After a six-month delay due to the Covid-19 pandemic, the Indian Premier League finally began about 10 days ago. And the initial round of fixtures saw eight cricketers miss matches due to injuries. The spate of injuries is in line with concerns regarding athletes’ overeagerness in returning to competition after a long layoff and doing too much, too quickly. The majority of cricketers jumped into their first, high-profile assignment since the lockdown after a month-long quarantine/training period in UAE. And experts believe such factors could lead to increased risks.
Who are the injured cricketers?
R Ashwin (Delhi Capitals) and Mitchell Marsh (Sunrisers Hyderabad) left the field during the second and third matches of the tournament; the India spinner hurt his shoulder while the Australian all-rounder suffered a campaign-ending ankle injury. Incidentally, both were injured trying to stop runs off their own bowling in their first overs. Both Sunrisers and Delhi already have sidelined cricketers as New Zealand captain Kane Williamson hurt his quadriceps while training, while India pacer Ishant Sharma has been struggling with back spasms.
For Chennai Super Kings, Ambati Rayudu missed two games after a match-winning 71 in the opener due to a hamstring niggle, while all-rounder Dwayne Bravo is yet to play after hurting his knee during the Caribbean Premier League earlier this month. Overseas fast bowlers Chris Morris (Royal Challengers Bangalore) and Nathan Coulter-Nile (Mumbai Indians) have also missed their first two games due to injuries.
What do specialists say about returning to competition too quick?
“We are recommending that there has to be a graded return to competitive training,” says Dr Ashok Ahuja, former head of Department of Sport Medicine and Science at the National Institute of Sports (NIS) in Patiala. “In the first week, one should start from 50 per cent of the pre-lockdown training load. And then it takes about six weeks to come to 80-90 per cent of the capacity of professional athletes. That’s the general guidelines being issued by every association in every country.” Ahuja adds: “Those who are not following it, and with that eagerness to get into the competitive mode, they’re bound to get injuries.”
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What have been the guidelines worldwide?
A paper published in the Journal of Functional Morphology and Kinesiology in April said: “In eight weeks of detraining, athletes will lose muscle mass, muscle strength and power with a decrease of electromyographic activity (EMG), reflecting reduced muscle activation. Such a reduction in skeletal muscle activity could significantly increase the risk of injuries both in non-contact and contact sports… The risk is greater for team sports where athletes cannot program a single competition but are instead “forced” into the competitive season with weekly games.”
Federations worldwide have also cautioned athletes and coaches against overeagerness in returning to action. USA Gymnastics issued a pre-return fitness questionnaire, asking athletes for logs of cardiovascular and strengthening training and if there are “skills or activities you are hesitant to attempt in the early stages of your return to training?”
In the same handbook, the body advised coaches on safe reintegration of athletes after the restrictions.
“Athletes will be eager to get back to gymnastics and will be very tempted to ramp up quickly or jump back too soon to skills that they were previously able to perform prior to gym closures. As a coach, it’s very important to not let this happen too quickly,” reads the handbook. “After this prolonged absence from training, there will be a significant amount of anticipation and excitement to resume gymnastics training – including gymnasts, coaches, and family members. This highly anticipated return to training is prone to a process that is too quick. An accelerated return puts the gymnast at high risk for injury.”
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Are fast bowlers more at risk?
Five out of the aforementioned eight injured cricketers are pacers, hinting at possible increased risk in returning to cricket. South Africa all-rounder Chris Morris picked up a side strain in UAE while Aussie Coulter-Nile is nursing niggles. Both last played during the T20 Big Bash League in February. Ishant Sharma too last played in February in the first Test in New Zealand before an ankle injury ruled him out of the tour. Bravo and Marsh played competitively earlier this month before old injuries (knee and ankle respectively) flared up — another risk of returning to post-lockdown competition too quickly according to experts.
“…In the case of fast bowlers, it’s about making sure that they’re not doing too much, too soon… that on a week-to-week basis they’re not adding to what they’re doing too quickly, and that if they do have a break it’s not for too long,” Surrey’s physiotherapist Alex Tysoe told Cricinfo. “What we want now is to have a nice smooth take-off, to get back to that analogy, where we’re getting bowlers to take off reasonably quickly while doing it as safely as possible.”
Tysoe, who oversaw English pacer Sam Curran’s return to training in May, added: “One of the things we can’t do is influence the bone density of the spine. Pete Alway, who did a PhD with the ECB, did his research on spinal density of fast bowlers, and we now know that there’s nothing that can strengthen the spine for bowling better than bowling itself. You lose spine density pretty quickly when you stop bowling, and predictably it can take you longer to build that up: we need to be mindful of building them back up sensibly.”
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Are there any specific injury risks?
There were six reported soft-tissue (muscles, tendons and ligaments) injuries in the first eight games of Bundesliga when the league restarted in May after 66 days. According to sports science specialist Joel Mason, Bundesliga injuries went from a pre-lockdown average of 0.27 per game to 0.88 in that first round of fixtures.
“The early indications from both training and matches continue to point in one direction — that post-lockdown injury rates are comfortably outside the boundaries of the typically observed injury rates,” Mason wrote in a blog post.
A notable previous example of quick return after a layoff came during the National Football League lockout in 2011, when a pay-dispute delay shortened pre-season training camps from 14 weeks to 17 days. Ten Achilles tendon injuries occurred over the first 12 days of training camp, and several more when the competition resumed.
What other factors can add to said risks?
According to Athletics Federation of India’s (AFI) high performance director Volker Herrmann, lack of Vitamin D, produced when the body is exposed to the sun’s rays, can lead to stress fractures or muscle injury, especially when athletes resume training after long breaks.
“Interestingly a lot of our athletes are lacking in Vitamin D. We were thinking whether it was due to the lockdown. We took blood samples after the lockdown in June. In general they were more or less back in their rooms, it is one possible explanation,” Herrmann told The Indian Express.
“Vitamin D helps with recovery, especially of the muscles and it also reduces the recovery time. It is also related to the bone density. Sometimes athletes are dealing with stress fractures and that can be due to an overload but it can also be because of Vitamin D deficiency,” said Herrmann.
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