Common Injuries sustained while playing cricket

Summary

Cricketing injuries are a lot more common than previously thought. When cricket enthusiasts play regularly, and in different formats, injuries are inevitable. While some players are aware of the injuries and know how to prevent them or protect themselves, a large majority of players are not even aware. Injuries are often dismissed as mere sprains. This puts the player’s mobility at risk and can lead to long-term complications. To prevent this, cricket enthusiasts must be aware of such injuries and seek medical attention when they happen. 

Introduction

Cricket is the most popular sport in India, even though Hockey is the official national game of the country. The British left many legacies behind for Indians, some unpleasant, some useful, and one of them is cricket. Its popularity can be explained by the fact that at the national level, the Indian team plays in all formats of the game – test, 50 overs, and 20 overs, and almost all-round the year.

At a more local, or societal level, cricket is played in streets, school or college playgrounds, locality playgrounds, and at the league level – in stadiums. While street games that involve a rubber-ball or tennis-ball may not result in chronic injuries, those who play league games or higher, which involve heavier bats and leather balls, and lasting a full day, can lead to both chronic injuries (long run, mild pain) and acute injuries (instant, shooting pain).

Such players may use all the protective gear that is available – which includes helmets that protect from craniofacial injuries (to head and face), sun hats to protect from sunburn, leg pads to protect the shin bone, elbow guard, thigh guard, arm guard, chest guard, abdomen guard and batting gloves to protect batters, and finally wicketkeeping gloves. Yet, in-spite of so much gear, cricketing injuries are common and its important to be aware of them. This will help the player take the pain more seriously and seek medical attention.

Common injuries

Craniofacial Injuries: It is only in the last 2 decades that every single batsman in major cricket tournaments sports a helmet. Before that, a player could choose to wear a helmet or just a hat. This exposed him or her to severe injuries in the face and head. A fast and rising ball can cause concussion when it hits the head, a mid-face fracture when it hits the face, zygoma when it hits the cheekbone and severe eye injuries when it hits the eye, eye-brow or bridge of the nose. This applies to batsmen. Wicketkeepers are more at risk from bails that fly off and hit them in the eye.

Shoulder injuries: Both bowlers and fielders are prone to shoulder injuries due to repeated and eccentric use of the shoulder. The rotator cuff is a group of 4 muscles which along with 4 joints forms the shoulder area. Sudden overloading of the shoulder (or putting a lot of stress or strain on the shoulders) can hurt the rotator cuff. Bowlers, fielders and batsmen are all prone to rotator cuff injuries. It is one of the most common cricketing injuries. Shoulder tendinitis and tendinosis are other common injuries. In this, the tendons which connect the shoulder bones to muscles get damaged or inflamed.

Elbow injuries: Batsmen who use heavy bats and an improper batting technique develop Lateral epicondylitis. Fielders who need to suddenly throw a heavy leather ball over long distances develop repetitive valgus strain of the elbow. This manifests as medial epicondylar apophysitis in teenage players. Fast bowlers develop what is called a valgus extension overload syndrome with secondary intra-articular degeneration.

Hand injuries: Injuries to the forearm is more common than injuries to the wrist. Injuries to the forearm include bruises, hematoma, fractures of the fingers and contusion. Contusion is when a hard object (such as a leather ball) hits the soft tissues of the hand at high speed. This results in a bruise which takes time to heal.

Trunk Injuries:

• Side strain: Pace bowlers have a bowling and a non-bowling arm. In the non-bowling arm, the oblique muscle can develop a tear and this causes what is called a side strain. It can also cause avulsion fractures in the osteochondral tips of the lower ribs. It can even lead to bony impingement and soft-tissue impingement.
• Lower rib periostitis: This is basically an overuse injury of the quadratus lumborum, also called the internal oblique muscles. It causes thoracolumbar back pain, also called ‘shin splits of the trunk’. Batsmen who use heavy bats, and bowlers who play a lot of cricket, develop this condition.
• Posterior lower chest-wall injuries: This develops in the side of the body, opposite to the bowling arm, in bowlers.

Lumbar injuries:

• Lumbar disc degeneration: Fast bowlers are prone to degeneration of intervertebral discs. They may continue to bowl and not notice the problem till they develop what is called a bilateral pars fracture.
• Spondylolysis: Bowlers who develop the above-mentioned fracture, or suffer from intense fatigue, even during the initial part of their bowling spell develop spondylolysis gradually. This can cause intense pain and spasms in the back.

 

Lower limb injuries: A study conducted on South African cricketers revealed that nearly half of all their injuries were lower limb injuries. These basically affect the following muscle groups or joints in the lower limb.

• Hamstring injuries: This is quite common in bowlers, especially those who bowl long spells and play several matches in short intervals of time (example IPL or T20 World Cup like tournaments). There are several risk factors for this, which includes: inadequate warm-up, bilateral asymmetry of knee flexor strength, fatigue while playing, strength imbalance between hamstrings and quadriceps, lower back injury and poor flexibility.
• Quadriceps: Quadriceps (‘quads’) are a group of muscles in the front of the thigh, and are one of the largest muscle-groups in the body. They are extensively used while walking, running, kicking and jumping. In all 3 departments of cricket – batting, bowling and fielding, the quads are suddenly and forcefully contracted in order to provide free movement of the knee and hip. Over time, it results in strain injuries to the quads.
• Knee-cap and knee-joint: Fast bowlers undergo a lot of workload or stress to the knee This results in medial tibial or femoral stress fractures, chondral degeneration and patellar tendinopathy. Fielders who frequently dive on the field, are prone to acute knee injuries.
• Ankle and Foot: While the forefoot is prone to injuries due to impact (from jumping while bowling), the hindfoot is prone to lateral ankle instability and overuse injuries. Cricketers also suffer from posterior ankle impingement which is a group of conditions including flexor hallucis tendinitis, os trigonum disorders, peroneal tenosynovitis, ankle synovitis and intra-articular loose bodies.

Outlook

Cricketing injuries if not taken seriously can lead to serious complications over time. They can cause permanent changes in one’s mobility, strength, fitness and flexibility. In rare cases, the person may have to quit playing sports of any kind.

If you, or any of your dear ones, actively play cricket, and are suffering from pain in some part of the body, please rush to a leading hospital in your city. Such hospitals have orthopaedic doctors on their rolls who specialize in sports injuries and sports medicine. This is a more effective approach than meeting a general physician or your neighbourhood orthopaedic doctor. These specialists are familiar with the pattern of injuries sustained by cricket enthusiasts. So, they can diagnose and treat the condition more effectively.  This will restore your health and fitness, and help resume playing at the earliest.

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Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

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Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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