Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analysis

Objective: The objective of the review was to describe the incidence and prevalence of injuries among female cricket players of all ages, participating in all levels of play. Introduction: Cricket, a bat-and-ball sport, is becoming popular among women of all ages and abilities worldwide. However, cricket participation carries a risk of injury. Injuries negatively affect sport participation, performance, and short- and long-term health and well-being. Injury prevention, therefore, is the key to safe, long-term cricket participation as a physical activity goal. Epidemiological data are needed to underpin evidence-based injury-prevention strategies. Inclusion criteria: Studies reporting incidence and prevalence of injuries in female cricket players of all ages, participating in all levels of play, were included in this review, including studies that report data by sex or by sport. Studies were excluded if they did not have enough data to calculate prevalence or incidence, did not distinguish female injury data from male injury data, focused on athletes participating in other sports, or focused on case studies. Methods: A systematic review and meta-analyses were conducted according to the JBI and PRISMA 2020 guidelines. MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and ScienceDirect were systematically searched from inception to August 2021. Additionally, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched. EBSCO MegaFile Premier, OpenGrey (SIGLE), WorldCat, Grey Matters, Grey Literature, and Google Scholar were searched for gray literature. Full-text articles that met the inclusion criteria were critically appraised using tools from JBI, and were extracted and synthesized in narrative summary and tabular format. Three meta-analyses were conducted: injury incidence rates, injury prevalence proportions, and injury incidence proportions. Heterogeneity was assessed using the I-2 statistic and the random-effects model. Results: Of the 7057 studies identified, 4256 were screened after duplicates were removed. A total of 23 studies met the inclusion criteria. Risk of bias was low for 21 studies. The injury incidence rate for elite cricket was 71.9 (SE 21.3, 95% CI 30.2-113.6) injuries per 1000 player hours, time-loss injury incidence rate was 13.3 (SE 4.4, 95% CI 4.6-22.0) injuries per 1000 player hours, and non-time-loss injury incidence rate was 58.5 (SE 16.9, 95% CI 25.6-91.7) injuries per 1000 player hours. The injury prevalence proportion for community to elite cricket was 65.2% (SE 9.3, 95% CI 45.7-82.3) and the injury prevalence proportion for community cricket was 60% (SE 4.5, 95% CI 51.1-68.6). The injury incidence proportion for community cricket was 5.6 (SE 4.4, 95% CI 0.1-18.3) injuries per 10,000 participants. Elite cricket players were more frequently injured than community cricket players. The most prevalent body regions injured were the shoulder and knee, and most were sustained by fast bowlers. Injuries to the hand, wrist, and fingers had the highest incidence and were most sustained by fielders. Conclusions: The study's findings can help stakeholders (including players, coaches, clinicians, and policymakers) make informed decisions about cricket participation by informing and implementing strategies to promote cricket as a vehicle for positive public health outcomes. This review also identified gaps in the available evidence base, and addressing these through future research would enhance women's cricket as a professional sport. Systematic review registration number: PROSPERO CRD42020166052