Why do young cricketers suffer low back pain?

With a domestic cricket season well and truly underway which will see a number of young budding fast bowlers take to the field I thought it would be appropriate to touch on the potential contributing factors for the development of low back pain in young fast bowlers. This has been a highly debated topic over the last 1-2 years with the seemingly increased rate of low back injuries in our up and coming Australian fast bowlers including Pat Cummins, Mitchell Starc and James Pattinson.

The most common lower back injury suffered by fast bowlers are lumbar bone stress injuries. Bone stress injuries result when localised strain and loading placed on the lumbar vertebrae exceeds the strength of the bone. This often occurs with fast bowling which requires forceful and repeated actions of bending, side bending and twisting.

In the literature there have been three well documented factors that are believed to contribute to bone stress injuries in fast bowlers. These factors are bowling technique, bowling workload and age.

Workload: High cumulative amounts of deliveries bowled throughout trainings, matches and entire seasons have been shown to increase the prevalence of lumbar spine injuries in fast bowlers. In addition atypical spikes in workloads where a player may have bowled significantly more on one particular day has also been seen to result in increased injury prevalence 21-28 days following this time. It is believed that bone needs time to adapt once it has been loaded and therefore bone stress tends to occur when adequate adaptation has not been allowed.

Age: In an injury surveillance study conducted by Cricket Australia lumbar stress injuries were shown to have the lowest mean age of injury onset (24 years) of all injuries suffered in the sample.  Ossification or maturation of the lumbar spine is not fully completed until 20-25 years of age. This is suggested to make the bone less able to absorb forces and more susceptible to failure before the age of 25 years.

This may therefore partly explain the recent injuries to Australia’s current fast bowlers as the Australian teams have had to rely on their younger fast bowlers including Pat Cummins (21), Mitchell Starc (24) and James Pattinson (24) to shoulder a higher percentage of the workload than Australian teams have had to in the past. This also underlines the apparent increased injury prevalence for Australian player’s currently compared to other countries such as England (James Anderson (31), Stuart Broad (28)) and South Africa (Dale Steyn (31), Vernon Philander (29)) whose spearhead bowlers are much older in age.

Jay Scott-Hunter