The shoulder in cricket: What's causing all the painful shoulders?

Shoulder injuries account for roughly 5% of all injuries sustained by cricketers, most likely an underestimation of a larger problem facing the sport. The cause for shoulder injuries has been sparsely investigated among cricketers. The aim of this review is to summarize the available literature on possible mechanism for shoulder injuries among cricketers. MEDLINE and EMBASE (Search terms: “cricket” AND “shoulder injuries”; “cricket” AND “rotator cuff tears”; “cricket” AND “impingement”; and associated synonyms) were performed in March 2014. The authors further canvassed the reference list of selected articles and online search engines such as Google Scholar. Inclusion criteria were studies that assessed shoulder injuries among cricketers. A total of 9 studies was identified on primary search, and later expanded to 15 studies. Bowlers and fielders are most frequently affected by shoulder injuries, likely a result of their overhead throwing actions. Spin bowlers tend to be worse for wear that fast bowlers. A number of possible theories have been proposed as to the cause for shoulder pain among cricketers including: scapular dyskinesia, glenohumeral internal rotation deficit and weak musculature surrounding the cuff. Most cricketers with shoulder pain appear to have an increase in external rotation and loss of internal rotation range of motion in the affected shoulder. We propose a combined mechanism of injury that results in shoulder pain among cricketers. Further work is needed to identify the cause of the problem and implement targeted interventions aimed at each step of the proposed pathway.