Cricket is a sport most people associate with injuries such as the occasional broken finger, bruises from a fast ball and a few pulled muscles but Batsmen, Bowlers and Fielders alike can be plagued with a whole range of conditions affecting the shoulders, legs and spine.

In this article we deal with the issue of back pain in fast bowlers, of which the major cause is the repetition of the bowling technique itself and the stresses it places on the spine.  Especially in children and adolescent players, the bones are still developing and are more susceptible to stress injury.

Fast bowlers generally use one of three bowling actions:

  • Front-on technique with hips and shoulders remaining parallel to the crease for much of the action.
  • Side-on technique where the bowlers’ shoulders are square on to the batsman.
  • Mixed action whereby the bowler usually counter-rotates the shoulders towards a side-on position early in the action.

A number of scientific studies have been carried out, showing that it is this mixed bowling action which causes most of the problems, due to the extra rotational stresses placed on the vertebrae.

One of the most common cricket related injuries seen in young players is a stress fracture to the vertebrae called spondylolysis but injuries to the discs and soft-tissue are regularly seen.

Spondylolysis is a stress fracture which occurs in an area of the vertebrae known as the Pars Interarticularis and the athlete will usually experience low back ache which is exacerbated by sporting activities and eases with rest.  As with all fractures, the treatment is around six weeks away from sporting activity, followed by physical therapy and spinal stabilisation exercises. Consultants will often refer to this conditions as “Pars Defect”

On X-ray or CT scan, the part of the vertebrae in question looks like a Scottie Dog, If a stress fracture is present, the Scottie dog will appear to be wearing a collar.

Usually the fracture is on one side of the vertebrae, but if the other Pars Interarticularis is affected then the whole vertebrae becomes unstable, slipping forwards, (a Spondylolisthesis).  This is a serious condition which can cause permanent damage to the spinal nerves and requires surgical correction.

Mechanical back pain

The symptoms of Pars Interarticularis defect (Spondylolisis) are very similar to general mechanical back pain but there is never anything normal about children and young sportspeople experiencing back pain.  Many times the problem goes unnoticed, the fracture will naturally heal but can often cause a thickening of the surrounding tissues which in the worst of cases can result in nerve impingement.  Only at a later date, may an x-ray show a previous vertebral fracture.

Modification of  bowling technique

Whether a vertebral fracture exists in a player or not, physical therapy and spinal stabilisation exercises will only go part of the way to rectifying the back pain.  Modification of a problematic bowling action needs to be addressed in order to  prevent recurrence of the injury.  It may not be that the bowler is doing anything wrong but the technique he is using may not be suitable for him.
Coaches need to look at the bowling action and either correct faulty technique or adapt technique to suit the player. Many professional bowlers use digital video analysis (motion capture) allowing images to be viewed in, slow motion.

More information
Singapore Sports & Orthopaedic Clinic – Find out more about Pars defect and other related conditions

England and Wales Cricket Board

Sports Injury Bulletin – References and research.

Stabilizer Pressure Biofeedback – A great patient training device to develop stability of the spinal muscles.

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