Lower Back Pain - Associated With Fast Bowling in Cricket

An Overview of Lower Back Pain in Fast Bowlers in Cricket

Cricket is one of the oldest sports known to mankind. With the advent of one day cricket in the mid 1970s and twenty 20 cricket in the early 2000s, its popularity has soared immensely. However, due to the staggering number of international matches being played now-a-days, there is a need to focus on prevention and management of injuries to players.

Epidemiology of lower back pain in cricket

Previous research has reported that lower back injuries occur in up to 60% of cricketers. The reasons attributed have been inadequate pre-season physical and psychological preparation, rapid escalation in training frequency, improper biomechanical aspects of fast bowling, duration of bowling spells and the overall work load in the season.

A longitudinal study carried out in South Africa found that bowling (41%) accounted for most of the injuries in cricket. Lower back pain and injuries in fast bowlers Fast bowlers are at particular risk of lower back pain and injuries compared to spin bowlers, batsmen and wicket keepers. Concomitant hyperextension of lumbar spine and rotation of the thoracic spine in fast bowling places a significant amount of stress on the lumbar spine. This causes injuries to the bones, joints, ligaments and muscles in and around the lumbar spine with resultant back pain. Pain is gradual in onset and is characteristically described as the 'crescendo-type' of pain, i.e. occurring at the end of day's play initially, then earlier the next time around and so on. Typically, it is sore when the player bends backwards especially if standing on one leg.

Risk Factors for injury to fast bowlers

Traditionally, fast bowling lower back injuries have been thought to occur due to hereditary factors, lack of proper technique, poor physical conditioning, and lack of pre-season preparation. There are two distinct actions by which pace bowlers deliver a cricket ball, side-on and the front on. These are defined in terms of the attitude of the feet, the non bowling arm, the shoulders, upper torso and the follow through. A third kind of action involves some features of either of these actions. The biggest disadvantage of mixed action is that it involves greater rotation of the shoulders to realign with the rest of the body.

Treatment

In most cases, complete rest from the sport is the treatment of choice. During this time, a progressive rehabilitation program to strengthen the structures supporting the lower back should be undertaken. Improving trunk core stability and flexibility is also undertaken. Use of a brace while bowling to support the back is also quite helpful. Surgical intervention is rarely required. Subtle modifications to the bowler's actions can be undertaken to reduce the stresses on the vertebrae.

Summary

The mechanisms underlying lower back pain need to be investigated further. Designing preventive interventions and proper management of fast bowlers from the early years may go a long way in allowing them in pursuing 'pain free' careers.