Cricket fast bowling technique and lumbar bone stress injury

Introduction: Lumbar bone stress injuries (LBSI) are the most prevalent injury in cricket. While fast bowling technique has been implicated in the aetiology of LBSI, no previous study has attempted to prospectively analyse fast bowling technique and its relationship to LBSI. The aim of this study was to explore technique differences between elite cricket fast bowlers with and without subsequent LBSI. Methods: Kinematic and kinetic technique parameters previously associated with LBSI were determined for 50 elite male fast bowlers. Group means were compared using independent samples t-tests to identify differences between bowlers with and without a prospective LBSI. Significant parameters were advanced as candidate variables for a binary logistic regression analysis. Results: Of the 50 bowlers, 39 sustained a prospective LBSI. Significant differences were found between injured and non-injured bowlers in: rear knee angle, rear hip angle, thoracolumbar side flexion angle and thoracolumbar rotation angle at back foot contact (BFC); the front hip angle, pelvic tilt orientation and lumbopelvic angle at front foot contact (FFC); the thoracolumbar side flexion angle at ball release and the maximum front hip angle and ipsilateral pelvic drop orientation. A binary logistic model, consisting of rear hip angle at BFC and lumbopelvic angle at FFC, correctly predicted 88% of fast bowlers according to injury history and significantly increased the odds of sustaining an LBSI (odds ratio: 0.88 and 1.25 respectively). Conclusion: Lumbopelvic motion is implicated in the aetiology of LBSI in fast bowling with inadequate lumbo-pelvi-femoral complex control a potential cause. This research will aid the identification of fast bowlers at risk of LBSI, as well as enhancing coaching and rehabilitation of fast bowlers from LBSI.