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Bowling safe
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A weak shoulder need not end a player’s career
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BUSTED SHOULDER It made Courtney Walsh try a different bowling technique
The shoulder is the most abused joint in cricket. You’d think bowling causes most shoulder injuries and, in fact, spinners can rightly blame their bowling action for them. However, quicks such as Courtney Walsh owe their busted shoulders to thr
owing rather than to bowling. Fall on an outstretched arm can also damage the shoulder joint.
Most shoulder injuries in cricket are rotator cuff tears. The rotator cuff ties four trunk muscles (supraspinatus, infraspinatus, terer minor, and subscapularis) to the arm at the shoulder. Eighty-yard throws from the deep can tear the rotator cuff, hampering lifting the arm sideways. Weak muscles are one predisposing factor, but strengthening shoulders in the gym can make matters worse. Gym-goers tend to focus on the deltoid, trapezius and the pectoralis, ignoring the rotator cuff muscles. The result is throws that are more powerful causing more severe cuff tears.
Right after an injury, the shoulder might be too painful for any movement. Examination is usually possible after two days of rest and anti-inflammatory drugs. Depending on the muscle affected, distinct restriction of movement occurs.
Damage to supraspinatus will prevent initial abduction of arm. Pain on resisted external rotation of arm usually means damage to infraspinatus. Pain on resisted internal rotation occurs with subscapularis damage. Injection of local anaesthetic into the subacromial space will help differentiate a partial tear from a complete tear. With a partial tear, movement is possible once pain subsides; with a complete tear, the movement fails even in a painless joint. Radiography, MRI and arthroscopy are diagnostic tools that aid clinical examination.
The treatment of a complete tear is surgical repair. Incomplete tears and inflammation of the cuff require a few weeks of rest, anti-inflammatory drugs and physiotherapy. Avoiding throwing for a few weeks is essential. Chronic case might require injection of corticosteroids into the shoulder joint, decompression of the subacromial space and excision of the coracoacromial ligament. During recovery, it is important to strengthen the shoulder cuff muscles before strengthening the deltoid, trapezius and pectoralis.
With chronic injuries, recovery is often unsatisfactory. That does not necessarily mean the end of a career. Teams have found ways to hide players with exceptional talents and weak shoulders. If all else fails, it may be possible, like with Courtney Walsh, to bowl the ball in rather than throw it.
RAJIV. M
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