Ishant in doubt for South Africa series

MUMBAI: India's new pace spearhead Ishant Sharma is in doubt for the upcoming home cricket series against South Africa after he was advised two to three weeks' rest to recover from a toe injury.
     
The Delhi speedster, who impressed one and all with his pace and aggression Down Under, has seen significant healing but needs time for the pain to subside and full healing to take place.
    
Outgoing Physio John Gloster has advised Ishant rest for two-three weeks from bowling and running.
     
"No compromise on this instruction... Strength and focus on core stability, gluteal strength, quadriceps strength and hamstring/hip flexor flexibility," Gloster said in his report to the BCCI..
     
Ishant also suffers from inflammation on his forefinger and Gloster advised him to continue with anti-inflammatory techniques until the problem is resolved.
    
Yuvraj Singh's knee has been deemed fit enough for cricket but the left-hander is advised to lay "emphasis on strengthening and stability without high impact activity."
    
"Must have minimum two weeks (ideally three) break from cricket and excessive loaded activities," the report said, asking him to do swimming, cycling and water running.
    
Off-spinner Harbhajan Singh's hamstring is a cause for concern and will require minimum two weeks' rest from bowling and running post tour
   
He needs to avoid long distance running and running on inclines.
    
"Once this condition starts to impede his ability to bowl, then surgical intervention will need to be considered."

Following is the post-tour rehab advice and protocols for various cricketers, according to physio John Gloster:
    
Yuvraj Singh:
- L ACL deficient knee, subluxation episode Perth test vs Aust Jan '08
- MRI and investigation with sports physician at that time. Mx plan instigated.
- Full reassessment with Dr David Young (orthopaedic surgeon) in Melb Feb '08. Confirmed his availability to return to cricket (see full report in clinical notes).
- Plan post Aust tour will be on emphasis of strengthening and stability without high impact activity
- Must have min 2 weeks (ideally 3) break from cricket and excessive loaded activities.
- Emphasis on x-training (swimming, cycling, water running)
- Maintenance of stability program, balance exercises and gluteal retraining
Things to Watch
- pain posterior knee
- obvious swelling and persistence of swelling
- morning stiffness+
- fielding positions (straighter approach and attack to the ball, care on turning etc)
- Instability. Another episode of subluxation and giving way = Surgical Intervention required.
    
Ishant Sharma:
               
L great toe
- stress # through distal phalanx great toe (left), secondary to shape of phalanx
- significant healing/callous formation already evident (Dr. David Young, Dr. Michael Johnson, Dr. Soni). See full reports and scans in clinical notes
- min 2 - 3 weeks rest from bowling and running post tour. No compromise on this instruction
- allow pain to subside and full healing of # to complete.
- Strength and focus on core stability, gluteal strength, quadriceps strength and hamstring/hip flexor flexibility
       
R forefinger acute tendon sheath inflammation
- continue with anti-inflammatory techniques (NSAIDS, Ice, Co-Bahn, gel STM etc) until resolved

Harbhajan Singh:
- L hamstring tendon enthesopathy (Dx. Dr David Young)
- Will require min 2 weeks rest from bowling and running post tour
- To avoid long distance running, running on inclines etc
- Continue with deep Tr Friction Rx to area, hamstring release STM, neural stretches etc
- To continue to monitor condition.
- Once this condition starts to impede his ability to bowl then surgical intervention will need to be considered (see full report, Dr David Young in clinical notes).
    
Sachin Tendulkar:
- R adductor tendonosis (? enthesopathy) with deep hip flexor involvement
- Requires min 2 weeks rest post tour from aggravating (pain inducing) activities
- Must not allow this condition to settle into 'chronic phase' otherwise may take further 2 weeks to control
- Once pain settles then commencement of deep release massage therapy to region, flexibility for R hip region incl adductors and flexors
- Once pain free then recommence basic strength training to adductors initially in water then with band resistance
    
Irfan Pathan:
- requires min 2 weeks break from competitive cricket to concentrate on conditioning
- main focus areas are to be low back, sides and shoulder strength/stability
    
S Sreesanth:
- L ankle instability
- Emphasis on continual strength/stability and proprioceptive rehab of L ankle as well as ongoing glut med strengthening
- R shoulder and scapular stability maintenance program ++
- ? requires cortisone injection into R DIP forefinger. # 2004, now sensitive+ and requires some form of intervention to alleviate sensitivity from recent knocks
    
Mahendra Singh Dhoni:
- R hand 4th finger DIP severe sprain ? # 2nd final vs Aust 5th March
- Will need to be x-rayed on return to India and treatment avenue pursued.