It’s summer and we all know what that means - CRICKET SEASON!! So let’s talk cricket injuries...
Bone stress injuries occur when repeated load is placed upon the same areas of bone.
Fast bowlers are susceptible to these injuries due to the repetitive and rapid nature of their action.
Factors that can lead to bone stress injuries are - overload, prior history of bone stress injury, altered biomechanics, and changes in footwear and surface.
The most common areas effected in fast bowlers are the lower back, pinky and big toe metatarsals. Early diagnosis is pivotal for optimal recovery and a carefulre habilitation plan needs to be put in place to ensure proper healing.
Our fast bowlers, Pat Cummins and Mitchell Starc have to bowl with a unique, asymmetrical action which loads the trunk through rotation, extension &side flexion. When doing this over and over again, it can lead to the development of a stress reaction or fracture.
Repeated microtraumato the pars interarticularis (pars for short) results in the injury. When thepars sustains a fracture it is termed a spondylolysis. Pars defects most commonly occur at the L4 & L5 spinal levels (Crewe et al.2012).
Athlete age, bowling technique and overall load (total number of deliveries bowled) have a big impact on the likelihood of developing a spondylolysis.
Bowling techniques can be classified as front on, side on or mixed techniques. Studies have shown that if you bowl with a mixed bowling technique you have a greater risk of lower back injury than if you bowl with a side or front on technique. Aphysiotherapist can work together with the fast bowling coach to determine adequate load and bowling technique alteration.
Initially, treatment for spondylolysis consists mainly of restricting bowling and preventing the injury from progressing to a bilateral defect or spondylolisthesis (where part or all of the vertebrae slip forward on one another).
Another area at risk of injury to the fast bowler is the foot, mainly due to the ‘front-foot’ law in place to prevent no balls.
The sudden braking that occurs during a fast bowler’s action puts up to 7x their bodyweight through their front foot on landing. Due to the repetition involved, itis no surprise that this is a common cause of injury and was a prominent factorbehind Cricket Australia’s ‘rotation policy’ for their fast bowlers in an attempt to prevent this issue from occurring.
Mitchell Starc has experienced many foot and ankle stress related injuries in his right foot which, due to being a left-arm bowler is his front foot. Other causes of foot stress fractures include increased training loads, firmer surfaces, poor foot mechanics / footwear and diet deficiencies.
Management of these stress fractures can usually be achieved through a period of non/altered weight bearing for 4-8 weeks and then a gradual resumption of regular activity and training loads.
Stress fractures of the 5th metatarsal however may be more complicated and even require surgical intervention due to a poorer blood supply than the others.