Common Knee Injuries in Professional Cricket

Professional cricketers are highly susceptible to knee injuries, particularly fast bowlers, due to the repetitive, high-impact stress on

the knee joint during delivery. While some injuries are from overuse, others can be acute and severe, potentially ending a career. This year's Ashes series has already been hit with injury concerns with fast bowlers Pat Cummins, Josh Hazlewood and Mark Wood all facing fitness problems before the first test.


As The Ashes down under draws nearer, Owen Wall of Leeds Knee Clinic discusses common knee injuries in professional cricket.


Overuse injuries


  • Patellar tendinopathy: Also known as "jumper's knee", this is a common overuse injury for fast bowlers due to the strain on the patellar tendon during the delivery action. Over time, this stress can cause tendon fibers to break down.
  • Chondral degeneration: High career workloads and the constant impact on the knees can lead to the degeneration of the cartilage that cushions the knee joint.
  • Anteromedial articular impingement: This occurs in fast bowlers from the repetitive, high-force hyperextension of the leading knee during the bowling stride. It can lead to pain and cartilage damage.
  • Medial meniscus tear: This cartilage injury is often caused by quick turns while running but can also develop gradually from wear and tear.


Acute injuries


  • Collateral ligament tears: Ligaments on the side of the knee, such as the medial collateral ligament (MCL), are vulnerable to tears from twisting actions, especially when a player's foot is fixed or catches in the turf.
  • Cruciate ligament tears: While less common than in contact sports, tears to the anterior cruciate ligament (ACL) can occur from sudden twisting or awkward landings, often during fielding.
  • Meniscus tears: Acute tears to the cartilage (meniscus) can result from twisting actions, awkward landings, or sliding to field the ball.
  • Fractured patella: In a rare but devastating example, England fast bowler David Lawrence shattered his kneecap mid-delivery in 1992, an injury that ultimately ended his career.


Risk factors for knee injuries in cricket


  • Role on the team: Fast bowlers are the most vulnerable due to the extreme, repetitive force of the bowling action, but fielders and batsmen can also suffer acute injuries from sudden movements.
  • Workload: Increased bowling workload is a major contributor to overuse injuries like tendinopathy and stress fractures, and is presumably influenced by the rise of T20 cricket.
  • Biomechanics: Incorrect or inefficient bowling and landing mechanics can exacerbate stress on the knee. Improved landing techniques can reduce impact forces.
  • Training and fatigue: Inadequate warm-ups, fatigue during play, and poor strength and conditioning can all increase injury risk.
  • Genetics and age: An individual's genetic makeup and physical attributes, as well as advancing age, can influence their susceptibility to wear-and-tear injuries.


Prevention and management


To mitigate the high risk of knee injuries, prevention strategies are crucial and include:


  • Strength and conditioning: Regular strengthening exercises for the core, lower limbs, and hamstrings can help stabilise the knee joint and improve balance.
  • Workload management: Monitoring bowling workloads is particularly important for younger players to avoid overtraining and allow for adequate recovery.
  • Protective equipment: Cushioned insoles can help reduce the impact forces on the knees.
  • Proper technique: Analysis and correction of bowling and fielding technique can prevent poor landing mechanics.
  • Rehabilitation: For injuries that do occur, proper rest, physiotherapy, and a structured rehabilitation plan are essential for recovery and safe return to play. Surgical intervention may be necessary for severe injuries like ACL or significant meniscal tears.

Serious knee injuries have affected the careers of many professional cricketers, ranging from catastrophic, career-ending incidents to chronic issues requiring multiple surgeries. The following are some notable examples from England and Australia:


  • David Lawrence (England): The most horrifying and definitive example in cricket. In 1992, during a test match in Wellington, the powerful fast bowler's kneecap shattered mid-delivery. The sickening sound was audible across the ground, and Lawrence's promising international career ended almost instantly. He required a long, painful rehabilitation but was never able to return to full fitness and ultimately retired.
  • Craig Kieswetter (England): While not a knee injury, Kieswetter's case is a prominent example of a career ended by a severe injury. In 2014, the wicketkeeper-batsman suffered a serious eye injury when a ball struck his helmet grille, damaging his eye socket. Despite surgery, he suffered from double vision and was unable to return to his previous level of performance, forcing him to retire at age 27.
  • Ryan Harris (Australia): An incredibly successful and highly-rated fast bowler whose career was plagued by recurring knee problems. The constant workload and degeneration of cartilage took a toll, and he was forced to retire due to the persistent knee pain in 2015, just before an Ashes tour.


Career-threatening and chronic issues


  • James Pattinson (Australia): This promising Australian fast bowler's career was an ongoing cycle of brilliant performances followed by injury layoffs, including persistent knee problems. Pattinson finally retired from international cricket in 2021, citing his struggles to get his knee right for the rigours of test cricket.
  • Michael Vaughan (England): The former England captain suffered from chronic knee cartilage problems for much of his career. He underwent multiple operations to manage the issue, ultimately missing England's defence of the Ashes in 2006/07 due to the injury.
  • Andrew "Freddie" Flintoff (England): A dynamic all-rounder, Flintoff's career was beset by multiple injuries. Chronic knee problems, including a meniscus tear, ultimately led to his retirement from Test cricket in 2009.


Acute but recoverable injuries


  • Usman Khawaja (Australia): The Australian batsman tore his anterior cruciate ligament (ACL) in 2014. While a very serious injury that sidelined him for nine months, Khawaja was able to make a successful return to international cricket after surgery and rehabilitation.
  • James 'Jimmy' Anderson (England): The veteran fast bowler, known for his incredible longevity, has had several injury scares over his career. In 2019, he suffered a knee injury while playing for Lancashire but was able to recover in time for the Ashes series later that year.



A batsman in cricket hits a shot into the gloves of the wicket keeper

Many of the above issues can be treated by modern techniques developed by professional physiotherapists (strength and conditioning work, eccentric loading, blood restriction loading etc), especially those conditions which reflect chronic overload, eg patella tendinopathy (“jumper’s knee’), friction ileo-tibial band syndrome (“runner’s knee’), and quads tendinopathy. Other knee issues, such as chondral damage, meniscal tears, and internal knee ligament injuries can easily be treated with arthroscopic-assisted knee surgery, with reproducible and excellent results. External knee joint ligament injuries which are refractory to non-operative management can be surgically treated with open ligament reconstruction, again with excellent results. The rehabilitation times are however often lengthy and times to return to play can be around 9 to 12 months.


If you play at any level, or if you have a general interest in cricket, The Ashes will capture your imagination. If you have or do experience any knee issues, please contact me at The Leeds Knee Clinic for further help and information.