Different tissue type categories of overuse injuries to cricket fast bowlers have different severity and incidence which varies with age

Abstract

Introduction: It has been well documented that injury to fast bowlers in cricket has been and remains one of the most significant of the sport's ongoing sports medicine challenges. Previous injury, workload variations and bowling biomechanics are all considered to be significant risk factors in the development of these injuries. The purpose of this study was to further investigate the variation in severity and incidence of injury to different tissue types and ascertain whether age is a significant risk factor in these injuries. Method: This study amalgamated the injury data files from the Cricket Australia Injury Surveillance program and match workload data from official scorecards of First class (long form) and List A (short form) over 14 seasons from 1998-99 to 2011-12 inclusive. Results: The 14 season data followed 215 separate bowlers playing in 1588 separate matches for 4014 long form and 6321 short form player matches. Over that time fast bowlers suffered a total of 563 bowling related injuries with 62 joint injuries, 101 bone injuries, 292 muscle injuries and 108 tendon injuries that resulted in matches lost. Age was calculated on the first day of a match and was then characterised into 5 groups: <22 y.o., -22-25 y.o., -25 to 28 y.o., -28 to 31 y.o., -7gt;31 y.o. The severity of the different injury types did not vary much across the age groups but there are some quite marked differences in the incidence of the injuries across different ages. Younger (<22) and older (7gt;31) are 1.8-3.7 times more likely to suffer a joint injury than the other age groups. Younger bowlers are 3.7-6.7 times more likely to suffer a bony injury than all the other age groups. Younger bowlers are slightly more likely (1.4-1.6 times) to suffer a muscle injury. The incidence of tendon injuries is quite similar across the 3 youngest age groups and gradually increases in the 28-31 group and is at the highest in the 7gt;31 group. Discussion: In conclusion this study demonstrated that younger age is a considerable risk factor in the development of bone stress injuries in cricket fast bowlers. The lumbar spine is particularly vulnerable and this is likely to be a combination of skeletal maturity and training age capability. The younger fast bowler also is more susceptible to side strain injury for similar reasons. Finally while under the current classification system tendon injuries increase with older age this appears to be driven by the classification of ankle impingement as a tendon injury.