Background: Limited research in cricket bowlers and baseball pitchers has shown a correlation between workload and injury risk.
Hypothesis: Acute high bowling workload in cricket leads to increased risk of bowling injury in future matches.
Study design: Cohort study (prognosis); Level of evidence, 2.
Methods: One hundred twenty-nine pace (fast) bowlers who bowled in 2715 player matches over a period of 10 seasons were followed to compare overs bowled in each match and injury risk subsequent to the match.
Results: Bowlers who bowled more than 50 overs in a match had an injury incidence in the next 21 days of 3.37 injuries per 1000 overs bowled, a significantly increased risk compared with those bowlers who bowled less than 50 overs (relative risk [RR], 1.77; 95% confidence interval [CI]: 1.05-2.98). Bowlers who bowled more than 30 overs in the second inning of a match had a significantly increased injury risk per over bowled in the next 28 days (RR, 2.42; 95% CI: 1.38-4.26). Time periods of less than 21 days or more than 28 days after the match in question did not yield significant differences in injury risk per over bowled between high and low workload bowlers.
Conclusion: High acute workload in cricket fast bowlers may lead to a somewhat delayed increased risk of injury up to 3 to 4 weeks after the acute overload, possibly via a mechanism of damaging immature (repair) tissue.
Clinical relevance: Cricket fast bowling and possibly baseball pitching workloads require scrutiny not just for acute injuries but also for injury prevention in the subsequent month.