Heather Knight: Hamstrung no longer after slow road to recovery

Imagine the dread. The one thing you worked for so dearly is threatened to be snatched away from you. Imagine the fear. Of missing out of an event you so looked forward to.

Imagine being Heather Knight in May.

Having relinquished England's captaincy after nine years, she was looking forward to a summer of cricket back in the ranks, with the goal of the Women's World Cup at the end of it. She remained a vital cog for England under the new leadership of head coach Charlotte Edwards and captain Nat Sciver-Brunt. But an innocuous turn for a single threatened to ruin it all for her. She heard something pop while batting in the 19th over of a T20I in Chelmsford but did not walk off the field until the innings ended.

Knight had suffered a right hamstring tendon tear, in which the tendon had detached from the bone. Recovering from such injuries takes anywhere between four to six months; the World Cup was only 17 weeks away, with England's departure for a pre-tournament camp in Abu Dhabi a week ahead of that. Opting for surgery would have definitely put the former captain out of the competition. So, alongside England's team of physios and doctors, she decided to try the rest-and-recovery method.

"She's very, very passionate about playing cricket for England and very passionate about the World Cup," Angela George, National Lead for Physiotherapy - England Women, tells ESPNcricinfo. "So we knew that it was quite simple for us, really, that we needed to explore the conservative management. And we knew also that, if it wasn't going to work, we would know about it and at least we would have tried. We went for the conservative option, which if you looked at the injury at the time, was about 50-50 as to whether it would be better to surgically repair or more conservatively manage."

Knight had already suffered a hamstring tear on the same leg in 2013. So that left her slightly more prone to injury. The other factor was an increase in her workload. England's new regime places an importance on players' participation in domestic cricket, with Knight featuring in the Women's One Day Cup for Somerset. Of course, she was not left unmonitored. England use a workload monitoring system called Insights 360 that helps to mitigate injuries. But not all injuries can be predicted, let alone prevented.

"Her feedback to us around April was that her hamstrings had been in the best place that they felt for a long time," George says. "We've done a lot of work on strength, motor control, hip mobility and just making sure that her hamstrings are in tip-top shape. But she probably had played a bit more cricket domestically than she had done at this point. So we knew we were on a bit of an edge with it, but fundamentally, sometimes these things just happen. The human body is so complex that, we can't just say, right, that's going to go at that point, so stop doing that."

The limited time added to the challenge. There were periods when they could push but also time they had to bide their time in order for her tendon to heal. There were no shortcuts. It was not just about getting Knight fit to board the plane; it was about making sure she was at her best for the World Cup.

"As week by week went, we were quite slow to start off with and that caused a bit of frustration for Heather because she just wanted to get going," George says. "She wasn't looking for us to take shortcuts because, fundamentally, she has a lot of trust in our team to look after her. Whenever we debated something, we came back to the point that, if we push too early and things break down, she was not going to be happy.

"Although Heather was coming to us with frustrations - as I would expect her to, as I would hope her to - and wanted to push us as fast as she can, we were always able to justify our decisions that fundamentally, the body needed to heal and put that part of the tendon back onto the bone."

Progress was slow for the first three months. They used MRI imaging at every step of her recovery. Knight worked on her upper body strength and on her other leg in this period. They finally pushed forward mid-August.

"That was the time that the MRI started looking really good and we were happy that anything that we were putting through her body, the tendon wasn't reacting to it."

Knight's work with London Spirit as a team mentor also kept her occupied. Two weeks before England were to depart for Abu Dhabi, they accelerated her recovery through increased workload.

"When we brought back a lot of cricketing skills, that's when she could really show herself that her hamstring did not let her down," George says. "We knew that because we'd done a lot of work, but she needed to show her own body that, actually, everything was fine."

Throughout the recovery, England's management remained adamant that, if fit, Knight would be in straightaway for the World Cup. A lack of game-time was not considered a hindrance, given her previous form in the domestic season and the T20Is against West Indies.

"We knew that she would not need an awful lot of game-time to get back to her very best," George says. "Her hamstrings were in such a good place that, actually, we sort of knew that we could afford not to push the playing beforehand. That didn't sit all that well with Heather because she just wanted to get playing, but we knew we had it in the back of our locker, really."

In her first knock after recovery, Knight made a 48-ball 41 in England's unofficial warm-up match against New Zealand in Abu Dhabi, and a fluent 37 in the official warm-up against India in Bengaluru.

Imagine the dread in the opposition. Imagine a fit Heather Knight at her best at the World Cup.