The nature and incidence of fast bowling injuries at an elite, junior level and the associated risk factors

Fast bowlers are especially prone to injury as they perform their bowling techniques repetitively at very high intensities. The fast bowling action in the past has been described as a highly explosive activity that produces high levels of stress and strain on the body. The aim of this study was to compile an injury profile of 46 fast bowlers aged 11 to 18, and to identify the associated risk factors for injury during an academy cricket season. A descriptive correlational research design was utilised. Subjects were selected according to age and fast bowling ability. These subjects were observed for one academy cricket season (March to November). Three testing sessions occurred during this time (T1, T2 and T3). Each subject completed two questionnaires: i) bowler history (at T1) and ii) injury history (at T1, T2, and T3). These assisted in grouping the subjects according to their responses into one of three injury classifications (uninjured = S1; injured but able to play = S2; injured and unable to play = S3). Anthropometric and postural data for the entire group of fast bowlers were also collected pre-season (T1). Physical fitness screenings were also conducted during each of the three testing sessions to establish any relationship between the fitness of each fast bowler and the occurrence of injuries. Additional factors assessed during the season were bowling techniques and bowling workload. Statistical significance was indicated by p-values less than .05 (p< .05), while practical significance was indicated by either Cohen’s d-values of 0.2 or better (d>0.2) for tests based on sample means or Cramer’s V for tests based on sample frequencies, the values of which depend on the applicable degrees of freedom. All fitness scores as well as bowling workload figures for each testing session were converted to standard T-scores and these in turn were summated to derive overall fitness and workload T-scores. ‘TT’ indicated the overall average score for the entire season. Changes in performances, bowling workload and injury status were analysed using ANOVA and ANCOVA. A regression analysis was also conducted to analyse the relationship between bowling workload and weeks incapacitated. This study found that hyperextension in the knees had the highest incidence of postural deviation injury (43 percent) followed by winged scapula (39 percent). Only 15 percent of the fast bowlers remained injury-free for the duration of the season, while 35 percent of the subjects were at some stage injured to such an extent that they were unable to play. The incidence of serious injury (S3) showed a statistical and moderate practical (V=0.23, d.f. ≥2) significant increase throughout the data collection period (4 percent at T1 to 30 percent at T3). The most common injury was to the knee (41 percent) followed by those to the lower back (37 percent). These injuries occurred mostly during test periods T2 and T3. The nature of injuries were predominantly strains and "other" which accounted for 39 percent of the injuries overall (TT) and had the highest reported incidence during the period T1 to T3. Sprains followed with an overall incidence of 14 percent. Less frequently reported injuries were tears, fractures, bruises and dislocations. The degree of severity of injuries was defined in terms of the number of weeks a player reported being incapacitated as a result of injury during the academy session. During midand end-season bowlers were on average incapacitated approximately one week out of every five due to injury. The statistics for the duration of the study translate to approximately one week incapacitated out of every seven weeks of play. When comparing the S1/S2 bowlers with the S3 group, the S1/S2 bowlers performed consistently better than the S3 bowlers in all the fitness variables tested. However no significant differences (p>.05) in either flexibility or muscle strength were observed. Of the risk factors analysed, bowling workload presented a statistically significant (p<.0005) increased risk for injury. A strong significant positive relationship (p<.0005, R²=.619) was found between weeks incapacitated and bowling workload, supporting the finding that increased bowling workloads show a linear relationship with the increase in the number of weeks incapacitated from normal play. This study concluded that inadequate fitness, high bowling workload and bowling technique all have a multi-factorial role in predisposing a bowler to increased risk for injury. These variables did not act alone, but have all contributed to recurring injuries. The bowling action alone would not have been detrimental if the workloads were not in excess of the recommended guidelines. Furthermore the workload would not have been as detrimental if the bowlers were well conditioned and uninjured. Management of minor injuries and adequate recovery time, coupled with adequate and relevant fitness preparation would better prepare fast bowlers for the demands of the gam