Bone Density and Cross-sectional Geometry of the Proximal Femur Are Bilaterally Elevated in Elite Cricket Fast Bowlers

Abstract

The skeleton of a cricket fast bowler is exposed to a unique combination of gravitational and torsional loading in the form of substantial ground reaction forces delivered through the front landing foot, and anterior-posterior shear forces mediated by regional muscle contractions across the lumbo-pelvic region. The objectives of this study were to compare the hip structural characteristics of elite fast bowlers with recreationally active age-matched controls, and to examine unilateral bone properties in fast bowlers. Dual-energy X-ray absorptiometry of the proximal femur was performed in 26 elite male fast bowlers and 26 normally active controls. Hip structural analysis (GE Lunar; enCORE version 15.0) determined areal bone mineral density (BMD) of the proximal femur, and cross-sectional area, section modulus (Z), cross-sectional moment of inertia, and femoral strength index at the narrow region of the femoral neck. Mean femoral neck and trochanter BMD were greater in fast bowlers than in controls (p <0.001). All bone geometry properties, except for cross-sectional moment of inertia, were superior in fast bowlers (p <0.05) following adjustment for height and lean mass. There were no asymmetries in BMD or bone geometry when considering leg dominance of the fast bowlers (p > 0.05). Elite fast bowlers have superior bone characteristics of the proximal femur, with results inferring enhanced resistance to axial compression (cross-sectional area), and bending (Z) forces, and enhanced strength to withstand a fall impact as indicated by their higher femoral strength index. No asymmetries in hip bone properties were identified, suggesting that both torsional and gravitational loading offer significant osteogenic potential.

Bone health and asymmetry in elite female cricketers

“…The high BMD at both femoral neck and total hip sites is comparable to elite female athletes participating in high impact sports, such as volleyball (Bellver et al, 2019). There was no significant difference in BMD or section modulus between or within groups (Figure 2), similar to the findings observed in male fast bowlers (Lees et al, 2018). This demonstrates that the total bone loading on the proximal femur is similar between and within positions.…”

“…Batters, fast bowlers and spin bowlers all demonstrated proximal femur Z‐scores in excess of +2.4 (Table 2), demonstrating the osteogenic potential of participating in cricket at the proximal femur, similar to the findings observed in male fast bowlers (Lees et al, 2018). The high BMD at both femoral neck and total hip sites is comparable to elite female athletes participating in high impact sports, such as volleyball (Bellver et al, 2019).…”

“…The accrual of bone is greatest on the contralateral (to bowling arm) side of L3 and L4, where BMD is up to 14.6% greater than the ipsilateral side (Alway et al, 2019). Further, male fast bowlers have significantly elevated contralateral and ipsilateral hip BMD and section modulus compared with a control population, which suggests that these regions also experience significant loading, but BMD or section modulus did not differ between hips (Lees et al, 2018). A major cause of time‐loss in female cricket is through lumbar bone stress injuries (Evans, Langley, & Ranson, 2015).…”

Anthropometric and morphological characteristics of elite male cricket bowlers and batters over time: A systematic review

“…Based on the search criteria, only five full-member cricket nations have collected some form of data regarding the anthropometrical and morphological characteristics of elite male bowlers and batters. These nations include England (28 studies), 4,27–53 Australia (17 studies), 7,25,54–68 South Africa (five studies), 16,19,24,69,70 India (one study), 71 and Sri Lanka (one study). 72 Of the published research, most has focused on bowlers (45 studies), with a limited amount of literature directed around batters (12 studies).…”

The oblique triangle configuration of three parallel screws for femoral neck fracture fixation using computer-aided design modules

“…The overall cross-sectional area of the internal fixation is positively related to the bending section modulus and the torsion section modulus 16 , 30 . The larger the overall cross-sectional area of the internal fixation indicated the more dispersed stress of the screws in the femoral head, and the less displacement of the fractured end 31 . The results of this study showed that the area ratio of OT configuration was not affected by the three factors of the inclined ellipse, and remains a stable value (0.413).…”