Low back pain in fast bowlers is a common problem and can affect the junior athletes, recreational and professional athletes. 

Low back pain in fast bowlers is typically described as a dull constant ache on one side of the low back. The pain is usually opposite to the bowling arm.  Pain may radiate into the buttock and into the hamstring and will rarely involve pain below the knee or tingling into the feet. 

Fast bowling involves large lumbar movement and rotation at great speeds. It is the repetitive nature in the extreme end range extension and rotation positions that causes great stress on the back, particularly through the bony pars of the lumbar vertebra. 

A Cricket physiotherapist will be able to identify the source of your pain which in cricketers has been shown to develop from stress within the vertebral bones. This bony stress is the body’s response to exercise.  If the spine is unable to recover and heal, it may go on to develop a stress fracture. 

Stress fractures occur in skeletally immature adolescent athletes and athletes under the age of 25. The spine is the last part of the skeleton to mature leaving it susceptible to injury. 

A Cricket physiotherapist will complete a thorough lumbar spine assessment and biomechanical analysis. This will provide the basis of a personalised treatment plan. If fast bowling continues to be painful you may be advised to rest from bowling or reduce the total overs bowled in a week.   

A Sports physiotherapist will ensure that you rest from the aggravating activities but provide appropriate alternative training to ensure that you maintain peak physical fitness.  This will include a focus on strengthening of core abdominal muscles, gluteal muscles, and targeting stretches of the hip flexors and hamstrings. 

If a diagnosis of a stress response is made early and a treatment regime is implemented, the athlete will return to normal activity within a four to six-week period.  If the athlete presents later and has developed a stress fracture, the time to return to sport is typically in the order of 12 weeks.

In order to have a pain free return to sport the athletes bowling technique may need to be changed to improve performance and reduce the risk of re injury. Technique wise fast bowlers use three different styles. Side on, front on or a mixed technique where the lower half of the body is front on and the upper half side on. It is the combined position of lower body front on an upper body side on that has the most issues and incidence of stress fractures.  

The take home tip is to be proactive if in pain get your back assessed so you can enjoy your summer of cricket!

Craig Paulsen MSK and Sports Physiotherapist