International consensus statement on injury surveillance in cricket: a 2016 update

A systematic review of injuries in recreational field hockey: From injury problem to prevention

The purpose of this study was to gather information from scientific literature related to all steps of Van Mechelen's "sequence of prevention" for injuries applied to youth and adult recreational field hockey players. A systematic review was conducted in Medline via Pubmed and in SPORTDiscus via EBSCOhost. Twenty-six original studies were included. Regarding injury incidence (step 1) results showed several overall injury incidence rates (youth: 1.47 per 1,000 Athlete Exposure (AE) time-loss (TL) injury up to 11.32 per 1,000 AE TL ánd non-time loss (NTL) injury, adults: 2.2 NTL injury per 1,000 AE, 15.2 injury per 1,000 hours of sports participation). Considering games and practices, most injuries were sustained in games (youth: 4.9, adults: 7.87 per 1,000 AE). Considering body parts, highest injury incidence rates were found in body parts in the lower extremities (youth: knee injuries in games (0.33 per 1,000 AE), adults: hamstring injuries in pre-season (0.75 per 1,000 AE)) and injuries in the head/face/eye (youth: 0.66 and adults: 0.94 head/face/eye, 0.71 head/face and 0.63 concussion per 1,000 AE). Regarding aetiology (step 2), no studies were found. Regarding the efficacy of available interventions (step 3 and 4), one study was found among youth players, describing a warm-up programme.

A decade of head, neck and facial cricket injury hospitalisations in Victoria, Australia: From 2007/08 to 2016/17

OBJECTIVES

To present an epidemiological profile of hospital-treated head, neck and facial cricket injuries from 2007/08 to 2016/17 in Victoria, Australia.

DESIGN

Retrospective analysis of emergency department and hospital admission data.

METHODS

An analysis of Victorian hospital-treated head, neck and facial cricket injuries of all cricket participants over 5 years old between July 2007 and June 2017.

RESULTS

Over the decade, 3907 head, neck, facial (HNF) cricket injuries were treated in Victorian hospitals. The number of HNF cricket injuries substantially increased in the 2014/15 season from 367 to 435 injuries and remained over 400 in the subsequent years. More injuries were reported for male compared to female participants, 3583 compared to 324 injuries. When adjusted for participation in competitive cricket, the injury incidence rate was 1.3 per 1000 participants for males and 0.4 per 1000 participants for females. The 10-14year age group most frequently required hospital treatment. Open wounds were the most common type of injury (1166, 29.8%) and the main mechanism for HNF cricket injury for this decade was hit/struck/crush (3361, 86.0%).

CONCLUSIONS

This study provides a novel and current insight of the incidence and details of HNF injuries among cricket participants in Victoria over a decade. It is evident that males and younger participants, regardless of gender, have a higher risk of sustaining a HNF injury. This study provides a solid evidence base for stakeholders in developing strategies to minimise head, neck and facial injuries to make cricket a safe sport for all.

Injury and Player Availability in Women's International Pathway Cricket from 2015 to 2019

This prospective cohort study aimed to describe injury and illness epidemiology within women's international pathway cricket, understanding what influences player availability in this unique context where players are contracted part-time. Approximately 8.4% of players were impacted by injury or illness during the year, with an average 2.3% of players completely unavailable on any given day. Most medical complaints occurred during training (111.2 injuries/100 players per year). Of all complaints, medical illness had the highest overall incidence (45.0 complaints/100 players), followed by hand injuries (24.7 injuries/100 players). Gradual onset injuries were most common. Overall average match time-loss complaint prevalence rate was 4.1% and average match time-loss injury incidence rate was 7.0 injuries/1000 days of play. Fielding (56.4 injuries/100 players per year) was the activity resulting in the highest average overall and time-loss injury incidence rates, though 'other' activities (e. g. those occurring outside of cricket participation) collectively accounted for 78.3 injuries/100 players per year. The high incidence of medical illness relative to other complaints may be a distinct feature of the women's cricket international pathway compared to other cricket samples. The high occurrence of injuries arising from 'other' activities, likely due to part-time participation, presents an opportunity for targeted injury prevention strategies.• The first study on an international women's cricket pathway, contributes to the empirical base for specific injury risks associated with the women's cricket game, which is an emerging research area for a developing sport.• Some of the findings may be a distinct feature of the women's cricket international pathway, highlighting potential opportunities for targeted prevention strategies.• With the upcoming development of an elite domestic structure these preliminary findings will provide a good starting point for physiotherapy and medical staff working in these contexts.

Prospective reporting of injury in community-level cricket: A systematic review to identify research priorities

OBJECTIVES

Cricket is a popular sport enjoyed worldwide. Injuries in cricket are not well understood at community level but are important to understand for prevention to ensure the game continues to be enjoyed safely. This systematic review was designed to assess the quality of data collection and reporting, and to summarise the injury data, in studies of community cricket players.

DESIGN

Systematic review.

METHODS

Nine databases were searched to November 2018 using the terms "cricket*" and "injur*". A nine-item critical appraisal and three-item likelihood-of-bias evaluation was conducted on included studies. Data completeness was evaluated against recommendations in the international cricket consensus statement for recording/reporting injury and the Australian Sports Injury Data Dictionary (ASIDD). Descriptive injury data (n,%) are presented in tabular format for different subgroups (activity, position, population).

RESULTS

Thirteen studies were included, of which eight were rated as unclear, one as high and three having a low likelihood-of-bias. The mean score for completeness of data against the consensus statement was 3.5/10 (95%C.I. 2.8-4.2). The mean score for completeness of data against the ASIDD was 4.4/6 (95%C.I. 3.9-5.0). Bruising and inflammation was the most common injury in junior cricket. Stress fractures were most common in studies of bowlers. Where studies included all activities, batting accounted for most injuries (7-49%).

CONCLUSIONS

The included studies inconsistently addressed recommended items for injury surveillance in community sport and cricket. Most studies focused on junior levels or adolescent bowlers, with bruising/inflammation and stress fractures being most common, respectively.

Statement on methods in sport injury research from the 1st METHODS MATTER Meeting, Copenhagen, 2019

High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.

Statement on Methods in Sport Injury Research From the First METHODS MATTER Meeting, Copenhagen, 2019

High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876.

The cricketer's shoulder and injury: Asymmetries in range of movement and muscle length

Background

Shoulder injuries in cricket are often undetected and untreated.

Objectives

To determine whether there are associations between shoulder internal and external rotation range of movement (ROM), throwing arc (TA) ROM, glenohumeral internal rotation deficit (GIRD), external rotation gain (ERG), pectoralis minor muscle length and the incidence of shoulder injury during the first 3 months of a cricket season amongst provincial and club cricketers.

Method

Male, actively participating, provincial and club cricketers were included in this prospective longitudinal cohort study. The independent variables included shoulder pain, which did not limit participation in cricket training and matches; shoulder external and internal rotation (ROM, TA ROM, GIRD and ERG) and pectoralis minor muscle length. Time-loss dominant shoulder injury was recorded for 3 months.

Results

Nine of the 32 participants sustained dominant shoulder injuries. Initial non-time-loss shoulder pain during baseline testing was associated with time-loss in-season shoulder injury (p = 0.007). Statistically significant side-to-side differences were found for all of the independent variables (internal rotation ROM, TA ROM and pectoralis minor muscle length distance), with the exception of external rotation ROM, amongst the uninjured players.

Conclusion

Non-time-loss-defined shoulder pain in actively participating cricketers seems to be a precursor to time-loss shoulder injury. Asymmetries in ROM and pectoralis minor muscle length in uninjured cricketers may have a protective role to play in the case of shoulder injury.

Clinical implications

The presence of shoulder pain and asymmetries in ROM should be investigated during the pre-season screening procedures, and early intervention should be implemented where appropriate.

International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.

Injuries in England and Wales elite men's domestic cricket: A nine season review from 2010 to 2018

OBJECTIVES

This study primarily aimed to explore injury incidence rates in the three main domestic competition formats in England and Wales (First-Class, One-Day and Twenty20 [T20]). For the first time, the study also describes the epidemiology of elite men's domestic cricket injuries across nine seasons (2010-2018 inclusive).

DESIGN

Prospective cohort analysis.

METHODS

Injury incidence and prevalence from all injuries calculated according to the updated international consensus statement on injury surveillance in cricket, with statistical process control charts (SPC) used to detect trends in the data.

RESULTS

The average match injury incidence was 102 injuries/1000 days of play, with highest incidence in One-Day (254 injuries/1000 days of play), followed by T20 (136 injuries/1000 days of play) and First-Class Cricket (68 injuries/1000 days of play). Most match injuries were sustained during bowling (41.6 injuries/1000 days of play), followed by fielding (26.8 injuries/1000 days of play) and batting (22.3 injuries/1000 days of play). The thigh was the body area most commonly injured (7.4 injuries/100 players per season), with lumbar spine injuries the most prevalent (1.3% of players unavailable on any given day during the season). On average, 7.5% of players were unavailable on any given day during the domestic season when all injuries were considered (match and training). The SPC charts showed relatively consistent match injury incidence for all competitions, reproduced across all nine seasons.

CONCLUSION

These findings provide a robust empirical base for the extent of the injury problem in domestic cricket played in England and Wales, with similar injury profiles across the three formats.

Medical-attention injuries in community cricket: a systematic review

Objectives

The aim was to identify and describe outcomes from original published studies that present the number, nature, mechanism and severity of medically treated injuries sustained in community-level cricket.

Design

Systematic review.

Methods

Nine databases were systematically searched to December 2019 using terms "cricket*" and "injur*". Original, peer-reviewed studies reporting injury for at least one injury descriptor (body region, nature of injury and/or mechanism of injury) in community-level cricketers of all ages were included. Qualitative synthesis, critical appraisal and descriptive summary results are reported within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results

Six studies were included: five reported hospital-treated data and one reported insurance claims data. Two had a low risk of bias. In hospital-based studies, fractures were the most frequent injury type. Upper and lower limb injuries (age ≥15 years) and injuries to the head (age <15 years) were the most common body region injured. Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type.

Conclusion

Hospital treatment data were most prominent, which emphasised injuries of a more serious nature or requiring acute care. These injuries were primarily fractures, dislocation/sprain and strains, bruising and open wounds with the majority resulting from players being struck by the ball. Research into whether properly fitted protective equipment, at an approved standard, is worn and is effective, is recommended.

International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS))

BACKGROUND

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date.

OBJECTIVE

To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension.

STUDY DESIGN

Consensus statement of the International Olympic Committee (IOC).

METHODS

The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019.

RESULTS

This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS).

CONCLUSION

The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.

Incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers, association with bowling workload and seasonal variation

OBJECTIVES

Since much of the previous epidemiological research into lumbar stress fracture was conducted, there has been a marked increase in the amount of cricket being played. The aims were to determine the incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers between 2010 and 2016, determine the association with match bowling workload and observe seasonal variation in workload and injury.

METHODS

Lumbar stress fracture incidence and prevalence rates were calculated using new international methods for epidemiology in 368 professional English fast bowlers from 2010 to 2016. Workload variables were compared between lumbar stress fracture case and non-injured control groups, before entry in a logistic regression.

RESULTS

Fifty-seven lumbar stress fractures (mean age 22.81) were reported. Injury was most common in July and September. Match incidence was 0.16 lumbar stress fractures per 10 000 deliveries, annual incidence was 2.46 lumbar stress fractures per 100 fast bowlers and annual prevalence of lumbar stress fractures was 1.67% of squad days. Significant workload variables were observed between cases and controls. A peak 7-day workload of greater than 234 deliveries significantly increased the odds of sustaining a lumbar stress fracture 11-fold compared with bowling fewer than 197 deliveries.

CONCLUSION

Lumbar stress fractures are common in young fast bowlers possibly due to immaturity of the lumbar spine. The condensed early and late-season schedule may be causing periods of overuse, resulting in an increase in incidence of lumbar stress fracture. Reduction of workload in young fast bowlers is needed to reduce incidence.

Injury profiles in elite women's T20 cricket

OBJECTIVES

To Describe the injury incidence and prevalence during two years of a professional women's T20 cricket tournament.

DESIGN

Prospective cohort study.

METHODS

Injuries were recorded prospectively for 68 matches during a professional women's T20 tournament in 2016 and 2017. There were six teams of 15 players. Participants were female, aged between 16-38 years (mean 23.4±4.8). Time-loss and non time-loss incidence and prevalence were calculated for match days, region, skill group, mode and activity at time of injury.

RESULTS

The greatest incidence occurred in the shoulder (1.8 injuries per 100 match days), lower back (1.7 injuries per 100 match days) and knee (1.7 injuries per 100 match days). The highest time-loss prevalence occurred in hand (1.7%), head/face (0.8%) and thigh (0.6%). All head injuries were concussion. Catching related injuries caused the most time-loss (2.5% prevalence) and throwing related shoulder injury had the highest incidence (2.3 injuries per 100 match days). Gradual onset injuries had the highest overall incidence (7.9 injuries per 100 match days).

CONCLUSIONS

In elite female T20 cricket, time-loss injuries, particularly impact/traumatic injuries are most likely to occur during fielding, suggesting pitch side support and trauma training is a priority. The high incidence of gradual onset injuries, particularly throwing related shoulder pain, indicates that managing workload and ensuring physical preparedness is vital.

Design, Development, and Evaluation of an Injury Surveillance App for Cricket: Protocol and Qualitative Study

Background

Injury surveillance and workload monitoring are important aspects of professional sports, including cricket. However, at the community level, there is a dearth of accessible and intelligent surveillance tools. Mobile apps are an accessible tool for monitoring cricket-related injuries at all levels.

Objective

The objective of this paper is to share the novel methods associated with the development of the free TeamDoc app and provide evidence from an evaluation of the user experience and perception of the app regarding its functionality, utility, and design.

Methods

TeamDoc mobile app for Android and Apple smartphones was developed using 3 languages: C++, Qt Modeling Language, and JavaScript. For the server-side connectivity, Hypertext Preprocessor (PHP) was used as it is a commonly used cross-platform language. PHP includes components that interact with popular database management systems, allowing for secure interaction with databases on a server level. The app was evaluated by administrating a modified user version of the Mobile App Rating Scale (uMARS; maximum score: 5).

Results

TeamDoc is the first complementary, standalone mobile app that records cricket injuries through a smartphone. It can also record cricketing workloads, which is a known risk factor for injury. The app can be used without the need for supplementary computer devices for synchronization. The uMARS scores showed user satisfaction (overall mean score 3.6 [SD 0.5]), which demonstrates its acceptability by cricketers.

Conclusions

Electronic injury surveillance systems have been shown to improve data collection during competitive sports. Therefore, TeamDoc may assist in improving injury reporting and may also act as a monitoring system for coaching staff to adjust individual training workloads. The methods described in this paper provide a template for researchers to develop similar apps for other sports.

Match injuries in Sri Lankan junior cricket: A prospective, longitudinal study

OBJECTIVES

Understanding the nature of injuries in cricket is key to mitigate injury risks and prioritise preventive measures. This study aimed to identify the incidence and nature of match injuries among Sri Lankan junior cricketers.

DESIGN

Longitudinal follow-up study with prospective in-season data collection.

METHODS

A national survey of schoolboy, division-1 cricket teams in under-15 and under-17 age groups. Using a paper-based questionnaire, distributed to school-teams at the start of the 2016 cricket season, respondents recorded any injuries, including the site, type and mechanism. Match injury incidence rates (match-IIR) (injuries/100 match-player-days) were calculated overall, by position and for match time loss (MTL) and non-MTL injuries.

RESULTS

From 59 school-teams, 573 players responded, with 404 players reporting 744 injuries in 648 matches. The match-IIR was 28.0 injuries/100 match-player-days (95% CI=26.0-30.2). The highest match-IIR was reported among fielders (46.0% of all injuries sustained; match-IIR=12.9) compared with batters (25.4%; match-IIR=7.1) and bowlers (20.3%; match-IIR=5.7). Abrasions and bruises to the knee or elbow were the most common injuries among fielders, with the majority being non-MTL injuries.

CONCLUSIONS

Almost half (46.0%) of all injuries were to fielders, and more research into their severity and mechanisms is needed to identify the need for, and design of, preventive measures. Batters sustained a relatively large number of facial-organ injuries from being struck by the ball, presenting a need to evaluate the use and appropriateness of helmets by Sri Lankan junior cricketers. Similar to other junior cricket studies, the most common injuries among bowlers were strains and sprains, mainly affecting the lower limbs and lower back.

Epidemiology of Injuries in Women Playing Competitive Team Bat-or-Stick Sports: A Systematic Review and a Meta-Analysis

BACKGROUND

Team bat-or-stick sports, including cricket, softball and hockey, are popular among women. However, little is known about the injury profile in this population.

OBJECTIVE

The aim was to describe the incidence, nature and anatomical location of injuries in bat-or-stick sports played by women in a competitive league.

METHODS

This review was prospectively registered (PROSPERO CRD42015026715). CINAHL, MEDLINE, PsycINFO, PubMed, SPORTDiscus were systematically searched from January 2000 to September 2016, inclusive. Peer-reviewed original research articles reporting the incidence, nature and anatomical location of injuries sustained by women aged 18 + years in competitive bat-or-stick sports were included. Two meta-analyses based on injury incidence proportions (injury IP) and injury rates per 1000 person-days of athletic exposure (AE) were performed.

RESULTS

A total of 37 studies satisfied the inclusion criteria, and five had low risk of bias. The weighted injury IP was 0.42 [95% confidence interval (CI) 0.39-0.45]. The weighted injury rate was 6.12 (95% CI 6.05-6.18) overall, and greater in games [15.79 (95% CI 15.65-15.93)] than in practice [3.07 (95% CI 2.99-3.15)]. The ankle was the most commonly injured anatomical location, followed by the hand (including wrist and fingers), knee and head. Soft tissue and ligament injuries were most common types of injuries.

CONCLUSION

Injury prevention in women's sports is a novel and emerging field of research interest. This review highlights that injury incidence is high among female bat-or-stick players, but little information is known about direct causal mechanisms. This review clearly establishes the need for enhancements to injury data collection. Without this information, it will not be possible to develop evidence-based injury prevention interventions.

Incidence of Concussion and Head Impacts in Australian Elite-Level Male and Female Cricketers After Head Impact Protocol Modifications

Background:

Concussion in sport is a topic of growing interest in Australia and worldwide. To date, relatively few studies have examined the true incidence of concussion in cricket.

Hypothesis:

Concussion in cricket is more common than current literature suggests.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 4.

Methods:

This is a prospective registry and subsequent analysis of head impacts and concussions in elite-level male and female cricketers in Australia over 2 seasons (2015-2016 and 2016-2017). A total of 172 male and 106 female domestic and international players in 2015-2016 and 179 males and 98 females in 2016-2017 were included.

Results:

There were 92 head impacts (29 concussions) in men’s matches and 15 head impacts (8 concussions) in women’s matches. Match incidence rates per 1000 player days were 7.2 head impacts (2.3 concussions) in elite male cricket and 3.7 head impacts (2.0 concussions) in elite female cricket. This equates to a head impact every 2000 balls and concussion every 9000 balls in male domestic cricket. Concussion rates per 1000 player-match hours were 0.4 for elite males and 0.5 for elite females; 53% of head impacts in females were diagnosed as concussions compared with 32% in males, and 83% of concussions resulted in missing no more than 1 game.

Conclusion:

The rate of concussion in cricket is higher than previously appreciated; however, the majority of patients recovered quickly, and players generally did not miss much playing time as a result. The institution of concussion policies after head impact, including player substitution, appears to have had an effect on increasing reporting of symptoms, resulting in an increase in diagnosis of concussion.

Clinical Relevance:

Concussion in cricket is not as infrequent as previously assumed. Ongoing review of the rules and regulations is required to ensure that protection of player welfare lies in parallel with other sporting codes.

Risk Factors for Non-Contact Injury in Adolescent Cricket Pace Bowlers: A Systematic Review

BACKGROUND

Adolescent cricket pace bowlers are prone to injury. Recognising the risk factors for non-contact injury in this population will aid future injury prevention strategies.

OBJECTIVE

To identify the risk factors for non-contact injury in adolescent cricket pace bowlers.

METHODS

We systematically searched PubMed, Cochrane Library, PEDro, SPORTDiscus, Embase, and the South African Journal of Sports Medicine to identify all experimental and observational studies reporting risk factors for non-contact injuries in pace bowlers (aged 12-19 years). The search syntax included terms relevant to cricket bowling, injury, and known risk factors for injury. The Newcastle-Ottawa Quality Assessment Scale and a modified Newcastle-Ottawa Quality Assessment Scale were used to assess the risk of bias in the cohort and cross-sectional studies, respectively.

RESULTS

Sixteen studies (five cross-sectional studies, 11 cohort studies) comprising 687 participants (96% male, 75% playing cricket in Australia) met the selection criteria and were included for qualitative synthesis. Three cross-sectional studies were rated as high risk of bias and two as very high risk of bias. For the cohort studies, three were rated as low risk of bias, and eight as high risk of bias. Injury was associated with bowling biomechanics (excessive lateral trunk flexion and pelvis/hip kinematics), reduced trunk endurance, poor lumbo-pelvic-hip movement control, and early signs of lumbar bone stress. Conflicting results were found by studies examining the mixed technique, bowling workload and quadratus lumborum asymmetry.

CONCLUSIONS

The current systematic review identified a number bowling biomechanics and various neuromuscular deficiencies as risk factors for non-contact injury in adolescent pace bowlers. These factors may provide a useful target for future interventional research aiming to prevent injury in this population. Future studies should utilise prospective cohort designs, and ensure that participants are injury-free at baseline, confounding factors are well controlled and attrition rates are reported.

REGISTRATION

This systematic review was registered a priori (PROSPERO, CRD42016043956).

Injury rate and patterns of Sydney grade cricketers: a prospective study of injuries in 408 cricketers

Background

The grade cricket competition, also known as premier cricket, supplies players to the state and national teams in Australia. The players involved are generally high-performing amateur (subelite) club cricketers. However, to date, there is no study on the injury epidemiology of Australian grade cricket.

Aim

To conduct injury surveillance across all teams playing Sydney Grade Cricket (SGC) competition during the 2015–2016 season.

Methods

A cohort study was conducted to track injuries in 408 male cricketers in 20 teams playing SGC competition. Players were tracked through the MyCricket website’s scorebook every week. Cricket New South Wales physiotherapists were alerted if there were changes to the playing XI from the last game. If any changes were made due to injury, then an injury incident was registered.

Results

During the course of the season, a total of 86 injuries were registered from 65 players, resulting in a loss of 385 weeks of play. The overall injury incidence rate was 35.54 injuries/10 000 playing hours with an average weekly injury prevalence of 4.06%. Lower back injuries (20%) were the most common injuries followed by foot (14%), hand (13.75%), knee (7.5%) and calf (7.5%). Linear regression analysis showed that the likelihood of injury increased as the mean age of the teams increased (R=0.5, p<0.05).

Conclusion

The injury rate in SGC is lower than that reported at elite level. However, the high rate of lower back injuries (20%) highlights an area of concern in this cohort. High workloads or inadequate physical conditioning may contribute to such injuries. This study sets the foundation for understanding injury epidemiology in grade cricket and examines the links between injury and performance, these results may assist coaches and administrators to develop and implement cricket-specific injury prevention programmes.

Injuries in Cricket

Context:

Cricket is a popular global sport that requires a combination of physical fitness, skill, and strategy. Although a noncontact sport, overuse and impact injuries are common since players engage in a wide range of physical activities, including running, throwing, batting, bowling, catching, and diving. Significant or match time-loss injuries are defined as those that either prevent a player from being fully available for selection in a major match, or during a major match, cause a player to be unable to bat, bowl, or keep wicket when required by either the rules or the team’s captain. This review describes the various region-wise injuries sustained in cricket along with their epidemiology, biomechanics, treatment, and prevention.

Evidence Acquisition:

Data were collected from peer-reviewed articles (obtained via PubMed search) published through November 2016 that involved the medical, biomechanical, and epidemiological aspects of cricket injuries.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

Cricket was one of the first sports to publish recommended methods for injury surveillance in 2005 from England, South Africa, Australia, the West Indies, and India. While the incidence of injuries is about the same, the prevalence of injuries has increased due to game format changes, increasing number of matches played, and decreased rest between matches. Bowling (41.3%), fielding, and wicket keeping (28.6%) account for most injuries. Acute injuries are most common (64%-76%), followed by acute-on-chronic (16%-22.8%) and chronic ones (8%-22%). The most common modern-day cricket injury is hamstring strain, and the most severe is lumbar stress fracture in young fast bowlers.

Conclusion:

With improved understanding of the scientific and medical aspects of cricket, along with advances in surgical and nonsurgical treatment techniques, the time to return to play has shortened considerably. While the prevalence of cricket injuries has increased, their severity has decreased over the past decades.

Cluster randomised control trial for cricket injury prevention programme (CIPP): a protocol paper

Background

Injury prevention programmes (IPPs) are effective in reducing injuries among adolescent team sports. However, there is no validated cricket-specific IPP despite the high incidence of musculoskeletal injuries among amateur cricketers.

Objectives

To evaluate whether a cricket injury prevention programme (CIPP) as a pretraining warm-up or post-training cool-down can reduce injury rates in amateur cricket players.

Methods

CIPP is a cluster randomised controlled trial which includes 36 male amateur club teams having cricket players aged 14–40 years to be randomly assigned to three study arms: warm-up, cool-down and control (n=12 teams, 136 players in each arm). The intervention groups will perform 15 min CIPP either as a pretraining warm-up or a post-training cool-down.

Outcome measures

The primary outcome measure will be injury incidence per 1000 player hours and the secondary outcome measures will be whether IPP as a warm-up is better than IPP as a cool-down, and the adherence to the intervention.

Trial registration number

ACTRN 1261700047039.

Risk factors for hamstring injuries in Australian male professional cricket players

BACKGROUND

Injuries to the hamstring are relatively common in professional cricketers (as they are in many team sports) and have increased in incidence in the "T20 era" (introduction of 20-over matches) of cricket since 2006.

METHODS

This study analyzed incidence of hamstring injury in the various elite male match types over a 20-year period (1995-1996 to 2014-2015 seasons). Risk factors for hamstring strain were assessed using a multivariate logistic regression analysis technique.

RESULTS

There were 276 match time-loss hamstring injuries recorded over a 20-year period at the Australian state or national player level, of which 170 occurred in one of 40,145 player match sets. The overall rate of match onset rate was 22.5 hamstring injuries per 1000 team days. Fast bowling onset injuries were the highest subcategory at a rate of 10.9 injuries per 1000 team days, although batting onset injuries were particularly common in 50-over (one day) international matches. Significant risk factors in logistic regression analysis, in addition to hamstring injury history, were being a fast bowler relative risk (RR) 2.5 (95% confidence interval (CI): 1.3-4.5) and playing a match in Australia RR 2.3 (95%CI: 1.3-3.9).

CONCLUSION

Fast bowlers suffer more hamstring injuries than other playing roles in cricket, particularly in First Class (multi-day) cricket. Batsmen are more likely to get injured in 50-over (one day) cricket. Playing in Australia (compared to overseas venues) leads to increased risk of hamstring injury.

Application of the subsequent injury categorisation model for longitudinal injury surveillance in elite rugby and cricket: intersport comparisons and inter-rater reliability of coding

BACKGROUND

When an athlete has more than one injury over a time period, it is important to determine if these are related to each other or not. The subsequent injury categorisation (SIC) model is a method designed to consider the relationship between an index injury and subsequent injury(ies).

OBJECTIVE

The primary aim was to apply SIC to longitudinal injury data from two team sports: rugby union and cricket. The secondary aim was to determine SIC inter-rater reliability.

METHODS

Rugby union (time-loss; TL) and cricket (TL and non-time-loss; NTL) injuries sustained between 2011 and 2014 within one international team, respectively, were recorded using international consensus methods. SIC was applied by multiple raters, team clinicians, non-team clinicians, and a sports scientist. Weighted kappa and Cohen's kappa scores were calculated for inter-rater reliability of the rugby union TL injuries and cricket NTL and TL injuries.

RESULTS

67% and 51% of the subsequent injuries in rugby union and cricket respectively were categorised as injuries to a different body part not related to an index injury (SIC code 10). At least moderate agreement (weighted and Cohen kappa ≥0.60) was observed for team clinicians and the non-team clinician for both sports. Including NTL and TL injuries increased agreement between team clinician and non-team clinician, but not between clinician and sports scientist.

CONCLUSION

The most common subsequent injury in both sports was an injury to a different body part that was not related to an index injury. The SIC model was generally reliable, with the highest agreement between clinicians working within the same team. Recommendations for future use of SIC are provided based on the proximity of the rater to the team and the raters' level of clinical knowledge.

Medical Attention Injuries in Cricket: A Systematic Review of Case Reports

BACKGROUND

Cricket, classified as noncontact game, has been shown to be associated with increased incidence of injury. Further the recent consensus update in cricket injury surveillance have updated the injury definitions which includes "Medical Attention" injuries. The purpose of this review was to systematically review the various case reports and studies reporting injuries in the game of cricket that fall under the gambit of medical attention injuries.

MATERIALS AND METHODS

A systematic review was conducted online using PubMed and Google Scholar, as per Preferred Reporting Items for Systematic reviews and Metaanalyses guidelines. Predefined eligibility criteria were applied, and the data thus compiled were analysed.

RESULTS

A total of 32 studies reporting 43 players including 42 males and 1 female were included in the review. Bowling injuries were the most commonly reported injury. Impact injury was the most common mode with acute presentation in batting and fielding injury, whereas it was gradual onset mode with chronic presentation in bowling injuries. Head and neck injuries were the most common in batting injuries while extremity injuries were common in fielding and bowling injuries. No injuries were reported in umpires.

CONCLUSION

The evidence provided, although not sufficient for any recommendation, it should alert the physicians and those concerned with the primary care of the cricketers to be vigilant of the eccentricity and severity of the injuries, their atypical presentation, mode, mechanism and trend, thereby being prepared for the unexpected presentations.

Incidence and prevalence of elite male cricket injuries using updated consensus definitions

BACKGROUND

T20 (Twenty20 or 20 over) cricket has emerged in the last decade as the most popular form of cricket (in terms of spectator attendances). International consensus cricket definitions, first published in 2005, were updated in 2016 to better reflect the rise to prominence of T20 cricket.

METHODS

Injury incidence and prevalence rates were calculated using the new international methods and units for elite senior male Australian cricketers over the past decade (season 2006-2007 to season 2015-2016 inclusive).

RESULTS

Over the past 10 seasons, average match injury incidence, for match time-loss injuries, was 155 injuries/1,000 days of play, with the highest daily rates in 50-over cricket, followed by 20-over cricket and First-Class matches. Annual injury incidence was 64 injuries/100 players per season, and average annual injury prevalence was 12.5% (although fast bowlers averaged 20.6%, much higher than other positions). The most common injury was the hamstring strain (seasonal incidence 8.7 injuries/100 players per season). The most prevalent injury was lumbar stress fractures (1.9% of players unavailable at all times owing to these injuries, which represents 15% of all missed playing time).

DISCUSSION

The hamstring strain has emerged from being one of the many common injuries in elite cricket a decade ago to being clearly the most common injury in the sport at the elite level. This is presumably in association with increased T20 cricket. Lumbar stress fractures in fast bowlers are still the most prevalent injury in the sport of cricket at the elite level, although these injuries are more associated with high workloads arising from the longer forms of the game. Domestic and international matches have very similar match injury incidence rates across the formats, but injury prevalence is higher in international players as they play for most of the year without a substantial off-season.