Different tissue type categories of overuse injuries to cricket fast bowlers have different severity and incidence which varies with age

Background. Cricket fast bowlers have a high incidence of injury and have been the subject of previous research investigating the effects of previous injury, workload and technique. Bone stress injuries are of particular concern as they lead to prolonged absences from the game, with younger bowlers appearing to be at particular risk. Objectives. To investigate the variation in severity and incidence of injury to different tissue types in fast bowlers and ascertain whether age is a significant risk factor for these injuries. Methods. A retrospective analysis of match bowling exposure in 215 separate fast bowlers over a 14-year period was undertaken. This information was amalgamated with injury surveillance data providing information on the incidence, location, tissue type and severity of injury. Age of the bowler was determined and the bowlers were stratified into five age groups to determine the influence of age on the injury variables. Results. Younger bowlers (less than 22 years old) were 3.7-6.7 times more likely to suffer a bony injury than all the other age groups. Older bowlers (greater than 31 years old) were 2.2-2.7 times more likely to suffer a tendon injury than the 3 youngest groups. Conclusion. This study has demonstrated that younger age is a considerable risk factor in the development of bone stress injuries in cricket fast bowlers. In addition there appears to be a higher incidence of tendon injuries in older fast bowlers although this may be explained by the current classification system of joint impingement as a tendon injury.