title: Risk of headache, temporomandibular dysfunction, and local sensitization in male professional boxers: a case-control study.
abstract: OBJECTIVE
  To evaluate differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality in professional male boxers (exposed to repetitive craniofacial trauma) who were actively training and without severe previous injuries compared with handball players.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  University-based physical therapy research clinic.
  
  
  METHODS
  Eighteen boxers (mean age, 23±4.61y) as the cases group, and 20 handball players as the comparison group (mean age, ±2y, and sex matched), were included. All participants (N=38) completed the assessment protocol.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold over the trigeminal nerve sensory branches, the masseter muscle, and the tibialis anterior muscle. The secondary outcome measure included the temporomandibular function (Helkimo Clinic Index).
  
  
  RESULTS
  The boxers showed slight mandibular function impairment, local muscular and neural sensitization, and a higher impact from headaches than did the handball players. The between-group comparison found significant differences in all outcome measures (P<.05), except in the tibialis anterior muscle pressure pain threshold on the dominant (P=.958) and the nondominant (P=.453) sides.
  
  
  CONCLUSIONS
  Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region than do professional handball players. It cannot be determined whether these findings are short-lasting, as a result of the training activity, or long-lasting.
authors.affiliation: University Center of Health Sciences San Rafael-Nebrija, University Antonio de Nebrija, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Mendoza-Puente
authors.affiliation: Faculty of Nursing, Physiotherapy and Podiatry, Department of Physical Therapy, University of Sevilla, Sevilla, Spain. Electronic address: angeloliva@us.es.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Oliva-Pascual-Vaca
authors.affiliation: Faculty of Nursing, Physiotherapy and Podiatry, Department of Physical Therapy, University of Sevilla, Sevilla, Spain.
authors.forename: Cleofás
authors.initials: C
authors.lastname: Rodriguez-Blanco
authors.affiliation: Faculty of Nursing, Physiotherapy and Podiatry, Department of Physical Therapy, University of Sevilla, Sevilla, Spain.
authors.forename: Alberto Marcos
authors.initials: AM
authors.lastname: Heredia-Rizo
authors.affiliation: Faculty of Odontology, Department of Stomatology, University of Sevilla, Sevilla, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Torres-Lagares
authors.affiliation: Department of Anatomy and Human Embryology, School of Physical Education and Sports Medicine, University of Cádiz, Cádiz, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Ordoñez
mesh_terms: D000293:Adolescent; D000328:Adult; D001914:Boxing / Q000293:injuries* / Q000502:physiology; D016022:Case-Control Studies; D012090:Cumulative Trauma Disorders / Q000150:complications / Q000503:physiopathology*; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000503:physiopathology; D017288:Pain Threshold / Q000502:physiology*; D011312:Pressure; D018570:Risk Assessment; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology / Q000503:physiopathology; D014276:Trigeminal Nerve / Q000503:physiopathology*; D055815:Young Adult
keywords: Boxing; Case-control studies; Central nervous system sensitization; Headache; Rehabilitation; Sports