Incidence and impact of time loss and non-time-loss shoulder injury in elite South African cricketers: A one-season,prospective cohort study

ObjectivesTo determine the incidence, prevalence and impact of shoulder injury in elite South African cricketers.DesignProspective longitudinal cohort study.MethodsOne hundred and six senior national/franchise cricketers completed a pre-season Kerlan-Jobe Orthopaedic Clinic shoulder and elbow (KJOC) score. All injuries sustained during the 2016/2017 season were captured on an injury reporting system. Injuries were verified by the respective squad physiotherapist at the end of the season and post-season KJOC score was obtained from all the players.ResultsEighteen percent (95% CI: 11–25%) of cricketers sustained a shoulder injury, at a rate of 0.19 injuries per player per year. Annual injury prevalence was 1.1%. Shoulder injury occurred primarily while throwing (58%). Fielding performance was maintained by adapting throwing technique (58%) or fielding position (21%). Thirty-two percent of shoulder injuries resulted in time lost to matches and/or training. A history of shoulder injury increased the risk of sustaining another injury by 1.91 times (95% CI: 1.73–2.15). Irrespective of injury, cricketers demonstrated consistently low pre- (78.5 ± 15.6) and post-season (81.2 ± 17.1) KJOC scores. Pre-season KJOC scores were significantly lower (r² = 0.106, p = 0.001) in those cricketers with a history of shoulder injury. Cricketers who sustained a seasonal shoulder injury had significantly lower (r² = 0.112, p < 0.001) post-season KJOC scores, indicating persistent shoulder pain or dysfunction.ConclusionThis is the first study to report both time- and non-time-loss shoulder injury in elite South African cricketers. All non-time-loss shoulder injuries compromised primary skill, while some resulted in changes to throwing technique and fielding position. Thus shoulder injury, whether it results in time loss or not, potentially impacts match performance.     

Self-reported skin cancer protection strategies and location of skin cancer in retired cricketers: A case study from membership of the Emu Cricket Club

Cricket is one of Australia's most popular sports with approximately 470,000 registered participants. Played as a summer sport, participants can spend long periods in the sun with potential skin damage a possible contributor to skin cancer. Three hundred and sixty-eight retired regional representative players received and were invited to complete a comprehensive survey that included questions relating to their individual playing history, injury rate, sun protection strategies and reported location of skin cancer. A total of 164 players (mean age 45.2 ± 12.1 years) responded to the survey representing a response rate of 44.6%. Of these, 61.6% reported no diagnosis of skin cancer. However, 38.4% had been diagnosed with at least one skin cancer with the most common site being the face followed by the arms. Of those respondents reporting the diagnosis of a skin cancer, 7.9% had skin cancer on 4 or more separate locations. Proportionally, the 45–55 years group had the highest incidence, with 55.8% of this group indicating they had a skin cancer in at least one anatomical location. By comparison those in the under 35 years age group reported an incidence rate of 16.7%. The incidence of skin cancer among respondents (n = 63) reporting either, occasionally, very rarely or never wearing sunscreen, a hat or long sleeved shirt was (n = 27) 42.9, (n = 14) 22.2 and (n = 39) 61.9%, respectively. The results suggest that skin protection strategies, such as wearing a wide brimmed hat, long sleeved shirt and the use of sunscreen, may help to reduce the risk of skin cancer in cricketers.     

A longitudinal study of injuries to athletes with disabilities

This study investigated the number and type of injuries that occurred to athletes with disabilities from 1990-1996. The subjects were U.S. athletes who participated in the 1990 World Games and Championships, 1991 U.S. Paralympic Trials, 1992 Paralympic Games, the 1994 World Athletics Championship, and the 1996 Paralympic Games. A reportable injury was defined as an injury/illness that was evaluated by the U.S. Medical Staff during these competitions. Illnesses (29.8%) were the most commonly reported problem followed by muscular strains (22.1%). The most commonly injured body locations were the thorax/spine at 13.3%, the shoulder complex at 12.8%, the lower leg/ankle and toes at 12.0%. The majority of these injuries were musculoskeletal to include strains at 22.1%, sprains at 5.8%, contusion at 5.6%, and abrasions at 5.1%. An area of concern was the high number of strains to the thorax and spine when compared to other body locations and injury types. Attention should be paid to the musculature of the thorax/spine, shoulder and hip/thigh to help reduce the number of the injuries in this region.     

The right to die: a South African perspective

The right to die is discussed here from a South African perspective. Even though there is still strong opposition to euthanasia in legal circles, organised religious groups and the public at large, there are academics and professionals who advocate passive euthanasia on moral grounds. If the right to die is seen (and accepted) as a mere continuation and extension of the right to a dignified life, there should be no valid opposition to it. Such acceptance will however go against judicial decisions that have been handed down in cases involving euthanasia.     

Renal trauma in a South African hospital: a two year study

A study was made of renal trauma in a South African hospital during the period 1977-1979. The diagnosis and treatment of the 119 patients admitted to the Surgical Unit with moderate to severe renal injury are described. The 21 patients with penetrating wounds were treated by surgical intervention. The remainder were successfully managed conservatively. In all cases every effort was made to salvage viable renal tissue.     

Fatal occupational injuries in the South Delhi construction industry: a retrospective study

One hundred and forty-five unselected autopsy cases of construction site accidents received from South Delhi were studied during the period from 1996--2002. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.61% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, the part of the body involved, the manner of accident, the cause of death and the pattern of injuries in different body regions. Death occurred at the scene of the fatal event in thirty-four cases; forty-three cases were dead on arrival at the hospital; sixty-eight cases died after being admitted to the hospital. Ethanol was detected in the blood of 16% of the cases.     

The incidence,prevalence, nature,severity and mechanisms of injury in elite female cricketers: A prospective cohort study

ObjectivesIncidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers over two seasons from March 2014 to March 2016, inclusive.DesignProspective cohort study.MethodsInjury data collected via Cricket Australia’s Athlete Management System on all elite female players over two seasons were analysed. Profiles of the nature, anatomical location and mechanism of injuries were presented according to dominant player position. Injury incidence rates were calculated based on match playing hours.ResultsThere were 600 medical-attention injuries; with 77.7% players reporting ≥1 injury. There were 79.5% acute injuries compared to gradual onset injuries. Of the all medical-attention injuries, 20.2% led to time-loss; 34.7% were match-time-loss injuries. Match injury incidence was 424.7 injuries/10,000 h for all injuries and 79.3 injuries/10,000 h for time-loss injuries. Of all the injuries, 31.8% were muscle injuries and 16.0% joint sprains. Wrist and hand (19.8%), lumbar spine (16.5%) and knee (14.9%) injuries were the most common time-loss injuries. Six players sustained lumber spine bone stress injury that resulted in the most days missed due to injury (average 110.5 days/injury).ConclusionsThere is a need to focus on specific injuries in female cricket, including thigh, wrist/hand and knee injuries because of their frequency, and lumbar spine injuries because of their severity.     

The relationship between fast bowling workload and injury in first-class cricketers: a pilot study

This study examined the relationship between the bowling workload of first-class fast bowlers and injury with the aim of identifying a "safe" fast bowling workload threshold. Twelve male fast bowlers (mean age 25 years) from an Australian state cricket squad were observed for the 1999--2000 cricket season. Workload was quantified by examining fixture scorecards and conducting surveillance at training sessions. Injury data were obtained from Cricket Australia's Injury Surveillance System. The seasonal incidence of injury was high with seven bowlers sustaining nine injuries. Whilst injured bowlers did not tend to bowl a greater number of deliveries on the day of injury, a significant increase in deliveries per session was observed in the 8-21 days prior to the date of injury (mean= 77) as compared with the rest of the season (mean= 60, p< 0.02). Bowlers with a weekly bowling workload above the mean of 203 deliveries were at an increased risk of injury (Risk Ratio (RR)= 6.0, 95% confidence interval (CI) 1.00-35.91). Those bowlers who bowled in five or more sessions in any 7-day period were also at an increased risk of injury (RR= 4.5, 95% CI 1.02 to 20.12). A consistent relationship between high bowling workload and injury was observed. The risk of injury was much higher for those bowlers with a sessional, weekly and monthly bowling workload above the group mean, especially when this high workload was consistent and sustained.     

Match injuries in Sri Lankan junior cricket: A prospective,longitudinal study

ObjectivesUnderstanding the nature of injuries in cricket is key to mitigate injury risks and prioritise preventive measures. This study aimed to identify the incidence and nature of match injuries among Sri Lankan junior cricketers.DesignLongitudinal follow-up study with prospective in-season data collection.MethodsA national survey of schoolboy, division-1 cricket teams in under-15 and under-17 age groups. Using a paper-based questionnaire, distributed to school-teams at the start of the 2016 cricket season, respondents recorded any injuries, including the site, type and mechanism. Match injury incidence rates (match-IIR) (injuries/100 match-player-days) were calculated overall, by position and for match time loss (MTL) and non-MTL injuries.ResultsFrom 59 school-teams, 573 players responded, with 404 players reporting 744 injuries in 648 matches. The match-IIR was 28.0 injuries/100 match-player-days (95% CI = 26.0–30.2). The highest match-IIR was reported among fielders (46.0% of all injuries sustained; match-IIR = 12.9) compared with batters (25.4%; match-IIR = 7.1) and bowlers (20.3%; match-IIR = 5.7). Abrasions and bruises to the knee or elbow were the most common injuries among fielders, with the majority being non-MTL injuries.ConclusionsAlmost half (46.0%) of all injuries were to fielders, and more research into their severity and mechanisms is needed to identify the need for, and design of, preventive measures. Batters sustained a relatively large number of facial-organ injuries from being struck by the ball, presenting a need to evaluate the use and appropriateness of helmets by Sri Lankan junior cricketers. Similar to other junior cricket studies, the most common injuries among bowlers were strains and sprains, mainly affecting the lower limbs and lower back.     

Hemimegalencephaly: a longitudinal MR study.

An infant with hemimegalencephaly was studied with MR at 5 days and again at 10 months of age. The initial scan showed an abnormally large left cerebral hemisphere. At the age of 10 months, the left cerebral hemisphere was smaller than the right--an apparent left-sided micrencephaly caused by normal growth of the right hemisphere and arrested growth of the left. The age of imaging of a patient with hemimegalencephaly can be important if the correct diagnosis is to be made.     

Injuries to elite male cricketers in Australia over a 10-year period

This study analyses injuries occurring to Australian male cricketers at the state and national levels over 10 years using recently published international definitions of injury. Data was collected retrospectively for 3 years and then prospectively over the final 7 years. Injury incidence has stayed at a fairly constant level over the 10 years. Injury prevalence has gradually increased over the 10-year period but fell in season 2004–2005. Increasing match scheduling over the 10-year period has probably contributed to the increasing injury prevalence. Fast bowlers miss, through injury, about 16% of all potential playing time, whereas the prevalence rate for all other positions is less than 5%. Some match and schedule-related risks for bowling injury have been noted, including a greater risk of injury in the second innings of first class matches (compared to the first innings), a greater risk of injury in the second game of back-to-back matches and an increased risk of injury in the rare situation of enforcing the follow-on in a test match. The introduction of a boundary rope at all grounds has successfully eliminated the mechanism of injury from collision with fences whilst fielding. Cricket is a much safer sport to play at the elite level for batsmen, fieldsmen, wicketkeepers, and spin bowlers than the football codes, which are the other most popular professional sports in Australia.     

Back injuries to fast bowlers in cricket: a prospective study.

Eighty-two high performance young male fast bowlers (mean age 16.8 years) were tested immediately prior to the season for selected kinanthropometric and physiological data. Subjects were also filmed both laterally (200 Hz) and from above (100 Hz) while bowling so that their front foot impacted a force platform during the delivery stride. The players then completed a log book over the ensuing season that detailed their training and playing programmes. All cricket related injuries over this season were assessed by a sports physician who used computerized tomography to assist in the diagnosis of spinal injuries. At the completion of this season the players were grouped according to their injury status (Group 1--bony injury to a vertebra; Group 2--soft tissue injury to the back that caused the player to miss at least one game, and Group 3--no injuries). A one-way analysis of variance was used to identify if any variables were significantly (P less than 0.05) different between the three groups, and a Scheffe post hoc comparison was used to determine which groups were significantly different. Eleven per cent of the players sustained a stress fracture to a vertebra(e) (L4 to S1), while 27 per cent sustained a soft tissue injury to the back. Bowlers with a low longitudinal foot arch were more likely to develop a stress fracture than those with a high arch. Shoulder depression and horizontal flexion strength for the preferred limb and quadriceps power in the non-preferred limb were also significantly related to back injuries. Results suggest that bowlers with the above physical characteristics, who bowl with these biomechanical techniques for extended periods, are predisposed to back injuries.     

The mental wellbeing of current and retired professional cricketers: an observational prospective cohort study

Objective: Scientific knowledge about symptoms of common mental disorders in professional cricket is non-existent. Consequently, the aims of the study were to determine the prevalence and the 6 months incidence of symptoms of common mental disorders (CMD: distress, anxiety/depression, sleep disturbance, adverse alcohol use) among current and former professional cricketers and to explore the association of potential stressors (significant injury, surgery, adverse life events, career dissatisfaction) and CMD.

Methods: An observational prospective cohort study with a follow-up period of 6 months was conducted among current and former professional cricketers from South Africa. Using validated questionnaires to assess symptoms of common mental disorders as well as several stressors, an electronic questionnaire was set up and distributed by the South African Cricketers Association (SACA).

Results: A total of 116 participants enrolled at baseline (overall response rate of 33%) and 76 of those participants completed the 6 month follow-up (follow up rate of 66%). The prevalence of symptoms of CMD in current professional cricketers was 38% for distress, 38% for sleep disturbance, 37% for anxiety/depression and 26% for adverse alcohol use. Among former professional cricketers, baseline prevalence as was 26% for distress, 24% for anxiety/depression, 21% for sleep disturbance and 22% for adverse alcohol use. Career dissatisfaction led to an increased risk of distress, anxiety/depression and sleep disturbance in current professional cricketers. Surgeries and adverse life events led to an increase in reported symptoms of distress and anxiety/depression in current professional cricketers.

Conclusions: It was concluded that symptoms of CMD are prevalent in both current and former professional cricketers and the association with surgery, adverse life events and cricket career dissatisfaction may provide some insight into possible mechanisms.     

Ice hockey injuries: incidence, nature and causes.

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors.     

Audit of a cardiac screening policy for elite Australian cricketers

ObjectivesTo report the compliance and results of an electrocardiogram (ECG) cardiac screening program in male and female elite Australian cricketers.Designcross-sectional study.MethodsElite cricketers were offered screening in accordance with Cricket Australia policy. Players who consented provided a personal and family history, physical examination and resting 12-lead ECG. An audit (1 February 2019) examined all cardiac screening records for male and female players in all Australian Cricket state squads from 16 years upwards. Data extracted from the Cricket Australia database included the number of players who underwent screening; signed waivers opting out; and had follow-up tests. ECGs were re-reviewed according to the International Criteria.Results710 players were included in the cohort (mean age 20.4 ± 4.9 years, 62% male). 692 (97.5%) players underwent recommended cardiac screening or signed a waiver opting out (1.1%). 173 (24.4%) players were screened (or signed a waiver) more than once. Follow-up testing was conducted for 59 (6.9%) cases. No players were excluded from sport due to a cardiac problem and no major cardiac incidents occurred to any player in the audit cohort. Review of 830 ECGs showed benign athlete heart changes, including sinus bradycardia (33.5%), left ventricular hypertrophy (16.3%), and incomplete/partial right bundle branch block (8.4%), were common but abnormal screening ECGs were uncommon (2.0%).ConclusionsAn audit of a cardiac screening program in elite Australian cricketers found excellent compliance. A small proportion required follow-up testing and no player was excluded from sport due to a cardiac problem. ECG analysis suggested cricket is a sport of moderate cardiac demands, with benign athlete heart changes common.     

Human Decedent Identification Unit: identifying the deceased at a South African medico-legal mortuary

International Journal of Legal Medicine - The Johannesburg Forensic Pathology Services medico-legal mortuary perform postmortem examinations on all cases of unnatural deaths in the greater...