Besides soccer, cricket is the world’s most popular sport.
Bringing the timespan of a cricket match closer to that of other widely followed sports has meant a dramatic change in game play and strategy. These refinements in the format and duration of cricket in recent years, have attracted a renewed buzz and excitement around the sport.
The new, fast-paced T20 format has subsequently had an impact on the type and prevalence of injuries sustained during play. For this reason, it is important that both players and coaches are aware of these injuries.
Bearing this in mind, allows players and coaches to both avoid and identify injuries early.
Also, having this knowledge allows coaches to modify the team or individual player's training program, with the overarching aim of extending the sportsperson's playing career.
Head trauma
Batsmen and wicket keepers are the most vulnerable players when it comes to head injuries. It should be remembered that helmets cannot completely protect against other head and eye injuries and/or facial fractures!
Helmets, even though worn at the time of injury, also do not completely eliminate the risk of concussion.
Players demonstrating signs of concussion should be assessed and appropriately managed. However, a well fitted helmet and appropriate eye wear will go far in limiting traumatic contact between player and the ball.
Shoulders
The shoulder of the throwing arm is commonly injured during fielding (when throwing) more than during bowling. But, among bowlers, spin bowlers are more affected by shoulder injuries than fast bowlers.
Shoulder injuries warrant appropriate specialist assessment, investigation and management. This is to limit the complications associated with delayed diagnosis.
Coaches should ensure their players follow sound training programs and ensure players apply a technically appropriate bowling technique.
Elbows
‘Tennis elbow’ is common in batsmen due to improper batting technique or equipment (e.g. use of a heavy bat). It arises as a pain located on the outside of the elbow.
In contrast, ‘golfers elbow’ may occur in teen athletes who play as close in-fielders and fast bowlers. Due to a forward whipping motion of the arm, the inner aspect of the bowling elbow is strained resulting in pain.
Hands
The pinkie is commonly affected, commonly resulting in dislocations of the joint closest to the fingertip (Distal Interphalangeal Joint - DIPJ).
Strapping the last 2 fingers may help prevent DIPJ dislocations.
Trunk
Trunk injuries comprise of:
- Side strains (on the non bowling arm side)
- Lower rib periostitis (inflamed tissue around the bone)
- Lower chest wall injuries (non bowling side)
- Back pain (aka “shin splints of the trunk”).
Disc degeneration and stress fractures - commonly involving L4 and L5 vertebrae - occur on the non bowling arm side and often affect fast bowlers during delivery of the ball.
Hamstrings and quadriceps
'Hams' and 'quads' injuries have been rising in incidence following the increasing popularity of T20 cricket.
Provoked by a high number of overs bowled and fielded in quick succession, most hamstring injuries occur on the non bowling side; whereas most quads and calf strains occur on the bowling side.
Coaches and players should ensure and adequate warm-up, avoidance of fatigue, and appropriate training programmes. These training programs should emphasize the improvement in hamstring strength relative to quadriceps strength.
This tailored training strategy is doubly important as there is a direct correlation between lower limb muscle injuries and a higher risk of lumbar stress fractures.
Knees
Fast bowlers suffer patellar tendinopathy, cartilage degeneration, and stress fractures in the lower limbs.
A good training programme, and a reasonable balance between rest and play helps reduce this risk.
Foot/ankle
The forefoot is more prone to acute injuries during bowling - with fast bowlers at highest risk.
In contrast, overuse injuries in cricket usually affect the hindfoot.
In summary, as cricket changes, the type of injuries associated with play have similarly evolved.
Both players and coaches should be mindful of these specific injuries and actively manage them.
Teams should consider modifying their training programmes both in- and off-season.
In particular, note that:
- Bowling accounts for almost half of all reported injuries
- Lower limb injuries form nearly half of all reported injuries
Note that younger players are more likely to sustain more overuse and bowling injuries than older players. Training and injury prevention programs should take these factors into consideration.
If you, your coach or physio are concerned about an injury sustained during play, or one’s risk of injury, do book an assessment. Several simple tests can be conducted to assess players at risk for sports related injuries.
Paraphrasing actor Trevor Howard:
"A single way to avoid an injury is worth fifty ways of curing it."
Dr Anne Maina
Specialist Orthopaedic surgeon
MBBCh (Wits), FC Orth (SA), MMed Ortho (Wits) CIME
References:
1. Pardiwala DN, Rao NN, Varshney AV. Injuries in Cricket. Sports Health. 2018;10(3):217-222. doi:10.1177/1941738117732318