An insight into junior cricket injuries

Since the 1998/99-season cricket Australia has conducted an annual ongoing injury survey, recording injuries in all of Australia’s first class players. This information has proved enormously beneficial for the management of Australia’s elite players. Across the world this collection of information of adult cricket players and their injuries has been growing, but what about injuries in junior cricket players? The research for injury patterns in junior players is scarce. One relatively recent study was undertaken by a group in the South African Journal of Sports Medicine, this five-year retrospective study recording data on the injuries of elite junior cricketers and compared their injury patterns to senior elite players.

Adult studies have shown fast bowlers are the most likely to become injured during the delivery and follow through, followed by fieldsman and then batsmen. This study found that junior fast bowlers were the most likely to become injured however these occurred mainly during the run-up and delivery. With fieldsman and then batsmen coming in second and third for injury occurrence.

Studies have found that adult cricket players are more likely to sustain injury in the first two months of the season, with injuries predominantly happening during matches. On the other hand junior players were more likely to become injured in 1-day matches or practice throughout the entire season.

Junior and senior players showed similar injury patterns for lower and upper limbs. However, junior players sustained more back and trunk injuries. According to the researchers 49% of injuries sustained by junior cricketers are in the back and trunk. We would expect this number to be high due to the high prevalence of stress fractures predominantly in fast bowlers. However, it was found that for under 15, 17 and 18 year old teams 27%, 25% and 18% respectively were muscular injuries in the back and only 12%, 8% and 9% respectively accounted for stress fractures in the back. This finding would appear to be in conflict with the high incidence of stress fractures reported in most other studies in regards to young fast bowlers.

The correlation between increased workloads and increased likelihood of injury amongst fast bowlers was confirmed with this study and has been well known in the cricket community for many years. The authors suggested that fast bowlers were more likely to become injured if they bowled 50 balls per day more than three times a week. Current Australian research has found that not only is the number of balls bowled a critical issue but also how frequently. It is much better if you are a 16 year old to bowl three times per week five to six overs each time, rather than attempting to bowl a lot of overs on the weekend. Once your program is finished with Andre it is important that you continue to bowl regularly over the holidays, going down to the nets, warming up and bowling five overs two to three times per week. Don’t attempt to bowl the five overs all at once because you don’t do that in a game, rather in a match you bowl an over and then you have an over off. Attempt to mimic that in your training session. If you follow this simple rule, you will arrive at the start of your cricket season with a regular bowling workload, which will enable you to handle the increased load of the season. Remember that fast bowling is highly demanding intense activity, which requires you to be fit, flexible, uninjured and bowling regularly.

According to the study, overuse injuries are found to be more common in the under 15-year-old team. This could be due to the athletes playing more than one sport, or playing for more than one team. As overuse injuries are becoming more common and are increasing in younger athletes it is important that coaches, players and parents are monitoring the workloads that are being implemented. This is why Andre takes injury prevention and workload monitoring seriously.

To ensure injury prevention the following points must be taken into consideration:
– Always warm-up and cool-down appropriately
– Wear the right protective equipment for all training and matches
– Stay hydrated and well fueled (eat quality food) before, during and after training or matches
– Maintain good leg strength, shoulder strength and core stability
– If you want to make technical changes to your batting or bowling, it is important to make these changes slowly. Do not attempt to go down to the nets and spend an hour, running through a new action but rather slowly introduce it over a period of time and ensure you are working with your coaches who are able to monitor these changes

Recovery Techniques – What’s the Evidence?

You may have seen footage during the sports reports of athletes wearing compression garments, sipping on sports drinks or swimming in cold conditions. It is common routine for athletes to utilise recovery methods to assist with the high demand of physical activity, whilst minimising muscle soreness and gaining the most benefit out of each training session. Several products have failed to live up to the benefits they claim, lacking in evidence and leaving a significant financial burden. So, what does the evidence tell us about basic recovery aids?

The American College of Sports Medicine (ACSM) reviewed five of the most common recovery aids: compression, massage, caloric replacement and, cold and heat.

Compression
Research has indicated that compression garments are beneficial as a recovery aid. This form of therapy decreases delayed-onset muscle soreness (DOMS) and improves performance on distance running, cycling power, muscular strength and power, and reduces the risk levels of muscle injury.

Massage
Massage is the most commonly used recovery aid for athletes across all sports and levels of competition. It may delay the time to DOMS, however it can briefly decrease muscular strength shortly after treatment. The foam roller technique is used to provide controlled pressure to muscles, which may also decrease DOMS and improve athletic performance.

Calorie Replacement
To improve muscle glycogen (carbohydrates) replenishment and muscle repair and growth, it is necessary to eat a normal healthy diet when exercise sessions are at least 24 hours apart. Athletes who train or compete more frequently, can improve muscle glycogen replenishment by consuming foods with higher glycaemic index and using earlier carbohydrate replacement. Improving muscle recovery can be done by protein supplementation and protein-carbohydrate recovery aids. The Position Statement on Nutrition & Athletic Performance by the ACSM encourages carbohydrate replacement within 30 minutes of post-exercise with 1 to 1.5 grams of carbohydrate per kilogram of body weight at 2-hour intervals up to 6 hours.

Cold
Cold therapy is believed to work by influencing inflammation, blood flow, nutrient transport, nerve conduction velocity and pain perception. The majority of literature on cold therapy as a recovery tool involves cold water immersion (CWI). During repeated bouts of endurance exercise in the heat, CWI helps maintain low body temperature and improve performance. There are small benefits like the reduction of DOMS as well as improvements in athletic performance such as a quicker recovery of sprint speed. Ice should be applied for no longer than necessary (5-15 minutes) and monitored during treatment.

Heat
Heat is suggested to decrease muscle soreness by increasing blood flow to treated areas, which improves oxygen uptake and flushing out exercise-related waste products from recovering muscles. There is no strong evidence to support the benefits of the application of heat alone, as most studies have used a blend of heat and cold treatments (sauna/spa, cold water therapies). However, it should be mentioned that different forms of heat treatments (hot packs) are regularly used for treatment of muscle stiffness and soreness.

Each form of recovery aid has its benefits for specific athletes in their chosen athletic scenario. It is important to understand the benefits based on evidence-based research rather than what TV, billboards or social media promote. This understanding can help prepare both athletes and coaches to be effective in their approach to using recovery methods, which will contribute to the overall performance during training sessions and competitions. If I was to give advice to a young athlete, it would be to eat well, stay hydrated and get plenty of rest.

~ Lindsay Trigar
Lindsay Trigar Physiotherapy

The importance of year-round strength training in cricket

Research into the fitness requirements of cricketers has lagged behind similar research into most other sports. The football codes discovered much earlier that you could not become fit for team sport by just playing that sport. Perhaps part of the cricket world’s unwillingness to adapt was due to the fact that up until the 1970’s it was seen as a slow, low intensity sport. The birth of one-day cricket saw the requirements of fitness for the game change, players were forced to learn to turn 1s into 2s and chase much harder in the field. Then with the evolution of T20 cricket across the globe a new level of fitness has evolved. This format of the game moves rapidly and there are increased demands in intensity and explosive power with bat, ball and in the field.
It was in the 1990s that research really started to be undertaken and training programs where implemented based on scientific evidence. Fitness, we now know is a very important aspect of cricket performance with physically prepared cricketers proven to perform better, more consistently and with fewer injuries. The physical attributes of strength, speed and endurance enables a cricketer to bat with power over long periods of time, bowl faster and with greater accuracy, and to field more athletically. The shorter formats forced players to be fitter, stronger and faster. It is for these reasons that the Andre Burger academy has included strength, power and fitness components. In the modern game, it is not enough to just play and rely on your skill. Anyone who intends taking their game seriously must be committed to becoming and remaining as fit and healthy as possible.
Two interesting articles have recently appeared in the literature. A group of researchers in Manchester England measured the strength, power and speed performances of the local County team following their preseason strength and conditioning program. They then continued to monitor the players’ results throughout the season once the players had ceased this strength program and continued into the cricket season. They found that the players performance decreased in all the measures once the season got underway which showed that the physical demands of the English County Cricket season alone are not enough to maintain preseason strength, jump and sprint performance. Their recommendation was that coaches should implement a time effective resistance training strategy in season. From their research they suggested that one strength training session per week should be undertaken throughout the season to maintain the benefits of the preseason training load. I would recommend that even young cricketers should maintain strength training throughout the year.
Cricket today is a different game to what your grandfathers played and our knowledge of strength training and injury prevention has evolved significantly. Therefore, year round efforts should be made to maintaining strength training.

Written by Lindsay Trigar
Lindsay Trigar Physiotherapy

Osgood-Schlatter’s or Sever’s

Knee and heel pain in children?
Young children often report pain 3-5cm below their kneecap or in the back of the heel when involved in physical activity. Parents often worry that they have a significant knee or ankle problem. But in most cases these children are complaining of Osgood-Schlatter’s or Sever’s. These are both conditions affecting pre-adolescents and adolescents, particularly those who are very physically active. Both these conditions tend to affect children between ages 11-15 years in boys and ages 8-13 years in girls. However, both of these conditions are more common in boys. Osgood-Schlatter’s accounts for around 13% of adolescent knee pain. Sever’s accounts for around 16% of all musculoskeletal injuries in children.

Why does this occur?
There are two types of growth plates in bones:
• One type of growth plate increase the length and thickness of the bone
• The other type of growth plate is found where large muscle tendons attach to a bone.
• Osgood-Schlatter’s occurs where the large quadricep muscles attach to the front of the lower leg. While Sever’s occurs where the large calf muscle (Achille’s tendon) attaches into the heel bone.
• During a growth spurt there is lots of bone activity and pain occurs with activity. Repetitive contraction of these large muscles causes traction on the growth plate and this can cause pain.

What are the symptoms?
• Constant dull ache
• Sore to touch in these areas
• Swelling in these areas
• Sharp pain during activities such as running, jumping and kicking
• In 60% of cases, the condition effects both sides
• Unable to complete normal training sessions
• A limp when walking
• Parents will often recognise a growth spurt

How to treat it?
Both of these conditions usually resolve by themselves with time, ~4-8 weeks. Treatment is usually based around activity modification. For example, reducing amount of overs bowled in the nets or not practicing running between wickets. Other treatment options can include taping, ice, pain-relieving medications, stretching, strengthening of the quadriceps or calf muscles and physiotherapy. In some cases, these symptoms can mimic other conditions. If the symptoms have not resolved within 4-8 weeks then it is best to seek the help of a Doctor or Sports Physiotherapist.

So the take home message is that nearly always the problem is nothing more than the conditions described above. There will be full recovery at the completion of the growth spurts. There is rarely a need to stop your activity completely but rather modify your training workload. Next time you are at an U13 junior sporting event, have a look at the youngsters who are limping or running flatfooted. They are experiencing the pain of Osgood-Schlatter’s or Sever’s.

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