What Really Happened When Dale Steyn Fractured His Shoulder?
I have an obsession with wanting to know different athlete's injuries if initial media reports are vague or if I believe they are misleading (It's a curse!).
If you follow cricket like myself, you may remember an incident that occurred in 2016 to South African fast bowler Dale Steyn when he went down injured after bowling in the Perth test match against Australia.
Dale Steyn Moment's After Fracturing His RIght Shoulder. Credit: indianexpress.com
If you would like to see the video of the incident, you can watch it here.
To most of us watching, this looked like a pretty innocuous injury - but we also know that the most seemingly innocent injuries can also be the most serious! So it proved, as it is only now, as we are heading into 2018 that Steyn is looking to come back from injury.
So what happened?
The Injury Explained
Initially, almost every news site reported the injury as a "fractured shoulder". Not good enough! The "shoulder" is made up of 4 joints: The glenohumeral joint, the acromioclavicular (AC) joint, the sternoclavicular joint and the scapulothoracic joint. What got broken?
After doing more googling than many sane people might do, I eventually came across a report that described the injury:
"Today while he was bowling he explained that he felt something thud or pop. He immediately came off, we went to the hospital and had some scans done and they showed that he’s been diagnosed with a fracture of the coracoid process of the right shoulder." - Dr Moosajee, South African Team Doctor
Anatomy of an Injury Unseen
The coracoid process is a part of the scapula or "shoulder blade". It hooks forward and can be felt on yourself just below your collarbone.
The main information to take from the anatomy of the coracoid process is that it is the attachment for your pec minor, one of the heads of your biceps and a muscle called the coracobrachialis.
So What Happened To Dale Steyn?
Essentially what we are looking at here with Steyn is an overuse injury. Repetitive use of the shoulder in the bowling action essentially caused the muscle tendons attached to coracoid process to pull the bony structure away from the shoulder blade!
In the video you might have heard the commentators discussing how he had had an injury coming into the test match. This was revealed afterwards to be a "stress reaction" - the bone had begun to weaken from the pull of the muscles on it.
The delivery which caused the fracture was quite simply the final straw!
So They Stitched It Back Together?
...And some! The likelihood is that Steyn went in for surgery to reattach the tendons back to the shoulder blade. That is likely to have taken place within a week or two from the initial injury. From that point, Steyn is likely to have been getting progressed through a painstaking rehab program supervised by his physio.
His medical would have wanted him to build up strength of the muscles in the shoulder initially in a stable position (arm tucked into his side) and worked towards what we call 'functional movements'. For him, this would be his bowling motion, with incredibly fast overhead shoulder movements.
One study in 2010 found that the force through the shoulder in female fast bowlers was nearly 600N - as Dale Steyn is one of the greatest fast bowlers in the men's game, it is likely that this number is conservative for him... That's a lot of force that the shoulder needs to hold up to!
Only time will tell whether Steyn is able to be the force that he once was in the cricketing world - age and wear and tear in his shoulder may cause him to struggle to return to his peak ability. I for one though, won't be betting against him!