Shoulder Injuries in Cricket Bowlers : Mechanisms & Prevention

The cricket bowling action is a complex movement, involving the coordination of multiple body segments and the propulsion of a ball at high speeds (Ferdinands, 2011). This explosive throwing action involves a rapid circumduction of the arm at the glenohumeral joint, with the transfer of kinetic energy from the lower to the upper extremities. This translation of energy and high joint angular velocities at the glenohumeral joint places the dominant shoulder at a high risk of injury. Therefore, strength and conditioning coaches working within cricket performance need to be aware of the shoulder injury risks associated with the bowling action, and the mechanical principles that underpin these injury risks.    

Biomechanical Injury Mechanisms

Research by Green et al (2013) previously highlighted the high occurrence of shoulder injuries within elite cricket. The authors reported that the individual athletes who were currently suffering shoulder pain consistently presented a downward rotated scapula. Such a position of the scapula leads to increased forces acting on the subscapularis and glenohumeral joint as the shoulder undergoes rapid internal rotation during throwing actions. Furthermore, excessive internal rotation of the shoulder predisposes the athlete to supraspinatus impingement risk, whereby the supraspinatus tendon and long head bicep tendon become mechanically impinged within the sub-acromial space. Such a persistent mechanical impingement can lead to repeat acute shoulder pain and eventually result in chronic shoulder pain, thereby seriously debilitating the athlete.

Overuse & Underuse Injury Mechanisms

Interestingly, it would appear that both overuse and underuse of the shoulder via repeated bowling actions are both significant shoulder injury risk factors. Dennis et al (2003) previously reported that bowlers with an average of less than 123 deliveries per week or more than 188 deliveries per week were at a higher risk of shoulder injury. The authors investigated the relationship between shoulder injury rates and bowling load within elite fast bowlers and reported this high workload vs low workloads duality. Therefore, it is apparent that there exists an optimal ‘fast bowl maintenance workload’ that should be adhered to within practice. In addition, a lack of shoulder strength and rate of force development may contribute to the occurrence of shoulder injuries in fast bowlers who fall within the low threshold bracket. Likewise, the high workload group may have a lack of shoulder strength-power endurance.

Preventive Measures

Therefore, strength and conditioning coaches working within cricket need to be aware on the biomechanical demands of repeat bowling and throwing actions and the preventive measures that can be put in-place to manage the risk of shoulder injury. These preventive measures should include adequate shoulder external rotation strength relative to the athletes opposing internal shoulder rotation, adequate shoulder internal and external range of motion, scapular stability interventions that allows the anterior and posterior scapular muscularity to correctly co-contract and therefore stabilise the scapular during rapid throwing actions and unilateral shoulder strength and unilateral shoulder power based training (e.g. single arm overhead press variations and single arm med ball throw variations, respectively). Practitioners need to consider the overall bowling practice volume per micro-cycle, ensuring that an optimal volume of bowling practice is scheduled, therefore avoiding any potential overuse and underuse injuries. Finally, it is evident that the overall fast bowling workload needs to be accurately monitored across each individual player and not generically across the team.