February 14th 2015 saw the start of the Cricket World Cup hosted jointly by Australia and New Zealand. I must confess to knowing very little about cricket. What I do know is that for test matches that last 5 days players still wear white, that the aim of the game is to knock the little stick off the big sticks behind the batsman and to rack up as many runs as you can without being bowled out. When you get 100 runs they call it a century. Beyond that I get very lost particularly on the physics behind the trajectory of the ball etc. Anyway, due to my very base level of knowledge on a complex sport I'm calling upon Thihan Chandramohan (known as T), head physio for Hampshire Cricket team for this blog post. I am always interested to know about the injuries and treatment of elite sports people and I always think it makes for interesting reading when you can peer into someone else world for 5 minutes! So without further ado I give you T...
KT: Let's start with the basics... Did you play cricket when you were young?
TC: I always say that I was pre-destined to enjoy cricket due to my half-Indian, half- Sri Lankan heritage. Add to that being born in England and raised in Australia, cricket is the game which binds these nations together. Sadly, despite this genetic and cultural mix and many hours in our suburban backyard playing cricket with my brother, the cricket genius never materialised. When I did play social cricket games with friends as a teenager I was always the designated non-batting, non-bowling, outfielder… and I can’t catch.
I did (and still do) enjoy watching cricket which actually led me towards a career in physio. I was about 14 years old and watching a Test match. The Australian captain, Allan Border went down with a back injury while batting. The Aussie physio trotted out and manipulated his back on the pitch and Border went on to make a hundred. I was amazed and thought, if I could never make a hundred for Australia, maybe I could be the guy who keeps the players who can do it on the park. At the time I didn’t know what a physio was, but I knew I wanted to be one.
KT: How long have you been working with Hampshire Cricket?
TC: I moved to Hampshire County Cricket for the 2013 season so have been here for just on 18 months. Prior to this I was physio for the Victorian Cricket Team from 2009 and have worked in sports physio my whole career.
KT: What are the common injuries that cricket players often get?
TC: Cricket is an unusual sport in that fast bowlers are the guys who get about 70% of all injuries, particularly those injuries that stop them being able to play. Most commonly these are lower limb overuse problems such as knee and ankle tendinopathies, cartilage injuries to the hip, knee and ankle as well as bone stress lesions, especially in the lower back. They are also susceptible to the usual lower limb soft tissue strains seen in other high intensity running sports.
Batsmen get injured too, but these tend to be on the less severe end of the spectrum. That is, except for fractures caused by getting hit by the ball, which mainly occur to the hands and upper limb.
KT: Why are these particular injuries so common?
TC: For bowlers some of the most debilitating and common injuries are lumbar or lower back stress lesions. Typically seen in adolescent and young adult fast bowlers, pain onset is usually gradual with worsening symptoms on continued bowling. It is a complex pathology related to a multitude of co-factors including; growth stage and rate, bowling workload, bowling action mechanics, muscular strength and many others. It is so common that every international fast bowler will have been through at least one bout of rehab for lumbar stress reactions or fractures and many will have had multiple episodes. The primary cause is due to the high compressive and shear forces which the lumbar spine needs to absorb and transmit during the fast bowling action. In fact some studies show ground reaction forces at front foot contact to be 8 times body weight. Fast bowlers can do this 120 times per day! A lot of the current research is looking at ways to better manage fast bowlers to minimize their risks of these injuries developing.
KT: How long does it take for a cricket player to get back on the field after an injury?
TC: Like any injury, return to play is dependent on the severity and nature of the pathology. Low grade stress reactions with early detection can be back playing within 3-4 months while full stress factures may mean missing up to 12 months of bowling and may even need surgery if the stability of the spine is compromised and pain persists.
KT: What are the most important aspects of successful injury recovery
TC: As a sport physio I have a big box of tools that I can use to help make this recovery process as efficient and effective as possible. These start with assessment tools and investigations to evaluate and objectify the problem. This allows me to then judiciously use specific treatments including manual therapy and dry needling for pain management and to improve particular movements and/or tissue quality.
However the crux of any rehab plan is a progressive motor control, movement patterning and strengthening programme with clear objective goals and steps to allow continuous progression and return the athlete to bowling. This often includes corrective exercise at the start of an injury rehabilitation programme.
KT: How does physio for an elite sportsman compare to physio treatment for non-sports people?
TC: The biggest difference, is that a professional athlete’s body is their tool for their livelihood. So as a physio, my job is not to rule them out of playing whenever they have a niggle. Nor is it to work my magic on them and get them fit to play whenever they need it.
My job is to make sure they never miss a training session, and never miss a game. The cricketers who achieve this, end up being better athletes because they get to practice their skills more then the guy who is injured all the time. And not surprisingly, the more you are able to practice, the longer and more successful your career in the sport. This process is not dissimilar for non-sports people but the expectations on outcome and commitment to recovery are different.
With elite athletes I am also lucky in having the opportunity to try to prevent injuries from happening in the first place. I do this through education and injury prevention programming. Using musculoskeletal screening assessments, I individualise their programs which becomes part of their routine. I feel this empowers the players to be more independent with their body management and gives them better awareness and understanding of their bodies to use them more effectively.
KT: Who are you backing for the Cricket World Cup?
TC: I have a soft spot of Australia as I have worked with a few of the current players over the years
KT: Who do you think will win?
TC: My tip is actually New Zealand, they have a great group of batters and bowlers, will play the conditions well and seem to be a winning team at the moment.
KT: Who is your favourite cricket player across all the teams worldwide and why?
TC: My favourite is the captain of Sri Lanka, Angelo Matthews as he is always so passionate about winning and never gives his wicket up easily.
So there you have it, an interview with an inspiring and lively physiotherapist for a sport I barely know anything about! With that said I hope England are doing well in the competition. Hampshire Cricket start their England 2015 season on 12th April. Find out more information at www.ageasbowl.com