Editor's musings: Bowled over by injury!
Updated: May 19
Cricket is a ridiculous sport, really. “Outsiders” look at those who participate in this complex pursuit with bemusement and existential nihilism. The day (or multiple days!) is spent with one team hurling a ball at some sticks while the other team tries to hit said ball away with a bigger stick. One team goes in, while the other team tries to get them all out… that old chestnut (Cricket: As explained to a foreigner…). Most importantly, there are several stoppages for consumption of food and drinks. Only people with way too much free time could have come up with such a thing. While it’s not an extensive cricket CV, I have coached a bit of cricket at u14 level, and was involved with a school 1st XI for two years. It may not be my forte, but I have some understanding and appreciation for this arduous affair. It’s a sport that is unbelievably tactical and requires some very specific and nuanced skills.
I recently came across a discussion on LinkedIn about a perceived increase in the number of young fast bowlers who are presenting with stress fractures. It was insinuated that modern S&C could be implicated. I was intrigued by the conversation, with discussion ranging from playing on harder surfaces to kids not climbing trees anymore. Personally, I’ve also come across many a cricket coach who has lamented the involvement of sport science in player management: “Player X can only bowl 36 balls today” or “Player Y has an overall subjective fatigue rating over 9000, s/he needs a beetroot smoothie and a nap”. Having been made more aware of the discourse between coaches and sport scientists and S&C’s, I decided to plough through a few journal articles to see what the literature says about cricket and injury…
The first thing to note is that fast bowlers are more at risk of injury than spin bowlers, batters, wicket keepers, or fielders[1–7]. It’s not that bowlers are getting injured in the field or while batting, because it has been specified that the act of bowling accounts for most injuries[2,5,7].
It is slightly different in junior cricket (u12-u16), as it seems that incidence of injury is more evenly spread among bowling, batting, and fielding, with an increase in overuse injuries creeping into the u16 age group. A study on South African elite schoolboy cricketers (16-19yrs) found that most injuries were attributed to bowling and that lower back strain and lumbar stress fractures accounted for 47% of these bowling injuries.
Lumbar stress fractures or lower back injuries are also the most severe injuries, accounting for the most days lost[1,5,6,9] (27.1% of missed match days between 2002 and 2008 in NZ). It is possible that people become more cognisant of these injuries due to their severity, leading to perception of an increase in lumbar stress fractures.
There is a higher incidence of injury at International level compared to Domestic competition (tab. 1)[4,6,10,11]. Does an increase in competitive level incur an increase in injury risk? If so, perhaps young cricketers playing at higher levels (provincial or academy) are exposed to a higher intensity. I know that for some, “intensity” seems out of place in the context of cricket, but you try face some of these school quickies!
There is more cricket being played at the elite level (139 games in 1998/99 to 203 in 2008/09). I’d bet that school/junior cricket is following this trend and playing more cricket than 10-15yrs ago. When it comes to match injuries, exposure has a lot to do with it; the greater your exposure, the greater the risk of injury. Then, with more games being played, there would be an increase in training, resulting in the overall workload of young cricketers becoming much greater than in the past. This workload itself is potentially harmful if not managed properly[12,13]. While high workloads can be problematic, it is also important to avoid sudden spikes in workload (too much too soon). In the earlier mentioned study on elite schoolboy cricketers it was shown that most injuries occurred at the start of the season in September, and in December after a period of less cricket due to school exams.
The literature suggests the interactions of poor technique, poor physical condition, and a heavy or sudden increase in workload are the culprits for an increased risk of injury. Furthermore, there is the fact that younger players are a more at risk population[2,3] and that early specialisation and overuse are problems for these young players.
There is also the possibility that there is actually an epidemic of lumbar stress fractures among young cricketers, but there’s really just too much to unpack here to narrow it down to one variable. Perhaps bad S&C practices are culpable. Perhaps it’s early specialisation and increased workloads. Perhaps it’s because children don’t get outside enough to run and jump and climb trees. Or maybe it’s the fact that more cricket, if not sport in general, is being played at greater intensities in more condensed periods. There’s even a chance that it could be down to coaching unsafe bowling technique. Personally, I think it would come down to some combination of poor physical development, early specialisation, and inappropriate workload of young players, but that’s what a sport scientist would say.
J Orchard, T James, E. A. Injuries in Australian cricket at first class level. Br J Sport. Med 36, 270–275 (2002).
Stretch, R. Cricket injuries: a longitudinal study of the nature of injuries to South African cricketers. Br. J. Sports Med. 37, 250–254 (2003).
Mansingh, A., Harper, L., Headley, S., King-Mowatt, J. & Mansingh, G. Injuries in West Indies cricket 2003-2004. Br. J. Sports Med. 40, 119–123 (2006).
Stretch, R. & Raffan, R. P. Injury Patterns of South African International Cricket Players Over a Two-Season Period. South African J. Sport. Med. 23, 45–49 (2011).
Ranson, C., Hurley, R., Rugless, L., Mansingh, A. & Cole, J. International cricket injury surveillance: A report of five teams competing in the ICC Cricket World Cup 2011. Br. J. Sports Med. 47, 637–643 (2013).
Frost, W. L. & Chalmers, D. J. Injury in elite New Zealand cricketers 2002-2008: Descriptive epidemiology. Br. J. Sports Med. 48, 1002–1007 (2014).
Milsom, N. M., Barnard, J. G. & Stretch, R. A. Seasonal incidence and nature of cricket injuries among elite South African schoolboy cricketers. South African J. Sport. Med. 19, 80–84 (2007).
Finch, C. F., White, P., Dennis, R., Twomey, D. & Hayen, A. Fielders and batters are injured too: A prospective cohort study of injuries in junior club cricket. J. Sci. Med. Sport 13, 489–495 (2010).
Orchard, J. W., James, T., Kountouris, A. & Portus, M. R. Changes to injury profile (and recommended cricket injury definitions) based on the increased frequency of Twenty20 cricket matches. Open Access J. Sport. Med. 1, 63–76 (2010).
Orchard, J. W., James, T. & Portus, M. R. Injuries to elite male cricketers in Australia over a 10-year period. J. Sci. Med. Sport 9, 459–467 (2006).
Stretch, R. A., Raffan, R. P. & Allan, N. Injury patterns of South African provincial cricket players over two seasons. South African J. Sport. Med. 21, 151–155 (2009).
Orchard, J. W. et al. Fast bowling match workloads over 5-26 days and risk of injury in the following month. J. Sci. Med. Sport 18, 26–30 (2015).
Orchard, J. W., James, T., Portus, M., Kountouris, A. & Dennis, R. Fast bowlers in cricket demonstrate up to 3- To 4-week delay between high workloads and increased risk of injury. Am. J. Sports Med. 37, 1186–1192 (2009).
Dennis, R., Farhart, P., Clements, M. & Ledwidge, H. The relationship between fast bowling workload and injury in first-class cricketers: A pilot study. J. Sci. Med. Sport 7, 232–236 (2004).