SpringerLink
Log in

Criterion-Based Rehabilitation and Return to Play in Fast Bowlers Following Arthroscopic Bankart Repair: Recommendations Based on a Detailed Clinical Review

  • Review Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Anterior shoulder instability due to labral tears in the dominant arm of cricket fast bowlers can be particularly disabling and results in significant match time loss. This often follows injuries sustained during fielding and training, although micro-instability following repetitive throwing progressing to overt anterior shoulder instability is also known. To ensure ball release speeds of over 140 km/h with different ball variations, these athletes require not only physical fitness and technical skill, but also a completely stable shoulder.

Methods

A literature search of “MEDLINE”, “SPORT DISCUSS”, and “GOOGLE SCHOLAR” was done to identify relevant articles published till the year 2023.

Results

A treatment approach that involves anatomic restoration of the shoulder via an arthroscopic Bankart capsulo-labral repair, followed by functional and biomechanical restoration via rehabilitation is the most predictable method to ensure a successful return to pre-injury fast-bowling status. A post-operative rehabilitation program that ensures a quick return to fast bowling without disrupting the surgical repair is crucial. Timely integration of exercises to recruit and strengthen the kinetic chain used for bowling and throwing plays a key role in this faster recovery. This current review provides a phase-wise, evidence-based rehabilitation guideline for return to competitive cricket after arthroscopic Bankart repair in a fast bowler. This review also highlights a structured return to bowling, throwing, and fielding program with a clinical decision-making process.

Conclusion

Exercise selection at an early stage that does not compromise the healing tissue, and timely integration of workouts to recruit and strengthen the kinetic chain used for bowling and throwing is the key strategy to allow faster recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Watson, S., Allen, B., & Grant, J. A. (2016). A Clinical review of return-to-play considerations after anterior shoulder dislocation. Sports Health., 8(4), 336–341.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gaunt, B. W., Shaffer, M. A., Sauers, E. L., Michener, L. A., Mccluskey, G. M., & Thigpen, C. A. (2010). The American Society of shoulder and elbow therapists’ consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. Journal of Orthopaedic and Sports Physical Therapy, 40(3), 155–168.

    Article  PubMed  Google Scholar 

  3. Ma, R., Brimmo, O. A., Li, X., & Colbert, L. (2017). Current concepts in rehabilitation for traumatic anterior shoulder instability. Current Reviews in Musculoskeletal Medicine, 10(4), 499–506.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hengeveld E, Banks K, Newton M. Maitland’s Peripheral Manipulation: Management of neuromusculoskeletal disorders. Fifth Edit. Vol. 2. Elsevier; 2014. 20–21

  5. Hengeveld, E., & Banks, K. (2005). Maitland’s Peripheral Manipulation. Elsevier.

    Google Scholar 

  6. Wilk, K. E., & Macrina, L. C. (2014). Nonoperative and postoperative rehabilitation for injuries of the throwing shoulder. Sports Medicine and Arthroscopy Review, 22(2), 137–150.

    Article  PubMed  Google Scholar 

  7. Savin, D., Cotter, E. J., & Cole, B. J. (2017). Rehabilitation and return-to-play following arthroscopic Bankart Repair. Oper Tech Sports Med., 25(3), 145–153.

    Article  Google Scholar 

  8. Cools, A. M., Struyf, F., De Mey, K., Maenhout, A., Castelein, B., & Cagnie, B. (2014). Rehabilitation of scapular dyskinesis: From the office worker to the elite overhead athlete. British Journal of Sports Medicine, 48(8), 692–697.

    Article  PubMed  Google Scholar 

  9. Cools, A. M., Borms, D., Castelein, B., Vanderstukken, F., & Johansson, F. R. (2016). Evidence-based rehabilitation of athletes with glenohumeral instability. Knee Surg. Sports Traumatol., 24(2), 382–389.

    Article  Google Scholar 

  10. Wilk, K. E., Arrigo, C. A., Hooks, T. R., & Andrews, J. R. (2016). Rehabilitation of the overhead throwing athlete: There is more to it than just external rotation/internal rotation strengthening. PM and R., 8(3), S78-90.

    PubMed  Google Scholar 

  11. Buteau, J. L., Eriksrud, O., & Hasson, S. M. (2007). Rehabilitation of a glenohumeral instability utilizing the body blade. Physiotherapy Theory and Practice, 23(6), 333–349.

    Article  PubMed  Google Scholar 

  12. Ratamess, N. A., Alvar, B. A., Evetoch, T. A., Housh, T. J., Kibler, W. B., Kraemer, W. J., & Triplett, N. T. (2009). Progression models in resistance training for healthy adults. Medicine and Science in Sports and Exercise, 41(3), 687–708.

    Article  Google Scholar 

  13. Amako, M., Arino, H., Tsuda, Y., Tsuchihara, T., & Nemoto, K. (2017). Recovery of shoulder rotational muscle strength after arthroscopic Bankart repair. Orthopaedic Journal of Sports Medicine, 5(9), 1–6.

    Article  Google Scholar 

  14. Talukdar, K., Cronin, J., Zois, J., & Sharp, A. P. (2015). The Role of rotational mobility and power on throwing velocity. J. Strength Cond., 29(4), 905–911.

    Article  Google Scholar 

  15. Popchak, A. J., Christain, H., & Poploski, K. (2021). Postoperative rehabilitation and return to play criteria after anterior shoulder stabilization procedures. Operative Techniques in Orthopaedics, 31(1), 100863.

    Article  Google Scholar 

  16. Half, G. G., & Triplett, T. N. (2016). Essentials of Strength and Conditiong (p. 617). United States, Human Kinetics: Fourth Edi.

    Google Scholar 

  17. Olds, M., Coulter, C., Marrant, D., & Uhl, T. (2019). Reliability of a shoulder arm return to sport test battery. Physical Therapy in Sport, 39, 16–22.

    Article  PubMed  Google Scholar 

  18. Van Cingel, R., Kleinrensink, G. J., Mulder, P., De Bie, R., & Kuipers, H. (2007). Isokinetic strength values, conventional ratio and dynamic control ratio of shoulder rotator muscles in elite badminton players. Isokinetics and Exercise Science, 15(4), 287–293.

    Article  Google Scholar 

  19. Vargas, V. Z., Motta, C., Vancini, R. L., De Lira, C. A. B., & Andrade, M. S. (2021). Shoulder isokinetic strength balance ratio in overhead athletes: A cross-sectional study. International Journal of Sports Physical Therapy, 16(3), 827–834.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ardern, C. L., Glasgow, P., Schneiders, A., Witvrouw, E., Clarsen, B., Cools, A., Gojanovic, B., Griffin, S., Khan, K. M., Moksnes, H., Mutch, S. A., Phillips, N., Reurink, G., Sadler, R., Silbernagel, K. G., Thorborg, K., Wangensteen, A., Wilk, K. E., & Bizzini, M. (2016). 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy. Bern. Br J Sports Med., 50(14), 853–864.

    Article  PubMed  Google Scholar 

  21. Shultz, R., Creighton, D. W., Shrier, I., Shultz, R., Meeuwisse, W. H., & Matheson, G. O. (2010). Return-to-play in sport: a decision-based model return-to-play in sport: a decision-based model. Clinical Journal of Sport Medicine, 20(5), 379–385.

    Article  PubMed  Google Scholar 

  22. Shrier, I. (2015). Strategic assessment of risk and risk tolerance (StARRT) framework for return-to-play decision-making. British Journal of Sports Medicine, 49(20), 1311–1315.

    Article  PubMed  Google Scholar 

  23. Dennis, R., Farhart, R., Goumas, C., & Orchard, J. (2003). Bowling workload and the risk of injury in elite cricket fast bowlers. Journal of Science and Medicine in Sport, 6(3), 359–367.

    Article  CAS  PubMed  Google Scholar 

  24. McNamara, D. J., Gabbett, T. J., & Naughton, G. (2017). Assessment of workload and its effects on performance and injury in elite cricket fast bowlers. Sports Medicine (Auckland, N. Z.), 47(3), 503–515.

    Article  PubMed  Google Scholar 

  25. Sgroi, T. A., & Zajac, J. M. (2018). Return to throwing after shoulder or elbow injury. Current Reviews in Musculoskeletal Medicine, 11(1), 12–18.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Griffin, A., Kenny, I. C., Comyns, T. M., & Lyons, M. (2020). The association between the acute: Chronic workload ratio and injury and its application in team sports: A Systematic Review. Sports Medicine., 50(3), 561–580.

    Article  PubMed  Google Scholar 

  27. Ahmun, R., McCaig, S., Tallent, J., Williams, S., & Gabbett, T. (2019). Association of daily workload, wellness, and injury and illness during tours in international cricketers. International Journal of Sports Physiology and Performance, 14(3), 369–377.

    Article  PubMed  Google Scholar 

  28. Hulin, B. T., Gabbett, T. J., Blanch, P., Chapman, P., Bailey, D., & Orchard, J. W. (2014). Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. British Journal of Sports Medicine, 48(8), 708–712.

    Article  PubMed  Google Scholar 

  29. Gabbett, T. (2018). Infographic: The training–injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medicine, 1(50), 273–280.

    Google Scholar 

  30. Reinold, M. M., Wilk, K. E., Reed, J., Crenshaw, K., & Andrews, J. R. (2002). Interval sport programs: Guidelines for baseball, tennis, and golf. Journal of Orthopaedic and Sports Physical Therapy, 32(6), 293–298.

    Article  PubMed  Google Scholar 

  31. Zaremski, J. L., Zeppieri, G., & Tripp, B. L. (2019). Injury prevention considerations in adolescent overhead-throwing athletes. Current Physical Medicine and Rehabilitation Reports, 7(3), 216–226.

    Article  Google Scholar 

  32. MacDonald Wells, D. C., Cronin, J. B., & Macadam, P. (2018). Key match activities of different fielding positions and categories in one-day international cricket. International Journal of Performance Analysis in Sport, 18(4), 609–621.

    Article  Google Scholar 

  33. MacDonald, D. C., Cronin, J., Mills, J., McGuigan, M., & Stretch, R. (2013). A review of cricket fielding requirements. S. Afr. J. Sports Med., 25(3), 87.

    Article  Google Scholar 

  34. Blanch, P., & Gabbett, T. J. (2016). Has the athlete trained enough to return to play safely? The acute:Chronic workload ratio permits clinicians to quantify a player’s risk of subsequent injury. British Journal of Sports Medicine, 50(8), 471–475.

    Article  PubMed  Google Scholar 

  35. Dijkstra, H. P., Pollock, N., Chakraverty, R., & Ardern, C. L. (2017). Return to play in elite sport: A shared decision-making process. British Journal of Sports Medicine, 51(5), 419–420.

    Article  PubMed  Google Scholar 

  36. Ardern, C. L., Österberg, A., Tagesson, S., Gauffin, H., Webster, K. E., & Kvist, J. (2014). The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction. British Journal of Sports Medicine, 48(22), 1613–1619.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Musculoskeletal Physiotherapy AUT, Auckland, New Zealand

    Ashutosh Nimse

  2. Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India

    Ashutosh Nimse & Dinshaw Pardiwala

  3. Mumbai Indians Cricket Team, Indian Premier League, Mumbai, India

    Ashutosh Nimse

  4. National Cricket Academy, Board of Control for Cricket in India (BCCI), Bangalore, India

    Nitin Patel

  5. The Maharaja Sayajirao University of Baroda, Boroda, India

    Nitin Patel

  6. University of Nottingham, Nottingham, UK

    Nitin Patel

Authors
  1. Ashutosh Nimse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nitin Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dinshaw Pardiwala
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ashutosh Nimse.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human or animal subjects performed by any of the authors.

Informed consent

For this type of study, informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 49 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nimse, A., Patel, N. & Pardiwala, D. Criterion-Based Rehabilitation and Return to Play in Fast Bowlers Following Arthroscopic Bankart Repair: Recommendations Based on a Detailed Clinical Review. JOIO 57, 1565–1574 (2023). https://doi.org/10.1007/s43465-023-00931-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-023-00931-5

Keywords

Search

Navigation