Thursday

The Great BurnOut Issue



Crickets Governing Bodies will lose the battle against player burnout unless they face up to the implications of an overloaded calendar and come to a happy medium.

Since the Ashes of 2005 the England and Wales Cricket Board (ECB) would seem to have had a hotline to the press with their latest announcement of injury. Michael Vaughan, Simon Jones and Ashley Giles have been the main ‘sicknotes’ within the England squad but there have also been ongoing problems for Andrew Flintoff and Jimmy Anderson that have necessitated surgery or extended periods of inactivity. Injuries to high profile players are of course nothing new. The two premier spin bowlers in world cricket over the last decade Muttiah Murilitharan and Shane Warne along with Shane Bond and Glenn McGrath representing the fast men, have had extended spells out of the game through injury over the last few years.

The Federation of International Cricketers’ Associations (FICA) headed by the former Australian spinner has long stated that there is too much International cricket on the global calendar. The main concern for the players’ union has been player burnout and attempting to maintain the highest quality by ensuring that the best player’s are fit to play at their best.

The International Cricket Council has a difficult balancing act in trying to raise funds to disseminate throughout the cricket world. Their philosophy is to try to spread the game globally by encouraging the established test nations to play the minnows more regularly, but also to encourage regular test and one day series between those same test nations. The league tables for both test and one-day cricket has further increased the pressure on all of the established cricketing nations to perform at the top of their game on a constant basis.

It would seem that the respective boards are stuck between the proverbial rock and a hard place. Do they continue to expose players to such a heavy workload or do they pick weakened teams on a regular basis to protect players from injury? The fact is that weakened sides are already being fielded regularly due to the surgeon’s knife. Having been on the consultant’s table some thirteen times (nine knee and four back operations) over the years I am well placed to have an opinion on at least some of the causes.

So how can we reduce injuries in cricket?

Traumatic injuries usually occur when the body is pushed beyond its limit and such strain leads to failure, be it to ligament, tendon, muscle or bone. Recent examples of such injuries are those suffered by Simon Jones and Andrew Symonds rupturing anterior cruciate ligament and bicep tendon respectively and are to a large extent unavoidable. David ‘Syd’ Lawrence remains a harrowing memory as he fractured his patella in the action of bowling in New Zealand. All that can be asked of players, trainers and physiotherapists alike is that players are as prepared as they can be to take the field. Certainly player preparation and fitness have increased exponentially over recent years but this does not seem to have transferred itself into fewer injuries for the players.

Fatigue injuries are slightly less obvious as they tend to creep up on players and selectors alike. Players attempting to perform at the top of their games over many years will inevitably have dips in form whether through physical or mental fatigue. Focusing on the physical aspect this can be broken into two categories. The player who feels physically drained and does not seem to be able to produce what was once expected. This player will possibly exhibit signs of an accompanying mental fatigue.

Physical signs can also be represented by a chronic injury that whilst allowing the player to continue taking the filed will lead to the player being unable to concentrate as well as before and being less effective in terms of their level of performance and the amount of work that they can get through. Andrew Flintoff is a good case in point as at times he has continued playing at the highest level with a persistent ankle injury leading to an inevitable decline in performance and ultimately to enforced rest after surgery. Both types of fatigue injury represent a great challenge to selectors, trainers and physiotherapists. Players are reluctant to admit to any kind of mental fatigue and those that have chosen this path and have taken time out of the game have been roundly criticised in the media when choosing to rest during a winter campaign. Players that have perhaps not judged those moments well enough have received support and sympathy rather belatedly, though it is important to stress that certainly the ECB and the Professional Players’ Association (PCA) have both improved their act in this area immeasurably in the more recent past. There is however no doubt that more could be done to help players with chronic injury to better rehabilitate. Players coming back from injury need to be given more time and more appropriate quality matches before they are rushed back into contention for test places. This winter the likes of Michael Vaughan, James Anderson and Ashley Giles have all been rushed into contention too soon and have to a man not been able to produce the sort of form of which they are capable. Selectors need to develop a much more rigorous attitude to player fitness and ensure that players coming back from injury really are ready to step back into the cauldron that is international cricket. They need anticipate player fatigue, both physical and mental, and rest players so that they can expect to perform at their very best whenever they pull on their national colours.

What are the techniques?

Presentation of lumbar stress fractures (spondylolysis) is not well covered within the literature. Symptomatic patients typically present with focal low back pain that sometimes can radiate into the buttock or away to the lower extremities. Symptoms are often of a gradual and mild in nature for some time, with an acute worsening after a particular event, causing the pain to become more chronic and dull with time. Typically in the early stages, the fast bowler becomes aware of pain after bowling only, followed by an earlier onset of pain as the condition progresses, until the pain is felt very early in a bowling spell and ultimately to the point where bowling becomes impossible. Right arm bowlers almost exclusively develop pain to the left side of the lumbar spine at a point named the pars interarticularis. A combination of rotation coupled with hyperextension and left sided lateral flexion is known to give rise to such fractures. This means that bowlers that lean back prior to delivery or that collapse on their non-bowling arm side or show excessive rotation of the spine through the action are very vulnerable to these types of pars fractures.

Historically there was thought to be just one bowling action for the fast bowler. The side-on action. A study by Elliott and Foster (1984) of four Australian International fast bowlers led to the recognition of a second technique known as front-on. Most of the studies into spondylolysis injuries in cricket were carried out by Elliott and Foster in Western Australia. They determined that for both the side-on and front-on techniques the hips and shoulders need to be in alignment with one another at back foot impact (BFI), and for there to be no notable deviation from this position until just prior to release.
The ECB cricket coaching manual (2000) equally stresses the need to keep the shoulders and hips in alignment as much as possible through the bowling action, and puts great emphasis on the position of the hips and shoulders at both BFI and front foot impact (FFI). The basic message is to reduce any twisting of the spine by keeping the hips and shoulders in the same alignment throughout the bowling action, and that the hips and shoulder orientation should match the side-on or front-on position of the feet. The ECB also have guidelines in place known as ‘the fast bowling directives’, designed to limit the numbers of balls bowled both in practice and matches in age group cricket. Almost universally players, parents and coaches alike dislike these limits but they are essential if we are to protect young bodies during the major growing years.


However much the bowling directives are disliked it is essential that we both limit the number of times young bowlers put their bodies under maximal stress and that we are ever more vigilant in assuring that techniques adhere to those in the coaching manuals. Given that
Elliott and Foster (1984) found mean vertical ground reaction forces (GRF) at front foot impact to be 4.7 times body weight. Similar mean vertical GRF have been noted in later studies ranging between 4.1 and 9 times body weight irrespective of the standard of performance (Elliott et al (1986), Mason et al (1989), Foster et al (1989) Elliott et al (1992), Elliott et al (1993) and Hurrion et al (2000). The lower limb absorbs much of the force but is unable to shield the lumbar spine from some of this impact (Nigg 1983). The lumbar spine is exposed to these forces whilst potentially hyper-extended, rotated and laterally flexed as the bowler attempts to summate a high degree of power from within the musculoskeletal system (Burnett et al 1998). By its very nature fast bowling is an extremely stressful occupation. When the body is required to absorb impact of such high values even with a completely pure action it is not assured of escaping injury. Without strict adherence to preparation and technique the chances of both minor and serious injury are inevitably increased.




Neil Foster represent England in 29 test matches and 48 one-day international matches and taking over 1,000 wickets in all first class cricket in that time. Due to knee and back injuries through his career Neil spent more and more time on the physiotherapy table and it caught his imagination. Neil is now a member of both the Chartered Society of Physiotherapists (CSP) and the Organisation of Chartered Physiotherapists in Private Practice (OCPPP). Neil's main clinic is run from East Bergholt in the Dedham Vale but he also runs clinics in Clacton-on-Sea and Great Bentley.

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