From Injury to the Playing Field (Part 1)

The recent spate of injuries that hit the West Indies cricket team has once again raised the ire of the West Indian cricketing public as to what more can go wrong with our team. The poor fitness levels, the lack of professionalism and the lack of a culture of fitness among the players were among the questions raised regarding this problem.

However, we must address the issue of conditioning and/or reconditioning protocols for our cricketers in a manner that would enable the West Indies to field its best team and keep injuries to a minimum. This will be a three part series to present a system of corrective and performance exercise, nutrition and lifestyle coaching that has been successful in returning athletes from injury to personal bests in performance and conditioning athletes to improved performance. This system is multi-disciplinary and was developed by Paul Chek, founder of the CHEK Institute.

The first part of this series will deal with corrective and performance exercise for a fast bowler who suffered an injury to the lumbar spine. Based on research from University of Western Australia, the back injuries that plague cricketers are disk injuries, spondylolysis and spondylolisthesis.

Spondylolysis is the fracture of the pars articular on one side of the vertebrae and spondylolisthesis is fractures on both sides of the vertebrae; these injuries are often referred to as stress fractures to the lumbar spine. Note the pars articular is the bony attachments that hold the vertebrae of the spine attached from vertebrae to another.

Spondylolisthesis severity is based on how much slippage forward of the vertebrae and is denoted in grades, for example a grade one is minimal slippage. Disk injuries can be defined as varying levels of derangement based on noted Spinal Expert Robin McKenzie's system.

A fast bowler, for instance, presents with one of the above injuries the first step is a comprehensive assessment of structure, movement skills and nutrition and lifestyle factors. There is re-evaluation every 4-6 weeks and as the program moves along the fast bowler's biomotor abilities are evaluated. These abilities are strength, power, balance, speed, agility, flexibility and endurance.

The first phase of conditioning to return the fast bowler to play is flexibility and stabilization training. The objectives of this phase is muscle length and tension restoration, segmental and dynamic stabilization. The protocols to achieve these objectives are corrective exercise, stretching, mobilizations, nutrition and lifestyle modifications and soft tissue work for trigger point and muscle adhesion/damage correction. The corrective exercises unload the spine i.e. exercises are done with the spine primarily in a horizontal position and the duration of a set is 60 seconds or more. Core function re-education is also a feature of this phase.

There are contraindications based on the type of injury in this phase for example for disk injuries flexion of the lumbar spine is a contraindication and extension for the other two aforementioned injuries. However, clients are told that flexion when lifting is okay a few weeks into this training, because this trains the spinal ligamentous system that plays an important role in spinal stabilization. The rule we use is if the weight of the object you are picking up can be done 20 times it is okay to flex your spine if not lift with a neutral(straight back) spine. A final point in this phase for spondylolisthesis and spondylolysis is restoration of full mobility of the thoracic spine.

The next phase of conditioning the objective is the restoration of functional movement patterns, for example this is when the fast bowler would begin to squat, deadlift, push, pull and twist and do supplementary exercises to strengthen these movement patterns. From here we move to integration training.

Integration training is where you are teaching the athlete to use his body in an integrated manner in functional movement patterns. It is interesting to note that this is the phase when most athletes often have difficulty at the beginning, because they have often in the past used their bodies in truncated movement patterns which could be a contributing factor to their injury in the first place! This phase is when speed, agility and quickness drills are introduced based on need. The next phase is to enhance strength required for fast bowling.

The strength phase or phases is when olympic lifting, odd lifts are introduced and enhancing the strength of integrated movement patterns germaine to fast bowling. We are now upon the final phase of training; power training.

Power training is the culmination of the gym work that would enable the fast bowler to have a carry over when he returns to the field of play. Power training consists of olympic lifting, medicine ball training and plyometrics. However before allowing an athlete to do box jumps a plyometric exercise, that athlete should be able to squat his or her bodyweight 5-6 times in 10 seconds.

This system of training can return a fast bowler with any of the aforementioned injuries back to fast bowling.

* In part two, we will discuss the process for shoulder injuries.