Fast bowlers, from greats such as Dennis Lillie and Waqar Younis to upcoming Indian pacer Prasidh Krishna, English footballer Marcus Rashford, as well as professional players across all sports have fallen prey to stress fractures in the lower back. These stress fractures are caused by a small crack in the lower back, the lumbar vertebrae to be exact. Such fractures are common among runners, fast bowlers and those into high-intensity sports such as basketball, football and badminton, and can threaten their careers.
As per a paper published in PubMed Central by Diego Costa Astur et al., stress fractures occur because of repeated and intense movements in a specific region, leading to fatigue. It is also caused by an imbalance in the functioning of the cells responsible for maintaining bone health — osteocytes (cells maintaining bone mass), osteoblasts (cells that form new bone cells) and osteoclasts (cells that degrade and facilitate resorption of the bone). This imbalance tends to make the bone prone to fractures when under pressure.
This condition, though commonly seen among professional athletes, is increasingly affecting weekend sports enthusiasts and amateur runners. Stress fractures strike when the muscles and bones in the region are not conditioned enough to handle the rigours and stresses involved in the activity. Thus, it becomes essential for weekend sports warriors to understand the cause of the injury and how to prevent it from happening.
What causes stress fractures in the back
“A stress fracture occurs when a particular body part is overused. A minor trauma repeatedly affecting the vertebrae over a period can lead to a minor fracture called stress fracture of the back,” says Bishwaranjan Das, musculoskeletal and sports injury physiotherapist at Manipal Health Enterprises, Mangalore, Karnataka. “The lower lumbar is the most loaded because it has the maximum curvature as well as maximum movements. So, it also gets more stressed, which can lead to a stress fracture. It differs from a regular fracture as one gets it over time.”
Though overuse is one of the main causes of the injury, any strain or tightness in the gluteal and hamstring muscles can also lead to stress on the lumbar vertebrae. “The glutes and hamstrings are connected to the lower lumbar. Sometimes, these muscles can become tight. If someone kicks or jumps with tight muscles continuously, it is harmful,” explains Das.
Lack of proper nutrition is another cause. This is especially true if your diet lacks the vitamins, minerals and proteins essential for maintaining bone health.
Physical conditioning to avoid stress fractures
“Fast bowling is one of the most unnatural human movements in sport,” points out Ramji Srinivasan, former strength and conditioning coach of the Indian men’s cricket team. “Due to this movement, fast bowlers are prone to injuries in the lower back, knees and shoulders,” adds Srinivasan, who was part of the Indian 2011 ICC World Cup winning team. “To avoid it, a proper screening along with specialised training protocols should be implemented. Further, they have to be customised as each bowler is different. Some may have similar bowling actions while others may have unconventional action, like Lasith Malinga from Sri Lanka or Jasprit Bumrah from India.”
Even the format in which a fast bowler is playing — test, one-day or T20 matches — needs to be considered before deciding the training regimen. And one should not load too much too fast, even while training.
“Often, people focus only on strength training while ignoring other components of fitness,” adds Srinivasan. “A fast bowler needs a high level of aerobic fitness, strength, flexibility, stability and balance. Thus, workload management needs to be done carefully with the bowler’s format and style in mind. All these work in tandem with each other.”
Symptoms of a stress fracture in the back
Das lists some of the most common symptoms of stress fractures in the lower back:
- Mild pain that aggravates with time,
- Back that gradually gets stiffer and more painful,
- Localised warmth and swelling in the affected area.
Stress fractures, if ignored, could lead to arthritis at an early age, disc-related problems and hampered mobility and productivity.
Takeaways
- Stress fractures in the lower back are commonly seen in athletes in high-intensity sports, such as basketball, football, badminton and rugby. Fast bowlers in cricket are also prone to this.
- For pacers, specialised training protocols need to be implemented, whereby all the required components of fitness are addressed.
- If ignored, stress fractures in the back can lead to arthritis at an early age or disc-related problems, which hamper mobility and productivity.
