What is an Abdominal Side Strain?

Cricket fast bowlers and javelin throwers often experience abdominal side strain, which tears the internal oblique muscle from the undersurface of one of the lower four ribs or costal cartilages, causing pain and discomfort. MRI scans can diagnose the site and severity of muscle tear, and bony stress lesions may also occur but are less common.

The injury strongly correlates with bowling or throwing speed, putting the fastest bowlers or longest throwers at higher risk. The mechanism of injury involves sudden eccentric contracture with rupture of muscle fibres, which occurs during the lengthening of the muscle and superimposed eccentric contraction.

To prevent injury, warm-up and stretching before spells of bowling or throwing are essential. Additionally, keeping the torso warm and performing trunk rotation and side flexion exercises can help. Treatment for a side strain involves ceasing bowling or throwing immediately, applying ice to the painful area, and seeking professional treatment. Recovery time typically takes four to six weeks before a return to sport. Consulting a physiotherapist with a special interest in cricket or throwing for specific advice is beneficial.

What Causes Side Strain?

Researchers propose that side strain injury results from sudden eccentric contracture causing the internal oblique muscle fibers to rupture. This is due to the muscle’s lengthening during movements such as bowling and throwing, which can then lead to superimposed eccentric contraction and overstrain.

Studies focusing on fast bowlers have shown that the muscle tear usually occurs on the non-bowling arm side. For instance, in a right-handed bowler, the left arm is extended high above the body before being forcefully pulled through to allow the right arm to follow through and release the ball. At the fully extended position, the internal oblique muscle on the left side is at maximum tension or eccentric contraction. The internal oblique muscle is likely to rupture due to the sudden, vigorous motion from this eccentric contraction or pull-through that enables the dominant shoulder to flex and release the ball. Other throwing sports have a similar mechanism.

How is Side Strain Diagnosed?

MRI is sensitive for side strain injury evaluation, showing abnormalities in all patients with suspected muscular tear. Muscular avulsion from bony or cartilaginous origin may cause periosteum stripping, leading to excessive bleeding despite low-grade muscle tear.

How to Prevent Side Strain

Warming up and stretching the injury before the spells of bowling is very important. Keeping the torso warm and performing a series of trunk rotation and side flexion exercises are recommended.

Side Strain Treatment

It is crucial to cease bowling and to throw immediately after injury and ice the painful area. For best results and reduced recovery time, seek professional treatment for a side strain. Most side strain injuries require 4 to 6 weeks of rehabilitation before a return to sport.

Please consult your trusted cricket physiotherapist for specific advice.

Common Cricket Injuries

Back Pain

• Back Muscle Pain
• Back Stress Fracture (Fast Bowlers)
• Facet Joint Pain
• Side Strain (Abdominal)
• Spondylolisthesis

Shoulder Pain

• Shoulder Impingement
• Rotator Cuff Syndrome
• Rotator Cuff Tear
• Bursitis Shoulder
• AC Joint Injury
• Dislocated Shoulder

Thigh & Hamstring Pain

• Thigh Strain
• Hamstring Strain

Knee Pain

• ACL Injury
• Patellofemoral Pain Syndrome
• Patella Tendinopathy

Shin & Calf Pain

• Achilles Tendinopathy
• Calf Muscle Strain
• Shin Splints

Ankle Injuries

• Anterior Ankle Impingement
• Posterior Ankle Impingement
• Sprained Ankle

Neck Pain

• Neck Arm Pain
• Pinched Nerve