The Temporomandibular joint injuries in boxers and combat sport athletes – diagnostics and therapeutic Management

Abstract

Temporomandibular joint (TMJ) injuries are a common yet often underestimated problem among boxers and combat sport athletes. The TMJ is a complex structure essential for chewing, speaking and breathing, and is highly susceptible to both acute trauma and chronic overload. Repetitive blows to the mandible, increased muscle tension and stress-related clenching significantly raise the risk of joint and muscular dysfunctions, which are frequently underdiagnosed and may lead to chronic pain, limited jaw mobility, joint noises and headaches.

This paper outlines the anatomy and biomechanics of the TMJ, emphasizing its vulnerability to trauma and microtrauma in combat sports. It reviews the epidemiology and injury mechanisms, highlighting the prevalence of disc displacement, capsular damage, degenerative changes and muscle-related disorders. Common clinical symptoms include joint pain, clicking, restricted mouth opening and muscle tenderness. Diagnosis relies on DC/TMD protocols, clinical examination and imaging techniques such as MRI and CBCT.

Treatment is primarily conservative, including patient education, physiotherapy, manual therapy and pharmacological management with NSAIDs and muscle relaxants. In refractory cases, minimally invasive procedures such as hyaluronic acid injections, botulinum toxin therapy, arthrocentesis and arthroscopy may be used, while surgery is reserved for severe conditions. The paper underscores the importance of individualized, multidisciplinary management and preventive strategies, including custom mouthguards, proper training techniques and early symptom recognition, to reduce the impact of TMJ injuries in combat sport athletes.