There is recognition that some fast bowlers do end up with spinal problems that include stress fractures. When one looks at images of their bowling it is clear that this repetitive movment over maybe even 15 years or more could be quite strenuous. There is thus no great surprise that lower back pain is highly prevalent in adolescent fast bowlers.
This has been studied using MRI scanning in Australian young bowlers. There was an increased incidence of S1, L4 and L5 stress fractures and responses when shoulder counter-rotation exceeded 44°, lumbar compression force exceeded 8 time body weight (BW) and compression multiplied by flexion torque exceeded 20 BW2 m. This study suggests that lumbar spine forces and moments are dependent on a number of fundamental kinematic descriptors of bowling technique. By modifying the technique, bowlers may be able to reduce lumbar loads to reduce the risk of lumbar injury.
Regular screening has been proposed.Screening for bone stress on MRI should be considered by clinicians managing developing cricketers to identify the risk of lumbar stress fracture development.
The prevalence of lumbar disc degeneration in fast-bowlers ranges from 21-65% with an incidence rate of 15% per year, and the prevalence of lumbar spine bony abnormalities ranges from 24-81%. Factors associated with lumbar spine injury in fast-bowlers are classified into un-modifiable (age) and modifiable (more intense bowling workload and mixed-bowling technique).Fast-bowlers have a high prevalence of lumbar spine injuries. Appropriate interventions, such as educational sessions, may be able to modify risk factors such as bowling workload and bowling technique and thus reduce injury prevalence.On average, around 9% of cricketers have an injury at any given time, although in fast bowlers over 15% are injured at any given time.
The photographs below taken on a single day of a county championship game between Sussex and Northants in UK shows some of the extremes of movement that are regularly observed.