Risk of Headache, Temporomandibular Dysfunction and Local Sensitization in Male Professional Boxers: A Case-Control Study

Objective: To evaluate the differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality, in professional male boxers (exposed to repetitive cranio-facial trauma) who were actively training and without severe previous injuries, compared to handball players. Study Design: Case-control study. Setting: University-based physical therapy research clinic. Participants: Eighteen boxers as the cases group and twenty handball players as the comparison group (age, ± 2 years, and sex matched), were included (23 ± 4.61 years). All participants completed the assessment protocol. Interventions: Not applicable. Main Outcome Measures: Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold (PPT) over the trigeminal nerve sensory branches, the masseter and tibialis anterior muscles. 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 compared to the handball players. The between-group comparison found significant differences in all outcome measures (p<.05), except in the tibialis anterior muscle PPT on the dominant (p=.958) and the non-dominant sides (p=.453). Conclusion: Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region when compared to professional handball players. It cannot be determined if these findings are transient, as a result of the training activity, or more permanent