Musculoskeletal predictors of non-contact injury in cricketers - Few and far between? A longitudinal cohort study.

Objective: To determine the musculoskeletal risk factors for injury amongst professional, domestic cricket players.

Design: Longitudinal cohort study.

Setting: Medical suites associated with the respective cricket franchises.

Participants: Professional, domestic cricket players (n = 97).

Main Outcome Measures: A pre-participatory musculoskeletal screening battery consisting of 21 tests including flexibility, neural tension, stability, strength, balance and pain provocation tests at the start of the cricket season. Non-contact, low back and lower limb (lower quarter) injuries were monitored throughout the season. Binary logistic regression and receiver operating curves were used to determine predictive value of each test.

Results: During the course of the cricket season, 38 of the 97 (39.2%) cricketers sustained a non-contact low back and/or lower limb injury. Increased hip internal rotation ROM on the dominant side (OR = 1.065; p = 0.036), no symptoms on active slump dominant side (OR = 0.289; p = 0.014), decreased combined elevation (OR = 0.934; p = 0.029), increased shoulder internal rotation ROM on the non-dominant side (OR = 1.022; p = 0.035) and increased GIRD (glenohumeral internal rotation deficit) (OR = 1.026; p = 0.042) predicted in-season non-contact lower quarter injuries. Although statistically significant, none of these variables were strong predictors of injury as shown by the logistic regression models (accuracy in classification rate: 59.8-62.9%), the area under the curve (AUC) of the receiver operating characteristic (ROC) curves (AUC≤0.652) and the cut-off scores which revealed high sensitivity (68.4-86.8%), but low specificity (25.4-54.2%).

Conclusion: Although only a few of the many tests included in the battery showed predictive validity, the value of screening procedures should not be underestimated due to other benefits such as building patient rapport, identification of pre-existing injuries, establishing clinical and functional baselines upon which individualised management programmes can be based.