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Showing posts with label rehabilitation. Show all posts
Showing posts with label rehabilitation. Show all posts

Thursday 18 February 2016

Saeed Ajmal - an inspiration in rehabilitation



An interview with Nagraj Gollapudi in Cricinfo



'Earlier the batsmen were scared to face me. Now there is a contest'


Saeed Ajmal talks about learning offspin afresh, how he plots dismissals with his remodelled action, and how ready he is for a Pakistan recall


"I watch my videos after every match to check if I have bowled any balls that are suspect. Ninety per cent of my deliveries are good"



Can we say in the last one and a half years you have had to learn offspin totally afresh?

I have relearned everything. Even with my body, I have had to start new exercises. Then I followed that up by bowling with a heavy ball. Everyone knows my right wrist is broken [in a bus accident]. The wrist bone protrudes out and my whole arm flexes. To get this under control, because it is already ten degrees, I have learnt to bowl with a heavy ball. To keep the wrist taut, my biomechanist, Dr Paul Hurrion, suggested I bowl with a heavy ball. I worked really hard. I bowled 12,000 deliveries during the rehab before coming back. I am developing those muscles. Initially I didn't have the pace, but thankfully my pace is up to 90kph.

From the time my action was called and till it was cleared, I have bowled at least 100 balls a day. When I had to clear my action I did a lot of bowling in that time. My body weight would fall on one side, my left leg would come up during the delivery stride. To avoid doing that, I strapped weights to my ankles so that the foot doesn't rise and come down flat upon landing.

Have you learnt new things about offspin that you didn't know before?

Definitely. I learnt a lot of things. I learnt that you can bring everything from your fingers if you are willing to work hard. At 38 I have learnt something that I probably never did in my 15 years as a cricketer. I had to become a child - like the first time I went into the academy as a ten-year-old. So I had to look at it like that again over the last year.



Bowling with a remodelled action during a match against Kenya in December 2014, a few months after he was banned © AFP


After you were banned, Saqlain Mushtaq was appointed by the PCB to work with you. Do you recollect the first delivery in the nets? Did you have to show Saqlain your action? 

He knew what my action was before. Working along with Saqlain bhai, I changed my action eight times. Initially he would like the action for a while, say for a month, but then he would change it. After ten days he would be impressed with a different action, but then say it is not proving to be effective. He would keep liking it but was not totally convinced. It reached a stage where one day, I just said I would leave it [bowling]. But Saqlain bhai said, "Himmat na haar." [Don't lose hope.] One day it will come.

I kept doing it. Then I started bowling well and gained confidence. I am not saying I have become zabardast [great] once again. But with the matches I am getting to play, the crowds are coming, I am enjoying bowling under pressure, and one day I will be available to play for Pakistan.

How difficult is it to unlearn something you have known all your life?

I was bowling with my earlier action for 22 years. Even now, when I see videos of my old matches, different things come to mind. Batsmen's legs used to shake, every batsman used to think twice before stepping out to hit me, lest the ball bounces or turns. I can't forget those memories. Now when a batsman stares back at me I get angry. I think: till last year he used to cry, but why is he staring back now? To bring that back I have worked hard in the last six months to make my action effective and get back my pace. Now my pace is really good. Also my doosra, even though it is not as big as it used to be, is still there. There is topspin and it moves out a little bit. I am happy that I'm bringing that back.

Do you ever feel in a situation, physically, that your action might go back to the old one? You have played county cricket, bowled long spells. An old action is a habit.

No way. I will leave cricket with this [new] action. If I am not effective, I will step aside and leave. What I have done, I am happy with. I have been bowling about 90% with the new action. The odd ball might have exceeded 20 degrees, but I work hard immediately to rectify that. I watch every video of my matches. Ninety-nine per cent of my deliveries are under control. Since I have not played international cricket I will need to continue to work on how I bowl under pressure. I also need to work on how I bowl when I am relaxed.

I will be back, and that day is not far. I have spent a lot of time outside and it hurts me when Pakistan loses.

What I have learnt is that to learn anything new you have to believe in yourself and believe your Allah. There is nothing in this world that man can't learn. I learnt the doosra by myself. All I did was watch videos of Saqlain Mushtaq and in one month I had learnt it. I wanted to try it out in the next domestic season and I did.

To come back to international cricket, I need new variations, so I should be able to spin from the side, from down here, from the top, so I can deceive the batsman and let him know that I am now here.

Your weapons have changed. Now you don't do big spin, for instance?

In the last six months I have played 100-plus club matches [back in Pakistan] where I was also hit for many sixes. I was starting to understand at what pace the batsman was hitting me. I played club tournaments, local tournaments, a few outside. Slowly my confidence was coming back. In my mind I started thinking, "Now I am delivering my hand in the correct fashion." Earlier I had doubts, it was in my mind that I was chucking. It took me nearly a year after the ban to get rid of the fear and khauf [dread]. Now it is out and if you noticed my bowling in the last domestic T20 tournament in Pakistan and now in this, there is a big difference.

Has there been a difference in your mental approach towards a batsman with the new action?
My ability against the batsman has remained the same. I am mature enough to understand how to play the batsman. I understand where the ball will go if I press this finger and this finger [points to different fingers on his right hand]. I have taken a year just to master these fingers, only to get my confidence back so that one day when I return to the Pakistan team I don't want to feel that I am finished or that I have come on somebody's sifaarish[recommendation]. I don't want to feel like a liability. If I feel I am finished, I will retire.

Are the variations the same as you used to have?

There is a little bit of change. Earlier my deliveries used to have a lot of bounce. Now I have killed the bounce somewhat. Because of the high arm, my hand used to drop, so to stop the wrist from falling, I have now locked that wrist, so the spin is less. Earlier my right wrist used to fall away due to the bone injury. Now I have locked the wrist at the time of delivery. Consequently, the spin and bounce have reduced. But my variations remain the same. I have also learned to deliver with a low bounce against a tall batsman who stands and hits, or moves back to hit. In these matches, you will see a better version slowly.



"Working with Saqlain bhai, I changed my action eight times" © ESPNcricinfo Ltd





Do you still bowl the doosra?

Definitely. I have cleared the doosra during the ICC testing process. Even against Karachi Kings I got Saifullah Bangash with a doosra. I bowled a few to Iftikhar Ahmed. Out of 18 deliveries I bowled six doosras. Once again, with the doosra, there has been no difference in pace. The only difference has been with the spin and bounce when I deliver the doosra and the topspinner. I still rely on the doosra. I know it is a weapon that unnerves a batsman. With time my hand speed will get faster, as it was before. Then the doosra will become more effective.

Of the deliveries that were banned, which is the most difficult to change?

The offspin. My wrist used to drop, and as soon as it used to drop - for the doosra it is fine - for offspin I had to lock the wrist and when I let it go, it did not break. Because the wrist remains locked now. So I found it really difficult to spin the ball. People think it is very easy, but for me it is really hard because my wrist bone is broken. I always need to ensure that the wrist does not fall. Now the ball has started breaking, and as an example I got James Vince lbw [against Karachi] with the offspinner.

Did you ever think about your bowling as much as you have done in the last year?

The biomechanist Paul Hurrion has really helped me. To control the wrist it took a lot of time. I never thought about it. Earlier I would think, "This is Chris Gayle, or Pietersen, no problem." Now I have to think about where to pitch it, how to get the batsman out. Earlier the batsmen would be scared to face me. Now there is a muqabla [contest].

Muscle memory is an important constituent of any learning process. It can't be built in a year. How do you deal with that challenge?

I agree. But muscle memory is built when you start as a youngster. I am a mature spinner. It didn't take me that much time again because I know how to put the ball in. I already had the memory of where to bowl to what batsman and from where to deliver. My focus was just to clear my action. I cleared it very soon. I am very happy that I have developed the memory so quickly. I had almost lost hope. But I have this belief inside. I believe that everything I can put my head to, I can achieve.


You said you put some weights on your ankles. Can you talk about that? And also bowling with a heavy ball?

Saqlain bhai would strap my wrists with 1kg bands on both wrists. He did not want my front arm staying to the side and the bowling wrist high and locked. I also strapped 2.5 kg weights on my [left] leg to make sure it did not go high and the head did not fall down sideways. The head needed to be straight and relaxed. I would then deliver with a heavy ball. It took me three months just to get used to it, to develop muscle.

Do you reckon it is difficult for bowlers to innovate within the numerous stringent restrictions imposed by the ICC, as opposed to batsmen, who have the freedom to keep innovating and improvising?

Perhaps it is easier for the fast bowlers, considering they have two new balls in ODIs. It has become very difficult for spinners. Why did the spinners start chucking, bowling faster? Heavy, broad, big bats, a mishit would go for a six; Powerplays, four fielders outside the circle, five inside in the ODIs. Pitches have changed. What can spinners do in such a setting? Spinners had to learn something new, and so started bowling faster. Earlier if you flighted the ball, you would get respect. Abhi agar hawa mein do toh hawa mein jaata hai. [Now if you toss it up in the air, it disappears into the air.] With the playing conditions changing, spinners started to learn to bowl fast and the chucking issue became prominent.

Fingerspinners can't survive in international cricket, especially in ODIs and T20 cricket. The guy who does not have variety will be hit. You have to have variations, and for that you have to work hard, otherwise you are out.



"I have this belief inside. I believe that everything I can put my head to, I can achieve" © Getty Images





Can you succeed as a spinner without throwing?

I have already given reasons as to why chucking started. There is nothing for the spinners. The ICC should allow spinners some relaxation. I said it to the ICC but it didn't make a difference.

Can you talk about examples where you enjoyed bowling after your action was cleared?

Last county season, I was playing for Worcestershire in a home one-day match against Leicestershire. Former England left-arm spinner Richard Illingworth, who played for Worcestershire, was the umpire. He asked me how I was going to get the batsman out. I told him I would bowl a whole over of offspin. He would push me to the leg side. Next over I would bowl the doosra and he would get caught at slip. So I bowled only offspin in the first over and the batsman played me to short midwicket. Next over, first ball, I bowled the doosra and he played it to the slips. Illingworth was astounded. I told him, this is cricket. I looked at what he was trying to do, and if he wins, it's fine. But what I was doing to him, that is in my control. I was making him play on my terms, not his.

So one thing that has not changed is how you out-think the batsman?
 

That cannot change. Against Karachi, bowling to Iftikhar Ahmed, I knew he plays to midwicket. So I was playing with him. First up, I bowled him a doosra. It was a little outside off stump. I know he does not step out, and he was beaten. I bowled him another doosra which pitched on the same spot. He went for a big hit and was beaten. I then bowled offspin from the very same spot. He was beaten again and he stared back at me.

I look for cues in a batsman. Kamran Akmal straightens his left leg to hit over midwicket. Sarfraz [Ahmed], if his shoulders are bending low, he is going to play the sweep. If he is standing normal and straight, he will not sweep. I have to pick this. Kevin Pietersen can hit a six by stepping out or by standing inside the crease. So I know to bowl it wide, so even if he hits, it might go high up in the air. I have learnt all this by playing for long, by playing with the batsman's mind, by learning to watch what the batsman is doing. You need to do your homework. You need to read the pitch, to understand how much bounce there is on the pitch. So you will need to figure out whether to flight it or not and such stuff.

How far away are you from playing international cricket?

I am ready. There is a big difference from the time when I played in the Bangladesh series last year after I was cleared. At that point I had the fear on the inside. Now I have removed that fear by working hard.

Saturday 10 January 2015

Do Ched Evans or Amir have an automatic right to rehab in sport?

 Kamran Abbasi in Cricinfo

The Pakistan board's unseemly haste to bring Amir back reflects poorly on it  © AFP
Enlarge
Ched Evans is a footballer trying to resurrect his career. He is also a convicted rapist. Evans says he is innocent and since his release from prison he is looking for a new football team. First, he made plans to train with his old club, Sheffield United, but the public outcry was such that Sheffield United distanced themselves from him. Any subsequent opportunities with other clubs have ended abruptly following protests and threats by sponsors to end deals. Evans and his supporters argue that he deserves a chance at rehabilitation.
A few weeks ago, Ramiz Raja questioned the rush to return Mohammad Amir to professional cricket. The crimes of Amir and his fellow spot-fixers are different to that of Evans, of course, but the principle championed by Amir's supporters is the same, that he deserves a chance at rehabilitation. Ramiz spoke from the heart, of how it would feel for other players to welcome back a cheat. Pakistan's linguistic innovator has also worked as chief executive of the Pakistan Cricket Board. He speaks from board and broad experience.
Rehabilitation of offenders is an important principle that has benefits for individuals and society. No doubt that Evans and Amir and other sportsmen who commit a crime during their sporting careers have every right to be rehabilitated, but the question is whether or not they have an automatic right to be rehabilitated back into the sport they have dishonoured?
Some professions take criminal conduct so seriously that practitioners can be disbarred or struck off. The medical and legal professions are prime examples. Decisions to end careers are difficult. Professional bodies, for example the General Medical Council and the Bar Council in the United Kingdom, are responsible for making judgements on whether or not individuals are fit to practise. Hence, a barrister who has committed rape or a doctor who has made fraudulent financial claims for patient treatments will probably be judged by the relevant professional council to be unfit to remain in the profession. A doctor or barrister can be rehabilitated into society, find alternative work, but any career as a doctor or barrister will be finished.
Some professions take criminal conduct so seriously that practitioners can be disbarred or struck off. The medical and legal professions are prime examples
Society rightly demands high standards of doctors and barristers since they hold positions of influence and power. A professional sportsman is influential too, even powerful, especially in a privileged position as a role model to thousands and millions of adoring fans. Why then should a sportsman have an automatic right to return to a profession? Why shouldn't he be judged by high standards too? Role models are immensely powerful in sport and brushing over serious misdemeanours risks diminishing the gravity of the crimes. Rehabilitation back into the sport might cause offence to team-mates, fans and victims. Being disqualified from a sport might be the most powerful deterrent to future spot-fixers and rapists.
None of this reduces the onus on society and professions to support the rehabilitation of offenders. Each case requires careful consideration by a suitably qualified governing body equipped to make judgements on the seriousness of offences. But just like other professions of influence and power, rehabilitation shouldn't necessarily mean rehabilitation back into a sport. Unlike medicine and law, sport isn't geared up to make such sensitive and profound decisions. The ICC, FIFA, and national bodies like the PCB and the FA, must ensure that codes of conduct for standards of behaviour are in place and that they are enforceable.
Ramiz began to articulate that Amir and other fixers from Pakistan and elsewhere should not be rehabilitated back into professional cricket. Dissenters in England argue that Evans should not be rehabilitated back into professional football. The governing bodies of cricket and football must consider mechanisms to put the honour, reputation and values of their sports before individual and corporate gain.
This will be an unpopular view for fans who have an emotional attachment to a tainted star. Amir's case is a perfect example, tugging at our heartstrings. His role in the spot-fixing of 2010 might be judged to be too minor to bar him from cricket? But the unseemly haste to return him to international cricket reflects poorly on the PCB and ICC. A code of conduct panel for cricket might judge that other spot-fixers and match-fixers should never return to the sport. It might even decide the same for Amir?
Either way, the current systems and processes of the ICC and PCB, like the governing bodies of other sports, seem to miss the point on rehabilitation. Sport, as we are reminded each time a great player retires or moves on, is far bigger than any individual.

Sunday 1 April 2012

What to do when you've done your hamstring

by Andrew Leipus in Cricinfo
 
Overwhelming feedback so far shows there are a lot of ESPNcricinfo readers out there currently suffering cricket injuries and they want some help. There are volumes of research out there but over the next few articles I will broadly discuss some guidelines on what I commonly see in practice, and provide some information that might be useful. Of course, it goes without saying that all injuries are unique and wherever possible you need to seek professional advice.

I have just read that my old captain of many years, Sourav Ganguly, has pulled a hamstring which kept him out of the Syed Mushtaq Ali Trophy quarter-final recently. Whilst this was unfortunate for Bengal, what was of interest was his comment that he will be fine by the time the IPL starts. This leaves him around two weeks in which to recover and complete his rehab. But the IPL also presents an interesting challenge to players, in that often they are coming off long seasons or a Test series. The increased intensity and speed of play during a Twenty20 is potentially a risk for the players, and where time allows, they should be gradually increasing their training intensity during the pre-camp. 

Sudden transition from standing around during Test cricket to explosive T20 is an injury waiting to happen and players need time to prepare adequately. I hope Sourav can recover in time. Unfortunately, hamstring strain injuries are a challenge for both the players and support staff, given their high incidence rate, slow healing, and a tendency to recur.

There is a continuum of muscle impairment that can occur in sport, ranging from simple muscle cramping or soreness to the worst-case scenario, of a complete rupture. We like to classify the degree of injury as a grade 1, 2, or 3, as it gives us an idea of how quickly we can get the player back to sport again. The greater the damage, the longer the rehabilitation period for restoration of full function.

Hamstring strains are quite common in cricket and can occur when overloaded eccentrically, like if the hamstring attempts to control a rapidly flexing hip/trunk or an extending leg, or both. This can happen during bowling, running between wickets or sprinting in the outfield, so every player is a potential victim. When the load applied or expected to be controlled by the muscle exceeds its capabilities, especially when on stretch, the muscle fibres tear or get damaged.

In terms of self-diagnosis, if you experience hamstring muscle soreness after a long day in the field or following training in the gym, the problem is unlikely to involve disruption of muscle fibres and will probably heal in a day or two. Many players experience this feeling after long days in the slips during a Test match. But a massage or ice bath in the evening will always help them recover by morning.
Actual muscle strains, however, always are accompanied by an acute onset of pain. A sudden, sharp "grabbing" behind the thigh is generally an indicator of a strain. Feeling pain or a swelling under your thigh when sitting is also quite indicative. The more intense the pain, generally, the higher the grade of injury.

The delineation between strong cramping and a mild strain is often difficult to diagnose, especially when the player is fatigued and dehydrated. This poses problems now that substitute runners are not allowed. Regardless, a grade 1 will probably let you continue playing, albeit with some discomfort, a grade 2 or 3 will bring you off the ground, limping. If this acute "grabbing" or "tearing" sensation isn't experienced and the hamstring pain arrives insidiously, there is a good chance the pain is being referred from surrounding areas like the lower back or pelvis. The management for this sort of injury is very different. There are many other possible sources of hamstring pain, often co-existing. This often results in a player return to sport remarkably quickly, since no muscle is actually injured at the time.

The initial management of all strains begins with protecting or offloading the muscle - applying an ice compression for 15-20 minutes every hour or two for a couple of days (commonly longer). A lot of people start to exercise too early post-injury, and in my experience sometimes it's better left alone, to allow for the natural healing processes to begin. A good rule of thumb to follow is not to do anything that hurts - it is common sense but not always followed, and leads to a premature return to sport, getting injured again, and even more time out of the game.

After a few days, when walking is easier, aim to gradually restore full range of movement, develop good alignment of scar tissue and regain optimal strength, since injured muscle becomes inhibited or weak almost immediately. Active stretching is useful in regaining movement - when sitting, use the quads to straighten the knee and provide a gentle hamstring stretch. It's much more preferable to static stretching at this stage. Soft-tissue massage is also beneficial to normalise muscle tone and soften the healing scar tissue.
 


 
A lot of people start to exercise too early post-injury, and in my experience sometimes it's better left alone, to allow for the natural healing processes to begin. A good rule of thumb to follow is not to do anything that hurts
 





A good sports physio will address these issues and examine for any other contributing or driving factors that may be modifiable, such as muscle imbalances, weakness, poor flexibility or dysfunctional movement patterns. In other words, they will look for reasons, biomechanical or otherwise, why the injury possibly occurred and try to correct or improve them.

After this, a progressive amount of training load is needed to strengthen the injured and weakened muscle without injuring it again. Some of the better traditional exercises prescribed early in rehabilitation don't require any equipment and include hip bridging off of a bench, squats, lunges, deadlifts and single-leg standing windmills.

Hamstring curl machines found in gyms certainly have their place in rehab but are a luxury not a necessity. Stationary cycling is also beneficial for maintaining cardio fitness and initially provides a low load to the hamstring. Access to a spin bike is useful if it has a weighted fly-wheel, since this will introduce an eccentric load to the hamstring. Eccentric loading has been shown to be a critical component to full hamstring rehabilitation.

Jogging can be reintroduced gradually, initially as sideways movements, which places less stress on the hamstrings. As pain-free contraction and full range of motion are regained, drills such as 80-metre run-throughs are common, like 20m of gradual acceleration leading into 40m of steady pace, followed by a deceleration over the next 20m. The distances and intensities of the acceleration and steady pace are gradually increased from session to session as the injured muscle adapts to increasing loads. Progression is based on the ability to complete each session successfully and wake up the next day without pain or stiffness. The ultimate goal is rapid acceleration into a full sprint, and for cricket, rapid changes of direction.

At some stage during this programme, cricketing skills will be reintroduced. For example, once lunging is comfortable it is quite reasonable to begin easy net sessions. Similarly, bowlers coming off hamstring strains need to begin "walking through" their actions, progressing to controlled medicine-ball throws and gradually bowling off a short run.

As mentioned at the start, there is no recipe. What you need instead is a structured and flexible progression of loading the injured muscle and the reintroduction of the necessary skills to avoid the development of altered movement patterns associated with the injury. The loads can be increased as the muscle becomes stronger, as can the progression of the gym programme to include more dynamic functional training and plyometrics/power training.

In terms of returning to play, don't be one of the many people who equate a lack of pain or stiffness with being fit. Prevention of re-injury starts with thorough rehabilitation of the current injury. Incorporating a dynamic warm-up before playing is the norm nowadays and static stretching is uncommon (although there still is a place for it). Bowling actions need to be reviewed carefully by the coach to ensure there is no altered movement - bowlers often don't finish their actions completely when recovering from a hamstring strain, and avoid short or full deliveries as they require a slightly longer delivery stride.

Ultimately, the best functional testing is seen under match conditions. Muscles tend to tighten when weak or fatigued and the best practice for this is to play a match, often at a lower grade than usual, in order to better control the efforts.

As you can see, there is a lot to cover in management of the "simple" hamstring strain and this has just been an introduction. But the best piece of advice I can give for prevention of hamstring strains is to be physically well conditioned. The more functionally strong the muscle, the less likely it is to fail.