The Ballistic Six – Shoulder Injury Prevention for Fast Bowlers
If I had a dollar for each (parent of) young/sub elite fast bowler who complained of sore shoulders or related soft tissue injuries, I would not need to work.
If you play cricket – and are a fast bowler- chances are you will be subject to more injuries than any other team mate in other roles . Bowling accounts in fact for 41.3% of the injuries, while fielding, and wicket keeping only 28.6%.(1)
Although not comparable to collision-based sports, Cricket has a surprisingly elevated number of soft tissue issues; this is mainly due to the length of the games and the frequency of some of the key actions: overuse is the main trigger.
It comes with no surprise that being robust creates resilience.
A strong shoulder is a must!
Be proactive and do NOT wait for the niggle or injury to present before you take care of it.
Generally fast bowlers’ shoulder injury prevention programs are nested under the “overhead throwing athletes” category (2). This includes Tennis players (think about their serve) and Volleyball players (think of a spike), baseball, Javelin and shot-put throwers for example.
If you belong to the above box, then this applies 100% to you.
As usual, before providing a solution, we made sure it was supported by the literature.
We found the “Ballistic Six”, a protocol created for baseball pitchers, which has been used and adapted for other overhead athletes.
The main aim of such programs is to create dynamic stability to the shoulder complex, so to protect it when the arm is moving and the soft tissue has to cope with large demands of eccentric strength, not only during the preparation for the throw (acceleration phase), but also during the arm deceleration at ball release.
A weak shoulder will in fact display an inadequate deceleration, to control the limb during this phase.
The external rotators (teres minor, infraspinatus) are the ones responsible for the management of the deceleration forces, preventing the shoulder to translate anteriorly at the end of the throw.
The internal rotators instead (Pec major and subscapularis) work pretty hard during the acceleration phase, moving from maximal external rotation to internal rotation.
Using Plyometric training has delivered great results in increasing strength and performance of the shoulder (3)
What is the Ballistic six?
It is a protocol made of 6 exercises.
All exercises must be executed with powerful movements, max effort, requiring a pre-stretch of the chosen shoulder, activating the stretch-shortening-cycle (SSC).
If you want to know (if not skip this sentence), the SSC happens when the muscle spindle (a sensory mechanism within the muscle fibres) gets activated by the sudden and quick stretch of the muscle fibre. When this happens, the concentric contraction that follows is more powerful into the opposite direction.
- Elastic ER (External Rotation)
- Elastic 90/90 ER (External Rotation)
- Overhead throw 2kg ball
- 90/90 flexion ER Decel Throw with 1kg ball
- 90/90 Abduction ER Decel Throw 1kg ball
- IR (Internal Rotation) Throw 1kg ball
Perform the exercises 2 per week for 10 weeks.
In order for the soft tissue to adapt to the exercises you will need to use some progressive overload.
According to the paper a good way to go is represented in the below table:
While practicing the exercises, we struggled to implement (the numbers 4, 5, and 6), unless you have really good catching ability in those half kneeling positions, and the right type of ball to catch.
We had the impression that the focus rather than being on the correct execution would shift away to the act of actually catching the ball.
So we have adapted this, by using a banded work with a partner (check out the video here or on our Instagram post). The partner would provide and replicate the stress on the eccentric phase of the movement (by pulling the band) which in turn would also create some resistance in the concentric phase. It felt very similar to the stress generated by catching the ball, minus the issues correlated to that.
We found this was way easier to implement and only required a couple of attempts to coordinate the 2 partners’ work.
The added bonus (in our opinion) is the perturbation created around the joint capsule, which might enhance the stabilisation process.
Of course, this adaptation is NOT supported by scientific evidence, but in our head it made sense.
Please avoid implementing that exercise if not supervised by a qualified strength and conditioning coach and have the right equipment.
Also, do not perform these exercises without adequate shoulder and scapular strength and control (a qualified coach can assess that for you!).
(1) Pardiwala DN, Rao NN, Varshney AV. Injuries in cricket. Sports health. 2018 May;10(3):217-22.
(2) Pretz R. “Ballistic Six” Plyometric Training for the Overhead Throwing Athlete. Strength and Conditioning Journal 2004 12;26(6):62-66.
(3) Ellenbecker TS, Sueyoshi T, Bailie DS. Muscular activation during plyometric exercises in 90 of glenohumeral joint abduction. Sports Health. 2015 Jan;7(1):75-9.