Aussie cricket fans have been hit with a blow over the past few days: fast bowler James Pattinson has been ruled out of the rest of the Ashes cricket series with a stress fracture in his lower back.
Unfortunately back pain in bowlers is an occupational hazard. Most professional bowlers will have back pain at some stage of the season. It needn’t be a big problem and often they play on through it as it doesn’t always have to impair function or performance.
Most back pain is caused by simple stresses and strains caused by overload rather than any specific pathology. It’s no different in cricketers but the repetitive nature of bowling can increase the chances of the odd niggle.
Although most of these problems will be ‘non- specific’, ie not caused by any specific structural problem, bowlers can be prone to one particular structural injury.
The biomechanics of the bowling action, and the repetitive nature of it, can place the lower lumbar spine under quite a lot of stress.
The pars interarticularis is a bony part of the back of the vertebral column. The nature of the bowling action can put this area under a lot of strain leading to a stress reaction in the bone which can cause pain. If this area continues to be overloaded it can cause it to break. In severe cases this might lead to one vertebra to move forwards slightly in relation to the others. This is called a spondylolisthesis. This can then put stress on other structures such as the disc and the joints.
In the event of any of these occurring the treatment is complete rest and it can take several months away from bowling to recover. So it’s best to try and stop it from happening. It is more common in the younger immature spine and so young adolescent cricketers are more at risk.
The two main reasons for this are the bowling technique and the sheer volume of bowling. At the elite level the latter is closely monitored nowadays to prevent over-bowling from over-loading the developing spine. But at lower levels of cricket this might be overlooked. It is recommended young bowlers bowl no more than twenty overs per week and no more than forty for adults.
The former has been linked to techniques that have more of a side-bending action, especially if the spine also extends a lot (backward bending). Bowlers with very ‘side-on’ actions might want to consider this. There is no consensus on whether a side-on or front-on action is better from a performance perspective. Nowadays bowlers are left to decide for themselves what they prefer or what comes naturally. But any issues of over side-bending or over-extending should be looked at from a technical perspective and this will limit the chances of developing these problems.
You may want to discuss any back problems related to bowling with a physiotherapist familiar with the mechanics of bowling and the typical problems encountered by bowlers.