19 June 2019
Lots of people are enjoying the Cricket World Cup being played on home soil but many people don’t realise how common it is to develop injuries while playing the Game of Kings.
At any given time approximately 9% of cricketers have an injury and although this rises to over 15% of fast bowlers, these injuries are most commonly from the shoulder tendons, back ligaments or leg tendons.
Overhead throwing and bowling places high stresses on the shoulder which is then repeated multiple times. In the late cocking phase of a throw the arm position is in maximum external rotation with the arm elevated to or above shoulder height. This puts huge stresses on the shoulder joint ligaments - especially at the front of the shoulder. Over time, the tissues at the front of the shoulder can become stretched and conversely the tissues at the back can get relatively tight. During the follow through phase of a throw, the arm rapidly internally rotates and the tendons are used to rapidly decelerate the arm while maintaining control of the ball on the socket. This can gradually lead to inflammation of the tendons in the shoulder (the rotator cuff tendons) or even lead to damage of the labrum, a very important ring of soft tissue that runs around the edge of the socket, which is important for maintaining stability of the ball on the socket.
Irritation of the rotator cuff tendons is very common due to overuse and usually results in pain that radiates down the side of the arm. Patients who have a deep intermittent pain in the shoulder and clicking may have damage to the labrum deep inside the shoulder around the socket. Alternatively, some patients get pain that comes from the end of the collarbone where it joins on the shoulder tip (acromion). Pain from the AC (acromioclavicular) joint is usually well localised to the end of the collarbone and the area can e very tender when pressed.
Prevention of shoulder injuries is very important and players should work on flexibility, strength and endurance. It is vital to warm up properly and stretch adequately. Correct bowling technique is obviously very important.
If a player develops shoulder pain then they should be assessed by a qualified therapist or shoulder specialist. In the acute phase consider using ice packs and anti-inflammatory tablets or topical gels. If further specialist tests are required then an ultrasound is useful for tendon assessment but if the labrum may be the cause then an MR Arthrogram is best. An MR arthrogram is more detailed than a plain MRI scan as a contrast injection is put into the shoulder first before having the MRI scan. This test is very useful for tears of the labrum and you can also assess the rotator cuff tendons at the same time.
Fortunately, the vast majority of cricket shoulder injuries can be managed with therapy, anti-inflammatories and correction of poor technique with the coach. Occasionally a steroid injection may be useful and on rare occasions a keyhole operation (arthroscopy) may be needed.
This article has been written for you by Consultant Orthopaedic Surgeon, Mr Tony Corner. If you’re worried about ongoing pain in your shoulder, book in to see Mr Tony Corner, today. Call our friendly self-pay team on 01582 788 412 and they can arrange the next step for you.