Shoulder injuries in cricket

Although cricket is not a contact sport, the level to which it is played nowadays does take its toll on the players, especially professional cricketers. Find out where and why most injuries occur and learn to prevent them.

Head injuries are quite common among cricketers – especially among young players. This type of injury is usually the result of a blow to the face from a ball travelling at a high speed. The nose, teeth and jaw can suffer severe fractures and bruising in this way.

As in rugby and soccer, concussion can occur. Symptoms include amnesia, memory loss, headache, confusion, poor coordination or vision difficulties. Players who have suffered concussions do not necessarily lose consciousness.

Little can actually be done to treat a concussion, other than rest. However, it’s crucial that a physician examine anyone who might have a concussion in order to exclude intracranial bleeding.

There are two main types of shoulder injuries which affect cricketers.
The first type is an overuse injury of the shoulder associated with throwing, typically referred to as “thrower’s shoulder”. The second type refers to acute, traumatic injuries,that are especially prevalent when players fall on a shoulder while they are fielding.

Thrower’s shoulder is a chronic shoulder pain that gradually worsens while the player is throwing the ball.

There are a number of potential causes:

  • Poor throwing technique
  • Shoulder muscle imbalance
  • Previous injury
  • Shoulder instability
  • Too much or too little practice
  • Poor posture.

Thrower’s shoulder involves injury to the tendons of the rotator cuff (the muscles around the shoulder joint), and may include weakness around the scapula (shoulder blade). There may be associated bursitis (inflammation of the joint sac) within the shoulder.

Management of this injury includes appropriate diagnosis and identification of all the potential causes of the shoulder pain. Pain management and rehabilitation are the two mainstays of treatment for this condition.
Rehabilitation is focused on both stability and strength around the shoulder joint. It is essential that there is a balance of strength around the joint.

Rehabilitation and correction of the cricketer’s throwing technique is important to prevent the recurrence of injury.

Traumatic injury to the shoulder classically occur when a fielder dives for the ball and lands hard on an outstretched arm. The injury could include damage in the form of tears to the tendons around the shoulder and in isolated cases dislocation of the shoulder may occur. Pain in this kind of injury usually limits participation in the game.

Management includes appropriate diagnosis, which in some cases will require referral to an orthopaedic surgeon. If the injury is significant, surgery may be necessary.

Following this, it is essential that the cricketer is appropriately rehabilitated to prevent weakness of selected muscles, which may in turn lead to a future overuse injury.

(Source: Janine Gray (BSc (physio), BSc (Med)(Hons) Exercise Science. Lecturer at the University of Cape Town and affiliated to the High performance Centre at Cricket South Africa.)

Not only golfers and tennis players suffer from arm and elbow injuries, cricketers are often struck down by them as well.

Improper batting and bowling techniques as well as incorrect equipment, such as bats that are too heavy, put unnecessary strain on the forearm.

Common types of injury include:

  • Tennis elbow
  • Thrower’s elbow

Tennis elbow is localised to the outside of the elbow. It can occur as a result of throwing, especially if the cricketer leads the throwing motion with his elbow.

Another possible cause of elbow pain would be a batsman attempting to use the wrist to flick the bat.
The pain is localized to the elbow and is aggravated by wrist and finger movements (such as shaking someone’s hand).

This injury is managed using physiotherapy and rehabilitation to correct strength imbalances of the forearm. It is important that the throwing and batting technique is assessed to identify risk factors for this injury.
Although not as common as tennis elbow, thrower’s elbow is just as debilitating and painful. Thrower’s elbow effects both the inside and outside of the elbow.

It is an overuse injury due to the extremely high forces on the elbow joint when throwing a ball. The throwing motion causes the structures on the medial side (inside) of the elbow to stretch, while at the same time compresses the structures on the lateral side (outside) of the elbow. Over time this results in micro fractures in the forearm bones and can eventually lead to bone spurs and bone chips.

Lower back injuries can take the form of stress fractures, particularly in adolescent fast bowlers. Other areas that could be damaged include the disc, facet joint or surrounding soft tissue. Spondylolisthesis or the forward slipping of one vertebrae over another, affects younger cricketers more than older players.
Lower back pain is not a problem exclusive to the fast bowlers and is equally devastating when it happens to batsmen or wicketkeepers.

There are many potential causes of these injuries. Poor bowling technique (called a mixed action technique), overbowling and relative youth are the common culprits. Other possible causes include poor physical preparation, the impact forces associated with the delivery stride, inadequate footwear, and previous injury.
Early detection and diagnosis is very important. Following this, treatment includes physiotherapy for pain and rehabilitation, which is undertaken by a physiotherapist and biokineticist.

The focus of the rehabilitation is twofold:

  • Firstly, it is essential to retrain the core muscles which are responsible for spinal stability.
  • Secondly, and equally as important, is strengthening of the entire trunk, upper and lower body in order to help the body deal with the huge impact forces associated with fast bowling.
    Biomechanical changes are often necessary and these can be achieved by means of collaboration between the medical team and the coach.