Cricket is one of the most popular summer sports played across the world, non-contact in nature injury can occur in a variety of fashions. Overuse injuries present most commonly within this sport and particularly in fast bowlers. Poor technique and repetitive actions contribute significantly to these injuries.
Contact injury does occur, generally from the cricket ball itself but also from contact with other players and the ground. Extreme injuries occur infrequently, the Prince of Wales was killed from a cricket ball to the head in 1751. However protective equipment and rule changes in recent times have largely eradicated such risks.
Injury rates have been suggested to be as high as 49% from national teams to school age. 22% of injuries occur to the lower limb, 17% to the back & 26% to the upper limbs. Bowlers are most at risk of injury at 47%, followed by batsmen 30% and fielders 23%. Recurrent injury has been estimated at 30% whilst 37% of new injuries recur within the same season. This suggests inadequate rehabilitation is completed, whilst screening and injury prevention strategies may not be employed.
Batsmen seem most at risk and understandably when you consider your opponent is launching a hard ball towards you at a speed of 75mph. Protective equipment does help, however contact with the ball can result in fractures, dislocations, and bruising to the feet, thighs, fingers, hands, forearms, ribs and face. Eye related trauma in cricket has been documented to account for between 5-14% of all sporting related eye injuries.
The bowling action involves extension, twisting and rotation of the low back, this occurs at speed whilst absorbing the large ground reaction forces of the approach run (up to 9 times body weight). Fast bowlers have been suggested to use one of three techniques. Two of which have indicated less risk of injury (front-on and side-on). The third technique is known as mixed action which combines the other two techniques. This mixed action increases the twisting, extension and side bending of the low back, placing considerable stress on the bony structures.
Poor technique combined with a fast approach speed increase risk of low back injuries. For this reason the Australian Cricket Board limits medium and fast paced bowlers to a maximum of eight consecutive overs in one spell and a maximum of twenty in a day.
Repetitive bowling and throwing long distances can result in overuse injuries to the shoulder complex. Inflammation of tissues within the shoulder may contribute to impingement and eventual degenerative changes to the rotator cuff, biceps and tears which can all contribute to ongoing pain and dysfunction. Bowlers often display tissue damage to the fingers where the seam of the ball creates friction, whilst the middle finger joints are frequently traumatised by the repetitive bowling action and may lead to arthritic changes.
Wicket keepers have been suggested to be at higher risk of arthritis within the knees due to the repeated unnatural squatting action. Running type injuries can occur to any position within the field of play and may be in the form of a soft tissue injury, usually hamstring, groin or thigh strains. Arthritis is always a consideration and may present in older players particularly within the knees, hips and ankles.
Like any athlete whether you are elite or recreational you basic physical fitness and conditioning does help to prevent injury occurrences. A balanced exercise regime that includes strength training, cardiovascular conditioning and flexibility will all help to build a solid foundation.
Specific strengthening, activation and flexibility exercises to develop movement control around the trunk, buttocks and shoulders will help to balance the muscular system, provide protection and enhance performance.
Practice to ensure technical proficiency can make serious difference to injury risks as noted earlier, so tweaking technique and developing high skill levels will lower potentially damaging forces.
Prior to a match and practice ensure you warm up correctly. A general five minute whole body warm up followed by your sport/position specific drills should be completed, this ensures correct movement patterns and technique is optimised and primed prior to participation.
Use of the correct protective equipment as advised by the England Cricket Board will help minimise risks of impact injuries. Remember Cricket is a summer sport so protect your skin with suntan lotion, your eyes with hats and sunglasses and your body’s hydration levels by ensuring you consume sufficient fluids over the days match.
If you do get injured it’s important to go to the right medical profession to ensure accurate diagnosis and management. Re-injury is frequently seen so ensuring you undertake the right rehabilitation can help you get back to playing earlier and reduce risks of re-injury.
View the below playlist for a few example exercises on injury prevention.
By Paul Williamson
Lead Physiotherapist, Perform at St. George's Park