Research into cricket Injuries at elite level In Australia has shown a rate of around 18 injuries in total for a squad of 25 players who play twenty matches in a season. On average, around 9% of cricketers have an injury at any given time, although in fast bowlers over 15% are injured at any given time.
There are very different physical demands involved in different types of cricket, which has meant the injury profile is slightly different between five day Test matches, 3 day matches and one day matches. The launch of Twenty 20 cricket has placed a new physical requirement on cricketers, although it is too early for the effects of these demands to be analysed in sports injury research.
Low back pain is particularly prevalent among younger fast bowlers. The repetitive action of bowling for long spells places excessive stress on the tissues of the lower back, where stress fractures of the vertebra (spondylolysis) can develop. Research has indicated that muscle injuries such as hamstring strains and side strains are the most common cricket injuries. These injuries are due to the functional demands of the sport where occasional sprinting and ball throwing may be repeated across a seven hour day.
1. Hamstring Strain
A hamstring strain is a tear in the muscle tissue. Hamstring strains tend to affect all cricketers regardless of position and account for around 15% of all cricket injuries. Hamstring strains occur during explosive sprinting activities such as bowling, taking a quick single or fielding a ball. The sudden stress can cause the hamstrings muscle tissue to tear. Any muscle tear is referred to as a strain and depending on its severity, it is classified as a first, second or third degree strain.
What can you do to prevent a Hamstring Strain?
In bowlers, especially fast bowlers there is a link between ‘over bowling’ and sustaining a Hamstring Strain. Over bowling can be avoided by recording a log of each bowler’s workload to prevent sudden overload or sustained overload. A warm up prior to cricket is designed to decrease muscle injuries because the muscle is more extensible when the tissue temperature has been increased by one or two degrees. A good warm up should last at least 20 minutes, starting gently and finishing at full pace activity. Compression Shorts are recommended for providing extra warmth around the Hamstring region.
If you have a hamstring strain follow the RICE protocol – rest, ice and compression and elevation (never apply ice directly to the skin). If you have to apply ice at home, an ice bag is recommended. This is a safe method of ice application to avoid the risk of an ice burn.
Seek advice from a doctor or chartered physiotherapist regarding rehabilitation . Most hamstring strains will be fully healed by 6 weeks, but recurrent problems can occur when a return to play is attempted too early.
2. Lower Back Pain
The repetitive action of bowling is the biggest cause of lower back pain in cricket, but bending to field the ball and standing in the field for prolonged periods also put stress on the back which can cause back pain.
Any structure of the lower back can be affected – the discs, ligaments, muscles or facet joints – but in fast bowlers, particularly younger ones, the most commonly affected part of the lower back is the ‘pars interarticularis’ region of the lumbar vertebra, where a stress fracture can develop. This is characterised by a back ache following cricket, particularly when bending backwards.
What can you do to prevent low back pain?
Fast bowling in cricket requires a combination of spinal hyperextension (bending backwards) together with rotation and side bending of the trunk. When repeated this puts excessive stress on an area of the vertebra called the Pars Interarticularis and this is where a stress fracture develops.
Bowling practice should be carefully monitored to ensure the lower back is not being overloaded. This is particularly important in adolescent players who have just experienced a growth spurt as they are known to be more at risk from this injury. Core stability exercises are important to prevent back problems in cricket players and shock absorbing insoles can help to reduce stress on the back.
What should you do if you suffer low back pain?
A soothing heat pack can reduce back pain and back muscle spasm. Once diagnosed, stress fractures of the lower back usually require 6 weeks of rest to allow the bone to heal. During this period, an exercise programme under the supervision of a physiotherapist can be started . This focuses on exercises to increase the muscular stability in the lower back.
Research has shown that poor muscular stability in the lumbar region can lead to low back pain. Core stability exercises target certain specific muscles which give the spine much better support. This prevents postural faults which can cause low back pain.
3. Side Strain
A side strain is fairly common in cricket, where it typically occurs in bowlers. A side strain refers to a tear of the Internal oblique, the external oblique, or the transversalis fascia at the point where they attach to the four bottom ribs. In cricket the bowlers suffer the side strain on the non-bowling arm side as a result of a forcible contraction of the muscle on that side while they are fully stretched as the bowling arm is cocked for bowling.
What can you do to prevent a side strain?
Core strength exercises using a swiss ball and resistance bands can improve muscle function across the trunk and pelvis and this can help to reduce the risk of a side strain.
Over bowling should be avoided. Each bowler should have a workload record and care should be taken to avoid sudden increases to the normal workload. The number of overs bowled per session should be increased gradually and adequate rest periods should be provided to prevent fatigue.
What should you do if you suffer a side strain?
In the early stages an ice pack can be applied for twenty minutes every two hours. A cohesive compression bandage can be applied to help to limit bleeding in the tissues. More active rehabilitation can be started under the supervision of a chartered physiotherapist, once the immediate pain resolves.
4. Shoulder Pain
Shoulder pain is common in cricket because of the repeated actions of throwing and bowling. The rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres minor) are small muscles situated around the shoulder joint, which can become damaged due to overuse during cricket.
Rotator cuff injuries often begin as inflammation (tendonitis) caused by repeated irritation. If the cause of the inflammation is not addressed, partial tears may develop in the cuff that could eventually become a tear all the way through one or more of the rotator cuff muscles.
What can you do to prevent shoulder pain?
All cricketers should pay attention to flexibility, strength and endurance of the shoulder muscles. Correct throwing and bowling technique can help to reduce injury risk. Shoulder stabilisation exercises under the supervision of a chartered physiotherapist can also help prevent damage to the rotator cuff tendons.
It is important that any increase in the amount of training or competition must be gradual in order to prevent overload of the rotator cuff muscles. In particular, bowling and fielding practice should be increased gradually to allow the rotator cuff tendons to adapt.
What should you do if you suffer shoulder pain?
Physiotherapy treatment can reduce acute (short-term) inflammation and chronic (long-term) degeneration of the cuff where a tear is not present. The objective of physiotherapy treatment is to limit inflammation using ice therapy (never apply ice directly to the skin). Anti-inflammatory medication prescribed by a doctor is often helpful.
A neoprene shoulder support can provide support and reassurance. If a rotator cuff tear has developed then the opinion of an orthopaedic consultant is required.
5. Sprained Ankle
A sprained ankle is pretty common in cricket. A sprained ankle is damage to the ligaments and soft tissues around the ankle, usually as a result of the ankle being twisted inwards. The ankle ligament and soft tissue damage produces bleeding within the tissues and an extremely painful, swollen ankle.
What can you do to prevent a sprained ankle?
Research has shown that bracing or taping the ankle can help to reduce the risk of a sprained ankle. The incidence of injury in people with taped ankles was 4.9 ankle sprains per 1000 participant games, compared with 2.6 ankle sprains per 1000 participant games in students wearing ankle braces. This contrasts with 32.8 ankle sprains per 1000 games in subjects that had no taping or bracing.
Because taping and strapping techniques often require application by a skilled physiotherapist, an ankle brace is often a more convenient alternative.
What should you do if you suffer a sprained ankle?
Immediately following a sprained ankle you can follow the PRICE protocol – Protection, Rest, Ice Therapy, Compression and Elevation of the ankle to reduce swelling.
Rehabilitation with a physio significantly improves the outcome following a sprained ankle. Wobble board training improves balance and proprioception. Research has shown that patients with ankle instability who underwent wobble board training experienced significantly fewer recurrent sprains during a follow-up period than those who didn’t do wobble board training