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

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