The incidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers: A prospective cohort study

Injury profiles in sub-elite Women's Cricket: Exploring incidence, prevalence, nature, onset and body region

INTRODUCTION

The rise in participation in sports, like women's cricket, is linked with increased injury risk. Providing high-level longitudinal data is the first step in implementing evidence-based injury prevention strategies.

DESIGN

Prospective cohort study.

OBJECTIVE

This cohort study aims to describe the injury profiles in sub-elite women's cricket in South Africa during the 2022/23 season.

METHODS

Injuries were prospectively recorded using injury surveillance questionnaires, injury surveillance database, and logbooks completed by each team's medical staff. Injury rates were investigated for match and training days, body region, player role, nature, and activity at the time of injury.

RESULTS

Three teams with a total of 44 players (20.86 ± 1.6 years) were included in the study. Injury incidence was 85.23 per 1000 player match days, 15.91 for match time-loss and 69.32 for non-time-loss, with 2.95% of players unavailable for match selection on any day. Fast bowlers had the highest injury incidence. Fielding caused 46.67% of all injuries. Injury incidence was higher in training than in matches. The wrist/hand had the highest injury incidence and caused the most match time-loss.

CONCLUSION

This study provides valuable insights regarding the current injury rates in sub-elite female cricket players.

A similar injury profile observed in franchise men's and women's cricket in England and Wales: injury surveillance analysis from the first three 'The Hundred' competitions

Objectives

To describe the injury profile of a novel format cricket competition ('The Hundred') and compare injury incidence and prevalence between the men's and women's competitions.

Methods

Medical staff prospectively collected injury data from the eight men's and women's teams during the 2021-2023 competitions. Injury definitions and incidence calculations followed the international consensus statement.

Results

In the men's competition, 164 injuries were recorded, compared with 127 in the women's competition. Tournament injury incidence was 36.6 (95% CI 31.4 to 42.7) and 32.5 (95% CI 27.3 to 38.7)/100 players/tournament in the men's and women's competition, respectively. Non-time-loss incidence (men's 26.6 (95% CI 22.2 to 31.8), women's 24.6 (95% CI 20.1 to 30.0)/100 players/tournament) was higher than time-loss incidence (men's 10.0 (95% CI 7.5 to 13.5), women's 7.9 (95% CI 5.6 to 11.3)/100 players/tournament). Injury prevalence was 2.9% and 3.6% in the men's and women's competitions, respectively. Match fielding was the most common activity at injury in both competitions. The thigh and hand were the most common body location time-loss injury in the men's and women's competitions, respectively.

Conclusion

A similar injury profile was observed between the men's and women's competition. Preventative strategies targeting thigh injuries in the men's competition and hand injuries in the women's competition would be beneficial. Compared with published injury rates, 'The Hundred' men's presents a greater risk of injury than Twenty20 (T20), but similar to one-day cricket, with 'The Hundred' women's presenting a similar injury risk to T20 and one-day cricket. Additional years of data are required to confirm these findings.

Lumbar Bone Stress Injuries and Nonunited Defects in Elite Australian Cricket Players

OBJECTIVE

To describe the presentation and management of lumbar bone stress injuries (LBSI), recurrent LBSI, and lumbar nonunited defects in elite Australian male and female cricket players.

DESIGN

Retrospective case series.

SETTING

Professional domestic and international cricket teams over 13 seasons.

PARTICIPANTS

Elite Australian cricket players.

INDEPENDENT VARIABLES

Symptomatic LBSI requiring time off cricket and lumbar nonunited defects, both confirmed by imaging.

MAIN OUTCOME MEASURES

Incidence, presentation, history, healing, and management.

RESULTS

211 LBSI were identified at an average incidence of 5.4 per 100 players per season. LBSI were most common in male pace bowlers younger than 20 years of age (58.1 per 100 players per season), however, were also observed in older players, females, and non-pace bowlers. Recurrent LBSI accounted for 33% (27%-40%) of all LBSI. Median days to return to match availability was 182 (128-251) days for all LBSI, with a shorter time frame observed for new and less severe injuries, and male spin bowlers. Healing was demonstrated in 87% (81%-91%) of all LBSI cases. 29 nonunited defects were identified and predisposed subsequent pain, LBSI, and spondylolisthesis.

CONCLUSIONS

LBSI are experienced by approximately 5.4 in every 100 elite Australian cricket players per season, with a high time cost of approximately 4 to 8 months. Nonunited defects also have a high time cost with associated subsequent lumbar spine issues. The findings of this study reinforce the importance of early detection and conservative management of LBSI, particularly for younger male pace bowlers and players with recurrent LBSI, which may be supported by MRI.

Rapid force generation during unilateral isometric hamstring assessment: reliability and relationship to maximal force

Limited research has reported the reliability of rapid force generation characteristics during isometric assessments of the hamstrings. Therefore, the purpose of the present study was to determine the between-session reliability of rapid force generating characteristics of the hamstrings and relationship to maximal force production. Twenty-three female soccer players (age: 20.7 ± 4.7 years; height: 168.7 ± 5.9 cm; body mass: 64.4 ± 6.7 kg) performed three unilateral trials of the 90-90 isometric hamstring assessment, on two separate occasions, separated by 7 days. Peak force, force at 100- and 200 ms and average rate of force development (aRFD) over 100- and 200 ms epochs were calculated. Absolute and fair-good reliability was observed for peak force and all rapid force generating measures (<8.33CV%, ICC >0.610). Significant and meaningful relationships (p < 0.001, r > 0.802) were observed for all rapid force generating measures and peak force. The 90-90 isometric assessment can be used to assess peak and rapid force generating reliably to enable practitioners to confidently track changes in performance over time as part of fatigue monitoring and management.

Foot and Ankle Injuries in Elite South African Cricketers: A Descriptive Analysis of Injury Surveillance Data

Introduction

Injury surveillance is an important part of injury risk reduction in the sporting population. This study describes the type, side (dominant or non-dominant), occurrence, impact, activity of onset, and severity of foot and ankle injuries in elite South African male and female cricketers.

Methods

Foot and ankle injuries sustained by elite cricket players between 2018 and 2021, obtained from the records of Cricket South Africa, were descriptively analysed.

Results

A total of 104 foot and ankle injuries in 82 players were recorded. The majority (n = 100; 96%) of injuries were on the non-dominant side. Bowling (n = 31; 30%) and fielding (n = 20; 19%) contributed to most injuries. The majority were first-time (n = 83; 80%) and non-impact injuries (n = 62; 60%). Fifty percent (n = 52) of injuries rendered players unable to participate in at least one match or practice session. Lateral ankle ligament injury was the most common injury sustained (n = 36; 35%).

Conclusion

The findings from this study can inform future researchers and assist healthcare service needs relating to injury risk reduction and management programmes. Effective rehabilitation programmes may reduce the risk of reinjury. Ideally, these programmes need to be role specific.

Using Randomized Controlled Trials in the Sports Medicine and Performance Environment: Is It Time to Reconsider and Think Outside the Methodological Box?

SYNOPSIS: Randomized controlled trials (RCTs) are ubiquitous in medicine and have facilitated great strides in clinical care. However, when applied in sport, RCTs have limitations that hinder implementing effective interventions in the real-world clinical setting. Pragmatic clinical trials offer some solutions. Yet due to the competitive, high-pressure nature of sport at the individual, team, and governing body level, RCTs are likely infeasible in certain sport settings. The small number of athletes at the elite team level, along with the potential financial consequences of randomizing at the individual athlete and team level, also restricts study power and feasibility, limiting conclusions. Consequently, researchers may need to "think outside the box" and consider other research methodology, to help improve athlete care. In this Viewpoint, we detail alternative study designs that can help solve real-world problems in sports medicine and performance, while maintaining robust research standards and accounting for the challenges that RCTs pose. We also provide practical examples of alternative designs. J Orthop Sports Phys Ther 2023;53(6):1-4. Epub: 18 April 2023. doi:10.2519/jospt.2023.11824.

A systematic literature review of injury epidemiology and surveillance practices in elite adult female field-based team sport

OBJECTIVES

To describe injury incidence and surveillance practices in elite adult female field-based team sports.

DESIGN

Systematic literature review.

METHODS

This review was prospectively registered (PROSPERO CRD42022318642). CINAHL, PubMed, MEDLINE, Scopus, SPORTDiscus, Web of Science, Open Grey and Google Scholar were searched from inception to 30th June inclusive. Peer reviewed original research articles that reported the incidence of injury sustained by females aged ≥18 years in elite field-based team sports were included. The Newcastle Ottawa Scale was used to assess the risk of bias.

RESULTS

Twenty prospective cohort studies investigating injury incidence in Australian football, American football, soccer, field hockey, rugby, rugby-7s and cricket were eligible. A higher injury incidence in match play compared to training was reported with the highest match and training incidence (132.7 and 42.1/1000 h of exposure respectively) in Australian football. The majority of the reported injuries were to the lower limb and involved muscle/tendon or joint/ligaments. There was heterogeneity in definitions of injury, severity and exposure, variations in methods of injury data collection and reporting with, not all data being collected/reported optimally, which limited comparison of studies.

CONCLUSIONS

This review highlights the lack of and need for injury data specific to this cohort. Establishing the incidence of injury with a robust injury surveillance system is the first step in the sequence of injury prevention. It requires consistency in definitions and methodologies, providing accurate and useful injury data, to guide targeted injury prevention strategies.

Comparison of injury profiles between elite Australian male and female cricket players

OBJECTIVES

This study presents seven seasons of injury surveillance data for both elite Australian male and female cricket players, revealing injury statistics and allowing for comparison between sexes.

DESIGN

Retrospective cohort.

METHODS

Participants were elite Australian male and female cricket players who were contracted to play for a national and/or state/territory team and/or T20 franchise between 2015-16 and 2021-22 (7 seasons). Injury data was recorded in Cricket Australia's Athlete Management System database and combined with match data. The STROBE-SIIS statement was used as the relevant guideline for this study.

RESULTS

Data for 1345 male player seasons and 959 female player seasons revealed sex-related differences in the injury incidence rates and prevalence. Males had higher incidence (average 136 vs 101 injuries per 1000 match days) and prevalence of match time-loss injuries (average 10.4% vs 6.5% players unavailable). However, the overall incidence of all medical attention injuries were similar between sexes (Incidence Rate Ratio (IRR) 0.9, 95%CI 0.8-1.0). The most frequent match time-loss injuries for males were hamstring strains (7.4 new injuries per 100 players per season), side and abdominal strains (5.5), concussion (5.0), lumbar stress fractures (4.3), and wrist and hand fractures (3.9). The most frequent match time-loss injuries for females over the 7 seasons were hamstring strains (3.1), concussion (2.3), quadriceps strains (2.4) and shin/foot/ankle stress fractures (2.0). The IRR of medical attention injuries for males compared to females was higher for lumbosacral stress fractures (IRR 2.3), elbow and forearm injuries (1.5), and concussion (1.4), and lower for lower leg, foot, and ankle stress fractures (0.6), shoulder and upper arm injuries (0.7), and quadriceps strains (0.6).

CONCLUSIONS

Robust long-term injury surveillance enabled the injury profiles of elite Australian male and female cricket players to be understood and compared. Males had a higher incidence and prevalence of match time-loss injuries, likely reflecting a higher match exposure.

Musculoskeletal discomfort and wrist flexor tendonitis among street sweepers and associated risk factors

BACKGROUND

Street sweepers are reported to suffer from high rates of work-related musculoskeletal discomfort worldwide, especially in their wrists.

OBJECTIVE

The study aimed to 1) determine the prevalence of musculoskeletal disorders and 2) specifically determine the prevalence of wrist flexor tendonitis and its associated risk factors among street sweepers.

METHODS

Three hundred and eighty-five sweepers employed by the Faisalabad Waste Management Company (FWMC) participated in this cross-sectional study. A self-structured questionnaire was used to collect data: the first section provided demographic information, the second assessed musculoskeletal disorders, and the third section assessed the wrist flexor tendonitis among street sweepers.

RESULTS

The mean age of the sweepers was 38.34 years. Out of 385 street sweepers, the prevalence of musculoskeletal discomfort was reported in 265 (68.83%). The prevalence of musculoskeletal discomfort in sweepers reported during COVID-19 according to the past 12 months, the highest three prevalence rates were 46.5% in the wrists/hands, 37.9% in the shoulders and 35.1% in the lower back. The three highest prevalence rates of musculoskeletal discomfort in sweepers according to the last 7 days were 29.6% in the wrists/hands, 24.4% in the lower back and 24.2% in the shoulders. Out of total 385 participants, prevalence of wrist flexor tendonitis was reported in 103 (26.8%) sweepers. Significant association was found (p < 0.05) between wrist flexor tendonitis and gender (p < 0.003), age (p < 0.05), working experience (p < 0.003), street sweeping distance (p < 0.01), number of brooms used per month (p < 0.002) and getting tired at the end of work (p < 0.001).

CONCLUSION

The prevalence of musculoskeletal discomfort and wrist flexor tendonitis seen during COVID-19 is high among sweepers, with wrist/hand being the most commonly reported region for pain. This study emphasizes the importance of providing guidelines about effective precautionary healthcare measures for street sweepers.

Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analyses

OBJECTIVE

The objective of the review was to describe the incidence and prevalence of injuries among female cricket players of all ages, participating in all levels of play.

INTRODUCTION

Cricket, a bat-and-ball sport, is becoming popular among women of all ages and abilities worldwide. However, cricket participation carries a risk of injury. Injuries negatively affect sport participation, performance, and short- and long-term health and well-being. Injury prevention, therefore, is the key to safe, long-term cricket participation as a physical activity goal. Epidemiological data are needed to underpin evidence-based injury-prevention strategies.

INCLUSION CRITERIA

Studies reporting incidence and prevalence of injuries in female cricket players of all ages, participating in all levels of play, were included in this review, including studies that report data by sex or by sport. Studies without enough data to calculate prevalence or incidence, that do not distinguish female injury data from males', that focus on athletes participating in other sports, or that focus on case studies were excluded.

METHODS

A systematic review and meta-analyses were conducted according to the JBI and PRISMA 2020 guidelines. MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and Science Direct were systematically searched from inception to August 2021. Additionally, Cochrane Controlled Trials Register and ClincalTrail.gov were searched. EBSCO MegaFile Premier (EBSCO), OpenGrey (SIGLE), WorldCat, Grey Matters, Grey Literature, and Google Scholar databases were searched for gray literature. Full-text articles that met the inclusion criteria were critically appraised using JBI-tools, and were extracted and synthesized in narrative summary and tabular forms. Three meta-analyses were conducted: injury incidence rate, injury prevalence proportions, and injury incidence proportions. Heterogeneity was assessed using the I2 statistic and the random-effects model.

RESULTS

Of the 7057 studies were identified and only 4256 screened after duplicates removed, 23 studies met the inclusion criteria. Risk of bias was low for 21 studies. The injury incidence rate for elite cricket was 71.9 (SE 21.3, 95% CI 30.2-113.6) injuries per 1000 player hours, time-loss injury incidence rate was 13.3 (SE 4.4, 95% CI 4.6-22.0) injuries per 1000 player hours, and non-time-loss injury incidence rate was 58.5 (SE 16.9, 95% CI 25.6-91.7) injuries per 1000 player hours. The injury prevalence proportions for community to elite cricket was 65.2% (SE 9.3, 95% CI 45.7-82.3) and injury prevalence proportions for community cricket was 60% (SE 4.5, 95% CI 51.1-68.6). The injury incidence proportions for community cricket was 5.6 (SE 4.4, 95% CI 0.1-18.3) injuries per 10,000 participants. Elite cricket players were more frequently injured than community cricket players. The most prevalent body regions injured were the shoulder and knee, and most were sustained by fast bowlers. Injuries to the hand, wrist, and fingers had the highest incidence and were most sustained by fielders.

CONCLUSIONS

The study's findings can help stakeholders (including players, coaches, clinicians, and policymakers) make informed decisions about cricket participation by informing and implementing strategies to promote cricket as a vehicle for positive public health outcomes. This review also identified gaps in the available evidence base and addressing these through future research would enhance women's cricket as a professional sport.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020166052.

Injury incidence within male elite New Zealand cricket from the early T20 era: 2009-2015

Objectives

This study aimed to describe the injury epidemiology of domestic and international level male New Zealand cricketers from seasons 2009–2010 to 2014–2015 across all match formats given the increasing popularity of T20 cricket.

Methods

Match exposure and injury surveillance data collected prospectively by New Zealand Cricket was analysed using international consensus recommendations for injury surveillance and reporting in cricket. Relationships between playing level, role and injury were statistically analysed.

Results

A total of 268 elite male New Zealand cricketers from seasons 2009–2010 to 2014–2015 were analysed from the New Zealand Cricket injury surveillance system. Total new match injury incidence rates were 37.0 and 58.0 injuries per 10 000 player hours in domestic and international cricket, respectively. Total new and recurrent match injury incidence in international cricket was approximately 1.7 times higher than domestic cricket (277.6 vs 162.8 injuries per 1000 player days). Injury prevalence rates were 7.6% and 10.0% in domestic and international cricket. The hamstring (8.2%) in domestic cricket and the groin (13.5%) in international cricket were the most injured body sites. Most match days lost in domestic cricket were to the lumbar spine (417 days), and groin in international cricket (152 days). There were statistically significant differences in injury between domestic and international level cricketers (χ²=4.39, p=0.036), and playing role (χ²=42.29, p<0.0001).

Conclusions

Total injury incidence rates in elite New Zealand cricket increased in 2009–2015 compared with previous data. International-level players and pace bowlers were the most injured individuals.

The relationship between cricket participation, health and wellbeing: A scoping review

Summarising and synthesising the evidence on cricket health and wellbeing can help inform cricket stakeholders and navigate future research directions. The purpose of this study was to investigate the relationship between cricket participation, health and wellbeing at all ages and playing standards, and identify research gaps in the existing literature. A scoping review was performed from inception to March, 2020. Studies were included if they assessed a construct related to health and/or wellbeing in cricketers, available in English. 219 articles were eligible. Injury incidence per 1,000 player exposures ranged from 1.8-5.7 injuries. 48% of former cricketers experienced persistent joint pain. However, former cricketers reported greater physical activity levels and mental-components of quality of life compared to the general population. Heat injury/illness and skin cancer are concerns and require further research. Cricket participation is associated with an inherent injury risk, which may have negative implications for musculoskeletal health in later life. However, cricket participation is associated with high quality of life which can persist after retirement. Gaps in the literature include prospective studies on health and wellbeing of cricketers, female cricketers, injury prevention strategies, and the impact of cricket participation on metabolic health and lifetime physical activity.

A systematic review of head, neck and-facial injuries in cricket

This systematic review was conducted to identify the incidence, nature and mechanisms of head, neck and facial (HNF) injuries in cricket and the reported use of helmets. Five databases were searched up to 30th November 2020. From peer-reviewed cricket injury studies published in English, studies reporting on HNF cricket injuries as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were selected. Twenty-nine studies were included. HNF injuries had a cumulative total of 794/5,886 injuries equating to 13% of all injuries. Non- specified HNF injuries (n=210, 26%) were the most prevalent type of injury followed by non-specified head injuries (n=130, 16%), other non-specified fractures (n=119, 15%) and concussions (n=60, 8%).The impact of the ball was reported as the most common mechanism for sustaining HNF injuries in cricket. The use of helmet was reported in only three studies (10%). From studies reporting on HNF cricket injuries, facial fractures, and concussions were the most common specified-types of injury. There is little evidence on reporting of HNF cricket injuries as per the international cricket consensus injury definitions, as well as the use of helmets at the time of injury.

Prevalence and incidence of injuries among female cricket players: a systematic review protocol

OBJECTIVE

The objective of this systematic review is to describe the incidence and prevalence of injuries in female cricket players participating in recreational-, school-, club-, and elite-level cricket.

INTRODUCTION

Recent investments in women's cricket, stand-alone tournaments, and increased visibility through new broadcasting milestones has increased participation in many countries. With increased participation of women in cricket comes increased risk of injury. Epidemiological data are needed to underpin evidence-based injury-prevention strategies. No systematic review or meta-analysis of injuries is currently available to provide a comprehensive overview of synthesized findings to make the evidence accessible.

INCLUSION CRITERIA

Studies on female cricket players of all ages and participating in all levels of cricket will be included. Studies that contain data on only male cricket players will be excluded. Studies where data from female cricket players can be distinguished from male players will be included. Injuries sustained when playing cricket, that are self-reported or diagnosed by a health care professional will be included. Definitions of injury including, but not limited to, medical-attention injuries, general time-loss injuries, or player-reported injuries will be considered.

METHODS

MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and ScienceDirect will be systematically searched from inception to the present. Cochrane Central Register of Controlled Trials and ClincalTrials.gov will be searched as well as gray literature databases. Retrieval of full-text studies, assessment of methodological quality, and data extraction will be performed independently by two reviewers. If possible, meta-analyses will be performed.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020166052.

Narrative review of mental illness in cricket with recommendations for mental health support

Introduction

Epidemiology reporting within the cricketing medical literature has emerged over the past 2 years, with a focus on physical injuries. Despite mental health in elite sport gaining increasing recognition, few studies have addressed mental health symptoms and disorders within cricket. Recently, cricketers have been prominent in the mainstream media describing their lived experiences of mental illness. As a result, some have withdrawn from competition and suggested there is an unmet need for mental health services within the sport.

Objectives

(i) To appraise the existing evidence on mental health symptoms and disorders amongst cricketers. (ii) To provide guidance on shaping mental health research and services within cricket.

Design

A narrative review of the literature from inception of available databases until 26 July 2019, with analysis and recommendations.

Results

Five studies were included in this narrative review. Studies covered a range of mental health symptoms and disorders, including distress, anxiety, depression, sleep disturbance, suicide, adverse alcohol use, illicit drug use, eating disorders and bipolar disorder. Results indicated that cricketers are at high risk for distress, anxiety, depression and adverse alcohol use. When compared with the general population, cricketers are more likely to experience anxiety and depressive symptoms. Rates of suicide were proposed to be high for test cricketers. Overall, studies to date have been of low quality, demonstrating non-rigorous research methods. Some studies have relied on non-validated questionnaires to collect self-reported data on mental health symptoms and disorders, while others have presented biographical data obtained through searches of the media.

Conclusions

The results of this narrative review highlight the lack of evidence underpinning mental health services for athletes within cricket. We suggest the following recommendations for future research and practice: (i) normalising mental health symptoms and disorders; (ii) working with and helping vulnerable demographic segments within the target population; (iii) designing and implementing early recognition systems of mental health symptoms and disorders; (iv) addressing the mental health needs of cricketers on a population basis.

Hand injuries in sports - a retrospective analysis of 364 cases

BACKGROUND

Hand injuries are common in sports and associated with high dropout rates and costs. Hence, efforts should strive for further risk prevention measures in order to increase safety in sports. This implies knowledge of sports injury risk profiles. So far, major surveillance programs exist mainly in Anglo-American countries, reflecting the specific concerns of sports in this part of the world. Data on sports injuries within Europe are scarce. As sports behaviour appears to vary demographically, we hypothesised that risk injury profiles differ as well.

METHODS

To assess whether the described sports injuries of the hand are applicable to the German population, we performed a five-year retrospective, single-centre analysis of sports-related hand injuries, using data from the Enterprise Clinical Research Data Warehouse of the Hannover Medical School.

RESULTS

Notable differences in comparison to other data were observed. Ball sports, cycling and equestrian sports caused most of the recorded hand injuries, which were predominantly fractures of the wrist and hand. Hand injuries in equestrian sports were associated with significantly higher operation and hospitalisation rates as well as a significantly longer inpatient treatment.

CONCLUSION

Risk profiles for sports-related hand injuries appear to differ not only in terms of age- and sex, but also geographically. Nation- and Europe-wide hand trauma registries as well as a broad registry participation are necessary in order to accurately assess the risk patterns in Europe; henceforth reducing hand injuries and their sequelae.

Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis

OBJECTIVES

We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.

ELIGIBILITY CRITERIA

Studies evaluating prevalence of LBP in adult athletes across all sports.

RESULTS

Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.

CONCLUSION

LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.

Cricket related hand injury is associated with increased odds of hand pain and osteoarthritis

Radiographic osteoarthritis (OA) is most prevalent in the hand. The association of hand injury with pain or OA is unclear. The objective was to describe the relationship between hand injury and ipsilateral pain and OA in cricketers. Data from former and current cricketers aged ≥ 30 years was used. Data included history of cricket-related hand/finger injury leading to > 4 weeks of reduced exercise, hand/finger joint pain on most days of the last month, self-reported history of physician-diagnosed hand/finger OA. Logistic regression assessed the relationship between injury with hand pain (in former cricketers) and with OA (in all cricketers), adjusted for age, seasons played, playing standard. Of 1893 participants (844 former cricketers), 16.9% reported hand pain, 4.3% reported OA. A history of hand injury increased the odds of hand pain (OR (95% CI) 2.2, 1.4 to 3.6). A history of hand injury also had increased odds of hand OA (3.1, 2.1 to 4.7). Cricket-related hand injury was related to an increased odds of hand pain and OA. This highlights the importance of hand injury prevention strategies within cricket. The high prevalence of hand pain is concerning, and further research is needed to determine the impacts of hand pain.

Situational factors associated with concussion in cricket identified from video analysis

Video analysis of situational factors associated with head impacts and concussion has been completed in several sports, however has yet to be completed in cricket. This study aimed to identify situational factors associated with concussion in elite Australian male and female cricket. Match video of head impacts were coded for player position, impacting object, source of ball, location of impact, and where the ball went after impact. Head impacts were then categorised as either concussion or no concussion based on clinical diagnosis. Data for 197 head impacts included 35 (18%) which were diagnosed as concussion. Head impacts typically occurred to an on-strike batter facing a pace bowler (84%). If the ball stopped or rebounded towards the source, 21% were diagnosed as concussion (13% if the ball deflected away from the source). If impact was to an unprotected head, 38% were diagnosed as concussion (16% if impact was to a helmet). If impact was to the back of the helmet or head, 40% were diagnosed as concussion (11–21% for other areas of the head or helmet). The combination of situational factors most consistent with concussion were impact from ball that hit the back of helmet or head and stopped or rebounded towards the source (PPV 80%, p = 0.002). Consideration of the situational factors of a head impact may improve the speed and accuracy of clinical decision making on whether to remove a player from the field for further assessment, particularly if clinical signs are unclear. Video may be used as a tool to support this process. Improved impact attenuation of cricket helmets, particularly at the back, may reduce the risk of concussion.

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.

Epidemiology of hospital-treated cricket injuries sustained by women from 2002-2003 to 2013-2014 in Victoria, Australia

OBJECTIVES

To present the first comprehensive epidemiological profile of hospital-treated injuries sustained by female cricketers from 2002-2003 to 2013-2014 in Victoria, Australia.

DESIGN

Analysis of routinely collected hospital data (detailed case-series).

METHODS

A retrospective analysis of hospital-treatment data associated with cricket injuries sustained by women between 1 July 2002 and 30 June 2014, inclusive were extracted from databases held by the Victorian Injury Surveillance Unit in Australia.

RESULTS

Over the 12-year period, 668 cases were treated in Victoria. Of these, 547 were emergency department (ED)-presentations. There were 121 hospital-admissions, of which, the length of stay was <2 days for 78.5% cases. All cases were treated and released, and no fatalities were reported. The 10-14 year age group most frequently presented to ED (19.9%) and were most commonly admitted to hospital (16.5% of the total admissions). Fractures were the most common cause of hospital-admissions (47.1%) but only accounted for 17.2% of the ED-presentations. Dislocations, sprains and strains, were the most common (36.4%) cause of ED-presentations. The head was the most commonly injured anatomical location (27.8% of ED-presentations and 28.1% of hospital-admissions), followed by the wrist and hand (27.8% ED-presentations and 17.4% hospital-admissions).

CONCLUSIONS

These findings provide the first overview of the nature of injuries requiring hospital attendance in female cricketers, and a foundation to inform the development of targeted injury prevention programs for female cricketers.