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Throwing workload and injury risk in elite cricketers

Objective To investigate the risk between throwing workload and upper limb injury in elite cricketers. Design Prospective cohort study. Setting Elite Australian cricket. Participants 28 adult male cricketers aged 18–32 years. Assessment of risk factors Daily throwing workload and injury were prospectively monitored over the 2007–2008 cricket season. Risk ratios (RRs) were calculated to describe the association between throwing workload and injury. Main outcome measurement Upper limb injury associated with throwing. Results Seven (25%) players sustained an injury during the season. Injured players threw approximately 40 more throws/week (p=0.004) and 12.5 more throws per throwing day (p=0.061) than uninjured players. Players were at a significantly increased risk of injury if they completed more than 75 throws/week (RR=1.73, 95% CI=1.03 to 2.92), and there was a trend towards an increased risk if they completed more than 40 throws per throwing day (RR=1.41, 95% CI=0.88 to 2.26). Injured players also completed more throws and had more throwing days (and consequently less rest days) in the week before injury, as compared with the rest of their season preceding that point. Conclusion An increased throwing workload is a risk factor for the development of upper limb injury in elite cricketers. Investigation of the kinematics of throwing in elite cricketers would complement this study, and further research is required to develop detailed throwing workload guidelines for cricketers across a range of ages.