Bernard Hopkins’ Age and His Acromioclavicular Joint
By Ramonito O. Legaspi: In the days leading up to his second encounter with Jean Pascal, some boxing fans and analysts counted Bernard Hopkins out. They thought he could no longer keep up with a fast paced action against a younger opponent. After all, Hopkins was 46 years old. Pascal, the light heavyweight champion, was 28.
But the challenger proved his critics wrong. He turned out to be a well- conditioned vintage “The Executioner” displaying his superior boxing skills and perfectly executing his well-laid out battle plan. Whatever Pascal dished out, Hopkins always had an antidote that negated Pascal’s youth and athleticism. Hopkins won via unanimous decision and became the oldest boxer to capture a world title.
After that fight, some observers began to look at him as a rare boxer who could still compete at an elite level despite his age. His superb performance seemed to defy the inevitable effects of aging. However, when he defended the title against Chad Dawson the following year, age did have an effect on him. Age terribly affects every boxer after all, however disciplined a boxer may be. And one of the dangers of boxers past their prime is susceptibility to traumatic injury.
In his fight against Dawson, Hopkins fell to the canvas on an outstretched arm when the former shoved him. He was grimacing in pain and unable to continue. Referee Pat Russell then halted the fight in the second round and declared Dawson as the winner via TKO. (But the decision was later reversed on the grounds that Dawson intentionally shoved him to the ground. Hopkins was awarded a disqualification victory.)
Later upon examination, Hopkins was found to have a right acromioclavicular injury.
Although superior/inferior acromioclavicular ligament binds the AC joint, it is the coracoclavicular ligament that provides greater support to the joint. Coracoclavicular ligament is not part of the anatomic structure of the AC joint (see Fig 1), yet it primarily controls the AC joint displacements. However, even with this very strong coracoclavicular ligament, AC joint is susceptible to trauma such as severe fall or direct blow to the shoulder.
The reason for AC joint’s susceptibility to trauma is because its articulating surfaces are small and incongruent. As a person ages, AC joint is even more susceptible to injury because of joint degeneration. “Degenerative change is common from the second decade on, with the joint space itself commonly narrowed by the sixth decade.” (Levangie and Norkin 2005, 242). Being past his prime, Hopkins’ AC joint must have undergone degeneration. His AC joint would have been less vulnerable to trauma when he was in his prime.
With his injured AC joint, Hopkins felt pain over the joint and it was hypermobile. When he would throw a right cross, it would aggravate the pain as it would compress the joint once his arm went past the midline. It would also aggravate the pain when he would bring his right arm too far away to gain leverage in launching a right cross. This was so because such movement the deltoid and trapezius muscles would pull the injured joint.
To check if it is indeed an AC injury, the examiner performs special tests. The acromioclavicular crossover, crossbody, or horizontal adduction test is one. This test can be done either actively or passively.
To perform this test actively, the examiner asks the patient to stand and then instructs him to move his hand toward the opposite shoulder. The test is positive if he feels pain over the acromioclavicular joint as he reaches his opposite shoulder.
To perform this test passively, the patient is placed in the sitting position. The examiner brings the patient’s arm to 90 degrees forward flexion and then places the arm at the end range of the horizontal adduction. Pain over the acromioclavicular joint is indicative of AC injury.
The other test which may help the examiner confirm his initial diagnostic impression is the acromioclavicular shear test.
Acromioclavicular shear test is performed by placing the patient in the sitting position. With cupped hands over the deltoid muscle, the examiner squeezes it with the heels of the hands. It is positive and it suggests AC joint pathology if the examiner notices abnormal movement at the acromioclavicular joint.
According to Klaiman and Fink, AC joint sprain and separations are divided into grades to be able to determine the extent of the AC joint injury.
“Grade 1 is defined as pain at the joint; however, the ligaments are intact, and there is no subluxation of the joint. Grade 2 is movement of the joint related to a tear in the AC ligament but not in the coracoclavicular (CC) ligaments. Grade 3 indicates a tear through both AC and CC ligaments. Grades 4 to 6 are defined by displacement of the clavicle posteriorly, superiorly, and anteriorly, respectively. In addition, grade 6 displacement involves entrapment of the distal clavicle in the surrounding muscles” (Klaiman and Fink 205, 829).
Perhaps Hopkins’ AC injury was only a grade 2 sprain, which his physical therapist treated it conservatively. It seems he has fully recovered from the AC sprain. Although he lost his title to Chad Dawson via majority decision in their rematch, Hopkins did not show any signs that his right shoulder was bothering him.
Let us see if the 48-year-old “The Executioner” can still deliver his tricks and tactics against the unbeaten Tavoris Cloud, the current IBF light heavyweight champion. Will Hopkins once again make history? Will he break his own record as being the oldest boxer to win a major world title? Or will we see him age overnight and suffer a crushing defeat against the young “Thunder”?
We will find that out on Saturday night, March 9 at Barclays Center in Brooklyn.
Klaiman, Mark D. and Flink, Kathleen. The Physical Medicine and Rehabilitation: Principles and Practice. Edited by Joel A. DeLisa. Philadelphia: Lippincott Williams & Wilkins, 2005.
Levangie, Pamela K. and Norkin, Cynthia C. Joint Structure and Function: A Comprehensive Analysis. Philadelphia: F.A. Davis Company, 2005.