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Cricket Injuries
Cricket is a
major international sport
played in more than 60
countries. The laws of
cricket were drawn up by the
London Club in 1744,
formalising a game that had
been played for a hundred
years before. While its
popularity spread throughout
the countries of the British
Empire and western Europe,
it was not until the
mid-19th century that
cricket gained its
international status and
regular international
matches were played between
touring teams.
The first
recorded international took
place in 1844, at St
George’s Park, New York,
between the United States
and Canada. Canada won. The
inaugural test match was
played between Australia and
England at the Melbourne
Cricket Ground in1877
Professionalisation and more
recently, media coverage
have led to a huge expansion
and popularisation of the
game as we know it today.
Ten nations are full members
of the International Cricket
Conference, and 45 more are
associated or affiliated
members.
Although
strictly a non-contact
sport, injuries in cricket
are common, and have been
documented as far back as
1751, when Frederick, Prince
of Wales (son of George II),
expired suddenly from an
abscess in his head as a
consequence of a blow he’d
received from a cricket
ball. For one of the widely
popular team sports, there
have been relatively few
publications in the medical
literature on cricket
injuries. This article
reviews the injuries
occurring commonly in
cricket and describes
measures to prevent or
minimise them.
Types and
causes of injuries
There are
three broad categories:
Direct impact,
Indirect,
and
Overuse.
1.Direct blow
injuries
occur when a player is
struck by the ball, collides
with another player, or
crashes into the boundary
fence. For example, bowlers
and fielders can be exposed
to balls of very high speed
and are at risk from a
misjudgement of the ball or
unanticipated bounce. A
cricket ball is a
leather-covered solid cork
sphere weighing 160g and
measuring 22.4cm to 22.9cm
in circumference. As the
ball is propelled down the
pitch at speeds of up to
150km/h, the batsman must
make a series of very quick
decisions, including
determining the line and
length of the ball, whether
to move forwards or
backwards, whether to play a
stroke and which stroke to
play. Any misjudgement
creates a visual inadequacy
which could cause the ball
to ricochet off the bat’s
edge or the batsman to miss
the ball completely, either
of which might end up with
the cricket ball colliding
with a body . The batsman’s
feet are vulnerable to being
struck by a ball and
lightweight batting shoes
offer little protection
against such impact.
Wicket-keepers can
experience great trauma,
especially on the receiving
end of a fast delivery.
Fielders are susceptible
both to direct blows from
the ball and running and
sliding into the boundary
fence.
Despite
batsmen and close-in
fielders wearing protective
equipment, reports of head
and eye injuries are common.
Other frequently reported
impact injuries are
fractures of the arm, hands
and toes, and soft-tissue
injuries to the upper arm
and thigh, thorax, abdomen
and testicles. Splenic
rupture has been reported
both because of a blow from
a cricket ball and collision
with the boundary fence, and
at the extreme, there was a
report of fatal cardiac
arrest after a player was
hit in the chest by a
cricket ball.
2.Indirect
injuries
are muscle, ligament and
tendon damage sustained
while attempting to perform
a specific activity. These
injuries are most prevalent
at the start of a season and
in players who pay less
attention to warming up and
their general level of
fitness.
3.Overuse
can produce a range of
injuries secondary to
running (eg lower limb),
throwing (eg shoulder and
elbow) and bowling (eg lower
back). But the most common
overuse injury is associated
with fast bowling. Bowling
involves repetitive
twisting, extension and
rotation of the trunk in a
short period, while body
tissues and footwear must
absorb large ground reaction
forces of 4.1 to 9 times the
bowler’s body weight. It is
the speed of the delivery,
and thus the force of the
action, that makes the fast
bowler more injury prone,
particularly to bony
abnormalities (eg
spondylolytic incidences,
spondylolisthesis,
spondylolysis, pedicle
sclerosis and pars defect),
disc degeneration, stress
fracture at various sites,
primarily in the metatarsal
bones, fibula and tibia,
muscle and other tissue
tears, and pain . The other
overuse injury is splitting
or wearing of the finger
skin as spin bowlers
repeatedly drag their skin
across the seam of the ball
to impart spin. The laws of
the game prohibit the use of
protective strapping, and
the skin may only partially
heal between matches. The
end or middle finger joints
are often traumatised
repeatedly by the bowling
action, and sometimes the
consequent osteoarthritic
changes can be severe enough
to end a bowler’s playing
career.
A
wicket-keeper may also
experience osteoarthritic
changes in the knees
(because of the action of
repeated squatting), and in
the joints of the hand, from
repeatedly catching the
ball.
Other overuse
injuries are related to
throwing, catching or
running. Repetitious
throwing can result in
instability, impingement
syndrome, degenerative
changes in the rotator cuff,
and tendinitis in the biceps
or a tear of the
supraspinatus tendon.
Running long distances
during matches predisposes
the player to stress
fractures, shin pain,
patellar tendinitis and
muscle tears.
Hamstring
injury
Hamstring
tears are a widespread
sporting hazard, reported in
sports as diverse as
athletics, football,
Australian rules football,
cricket, rugby, hurling,
dancing, water skiing and
judo. They are often
serious, causing long
rehabilitation times and a
increased susceptibility to
re-injury. Persistent
symptoms and slow healing
make hamstring tears a
frustrating injury.
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The
prevalence of hamstring
tears (defined as
‘preventing player
participation in a match’)
has been measured at between
11% and 16% in studies of
football, Australian rules
and cricket . About six
players per squad will pick
up a hamstring injury each
season in professional
soccer and Australian Rules
football.
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An acute
strain to the hamstring
muscles may result in a
spectrum of injuries ranging
from delayed onset muscle
soreness and partial strain
to complete muscle rupture.
Avulsion of the ischial tuberosity
(where the bone is pulled
off while the muscle
attachment remains intact)
occurs occasionally in young
athletes. Complete rupture
of the top end of the
hamstring complex.
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Injury can
cause a player to miss, on
average, three matches or
three weeks of play.
Anatomy and
function
The word
‘hamstring’ comes from ham
(back of the knee) and
string (tendon); the
hamstring group is comprised
of the three muscles that
together span the posterior
compartment of the thigh: semitendinosus,
semimembranosus and biceps
femoris. At their top end,
the muscles attach to the
ischial tuberosity of the
pelvic bone and the femur
(thigh bone). At their far
point, they attach to the
outer side of tibia and
fibula (the leg bones).
Risk factors
o
Hamstring
injuries in sport usually
happen as a result of rapid
acceleration or deceleration
while running or jumping.
The main modifiable risk
factors include:
·
inadequate
warm-up/muscle fatigue
·
muscle
tightness
·
imbalance of
muscular strength with low
hamstring to quadriceps
ratio
·
previous
injury.
Symptoms and
signs
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The most
common symptom of upper
hamstring tear is pain in
the back of the thigh or
buttock. Other symptoms
include swelling and
bruising (ecchymosis) of the
rear thigh, local
tenderness, asymmetry and a
slipping or bunching of the
avulsed muscle belly down
the thigh. Weakness and
visible defects with active
and resisted knee flexion
may confirm a complete
hamstring tear at the upper
attachment.
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After a
hamstring injury, diagnosis
is often delayed. Therapists
should be prepared to seek
early ultrasound imaging to
verify suspected tears. MRI
can also identify which
muscle has been injured and
the amount of tendon
retraction that has
occurred. Sciatic nerve
symptoms, such as numbness
or muscle weakness should
also be investigated. These
are often related to
inflammation and scarring
around the nerve, because of
its close proximity to the
injured muscle groups. Note
that pain referred from the
lumbar spine, sciatic nerve
or gluteal and piriformis
muscles may mimic hamstring
strains .
Management
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The initial
management of hamstring
injuries involves rest,
analgesia and ice packs. But
where you suspect a complete
upperattachment tear, a
conservative approach is not
advised. In these cases,
non-operative management is
associated with a delay in
return to sports and
long-term functional
impairment. It is currently
thought far better to seek
an early diagnosis and acute
surgical repair to reattach
the torn tendons.
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Cricket