England will be favourites to deliver at the 2019 ICC Cricket World Cup which starts tomorrow as they take on South Africa at The Oval. Keeping a clean bill of health is key to success in any competition, we take a look at 5 common cricket injuries which England will be hoping to avoid.
The rotator cuff are a group of 4 muscles located at the shoulder. It’s a really common injury in cricket for both bowlers and batsman.
Rotator cuff injuries are the most common shoulder injury and they can occur either as a result of a sudden, forced, powerful movement particularly into an ‘awkward’ position or as is most common, through overloading the shoulder joint. Overloading the shoulder at the start of a cricket season is common considering the time players may have had off.
Rotator Cuff Related shoulder pain is an all-encompassing term that describes pain or injury in the rotator cuff muscles themselves, in the tendons of the muscle, or in surrounding tissues like the bursa (fluid sacs found all over the body). This would also include a term you may be more familiar with - 'Impingement Syndrome'. This diagnosis is now included within Rotator Cuff Related Shoulder Pain. It used to be thought that pain in the shoulder was caused by certain structures 'impinging' on each other, rubbing together if you like and causing pain. We now know that this isn't actually what happens. What is more accurate is that the structures within the shoulder get more sensitive and it is almost impossible to tell which structure maybe the one that is causing the pain.
One of the best ways to manage injuries like this is to manage the overall load you are putting through your shoulder and it may mean putting the brakes on bowling those overs or batting that extra innings! Getting back to your activities slowly and not increasing load too quickly in general is a good recipe for reducing the risk of injury. Very good evidence tells us that using good strengthening exercises can help to reduce the symptoms of pain. However, symptoms can take up to 12 weeks to fully settle so it is important to be patient in your rehabilitation. England pace bowler James Anderson has had ongoing struggles with his shoulder in recent years.
Cricket balls are hard, and getting hit by one can often leave a bit of a bruise! This bruise is what we call a contusion. A ‘contusion’ is an injury that results following a hard, direct blow.
There is likely to be pain, warmth and swelling in the injury area, which are all signs of inflammation. The more redness, bruising or swelling that is present is a good indication of the level of damage that may have occurred.
The important thing to note about inflammation is that it is a normal and essential part of the healing process, so it is important that some inflammation is allowed for the injured tissues to heal properly. While it can be a good idea to see a medical professional if you can see redness and swelling after an injury, it isn’t something that you should worry about in the majority of cases. Completely resting an injured part of your body for too long is not a good thing, no matter how severe this issue. Lack of early management can lead to other problems related to disuse, such as joint stiffness or muscle weakness, or may cause pain in other areas when they have to compensate.
The best way to help yourself after an acute soft tissue injury is to follow our ‘MICE’ advice. By following these simple ‘rules’ you can assist the injured tissues to heal and can help yourself recover faster and better, getting you back to your usual activities as quickly as it’s safe to do so. It’s most beneficial to follow the MICE principles in the 72 hour period immediately following an injury, and the goal of this self-treatment is to control (but not stop) inflammation and to prevent the injury being made worse.
Movement - As soon as able you should start performing movements pulling the foot up, pushing it down, turning it inwards and outwards as far as you feel comfortable to. This prevents the ankle from becoming weak or stiff and helps you progress to the next stage.
Ice - Ice has been shown to be effective for pain relief and can be applied through a damp towel to the area for between 10-20 minutes, you should not lie on the ice and if the area becomes itchy or the pain increases, remove it. This can be completed 2 hourly but allow the area to return to normal before re-applying.
Compression - Using a tubigrip or neoprene brace is effective for pain relief and may help reduce swelling. It should feel tight but not so much that you can’t feel the foot below or it increases your pain.
Elevation - Raising the ankle above your heart level on pillows will help with pain and may reduce swelling. Both compression and elevation can be completed in between bouts of icing.
Ankle sprains can often occur in cricket when running into bowl or changing direction when running between the stumps. The ligaments of the ankle are damaged by excess forces placed upon them.
The ankle is a stable joint because of the number of ligaments it has around it, however when excessive movements in any direction are forced upon the ankle, often the muscles don’t respond quick enough to prevent damage to the ligaments. The outside ligaments are often injured when the foot twists inwards either with the whole foot on the ground or when on your tip toes (Inversion), the inside ligaments are often injured when the foot twists outwards on the leg (eversion) and the high ankle ligaments are often injured when the foot is rotated outwards..
The severity of ankle sprain is graded 1-3 from less severe (1) to more severe (3)
If you cannot put any weight through your foot and ankle then you should get checked by your GP or at A+E to be sure you haven’t broken any of the bones as this requires different management in the early stage.
For the majority of people this isn’t the case and with a grade 1 injury 80% of people will return to normal activity within 4 weeks.
Once you have an idea of severity ensuring you manage the acute symptoms appropriately is essential. The aims of this stage are control and reduce pain and swelling whilst maintaining as much ankle function as possible. Following the MICE acronym as above is a good idea again as well as getting some early load into the ankle when possible. Some rest when having sprained your ankle is a good thing but resting completely for too long is not, as we have previously discussed. So, as soon as you are able, walking on the ankle is a good thing despite it probably being a bit painful still.
England bowler Mark Wood has been troubled with ankle injuries throughout his career and was a doubt in the lead up to the match with South Africa.
Lower back pain is common in cricket and in particular with fast bowlers. When bowling you place a significant amount of force through your body some of which is absorbed in your back.
Back pain can be severe and can stop you from doing the things you enjoy, however in 90% of cases back pain is harmless and will not result in any long term ‘damage’. Most back pain will resolve within 6 weeks if you continue to move and engage in daily activities as much as possible. Back pain is often a result of a number of different things and rarely occurs because of a single injury event.
In more severe cases of back pain in cricket it can be due to something called ‘spondylolisthesis’, this is where small fractures can occur in particular part of the spine. It is more common in young or adolescent cricket players. It can be hard to tell whether these fractures are the true ‘cause’ of someone’s pain as they can be present in people who have no pain what so ever. The treatment for this is similar to less severe forms of lower back pain however, may need some prolonged time away from the game for a fuller recovery.
Common in fast bowlers, hamstring injuries often occur when the foot is planting on the ground in the action of bowling or when running between the stumps. Both of these actions require fast acceleration coupled with equally fast deceleration, which, is a good combination for a hamstring injury to occur. Another way you could strain a hamstring is by overstretching. This is less common in cricket but could occur when batting and stretching, trying to make the crease
Injuries can be categorised into 3 different grades as our ankle injuries were:
Grade 1. Mild muscle strain
Grade 2: Partial Muscle Tear
Grade 3: Complete muscle Tear
Grade 3 injuries are much less common than Grade 1 or 2 and usually require some specialist intervention so the advice in here mainly related to Grade 1 and 2 injuries.
In grade 1 hamstring injuries it may feel like a dull ache in your hamstring, you may notice it during or after running or over stretching whereas grade 2 injuries will be an immediate, sharp pain and will almost always mean you will have to stop running.
The initial injury management is again, similar to our contusions and ankle sprains – the MICE protocol. After the initial 72 hours of MICE it is important to start the rehab process. It was once thought that you needed to wait some time before starting to rehab a muscle like the hamstring but good evidence has shown that early rehab is much more beneficial. It is best to seek advice from a physio for specific exercises as everyone is different and will require different things. Running is always the last thing that you should return to following a hamstring injury and you must ensure you a strong enough beforehand. If you don’t and return to running too soon it increases your likelihood of re-injuring that hamstring.