Throwing Injuries in Cricket: Causes and Prevention

What the throwing action asks of a cricketer's arm

Throwing injuries in cricket build up over a season rather than arriving in one moment. A fielder's throw moves through four rough phases: wind-up, cocking, acceleration, and deceleration. In late cocking the shoulder rotates externally to close to its end range while the elbow sits bent and loaded. In acceleration that position reverses in a fraction of a second. Then the deceleration phase asks the posterior rotator cuff and scapular muscles to brake an arm that is already moving at speed, which is where a lot of tissue stress lands.

Bowlers, fielders and keepers all throw, but the demands differ. A boundary rider might make twenty long throws in a session on top of warm-up throwing. A keeper makes short, repetitive, awkward-angle throws. A quick bowler throws in the field and bowls, stacking two different shoulder and trunk loads in the same day. Any of those patterns can produce pain if the volume climbs faster than the tissue adapts.

Presentations we commonly see in cricketers

Most throwing-related complaints fall into a few groups:

• Posterior shoulder pain in the follow-through, often linked to how well the posterior cuff handles eccentric load.

• Deep, pinching pain at the back of the shoulder at maximum external rotation, sometimes described as internal impingement.

• Rotator cuff tendon pain that starts as stiffness after throwing and progresses to pain during.

• Medial elbow pain at ball release, involving the flexor-pronator group and the ulnar collateral ligament.

• Posterior elbow pain at full extension, associated with valgus extension overload.

• Neck and upper back stiffness that changes how the arm sits and how far the trunk can rotate.

Describing where the pain sits and when in the throw it appears usually narrows the field quickly. Pain at the moment of release points somewhere different to pain that only shows up on the follow-through or the next morning.

Why throwing injuries develop

Rotator cuff strength balance

Throwing hammers the internal rotators. They generate the throw, and they tend to get stronger and tighter with volume. The external rotators do the braking work and rarely get trained specifically. A common benchmark used in shoulder screening is external rotation strength sitting at roughly two thirds of internal rotation strength, tested with a handheld dynamometer. Cricketers who throw a lot and never train external rotation often sit well below that, and the deceleration phase is where it shows.

Range of motion changes and humeral retroversion

The humerus develops a natural twist during adolescence, called retroversion. In throwers this adaptation allows more external rotation, which is useful. It also tends to come with less internal rotation on the throwing side. A moderate difference between sides is normal in a thrower. A larger loss of internal rotation, or a drop in total rotational range compared to the other shoulder, is worth measuring and monitoring. Retroversion is a bone shape, so it cannot be stretched away, and pushing aggressive stretching at an already-loose joint is not the answer. What can be changed is soft tissue flexibility, thoracic rotation, and how the scapula moves underneath it all.

Load spikes

Most throwing pain we see follows a change. Preseason starts and a player goes from no throwing in winter to three sessions a week. A T20 block adds matches on consecutive days. A junior plays school cricket, club cricket and rep cricket in the same month. Tissue adapts to gradual increases in load, not to sudden ones, and throw counts in cricket are almost never tracked the way bowling loads are.

Technique and the kinetic chain

A throw starts at the ground. Weak rear-foot stability, limited hip rotation or a stiff thoracic spine means the arm has to make up the difference. Common technical patterns that add shoulder and elbow load include dropping the elbow below shoulder height, opening the front shoulder too early, throwing across the body from a poor base, and cutting the follow-through short. Amateur cricketers often get bowling coaching and almost no throwing coaching, so these patterns stay in place for years.

Signs worth getting assessed

Book an assessment if pain lasts more than a couple of sessions, if your throw has lost distance or accuracy, if you are warming up longer to get the arm going, or if you notice pins and needles into the hand. Sudden sharp medial elbow pain during a throw, or a shoulder that feels like it slips or catches, warrants earlier review.

What assessment looks like

A throwing assessment at SportsFit starts with the history: which phase of the throw hurts, how many throws you make in a typical week, what changed recently, your position in the field and your bowling load.

Physical testing usually includes shoulder rotation range measured on both sides at 90 degrees of abduction, total rotational range compared side to side, handheld dynamometry for internal and external rotation and for the scapular muscles, thoracic rotation, hip rotation and single-leg control on the back leg. Cervical spine and elbow screening follow if the history points there. Where possible we film the throw from the side and from behind, because arm position and trunk timing are hard to judge by eye at full speed.

Imaging is not routine. It becomes relevant for suspected structural injury, such as a significant ulnar collateral ligament or labral problem, and that conversation happens with your GP or a sports physician.

What management involves

Treatment typically combines hands-on work for painful and stiff tissue with a loading program. For the shoulder that usually means external rotation and scapular strength work with real resistance, progressing from slow controlled ranges to faster, throwing-specific positions. For the elbow it means wrist and forearm flexor loading alongside attention to how the trunk and legs contribute.

Return to throwing is staged. A graded throw program steps up distance, volume and intent one variable at a time, often starting at short distance with low throw counts and building over several weeks. Timeframes vary a lot between individuals and depend on the tissue involved, how long symptoms have been present and how much cricket you are playing while you rehabilitate.

Managing throwing load across a season

Start throwing in the weeks before preseason rather than on day one. Count your throws in the same way you would count overs. Build long throws gradually through the warm-up instead of firing in flat, hard throws from the boundary while cold. Keep external rotation and scapular strength work in the program during the season, not just when something hurts. Give the arm at least one full day off throwing after heavy fielding or a long spell in the field.

If you would like it assessed, you can book a free injury assessment.