breathing measures but not fitness more than usual training.
In 58 inactive young adults, 6 weeks of home Thai-boxing intervals (eight 60-second bouts with 60 seconds of easy movement between) raised fitness and grip strength and lowered blood pressure, resting heart rate and fat mass more than health education and moderate exercise did. Thai boxing adds kicks and knees, so this is indirect evidence for punch-only classes.
Bouts raise markers of muscle damage and stress hormones, more in competition than in sparring. Our reading: keep heavy leg sessions away from the day after hard sparring.
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Our suggestion: two strength sessions a week (legs and trunk first, then upper-body power, shoulders and grip) on days without hard sparring or bag sprints; the bag sprint rounds from the trial 2 or 3 times a week in 4-week blocks if you're experienced; easy running, skipping or cycling on other days; and a full rest day (editorial).
For boxing fitness, 2 or 3 sessions a week fit the NHS guidelines of 150 minutes of moderate or 75 minutes of vigorous activity a week, with strength work on 2 days.
England Boxing's Technical and Competition Rules 2026 set the return for its members. After a knockout from blows to the head or a concussion, the boxer is suspended for at least 30 days. They rest completely for 24 to 48 hours, then build up daily activities, and stay off training for the rest of the suspension. At 18 and under, they return fully to school before sport.
Once the suspension is over and they've been free of symptoms for at least 2 weeks, they step up through light aerobic exercise (under 70% of maximum heart rate, no weights), boxing-specific exercise (shadow boxing, skipping, interval runs) and non-contact training (bag and pad work, weights), with at least 24 hours free of symptoms at each step, or 48 hours at 18 and under. Before sparring, they must see a doctor for clearance. Then come technical sparring, full sparring and competition: no bout before day 35 at 19 and over, or day 39 at 18 and under.
If symptoms last 2 weeks (4 weeks at 18 and under), see a GP.
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For fitness boxers and anyone not covered by England Boxing's rules, the UK's grassroots concussion guidelines apply: anyone who might have a concussion stops at once and doesn't play or train again within 24 hours. Get assessed within 24 hours by a healthcare professional or by calling NHS 111, and call 999 for any red flag.
After 24 to 48 hours of relative rest, the return goes through light activity, then more exercise, then training without head impacts, then training with head impacts only once you've been free of symptoms at rest for 14 days. There's no competition before day 21, counting the day of injury as day 0. Contact NHS 111 if symptoms get worse or haven't improved by 14 days, and see a GP if they last more than 28 days.
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A systematic review of 36 papers found no strong evidence that amateur boxing causes lasting brain injury, but the studies were generally poor, and a few of the better ones found signs of injury in a minority of boxers. Weak evidence of harm isn't strong evidence of safety.
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Markers of brain-cell injury rise in the spinal fluid after amateur bouts, more with more or harder blows to the head, and in some boxers they stay raised after rest. In 30 elite amateurs, thinking tests didn't differ from those of non-boxers, though processing was slower in those whose markers stayed high. In 61 elite women, sideline balance and eye-movement tests improved after a world championships, probably partly from practice, so tests repeated over a short time can mislead.
In professional boxers and mixed martial artists, more fights and more years of fighting went with smaller volumes in deep parts of the brain (the thalamus and caudate) and slower processing speed, and over time, active boxers lost volume in the thalamus faster than people who didn't fight. That's an association, but it fits the idea that the dose of head blows matters.
Studies of professional boxers from earlier decades found high rates of chronic brain injury, and deaths in boxing, mostly after knockouts in professional bouts, still happen. Those samples are old or selected, with far more and longer fights than today's amateur boxers have, so they don't tell you today's risk.
A 2023 review of 93 studies found no single factor, including scan results, that is an absolute reason to retire from contact sport after concussion. A previous concussion went with a higher risk of another, and more symptoms at the start, sleep problems and symptoms set off by eye-movement and balance tests went with slower recovery. England Boxing's year-long suspension after three in 12 months is a rule, not an evidence threshold. Our suggestion: after repeated concussions or a slow recovery, get a specialist's view before any more sparring (editorial).
England Boxing's medical guidelines won't pass anyone fit to box who has epilepsy ("regardless of whether they are on medication"), has had a stroke or a bleed in the brain or brain surgery, has a detached retina or eyesight below its standard, an untreated hernia, a pacemaker or similar implant, a fracture in the last 12 weeks, or is pregnant. Unexplained fainting and heart murmurs are investigated first, which can delay passing fit by several months. Failing the medical often still allows training without sparring.
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Children under 10 can join a club and train, but can't compete, take part in skills bouts or spar. Under-18s need a parent's or guardian's permission.
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White-collar and unlicensed bouts aren't run under England Boxing's rules. If you later register with England Boxing, they must be declared and count towards your record. Our suggestion: only spar or fight with a medical, a qualified coach and a doctor at ringside, as England Boxing requires for its own events (editorial).
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Built on the site's warm-up guide and England Boxing's round lengths (editorial). No study has tested a warm-up for boxing.
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The movement on the figure: Standing punches (shadow boxing)
Each has a 3D demo. Shadow boxing shows the punches; pad work and bag work need a partner or a bag the figure can't show. Don't shadow box holding weights.
3D demoStanding punches (shadow boxing)Beginner · No equipment
3D demoJump squatIntermediate · No equipment
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell
3D demoSplit squatIntermediate · No equipment
3D demoPush-upIntermediate · No equipment
3D demoMedicine-ball chest pushBeginner · Medicine ball
3D demoCable wood chopAdvanced · A cable machine
3D demoStanding band external rotationBeginner · A band + An anchor point
3D demoFace pullIntermediate · A band
3D demoScapular push-up (push-up plus)Beginner · No equipment
3D demoFarmer's carryBeginner · A dumbbell + A kettlebell
3D demoBall squeezeBeginner · Other / check instructions
3D demoDead bugBeginner · No equipmentThe first two are new: a boxing fitness session with shadow boxing and optional bag rounds and no sparring, and a strength workout for boxers. Tabata and the other interval sessions suit fitness boxing; the shoulder, wrist, grip and neck routines look after the parts that take the load.
A 35-minute boxing workout with no sparring: a warm-up, three shadow boxing rounds, optional bag rounds, a punching finisher and core work.
35 minBeginner10 movesA band, A wallA 45-minute strength and power workout for boxers: jumps and chest throws, squats and single-leg hinges, push-ups, rows, rotator cuff, carries and grip.
45 minIntermediate18 movesA band, Medicine ballThree 4-minute blocks of 20 seconds hard and 10 seconds easy, with bodyweight moves and a minute between: the timing of the Tabata study, at home.
22 minIntermediate10 movesA wallA 20-minute no-equipment HIIT workout: jumping jacks, jump squats, mountain climbers, burpees, skips and bear crawls.
20 minIntermediate10 movesNo equipmentA full-body circuit of 8 stations: dumbbell squats, push-ups, rows, lunges, deadlifts and cardio moves, 40 seconds each, for 2 or 3 rounds.
35 minBeginner14 movesA dumbbell, A bench or boxA 25-minute interval session on a bike or rower: one-minute hard efforts with two minutes easy, building from 4 to 8 rounds.
25 minIntermediate1 movesCardio machineAn advanced jump training session: pogo hops, box jumps, split squat jumps, broad jumps and depth jumps.
30 minAdvanced8 movesA bench or box, A stepA 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.
25 minBeginner12 movesA wall, A bandWrist mobility and forearm strength for desk work, climbing, push-ups and handstands.
10 minBeginner7 movesA wall, A dumbbellA 20-minute grip session: warm up the wrists and fingers, train the hand and forearm muscles, then carry and hang to load your grip the way everyday life does.
20 minBeginner10 movesOther / check instructions, A bandDeep neck holds and shoulder-blade strength in under 20 minutes: one of the best-supported kinds of exercise for a stiff, sore neck.
18 minBeginner11 movesA band, An anchor pointTwo strength sessions a week fit around boxing training, on days without hard sparring.
Two full-body strength sessions a week: the minimum that meets health guidelines, with every set, rep and rest, and an 8-week progression.
2 training days45 minBeginner3 days a weekA 12-week beginner barbell program: squat every session, alternate bench and row with press and deadlift, and add weight each time until it stalls.
3 training days50 minBeginner3 days a weekA weekly workout plan for women: three strength days, cardio and pelvic floor training, with the evidence on periods, pregnancy and menopause.
3 training days45 minBeginner4 days a weekA 4-day gym workout routine for men: upper and lower days, each muscle trained twice a week, with sets, reps, progression and the evidence.
4 training days50 minIntermediateThe NHS advises speaking to your GP first if you haven't exercised for some time, or if you have medical conditions or concerns. The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) asks about a heart condition or high blood pressure, chest pain, dizziness or fainting, other long-term conditions and their medicines, and bone or joint problems. A yes to any of them means checking first.
The PAR-Q+ asks you to see a qualified exercise professional before vigorous to maximal exercise if you're over 45 and not used to it. Fast bag work is vigorous, so build up with steady rounds first.
The PAR-Q+ asks about a concussion or a blackout from a head injury in the last 12 months. No sparring or head contact until you're cleared: England Boxing members need a doctor's review before sparring, and everyone else follows the UK guidelines.
England Boxing won't pass you fit to box. Boxing fitness without sparring may still be possible: ask your doctor first (and your eye specialist after eye surgery).
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England Boxing has these investigated, with heart tests and a cardiologist's opinion, before passing anyone fit to box. See your GP first.
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The UK guidelines treat these as red flags after any head injury. Our suggestion: no sparring or head contact, and boxing fitness only (editorial).
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England Boxing won't pass anyone with a fracture in the last 12 weeks. Follow our broken hand or broken finger guide before punching again.
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England Boxing doesn't allow boxing in pregnancy, and the NHS advises against sports with a risk of bumping your tummy. Talk to your midwife about what's safe, and see our pregnancy guide.
The UK guidelines call these red flags, needing urgent assessment by a healthcare professional or at A&E (accident and emergency), by ambulance if necessary. England Boxing's advice adds clear fluid from the ears or nose, bleeding from an ear or new deafness, and drowsiness lasting more than an hour when you'd normally be awake. If a neck injury is suspected, only trained healthcare professionals should move the boxer.
The NHS says to get help from NHS 111 if, after a head injury, you're being sick, feel dizzy, take medicine that thins your blood, were drinking alcohol or taking drugs at the time, or have any other symptoms you're worried about. Don't play contact sports for at least 3 weeks; England Boxing members follow its longer minimums.
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The NHS says to go to A&E if a finger points at an odd angle, looks blue or feels numb, or bone is showing, and to get help from NHS 111 if it's painful, swollen and bruised or hard to move. A cut over a knuckle from a punch that hit someone's teeth needs help the same day, as our broken hand guide explains.
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Get help from NHS 111 for severe wrist pain, a snap, grinding or popping noise at the time of injury, a wrist you can't move or use to hold things, a change in its shape or colour, or lost feeling in your hand. Pain at the base of the thumb after a punch or a fall needs checking for a scaphoid fracture.
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Go to A&E if you can't move your arm, the shoulder has changed shape, or it's painful, bruised or swollen after an injury. Don't try to put it back in yourself.
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Get help from NHS 111 if floaters suddenly appear or increase, you see flashes of light, a dark curtain or shadow moves across your vision, or your sight suddenly blurs. These can be signs of a detached retina.
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Call 999 for sudden chest pain that doesn't go away, pain that spreads to your arms, neck, jaw, stomach or back, or chest pain with sweating, feeling sick, light-headedness or breathlessness.
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They protect against cuts and skull fractures, but their effect on concussion is uncertain, and ringside doctors warn that people may take more risks wearing one.
Fewer than 1 in 10 concussions involve being knocked out. Any suspected concussion means stopping: if in doubt, sit them out.
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No study supports it. Don't punch holding weights: the momentum strains the elbow and shoulder (our suggestion). Punch force goes with leg strength, explosive strength and the turn of the trunk, so train those instead.
Lower-body strength and power, and explosive upper-body strength, go with punch force; maximal bench press strength doesn't. These are associations in trained boxers.
Fitness classes involve no blows to the head. No one has measured injuries in classes, but most boxing injuries treated in US emergency departments happened in practice or training, and the commonest cause was hitting an opponent or an object, so wraps and gloves matter.
The evidence in amateurs is weak either way. Bouts raise markers of brain-cell injury in the short term, and in professional fighters more fights went with smaller brain volumes: associations that suggest keeping head blows to a minimum.
Shadow boxing and bag rounds for skill and fitness; squats, single-leg hinges and jumps for leg power; push-ups, rows and medicine-ball throws for the upper body; and rotator cuff, grip and core work. In trained boxers, leg strength and power go with harder punches more than upper-body maximal strength does.
Yes: steady bag work is moderate exercise and fast punching is vigorous, going by their measured energy cost. In one trial, 6 weeks of boxing-style home intervals raised fitness and lowered blood pressure in inactive young adults.
Yes. Shadow boxing, bag and pad work and boxing fitness classes involve no blows to the head, and England Boxing says that even people who fail its medical can usually keep training without sparring.
Train your legs and trunk with squats, single-leg work and jumps, and add explosive upper-body moves such as medicine-ball chest throws. Short all-out punching intervals on a bag also improved punching in experienced boxers.
Hand surgeons say hand protection reduces hand injuries, and England Boxing requires wraps and gloves in competition, but no trial has tested them. Wrap your hands for any bag or pad work, and build up how hard you hit gradually.
A tear in the hood of tissue that holds the finger tendon over the knuckle, usually on the middle or index finger. It's one of the commonest hand injuries in elite boxers, and most return to boxing after surgery, at about 8 months.
For England Boxing members: a 30-day suspension, rest, then step-by-step exercise once free of symptoms, a doctor's review before sparring, and no bout before day 35, or day 39 at 18 and under. Everyone else follows the UK grassroots guidelines: stop at once, get assessed within 24 hours by a healthcare professional or NHS 111, and wait at least 21 days before competing.
Repeated blows to the head carry risk. A review found no strong evidence of lasting brain injury from amateur boxing, but its studies were weak; bouts raise markers of brain-cell injury in the short term; and in professional fighters, more fights went with smaller brain volumes and slower thinking.
Not clearly. They protect well against cuts and skull fractures, but their effect on concussion is uncertain, and ringside doctors say not to rely on them for it. In England Boxing competition, senior men box without them and everyone else wears them.
England Boxing requires a yearly medical to spar or compete, and won't pass people with epilepsy, a past stroke, brain bleed or brain surgery, a detached retina, or who are pregnant; no one under 10 may spar. White-collar events aren't run under England Boxing's rules, so we suggest asking for the same medical and supervision before taking part.
Exercise education for people who play sport, not a personal prescription or a diagnosis, and clinical review of these pages is pending. Check with a GP or physiotherapist before hard training if you have a heart condition, chest pain, dizziness or an injury that isn't settling, and stop for sharp or increasing pain. Health disclaimer.
