injuryupdate
24-03-2004, 08:22 PM
Received via email:
I just wanted to get in touch with you to offer you some help in getting to the bottom of the recent epidemic of injuries being sustained by our representative cricketers.
I read recently that the Cricket Australia was to commission research that would help to identify factors predisposing our cricketers, fast bowlers in particular, to injury.
My interest is both clinical and academic. I'm a physiotherapist based in Sydney and I'm currently enrolled in a Musculoskeletal Physiotherapy Masters Program.
An observation of interest is the relatively high incidence of fast bowlers presenting with posterior impingement sydrome that have an os trigonum on xray. Ankle surgeon Martin Sullivan has operated on six Australian members of the Test or one-day side, five of them bowlers. Each time to remove a bone that has an incidence of somewhere between 2.5% and 13% in the general population. The incidence of os trigonum seems disproportionately high in the population of elite fast bowlers, and why is it only in their lead foot/ankle?. It could be hypothesised that the repetitive trauma of the bowling action induces changes in the posterior ankle complex that mimic the appearance of an os trigonum, eg a Shepherd's fracture of the posterior tubercle of the calcaneus, or some other stress related injury.
Additionally, impairments involving the lead foot may also have an impact further along the kinetic chain. For example, in Brett Lee's abdominal strain case, if he is unable to plantarflex his ankle maximally at delivery due to his posterior impingement there may be a resultant loss of transfer in angular momentum from his legs to his trunk. If his compensation strategy involves overactivation of his trunk musculature to ensure shoulder and wrist speed are preserved then he is at much greater risk of sustaining an abdominal muscle strain.
The issue of match scheduling and player workload is another subject of heated debate at the moment. I would be very interested to hear your thoughts on these ideas. I would also be very interested in being involved in any activities you are undertaking that will help get to the bottom of it all. If the opportunity to be involved does not exist then I would still sincerely appreciate being kept informed of any of your findings.
I just wanted to get in touch with you to offer you some help in getting to the bottom of the recent epidemic of injuries being sustained by our representative cricketers.
I read recently that the Cricket Australia was to commission research that would help to identify factors predisposing our cricketers, fast bowlers in particular, to injury.
My interest is both clinical and academic. I'm a physiotherapist based in Sydney and I'm currently enrolled in a Musculoskeletal Physiotherapy Masters Program.
An observation of interest is the relatively high incidence of fast bowlers presenting with posterior impingement sydrome that have an os trigonum on xray. Ankle surgeon Martin Sullivan has operated on six Australian members of the Test or one-day side, five of them bowlers. Each time to remove a bone that has an incidence of somewhere between 2.5% and 13% in the general population. The incidence of os trigonum seems disproportionately high in the population of elite fast bowlers, and why is it only in their lead foot/ankle?. It could be hypothesised that the repetitive trauma of the bowling action induces changes in the posterior ankle complex that mimic the appearance of an os trigonum, eg a Shepherd's fracture of the posterior tubercle of the calcaneus, or some other stress related injury.
Additionally, impairments involving the lead foot may also have an impact further along the kinetic chain. For example, in Brett Lee's abdominal strain case, if he is unable to plantarflex his ankle maximally at delivery due to his posterior impingement there may be a resultant loss of transfer in angular momentum from his legs to his trunk. If his compensation strategy involves overactivation of his trunk musculature to ensure shoulder and wrist speed are preserved then he is at much greater risk of sustaining an abdominal muscle strain.
The issue of match scheduling and player workload is another subject of heated debate at the moment. I would be very interested to hear your thoughts on these ideas. I would also be very interested in being involved in any activities you are undertaking that will help get to the bottom of it all. If the opportunity to be involved does not exist then I would still sincerely appreciate being kept informed of any of your findings.