With the amount of cricket played how does the team look to prevent injuries to fast bowlers?

Many people outside the cricket environment often ask, if there is much work from a physiotherapy point of view.  Cricket unlike many other sports, has a high percentage of overuse injuries, that is, injuries that develop over time due to repetition and hence becomes chronic in nature.  Stress fractures of the lower back to fast bowlers, rotator cuff shoulder injuries and tendonpathies (Achilles Tendon) are some of the chronic overuse injuries that occur in the sport.  These type of injuries need to be managed and prevented to allow players optimal game time.

Fast bowlers are by far the most prone to injury as compared to the other disciplines in the game.  This is purely due to the intensity they work at and their force expenditure at the crease.  The key to preventing injuries to fast bowlers is as follows :

1. Performing a throrough musculoskeletal assessment

2. Understanding their bowling action

3. Monitoring their weight, Skinfolds, and general fitness

4. Monitoring bowling workloads 

5. Having a keen eye on their recovery.

Musculoskeletal Assessments:

This is a specific physiotherapy assessment which is performed during our preseason.  The assessment is an objective screening tool which analyzes the player from head to toe.  At the conclusion of the assessment I will be able to distinguish areas of concern, which could potentially cause injuries in the future.  Following this, each player will then be handed their own specific prehabilitation programme (preventative programme), in the hope to prevent injuries to these areas of concern.  This programme will be maintained throughout the season

Bowling Actions:

Side on:

The side-on technique  is typically characterised by a low run-up speed, rear-foot positioned parallel with the popping crease, and a shoulder alignment at rear-foot strike that points down the wicket towards the batter approximately 180 degrees (shoulder segment angle) (Bartlett et al., 1996).  Thus, the fast bowler has the appearance of bowling ‘side-on’ as they begins the delivery stride, with the left hip and shoulder (for a right hand bowler) pointing towards the batter. A recent classification of bowling actions (Portus et al., 2004) describes the side-on action as “a shoulder segment angle less than 210 degrees at back foot contact, a hip-shoulder separation angle less than 30 degrees at back foot contact, and, shoulder counter-rotation less than 30 degrees (Portus et al., 2004). A key feature of a side-on delivery is that the lumbar spine is subject to less rotation when compared with other actions. The side-on action while being the most ‘traditional’ action is now considered to be extremely rare in modern day fast bowlers (Ferdinands et al., 2010; Ranson et al., 2008).

Semi:

This sub-classification is relatively new and was advocated as a safe technique by the Australian Cricket Board as recently as 1998 (Portus et al., 2004). In this action the shoulder segment angle lies between the front-on and side-on actions. Similar to both the side-on and front-on actions, there is little to no counter-rotation of the shoulders. It is described as “a shoulder segment angle from 210 to 240 degrees at back foot contact,

a hip-shoulder separation angle less than 30 degrees at back foot contact, and, shoulder counter-rotation less than 30 degrees "( Portus et al., 2004).

Front on:

The front-on action, made famous by the West Indian pace bowlers throughout the 1970s and 1980s (Hardcastle, 1991), has been adopted widely in the modern game (Ferdinands et al., 2009). In a front-on action, the bowler’s hips and shoulders are open prior to delivery, giving the appearance of the

bowler running straight towards the batter. This action is described as “having a shoulder segment angle greater than 240 degrees at back foot

contact, a hip-shoulder separation angle less than 30 degrees. at back foot

contact, and, shoulder counter-rotation less than 30degrees ” (Portus et al., 2004). As with the side-on action, the degree of rotation of the lumbar spine is less than in other actions.

Mixed action:

The mixed action is a combination of both the front-on and side-on bowling actions, therefore the exact technique can vary. For instance,when the back foot makes contact, the hips and lower limb can adopt an orientation consistent with a side-on action whereas the shoulders face front-on to the batter, but the opposite of this can also occur. The mixed action is defined

as any action with “a hip-shoulder separation angle equal to or greater than 30 degrees at back foot contact, or, shoulder counter-rotation

equal to or greater than 30 degrees ” (Portus et al., 2004). Recent studies

(Ferdinands et al., 2010; Ranson et al., 2008) employing more specific classification methods, have identified that this action is the most prominent in professional adult bowlers from England, Australia and New Zealand (Ferdinands et al., 2010; Portus et al.,2004; Ranson et al., 2008).

Contributors to injury:

Weight:

A body's relative mass or the quantity of matter contained by it, giving rise to a downward force; the heaviness of a person or thing.

Skinfolds:

Many athletes attempt to alter their body weight composition, either by trying to put on weight ( in the form of muscle) or by losing weight ( in the form of fat).  Certain sports require athletes to have large amounts of muscle mass.  Some sports require athletes to be a particular weight to compete. There accurate assessments of body composition is necessary in certain athletes.

Sum of 7 skinfolds:

The body fat measurements of 7 areas of the body are measured using calipers:

- Tricpes

- Subscapular

- Biceps

- Supraspinale

- Abdomen

- Anterior thigh - quadriceps 

- Medial Calf

Ground reaction forces (GRFs):

In physics, and in particular in biomechanics, the ground reaction force (GRF) is the force exerted by the ground on a body in contact with it. For example, a person standing motionless on the ground exerts a contact force on it (equal to the person's weight) and at the same time an equal and opposite ground reaction force is exerted by the ground on the person.  GRFs, occurs when a fast bowler pounds his front foot into the ground, up to 9times his body weight.  Imagine the force that goes through his front ankle, knee, hip and lower back.

Bowling Workloads:

Managing the amount of overs a fast bowler delivers is also extremely important.  Off particular importance is looking out for "spikes" in a fast bowlers week or month.  By "spikes", I mean, if a bowler bowls 30 overs in weeks 1 and 2 and suddenly bowls 60 overs in week 3.  Week 3 is seen as "spike" in his trend and is seen as a "red flag" (something to watch out for).  The increase workload could result in injury.  We would then look to lower his loads or rest him for a few days.

Weight, Skinfolds , GRFs, a poor bowling action, and high workloads do the math.......

Recovery:

Recovery is a major component of preventing the risk of injury in fast bowlers.  With the amount of cricket played these days, these athletes need to be managed well, to perform optimally for the next day or the next match.  This is the menu I request guys to follow:

1.  Hydration levels need to be monitored.  This is done using a refractometer, which        

     can analyze if a player is hydrated or dehydrated.  Players need to urinate in this

     machine, during the course of a day.  The results, allows me to see if they are 

     drinking enough fluids.

2.  Regular stretching - during a first class game, fast bowlers are requested to join 

     me in an early morning yoga session.  This allows players to focus on stretching, 

     using yoga positions.

3.  Nutrition is an important aspect of recovery, as refueling the body after a 

    long day is required to replenish nutrients lost.

4. Ice baths or pool sessions are done after a days play

5. Post match static stretching and form rolling must be done after a days play.

6. Massages are also available

Remember, fast bowling is not a easy job and to get to the top and remain there, managing our body is vital to your success.  Look after the little things and the bigger picture will draw itself.

@Craig_gov

Champions League Highlight

Bus trips are always a great time to reflect and today's trip to Bloemfontein is no different.  I am currently reading a book entitled Think like a Champion by Dr Rudi V Webster.  He highlights the importance of the mind and learning in general, in the cricket environment.   I could easily summarize this brilliant read, in a few paragraphs but I would encourage those interested in mental conditioning and learning about the great cricket minds, such as, Clive Lloyd, Raul Dravid, Jacques Kallis and MS Dhoni to purchase this book and add it to your ever growing library.

The major highlight of my Champions League, could be seen as strange to many.  The Lions had a day off in Jaipur, my wife and mum, whom were there supporting the team had left early that morning to discover the Taj Mahal, while I remained at the hotel to look after the boys.  

Rajasthan Royals were scheduled to play the Big Bash winners, Perth Scorchers.  I took a stroll downstairs to grab something to eat, between treating players and to my surprise I saw Paddy Upton and Justin Langer, sitting down together, chatting over a coffee.  Too those that do not know, Paddy Upton, is the Rajasthan Royals coach and the current Protea Performance Manager and Justin Langer was a legendary Australian cricketer and the current coach of Perth.  

Why was this strange?  Well, these were two head coaches, whom were going to lead their teams against each other, in less than three hours and here they were talking about the game.  How awesome was that?  I wish I was part of the conservation.  Two masters of the mind, one educated on mental conditioning and the other, known to have one of the strongest minds in game.

This ties into the book I am currently reading and ties into my thoughts of a learning environment.  Knowledge is power and empowering oneself can be done by simply sitting around and having a coffee at a restaurant and more importantly hanging around in a dressing room after a training session or a game and listening to the likes of Gordon Parson's and Neil McKenzie's of the world.  

@Craig_gov

A Side Strain

A Side Strain is a fairly common injury in cricket bowlers and more recently it has begun to effect batsman.  A Side Strain is a tear of the Internal Oblique, the External Oblique, or the Transversalis fascia at the point where these muscles attach to the four bottom ribs on the side opposite the bowling arm.

In cricket the bowlers suffer a Side Strain on the non bowling arm side as a result of a forcible contraction of the muscle on that side while they are fully stretched as the bowling arm is cocked for bowling. The affected muscle is forcibly stretched beyond its limits and the muscle tissue becomes torn.

Batsman in this current generation was also picking up this injury, due to the amount of balls being hit and the advent of T20 cricket.  Trunk rotation and the forcible impact of ball and bat repeatedly can cause injury.  

Signs and symptoms:

1.  DOMS - Delayed Onset of Muscle Soreness - this is fatigue to muscles post exercise, due to micro tearing.  Players with muscle soreness are at risk of injury.

2. Pain felt on side flexion and rotation of your trunk in standing. A stabbing type of pain would be felt between your lower ribs.

3. Pain on resisted trunk rotation ( obliques) and flexion in supine ( on your back)

4. Pain on coughing, squeezing, deep breathing and laughing. This is due to expansion of your rib cage

5. Pain felt with shoulder activities. The Lats play a huge role in shoulder function.  Your Lats insert at the humerus and forms a large triangular mass originating above the hip and lower vertebra.  Thus whenever you use your shoulder, it forces the rib cage to work, due to the origin and insertion of the muscle.  

Treatment:

RICE is extremely important in the first 72 hours

A guided PRP injection under ultrasound by an experienced Sports Physcian will help with recovery.

Hands on physiotherapy - soft tissue mobilization of the injured muscle must be done to reduce scarring and increase strength of the muscle.

Running must be prevented due to shoulder movement 

Rehab should include thoracic mobility, core stability and functional strengthening.

A grade 1 and 2 injury takes between 4-6 weeks to recovery

The player must be asymptomatic before playing again. 

Prevention:

Workload

Previous injury 

Thoracic immobility due to decrease ROM of lumbar vertebra

Look out for DOMS in a player

@Craig_gov

Sports Physiotherapist Required

A Sports Physiotherapist with an interest in cricket is required to work hand in hand within a multidisciplinary team in Johannesburg, South Africa.

Post graduate studies in OMT and SPT is required for the job.

For more information please contact me via email with an attachment of a CV:

govendercraig@yahoo.com

Opportunities are exciting and endless 

A Blast from the Past

Watch this rare insight into the first recorded fast bowling speeds.  Lillie, Thompson, Holding and the like go head to head.....

http://youtu.be/GjkBNxKZOE8

Preventing Stress Fractures of the Lower Back at a young age:

I previously wrote about the prevention of injuries in young fast bowlers and the "RED ZONE".  The age group between 16-22 and preventing stress fractures between those ages. Shane Watson, talks about his injuries and highlights major stress fractures at a young age.  He is still plagued by injuries to this day and I believe this is due to 3 stress fractures before the age of 19 and within the "RED ZONE".  A zone, when young fast bowlers can develop stress fractures primarily due to anatomical weakness and secondary due to a mixed action and high workload.  Degeneration to his lower back, has caused him to have multiple injuries along his "neural chain" (nerve pathway) that is, hamstrings and persistent calf injuries.  

Watch his interview 

http://youtu.be/XCQ_ZRrbsB0

@Craig_gov

The Pipeline......

It's 8am and the "Test" squad has just left the comforts of Sun City en route Olympia Park Stadium, Rustenburg.  For some of the squad, it has been a long tour,  having played against Australia "A" in a 2 match "Test" series and a Triangular, which included India "A".

We are currently playing the 1st "Test" against the India "A" team and clearly the Indian management selected this squad, based on the fact  that their top order batsmen need experience in South African conditions, ahead of their international tour later in the year.  Only the likes of Virat Kohli, Sachin Tendulkar and MS Dhoni were missing from their top 7  Test team.

The Australian "A" team, seemed just as strong on paper.  With  the majority of their squad having played international cricket.  What better preparation can a South African "A" squad ask for?  Being able to pit their skills against some of the best opposition available.   

Our boys have been given an opportunity to grow as cricketers.  However growth in the game does not only happen from playing, against household names but also interacting with South Africa's best coaches and consultants.  

For the first time, during this SA "A" season, coaches from each franchise were invited to be part of High Performance.  During the "Test" series against Australia "A", the squad had the benefit of exchanging thoughts with, Head coach, Vincent Barnes, Assistant coaches, Lance Klusner (Dolphins) and Piet Botha (Warriors).  The consultants included, batting guru; HD Ackerman, spin specialist Nicky Boje and Sports psychologist Maurice Aronstam, together with the fitness trainer from the Cobras, Dieter Swanepoel.  

The assistants in the Triangular Series, which saw India "A" defeat Australia "A" in the final, included Geoffery Toyana (Lions) and Malibongwe Maketa (Warriors Assistant).  Currently Sarel Cilliers (Knights) and Paul Adams (Cobras) are assisting during the India "A" "Test" series.  

Cricket South Africa's High Performance Department, headed by Vincent Barnes, managed by Corrie Van Zyl and assisted by Greg King have done an awesome job by brainstorming this current programme.  The list of coaches and consultants available for players to bounce off ideas and improve their game is immense.  They have developed an environment which allows players to learn and grow from the best available minds in South African Cricket.

The goal is clear to see.  It is all about the bigger and brighter picture.  To produce the best cricketers in the world and become the best cricketing nation in all formats consistently.   Providing our players with strong opposition and creating an environment to grow are some of the ways....watch the space. Last season there were 8 SA"A" players whom progressed to the Proteas.  I am sure, there will be a few more players representing this proud nation in the not to distant future. 

The pipeline is pumping.......

@Craig_gov

The 1st "Test" vs Australia A

The 1st "Test against Australia A took place at the L C De Villiers field in Pretoria, which ended in a draw.  Here is a story of the game through the lens of Alwyn Myburgh

 

The Importance of Club Cricket Education

Craig Govender and Abdulhaq 'Jack' Manack are part of some of the training sessions.

The Lenasia Cricket Club's mental training program that started last month has taken off so well that officials are confident this will provide players with the correct frame of mind and preparedness for the season ahead.

Already the big wigs of the game have been raked in for various sessions, all this is taking place at their indoor facility at the Buitun Nur Centre.

The first person to give a session was Craig Govender, physiotherapist of the Highveld Lions, who assisted the team with implementing a well-rounded fitness session. Govender had just returned with the national team from England.

He took time off his busy schedule to personally meet the players and take them through their paces. He shared his knowledge on fitness programs, tips, techniques and best practice and how to be prepared mentally for fixtures.

Yadene Singh, skipper of the Premier team said, "By concentrating on a combination of strength training and workout throughout the off season will enable our teams to perform with greater ability and reduce the risk of injury during the summer.

"Along with building a good base of strength and fitness, the skills of the game will also be of advantage to the boys."

The services of Abdulhaq 'Jack' Manack were also sought. His motivational sessions added that extra pep to club members. His main outline was how to succeed and the need to prepare oneself mentally for any given situation. "Mental preparedness in a game is half the battle won. Your mind must be switched on about the game ahead of you and not what's around you."

Manack also enquired about the vision of the players and how they should motivate themselves to be leaders.

Club chairperson Mohsin Ahmed added a few words about the sessions the players had. He said, "This is something we are hoping will impact on the players and these sessions are just working wonders. The mental preparedness sessions by Govender and Manack have been tremendous, the feedback we are getting is just great and I am sure it will benefit the boys.

"Our training in the fasting month will be confined to much of the indoor sessions over weekends but after that we will be moving to some practical stuff. Manack will do some sessions with the bat and bowling.

"We are now expecting the boys to put into practice what they have learnt from these two great personalities.

"Also, we make a special plea to donors to come forward to assist the club for maintenance of our indoor facilities."

The club is also expecting to have a session with Hussein Manack, the cricket commentator on SABC radio and TV.

Lower Back Injury Terminology

Stress fracture of the Pars Interarticularis:

Clinical features:

The patient complains of:

- unilateral low back ache, occasionally associated with buttock pain

- pain that is aggravated by movements involving lumbar extension, the 

  athlete may describe a episode of hyper extension that precipitated the pain.

Occasionally, stress fractures to the pars Interarticularis are asymptomatic.

On Examintaion:

- pain is produced on extension with rotation and on extension while standing     on the affected leg

- the athlete may often have an excessive lordotic posture with associated spasm of the hamstring muscles

- palpation reveals unilateral tenderness over the site of the fracture.

Spondylolysis:

Or stress fracture at the Pars Interarticularis is seen in sports involving repeated hyper extension plus or minus rotation, such as fast bowling.

Spondylolisthesis:

Refers to the slipping of part or all of one vertebra forward on another.  The term is derived from the Greek spondylos, meaning vertebra, and olisthanein, meaning to slip or slide down a slippery path.  It is often associated with bilateral pars interarticularis defects that usually develop in early childhood.

Bowling Actions:

Side on:

The side-on technique  is typically characterised by a low run-up speed, rear-foot positioned parallel with the popping crease, and a shoulder alignment at rear-foot strike that points down the wicket towards the batter approximately 180 degrees (shoulder segment angle) (Bartlett et al., 1996).  Thus, the fast bowler has the appearance of bowling ‘side-on’ as they begins the delivery stride, with the left hip and shoulder (for a right hand bowler) pointing towards the batter. A recent classification of bowling actions (Portus et al., 2004) describes the side-on action as “a shoulder segment angle less than 210 degrees at back foot contact, a hip-shoulder separation angle less than 30  degrees at back foot contact, and, shoulder counter-rotation less than 30 degrees (Portus et al., 2004). A key feature of a side-on delivery is that the lumbar spine is subject to less rotation when compared with other actions. The side-on action while being the most ‘traditional’ action is now considered to be extremely rare in modern day fast bowlers (Ferdinands et al., 2010; Ranson et al., 2008).

Semi:

This sub-classification is relatively new and was advocated as a safe technique by the Australian Cricket Board as recently as 1998 (Portus et al., 2004). In this action the shoulder segment angle lies between the front-on and side-on actions. Similar to both the side-on and front-on actions, there is little to no counter-rotation of the shoulders. It is described as “a shoulder segment angle from 210 to 240 degrees at back foot contact,

a hip-shoulder separation angle less than 30 degrees at back foot contact, and, shoulder counter-rotation less than 30  degrees "( Portus et al., 2004).

Front on:

The front-on action, made famous by the West Indian pace bowlers throughout the 1970s and 1980s (Hardcastle, 1991), has been adopted widely in the modern game (Ferdinands et al., 2009). In a front-on action, the bowler’s hips and shoulders are open prior to delivery, giving the appearance of the

bowler running straight towards the batter. This action is described as “having a shoulder segment angle greater than 240 degrees at back foot

contact, a hip-shoulder separation angle less than 30 degrees. at back foot

contact, and, shoulder counter-rotation less than 30degrees  ” (Portus et al., 2004). As with the side-on action, the degree of rotation of the lumbar spine is less than in other actions.

Mixed action:

The mixed action is a combination of both the front-on and side-on bowling actions, therefore the exact technique can vary. For instance,when the back foot makes contact, the hips and lower limb can adopt an orientation consistent with a side-on action whereas the shoulders face front-on to the batter, but the opposite of this can also occur. The mixed action is defined

as any action with “a hip-shoulder separation angle equal to or greater than 30 degrees at back foot contact, or, shoulder counter-rotation

equal to or greater than 30 degrees  ” (Portus et al., 2004). Recent studies

(Ferdinands et al., 2010; Ranson et al., 2008) employing more specific classification methods, have identified that this action is the most prominent in professional adult bowlers from England, Australia and New Zealand (Ferdinands et al., 2010; Portus et al.,2004; Ranson et al., 2008).

Contributors to injury:

Weight:

A body's relative mass or the quantity of matter contained by it, giving rise to a downward force; the heaviness of a person or thing.

Skinfolds:

Many athletes attempt to alter their body weight composition, either by trying to put on weight ( in the form of muscle) or by losing weight ( in the form of fat).  Certain sports require athletes to have large amounts of muscle mass.  Some sports require athletes to be a particular weight to compete. There accurate assessments of body composition is necessary in certain athletes.

Sum of 7 skinfolds:

The body fat measurements of 7 areas of the body are measured using calipers:

- Tricpes

- Subscapular

- Biceps

- Supraspinale

- Abdomen

- Anterior thigh - quadriceps 

- Medial Calf

Ground reaction forces (GRFs):

In physics, and in particular in biomechanics, the ground reaction force (GRF) is the force exerted by the ground on a body in contact with it. For example, a person standing motionless on the ground exerts a contact force on it (equal to the person's weight) and at the same time an equal and opposite ground reaction force is exerted by the ground on the person.  GRFs, occurs when a fast bowler pounds his front foot into the ground, up to 9times his body weight.  Imagine the force that goes through his front ankle, knee, hip and lower back.

Weight, Skinfolds , GRFs, a poor bowling action, and high workloads do the math.......

@Craig_gov

Craig Govender Physiotherapy @ The Bullring

The scourge of Lower Back injuries to fast bowlers

A lower back stress related injury to a cricketer equates to precious time away from the game, activity limitation and often pain.  This is devastating to any player (Hardcastle, 1991; Standaert and Herring, 2000).  Non – athletic populations can get away with this type of injury, however to a fast bowler, it relates to a batsman trying to bat without holding a piece of willow in his hands. 

The prevalence of these injuries in athletic populations is higher than in the general populations, with figures of 8% (Soler and Calderon, 2000) and 15% (Rossi, 1978) reported.  However there is a marked difference in cricket, which the prevalence for stress lesions in bowlers is between 11 and 67%, which is higher than any other sport.  Due to the popularity of the game, this has become a cause for concern.

High injury rates are found in younger fast bowlers (Stretch, 1995).  However most studies investigating lumbar bony stress injuries in fast bowlers use a relatively young study cohort, resulting in a possible bias regarding age as a risk factor.  There are biomechanical data (Cyron and Hutton, 1978; Farfan et al, 1976) demonstrating that the spines of those under 20 years area at increased risk to injury.  During repetitive mechanical loading of cadaveric vertebral samples, spines aged between 14 and 30 years showed the greatest susceptibility to fracture through the pars interarticularis (Cyron and Hutton, 1978).  This study also showed spines from subjects less than 20 years of age were weaker than spines from older subjects.  These authors theorized that as inter-vertebral discs are more elastic in younger spines, greater shear forces reach the articular facets placing greater stress on the neural arch.  Due to this, understanding that a fast bowler, presents with a mixed-action is important.  A further consideration is that ossification of the neural arch may not be complete until the age of 20, placing the structure at further risk.  This view is supported by others who consider the underdevelopment of the par interarticularis (Hardcastle, 1991) and lumbar transverse processes (Farfan et al, 1976) of the adolescent vertebra predisposes younger players to an increased risk of developing a spondyloysis.

While not a modifiable risk factor, those of younger (20>) age may benefit from targeted preventive interventions to correct technique, improve core strength and reducing workload.

Orchard, James, Kourntouris and Portus (2008), found the average incidence of lumbar spine stress fractures was 0.61 injuries per team per season.  The study was carried out amongst 7 elite Australian teams and 210 players.  This accounted for approximately 4.3 players diagnosed with a lumbar stress fracture annually. 

During 3 full seasons at the Highveld Lions, there as only been 5 reported lower back cricket related injuries.  All 5 of these injuries occurred during the 2010-2011 season.  Since then there has not been a lower back injury in 2 full seasons.

@Craig_gov

Craig Govender Physiotherapy @ The Bullring

Amsterdam, with the Proteas

My week with the Proteas in Amsterdam, was a truly inspirational experience.  I was sitting in a privately charted airplane on my way to London and reflected. I immediately thought of Mike Horn, Gary Kirsten , JP Duminy and the city of Amsterdam. 

Do many South Africans know Mike Horn? Before heading to Amsterdam I definitely knew of him, partly because of the work he had done with Proteas in Switzerland and with teams in the IPL. But now I acknowledge that he is a national treasure, a man that is humble, passionate and has done things that the bravest would sit back and admire. His stories are unbelievably motivational and every word captivates his audience. 

Together Mike and Gary Kirsten spoke to the team on the 3rd day and I sat at the back of the room with goose bumps.  Was I in a movie? Was this script written out by the directors of The Miracle and Remember the Titans? This was the pep talk of all pep talks...

I'm sure their words played in the head of the returning JP Duminy.  Class is definitely permanent and to me he really showcased the professionalism of a world class athlete.  This is a man who scored 150 not out in a return fixture against the Dutch after a 6,5 month lay off.  That amount of time out of the game can only go two ways.  Either the athlete looks at the time out as time to improve aspects of his game or not.   He could have easily slipped in depression, as some elite sportsmen do, due to the time out of the game.  He could have put on weight and be happy with his game, but he used the time out to improve himself holistically.  He is a mentally strong individual and this injury put him to test, physically I was impressed by his fitness and his achievement in his come back game showed his desire to perform for his country.

 Dutch Cricket Association proved to be outstanding hosts.  They did everything they could to make us feel welcome in their beautiful country.  Amsterdam itself is a beautiful city, set amongst canals, architecture and stunning museums. The cricket facilities and setting in Amsterdam was top draw. I'm pretty sure JP Duminy would acknowledge that the pitch was certainly a good one.

The 7 day camp definitely achieved the expectations, the powers that be had potted out some months ago. I am sure that this group of individuals that form the Champions Trophy squad, are highly motivated and accept the challenges that lie ahead.......

@Craig_gov

Craig Govender Physiotherapy @ The Bullring

The Shoulder

Supraspinatus impingement, biceps tendonpathy, SLAP Lesion, Acromoclavicular Joint Sprain....to name but a few. The shoulder is an extremely complex joint, mainly because is sacrifices stability for mobility.  

A shoulder joint can move 360 degrees, in every direction possibly, as compared to a knee which can be flexed and extended.  In the last few months I have a assessed and treated a few shoulder injuries and all have had different diagnosis's.  Due to the complexity of the shoulder and all its structures involved, it is extremely important to make the correct diagnosis.  If this is not done, pain an chronic issues can develop.  If a diagnosis cannot be made by objective tests then imaging, such as, X-Rays, Ultrasounds and MRI's need to be done.

A shoulder joint cannot function without the support of the scapula or "shoulder blade", the triangular shaped bone found on your upper back.  The scapula forms a supportive role, as it stabilizes the shoulder.  Rotator cuff muscles are important stabilizing muscles of the shoulder that originate from the scapular and attach in the shoulder joint.  Thus if there is an injury in the shoulder ( muscles, ligaments, tendons, nerves, the capsule, etc) it will effect the scapula and thus the stabilization of the shoulder.  Due to this, a shoulder injury should never be treated in isolation for best results.

A cricketers shoulder is extremely important for their performance.  Every player requires a strong and flexible shoulder joint, as they need the ability to throw.  Baseball and cricket have a strong comparison and the "overuse" of a players shoulder is one reason.  Cricket does not have any shoulder injury prevention strategies set in place, due to the lack of data.  However due to the popularity of baseball in the USA, there has been numerous studies done on shoulder injuries and preventative strategies.

Throwing is very explosive, when broken down into its phases biomechanically.   Due to the stress imparted on this joint during throwing, it is important that players follow a rigorous flexibility, stabilization and strength programme.  However the most important phase of prehabilitation is an actual throwing regime'.  This is when players build throwing endurance by a progressive throwing programme.

@Craig_gov

Tribute to my Alma Mata

Sport Skills for Life Skills (SS4LS)  is a cricket bursary programme founded by one, Adv Nicolas Kock and funded by a very special human being in Prof Johann Graaf.  

The programme based at the University of the Western Cape (UWC), had humble beginnings in 2000 with probably partially sponsoring 1-3 students.  Today  in the year 2013, the University and the programme helps about 20-25 aspiring cricketers achieve tertiary education.

UWC, is a former "bush" ( non-white university, of the past) University, located in Bellville, Western Cape.  It is neighboured by the well known University of Cape Town at the base of Table Mountain and the University of Stellenbosch, surrounded by beautiful vineyards and the Helderberg Mountains.  In 2001 I registered for a B.Sc Physiotherapy degree, but unbeknown to me, it would mark the beginning of a very heart warming relationship between an outstanding life skill programme and myself.

In 2000, Adv Nicolas Kock, the brainchild of programme took his idea to another socialist and philanthropist, Prof Johann Graaf.   From then on the relationship between the two has been able to produce an outstanding cricket club, which has won numerous premier league titles, having won the double twice and has been in 3 University Week finals within the last 5 years.  Currently UWC is the second best club in the country, having got to the Club Champs Final.  To date, we are probably one of the leading Universities that have produced semi pro and professional cricketers with degrees.  The likes of Francois Plaatjies, Gurshwin Rabie and Rowan Richards, are playing franchise cricket and all have degrees ranging from a Masters in Information Systems to Honours in Sociology.  A long list of amateur cricketers also found the benefit of studying at UWC rewarding.  The club has also drawn big name head coaches, namely Ezra Poole ( WP and North West wicketkeeper), Andrew Wylie ( Boland batsman) and currently Andy Moles ( English county batsman and former New Zealand Coach).

It was a honour to receive a bursary to complete my Masters in Physiotherapy and represent this life changing University as a budding cricketer and many more students will feel the same gratitude.  This proud University and programme is being represented throughout the country, in the work place and the cricket fields by proud alumni.  The legacy of UWC and SS4LS will continue to roll out, well rounded cricketers with degrees for years to come.

Thank you Prof Johann Graaf and the Graaf Trust for your unselfishness and support to a man who gave up being a lawyer to fore fill the dreams of many aspiring cricketers.

www.ss4ls.org.za 

@Craig_gov

The Pit Crew

Like any well oiled racing team, comes a pit crew, that regularly changes, the oil, tires and fixes any mechanically problems when required.  The Highveld Lions pit crew, aka the medical team includes the highly experienced Dr Jon Patricios, our team Sports Physcian, Strength and Conditioning Coach, Jeff Lunsky and myself as Physiotherapist.

Each of us, play a very important role, in keeping guys on the field.  Prior to the commencement of a season, each contracted Lions player has a medical screen done, by Dr Jon Patricios, a fitness and strength battery of tests by Jeff Lunsky and a very thorough musculoskeletal assessment by myself.  These screening procedures allows  each discipline of the medical team to plot out areas of strength and weakness in a cricketer.   A medical screen allows Dr Patricios to  check blood sugar, cholesterol, blood pressure, ECG's as well as many other tests, which can effect performance.  Jeff's tests, involve aerobic and anaerobic fitness, as well as strength, power and agility tests, which would give him a better understanding of the fitness of each player.  Thus he will then plot out training programmes to improve performance in a player.  From a musculoskeletal point of view, I am able to pinpoint, the finer areas that may cause injury in the future.  Hence each player will then be handed an individual program to limit some injuries from occurring.    The catch phrase is "prehabilitation".  Preventive rehabilitation which most players will perform.  

If an injury occurs, I will assess and diagnosis the player immediately.  It is then important that I get the correct diagnosis of injury, in order to relay a report to the coach and player.  Knowing the time out of play is important for both.  By this I mean, understanding the grade/depth of a tear, when it comes to muscle injures. Understanding, if a ligament or tendon is strained or torn or if a player has a fracture or broken bone.  These answers may not be easily diagnosed by objective testing, therefore if required an immediate referral to Dr Patricios is important.  As he will reassess the player and send him for further imagining.  Imagining may be a x-ray, mainly used to diagnosis bone injuries, Ultrasound Scans for tissue related injuries (muscles, tendons and ligaments), and if a diagnosis cannot be made our last option would be an MRI.

When a diagnosis is made, we are able to manage the injury appropriately, that is, understanding the time out of the game to undergo physiotherapy, initial rehabilitation and end phase rehabilitation (return to play rehabilitation).

Elite athletes are high performance individuals who need to be treated as such. The Lions cricketers form part of a high performance structure that enables them to perform at a high level for a prolonged period of time.  In order to achieve this the season is broken in different phases. Namely, Off-season, Pre-season and In- season.  Jeff Lunsky and myself are tasked in developing programmes which will condition our players for a 6-7 month season and now involves playing 3 formats of the game.   Jeff focuses his attention on the physical conditioning and strength of the players, whereas I focus on stability (core, shoulder and ankle), flexibility and throwing (conditioning of the shoulder).

As previously mentioned, prehabilitation is the focus and attempting to limit injuries from occurring is the goal.  All our programmes and injury prevention strategies are evidence based.  Thus understanding the sport and common injuries, together with the results from our screening helps us devise these programmes.

@Craig_gov

Craig Govender Physiotherapy @ the Bullring

Craig Govender Physiotherapy Practice

The Sunfoil Series is behind us and the exciting T20 series is now on our doorstep.  The Highveld Lions are gearing up to end this great season on a high.

With this in mind, the Craig Govender Physiotherapy Practice has just opened.  A sport injury practice based at the Bidvest Wanderers Stadium, Corlett Drive, Illovo, Johannesburg, South Africa. Anyone is welcome to receive treatment at the Bullring, the Home of the Bizhub Highveld Lions and South African Cricket.  My office is situated next to the famous Wanderers Home Changroom and is a mere glance away from our hallow turf.

Appointments can only be made by contacting me via email : govendercraig@yahoo.com or cell : +27 741474423.

Kind Regards
@Craig_gov

Highlights of 2012

Preseason:

The preseason began in the first week of July 2012, with Dave Nosworthy at the helm, as the Lions preparation was geared towards our second Champions League in 3 years.  Due to our success in the previous season, several players were in line for national selections, namely the Unofficial T20 Triangular in Zimbabwe, which Chris Morris participated in.  An SA "A" team was also selected, players like Aaron Phangiso,  Chris Morris mainly played in the limited over games, in Zimbabwe and in Ireland.  Pumi Matshitwe played in Tests against the Sri Lanka "A" in Durban and Temba Bavuma played in one Test against Sri Lanka "A" and was also selected to go on a month tour to Ireland.

SA A tours

On a personal note, I was selected as the SA "A" physio, for the 2 Test match series against Sri Lanka "A" in Durban, the One-day Triangular Series in Zimbabwe against Zimbabwe "A" and Sri Lanka "A" and the month tour of Ireland.  Working in different environments and with new staff, allows growth, learning and a different perspective on the game.  Working with the experienced Vincent Barnes, Greg King (former Indian and current Chennai Superkings trainer) and HD Ackerman were also highlights for me.  We had a proud team culture in the SA "A" Team, and to see guys like, Faf Du Plessis, Dean Elgar, Rory Klienveldt, Chris Morris and Aaron Phangiso progress to reach the heights as they did for the Proteas was hugely encouraging.

Whilst away on tour in Ireland, Dave Nosworthy had stepped down as Head Coach on the Lions, and the throne had been taken over by Geoffery Toyana.  

Sunfoil series

Our first game of the season was against Paul Adams, Cobras.  A game which we would like to forget for the result but it again exposed the undoubtable talents on one Quinton De Kock, who scored a superb 194 in our second innings.  The teams second game was at home against the highly charged up Dolphins, who showed a lot of aggression whilst bowling.  The result was highly encouraging as we defeated the Durban team and it also showed of the talents of Chris Morris, who picked up a Lions match record of 12/101 and so surpassing Garnett Kruger.  The win against the Dolphins proved to be the catalyst, to the start of a productive first half of the season for the team, as we headed into the Champions League.

Champions League

The squad assembled in Potch for training camp and played Scotland and the North West team.  We were cast as the under dogs, a team which "should not be around " said Stuart Clarke at the opening function.  Well, we didn't need any more motivation to play the way we did.  Sydney did beat us twice in the tournament and were worthy champions but the Lions did prove to the world that we were not there to make up the numbers.  We defeated 3 IPL teams en route to the finals.  Unfortunately  we did not pitch for that final, but players like Neil McKenzie, Gulam Bodi, Jean Symes, Chris Morris and Aaron Phangiso made the tournament team. That was a highlight in itself.

Momentum Cup

Many in South Africa, believed that the dismal performance in the Champions League final, would cause a "hangover" coming into the Momentum Cup 50 over challenge.  The opposite actually occurred as we had the perfect start and the perfect game against the Titans in the opener and continued a string of victories that would see us top the table and qualify for an automatic final place, which was against the Cobras.  The final was an anti climax as the Johannesburg weather got in the better of both the teams.  The Cup had to be shared, which was a disappointment for the team but half a trophy was definitely better than no trophy.

There is more to come from this squad of highly talented players and just reward was the selection of Quinton de Kock, Chris Morris and Aaron Phangsio for the Proteas T20 team to take on the Black Caps.  Here's to an even better 2013, may it be successful and injury free.

@Craig_gov