Turning Punch Elbow

By Dr Kristinn Tan

Localised elbow painThe first time I saw a candle extinguished was with a turning punch. The power generated by the punch begins in the firmly rooted feet, spiralling through the legs, amplified and directed by the hips into the fist. The potential energy released is phenomenal.

The action at the elbow is to straighten the joint in a throwing movement. However the joint does not lock out. This keeps the joint stable and allows for the maximum transmission of all that power. The error tends to occur when learning how to punch as we are told to relax and throw with force. It is jolly difficult to do both without the elbow locking out for a fraction of a second. Much of the trauma arises from this locking (hyperextension) of the elbow.

The result is pain in the elbow in the illustrated areas (Diag 1). Depending on the severity of damage the pain may occur only on repeated stress i.e. more turning punches or at rest. 

The elbow looks a little like diagram 2. The bony parts coming together, tension in the ligaments and joint capsule as well as reflex contraction of the biceps, limit movement on extension of the joint. Hence when over extending the elbow damage can occur to any of these parts diagram 3.

Anatomy of the elbow

Overstretching of ligaments, joint capsules and friction between surfaces all lead to inflammation of the joint. Joints are not well supplied by blood and the turnover of materials is slow hence the long healing times involved. Longstanding trauma can result in fragmentation of the cartilage with loose bodies in the joint, osteoarthritis, and irritation of the nerves that are closely associated with the joint.

What to do about it? 

Anatomy of elbowA good warm up and stretch is recognised to help prevent hyperextension injuries. However it is all down to punching technique (I know I’m starting to sound like a stuck record here). Not locking out the elbow reduces fist wobble which also means one is more likely to hit the mark.

Conventional Medical Advice. Once damage is done here’s a simple mnemonic to remember:

  1. Rest
  2. Ice
  3. Compression
  4. Elevation 

Other measures: Bracing or splinting (Tubigrip), Pain killers – Paracetamol and especially NSAIDs such as Ibuprofen.

Gentle massage is felt to help with pain. Tai chi instructor Mark Green advocates playing the form to help the healing process.


By Kristinn Tan


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