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Back You are here: Home Sports Basketball Free State Physio Bouncing Back in Cricket Season
Thursday, 01 November 2018 00:00

Bouncing Back in Cricket Season

Written by  Jason Hiemstra - Physiotherapist
Bouncing Back in Cricket Season Renate Monty Photos

In the 19th century, the British Empire was sprawled across the globe, doing its utmost to cover the entire known world, and taking the game of cricket with it. Back then, things were civilized. Gents clad in blazers and ties sat neatly in the grand stand and applauded while enjoying hot cups of tea.

Fast forward to the present; and we have scantily clad dancing girls, the barmy army bellowing merry tunes, the Castle Corner stronghold sledging fielders, and cricket games that finish in three hours!

One thing that hasn't changed is fast bowling.

Fast bowling has been described as an impact sport all on its own, with bowlers going through a series of collisions with the ground. Studies have shown that ground contact forces during the delivery stride are up to six times the bowler's body weight. (Stretch, 1999)

Bowling also involves repeated trunk rotation, hyperextension and axial compression (twisting). The combination of these movements places compression forces on the facet joints of the spine in the lower back that may lead to an injury common in youngsters.

The medical term for this injury is spondylolysis. A tongue twister all on its own, it is also known as a pars articularis stress fracture. A stress fracture is a small break in the bone caused by repeated loading (compression) above what the bone can tolerate or adapt to. The pars articularis is the name of the area, or piece of the bone where the injury occurs.

To recap, bowlers are considered to be prone to injury due to the nature of the sport. Research tells us that poor bowling technique, poor preparation, over bowling, decreased flexibility, and too much reliance on upper-body strength may increase your risk of injury. (Finch et al, 1999) A history of previous injury is a strong indicator for future injuries, so it is important to screen for old injuries and ensure that they are fully rehabilitated.

We will focus on the lower back, and in particular the pars stress fracture. This injury, although not exclusive to, is common in fast bowlers.

Signs and Symptoms

Typically pain is felt on one side of the lower back, and it is aggravated by leaning backwards, and may decrease with rest. The injury usually occurs on the opposite side of the body to the side which is performing the activity (left sided pain for a right arm bowler). Pain can be reproduced by firmly pressing on the affected area, or by leaning back while standing on the affected leg. I must add that some pars stress fractures may be pain free, and as such, may be an incidental finding on scans later in life.

Diagnosis

A detailed history taking and physical examination from a qualified physiotherapist or doctor may be sufficient to diagnose the pars stress fracture. The usual imaging done for a suspected injury of this type is first an X-ray and then a bone scan. These are done to confirm and exclude other diagnosis. (Pain may also be caused by a bone stress injury, rather than a full on stress fracture. This is a less severe injury, and treatment will vary slightly.)

Treatment

Initial treatment is rest from aggravating activities and prescription medication for pain or inflammation. Physiotherapy will aid your recovery, by working to reduce pain and muscle spasm. Once your pain has decreased, the most important area of treatment is strengthening. This will start with core stability exercises, which aim to create a 'muscular corset' to protect your spine. You will then progress to strengthening the 'mover' muscle groups, so that you become functionally strong. These exercises may mimic movements seen on the cricket pitch to prepare your body for the rigors of bowling.

Remember that these are guidelines and if the injury is more severe, it will require a more intense treatment approach. The nature of this injury also means that your treatment needs to be carefully monitored and progressed so as to avoid re-injury or any complications.

Prognosis

Your average pars stress fracture will keep you out of action for 6-12 weeks, with 4-6 weeks of progression back to full sport.

Prevention

Prevention is aimed at achieving good mobility of the spine, flexibility of the gluteal and hamstring muscles, and a strong core. In the pre-season, gradually increase the amount of bowling that you are doing, then increase the speed and intensity of your bowling. This allows your body to adapt to the stress that bowling places on it.

Ask your coach to observe your action to make sure that you aren't extending or twisting too much, minor adjustments to your technique may benefit you in the long run. If you have a history of back problems, avoid the 'front on' and 'mixed' bowling actions, as they place the largest amount of force on the spine. If you prefer these actions, ensure that you do pre-habilitation to lower your risk of injury.

Bowling work load is also a major factor in developing bone stress and overuse injuries. The South African and Australian cricket unions have even set up age group related guidelines for bowlers, limiting the number of overs which should be bowled in practice and matches. This has been done to help develop the youngsters, and to keep our fast bowlers injury free.

Happy bouncing!