Lower back injuries

Lower back injuries can take the form of stress fractures, and particularly adolescent fast bowlers are at high risk. Other areas that could be damaged include the disc, facet joint or surrounding soft tissue.

Spondylolisthesis, or the forward slipping of one vertebrae over another, affects younger cricketers more than older players.  A specialist must be involved, as many fast bowlers have stress reactions in their spine as an adaptation to the bowling action, yet........ they are pain free!

Lower back pain is not a problem exclusive to the fast bowlers and is equally devastating when it happens to batsmen or wicketkeepers.

There are many potential causes of these injuries. Poor bowling technique (called a mixed-action technique), overbowling and relative youth are the common culprits. Other possible causes include poor physical preparation, the impact forces associated with the delivery stride, inadequate footwear, poor/hard/low shock absorption surfaces and previous injury.

Early detection and diagnosis are very important. Following this, treatment includes physiotherapy for pain and rehabilitation, which is undertaken by a physiotherapist and biokineticist.

In rare instances the injury may not respond to conservative management and require surgical intervention – usually as a last resort.

The focus of the rehabilitation is twofold. Firstly, it is essential to retrain the core muscles responsible for spinal stability. Secondly, and equally important, is strengthening the entire trunk, upper and lower body, in order to help the body deal with the huge impact forces associated with fast bowling.

Biomechanical changes are often necessary, and these can be achieved by means of collaboration between the medical team and the coach.  The rehabilitation of these core stability muscles has to go hand in hand with bowling correction.  Bowling correction on its own, however, is not enough. It has been shown that high intensity core stability activation/rehabilitation results in changes in  positive changes to a player’s action.   

Content reviewed and enhanced by Dr Joe de Beer, a well-known orthopaedic specialist, and T-J Malherbe, a physiotherapist. Both are from Cape Town.