Dhillon et al.

Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2012, 4:42

[Link]

RESEARCH Open Access

Nature and incidence of upper limb injuries

in professional cricket players a prospective
observation
Mandeep S Dhillon*, Bhavuk Garg, Ritesh K Soni, Himmat Dhillon and Sharad Prabhakar

Abstract
Introduction: Cricket is the most popular sport in India, and is gaining in importance in all south-east Asian
countries. The purpose of this study was to prospectively investigate the incidence, nature, and site of acute upper
limb injuries sustained by professional cricketers of north India over a period of one year.
Material & methods: 95 cricket players (mean age 18.9 years) were prospectively evaluated for nature and
incidence of upper limb injuries from 1st November 2008 to 31st October 2009. For the purpose of comparison the
calculated injury incidence included injuries sustained during match as well as practice. Injuries were also grouped
according to the type of cricket activities such as batting or fielding.
Results: Out of 95 players evaluated, 24 were bowlers, 19 were batsmen, 8 were wicket keepers and the other
44 cricketers declared themselves as all rounders. There were a total of 16 upper limb injuries in 16 (16.8%) players.
The majority of injuries (10/16) occurred while fielding. Out of 16 injuries, 11 were seen in hand, 3 were observed
in elbow, while 2 patients suffered from shoulder problem. Twelve were acute injuries while 4 were classified as
repetitive stress injuries (RSI).
Conclusion: The incidence of upper limb injuries in cricketers at the professional and semi-professional level is
significant, causing them to miss matches or practice for a significant number of days. This is the first study of
Indian cricketers which documents the high incidence of upper limb injuries. The study highlights the importance
of injury surveillance for Indian cricket. It is a concern which needs to be addressed by the players, coaches,
teachers, administrators and medical personnel involved with cricket.
Keywords: Cricket, Injury, Upper limb, Bowler, Batsman

Introduction The incidence of cricket injuries has been reported in

Cricket is the most popular sport in India and is gaining very few studies. A survey conducted by the British Sports
in importance in all South east Asian countries. Its expan- Council [5] reported 2.6 injuries per 10,000 hours played.
sion over the past decades has placed greater demands on A similar survey conducted by the ACB [2] (Australian
cricketers due to increased playing hours and increased Cricket Board) reported the figure to be 24.2 per 10,000
performance expectations [1]. However, despite being the player hours, which is considerably higher than the
most popular team sport in this region, there is not a sin- figures reported by the British survey. Injuries to the
gle publication in the medical literature reporting cricket upper limb account for between 25% and 32% of all in-
injuries from India or the subcontinent. Many of the pre- juries. The most common types of injury are fractures,
viously published epidemiological data on cricket injur- dislocations and contusions sustained during batting and
ies, particularly at the elite level, have emanated from fielding, especially finger injuries [6-9]. Shoulder injuries
England, South Africa and Australia [2-5]. have also been reported, particularly in fielders [6,9].
Excluding the two previously cited surveys, the
* Correspondence: drdhillon@[Link]
remaining literature pertaining to cricket injuries usually
Department of Orthopaedics, Postgraduate Institute of Medical Education takes the form of isolated cases or case series with
and Research, Chandigarh, Sec-12, Chandigarh 160012, India

© 2012 Dhillon et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License ([Link] which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Dhillon et al. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2012, 4:42 Page 2 of 4
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specific data on the incidence and nature of injuries more than average batting skills. Thus it was important
incurred by professional cricketers is therefore limited. to evaluate if this subgroup had a different injury or
The purpose of this study was to prospectively investi- practice profile.
gate the incidence, nature, and site of acute upper limb All injuries to the upper limb region were analyzed.
injuries sustained by professional cricketers of north The information obtained was recorded and entered in a
India over a period of one year. computerized data base. Microsoft Excel (Redland, WA,
U.S.A.) was used to store and analyze the data. For the
purpose of comparison, the calculated injury incidence
Material and methods included injuries sustained during match as well as dur-
This was a prospective study to study the pattern of ing practice.
injuries in cricket players of North India. The study Orchard et al [11] defined injury prevalence as the per-
involved 95 players (composed of the Punjab Ranji centage of players missing through injury for each match.
Trophy team, the district teams of Punjab involved in It was calculated by using a numerator of “missed player
cricket camps and the under 19 teams of the Punjab games” with a denominator of number of games, multi-
Cricket Association). The study period extended from plied by number of squad members. However for this
1st November 2008 to 31st October 2009 over one year study, the prevalence was calculated based on the total
comprising one playing season and one off season of six number of “playing days” missed by the Cricketers due to
months each. The season in our set up is defined as time injury. Hence the numerator used was missed player days
period when players play competitive matches whereas multiplied by number of injured players with the denom-
off season is defined as the one when players keep on inator of average number of practice days multiplied by
practicing daily and often play local matches on weekends. total number of players. To calculate this, the total num-
All the players associated with these teams were iden- ber of days a player is either unable to play matches or
tified with the help of the Coaches and Physiotherapists practice cricket were taken into account. This is different
and Trainers of the Punjab Cricket Association (PCA). from calculations based on only “match days” lost. So
They were evaluated at the start of the season, using the another deviation in this study from the international
proforma designed at our institution. The player type was definitions was the inclusion of injuries which only
identified, and was categorized into a group i.e. bowler, caused missed time from practice.
batsman, wicket keeper and all-rounder. Categorization
of the players was done on the basis of the description by
the coaches and by the players themselves. Bowlers were Results
further divided into fast and slow bowlers. A fast bowler Out of 95 players evaluated 24 were bowlers, 19 were
[10] was defined as a bowler for whom the wicketkeeper batsman, 8 were wicket keepers and the other 44 crick-
would normally stand back from the stumps, due to the eters declared themselves as all rounders. Among 24
increased speed of the ball when bowled. All rounders bowlers 19 were fast bowlers and 5 were slow bowlers.
were categorised as the ones who put equal effort both Among 44 all rounders, 37 were spin bowlers and 7 were
in bowling and batting during practice. The players who fast bowlers. Most of the all Rounders were batsmen with
did not bowl, and were categorized as batsman. ability to spin the ball, or spinners with some batting
These players were followed up regularly during the ability. The average age of players in our study was
periodic training camps of PCA. The players were also 18.9 years (range 14–34 years) and average age of an
serially contacted by telephone once every three months injured player was 20.24years (range 15–30 years). The
over one calendar year. The practice profile of the player, average number of years, player under study were playing
any history of injury (including number of days of professional cricket was 6.8 (range 1–15 years).
practice/ number of matches missed) was recorded. The Apart from playing matches all the players practiced
injuries were commonly reported by the physiotherapists daily in PCA stadium Mohali and other stadiums of
and sometimes the researchers were directly informed Punjab. We noted that the training sessions have a uni-
of the injury by the players. form time table throughout Punjab, which comprised
A detailed record of the practice profile of each player
was kept. All injury definitions were as per the Cricket Table 1 Average practice profile of a player
Australia model defined by Dr. John Orchard [11] with a No. of hours of daily practice 5.5± 0.35
few modifications. One unique definition included in the No. of days of practice in a week 5.9±0.41
study has been the introduction of the term “all rounder” No. of weeks of practice in a year 41.7± 1.9
for purposes of player type classification. Most of the all
No. of days of practice in a year 245.4± 3.1
rounders are batsmen who can bowl a bit, mostly slow
No. of hrs of practice in a year 1351.9± 6.8
spin bowling; some bowlers on the other hand exhibit
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Table 2 Distribution of injuries according to type of player

BOWLING FIELDING BATTING WICKETKEEPING Total injuries
ALL ROUNDERS 1 8 1 – 10
BATSMAN — – 1 – 01
BOWLER 3 (2 fast bowler, one slow bowler 2 (Both fast bowler) – – 05
WICKETKEEPER — — – –
16

2 to 2.5 hours of physical training in the morning fol- Discussion

lowed by 4 hours of game practice in the evening session. The principal finding of this study is that upper limb
Practice is usually undertaken on six working days with a injuries are common in cricket players. The fingers
holiday on Sunday. However we found that most of the were the most common site of injury. A similar obser-
players, especially under 19 years, even played Local vation has been made by other studies as well [6-9].
Street or club matches on Sundays (Table 1). Specific studies on the incidence and nature of upper-
There were a total of 16 upper limb injuries in limb injuries incurred by cricketers are limited. In this
16 (16.8%) players (Table 2 & 3). The majority of injur- study, most of the upper limb injuries were sustained
ies (10/16) occurred while fielding. Four injuries were during fielding; all rounders were the most often affected.
seen while bowling (2 fast bowlers, 1 in slow bowler, Finger injuries usually occurred as a result of being
1 all rounder), while 2 injuries occurred while batting. struck by the ball during fielding, catching and batting.
Out of 16 injuries, 11 were observed in hand, 3 were in Out of the total injuries, 62.5% of injuries were severe
elbow, while 2 patients suffered from shoulder problem. enough to prevent the cricketer from returning to play
Out of 16 injuries, 12 were acute injuries while 4 were for more than 4 weeks. On comparing the incidence of
classified as repetitive stress injuries (RSI). injury in All Rounders and other players, there was
The average number of days a player missed practice / marked increased susceptibility to upper-limb injuries in
matches and was out of active cricket due to injury was all rounders (Table 2 & 3).
33.31 days, almost more than 1 month. The upper limb Many previous studies [2,9], especially those from
injury incidence per 10,000 hrs of practice for this study Australia, have focused on players during the playing
was 1.24. The upper limb injury incidence per 100 days season or during matches; leading to calculations based
of exposure was 0.07%. on “match hours” lost, and incidence and prevalence

Table 3 Distribution & Nature of Upper Limb Injuries in 95 players evaluated

[Link]. Age (yrs) Injury Player Activity during which Nature Number of days
injury sustained practice missed
1. 19 Mallet finger All Rounder Fielding Acute 30
2. 22 Jersy finger All Rounder Fielding Acute 40
3. 20 Mallet finger (Fast bowler) Fielding Acute 32
4. 18 Gamekeeper thumb All Rounder Fielding Acute 30
5. 16 Middle phalanx fracture All Rounder Fielding Acute 50
6. 16 Gamekeeper thumb Batsman Batting Acute 34
7. 22 Mallet finger All Rounder Fielding Acute 29
8. 18 Metacarpophalangeal joint dislocation (Fast bowler) Fielding Acute 41
9. 15 Bennett’s fracture All Rounder Fielding Acute 40
10. 21 Scaphoid fracture All Rounder Fielding Acute 43
11. 19 DeQuervain’s tenosynovitis All Rounder Bowling Chronic RSI 21
12. 22 Lateral epicondylitis All Rounder Batting Chronic RSI 23
13. 20 Medial epicondylitis (Slow bowler) Bowling Chronic RSI 24
14. 19 Olecranon fracture All Rounder Fielding Acute 60
15. 21 Acute biceps muscle strain (Fast bowler) Bowling Acute 15
16. 26 Supraspinatus tendinitis (Fast bowler) Bowling Chronic RSI 21
Dhillon et al. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2012, 4:42 Page 4 of 4
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doi:10.1186/1758-2555-4-42
data, it was observed that they have calculated their in- Cite this article as: Dhillon et al.: Nature and incidence of upper limb
jury incidence based on the injuries sustained during injuries in professional cricket players a prospective observation. Sports
matches and involved an elite international level cohort. Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2012 4:42.

Ours was a different methodology, as our calculations

were based mainly upon injuries sustained during prac-
tice and involved a larger number of under 19 and under
17 players of the PCA and total number of playing hours
also included time spent in physical training. In our
opinion, international players anyway play more intense
matches, and injury rates could be higher.
The incidence of upper limb injuries in cricketers at
the professional and semi-professional level is significant.
Consequently the players miss matches or practice for a
significant number of days. This is the first study examin-
ing Indian cricketers and the high incidence of upper
limb injuries found in this research should be addressed
by the players, coaches, teachers, administrators and
medical personnel involved with cricket. All rounders,
especially while fielding, were found to be most suscep-
tible to upper limb injuries. Injury surveillance in cricket
in India is still in its infancy. It is under-funded, its
importance unrecognized and its potential to improve
Indian cricket remains unrecognized. Publication of such
data has the potential to stimulate more funding and
research efforts towards injury surveillance and pre par-
ticipation evaluation of cricketers in the whole of the
subcontinent.
Competing interests
The authors declare that they have no competing interests.
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Authors’ contribution and take full advantage of:
MSD is the principal investigator and treated all the cricketers, BG and SP
prepared the manuscript, HD was the physiotherapist as well as collected
• Convenient online submission
data along with RKS. All authors read and approved the final manuscript.
• Thorough peer review
Received: 8 July 2011 Accepted: 31 October 2012 • No space constraints or color figure charges
Published: 8 November 2012
• Immediate publication on acceptance
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