This review (Gray et al (2000) Int J Sports Med 1 (4)) discusses that problem of great concern in modern cricket, the high incidence of low back injuries in fast bowlers, particularly young fast bowlers.
The research has found that common low back injuries in cricket fast bowlers are spondylolysis, accelerated disc degeneration, pidicle sclerosis and muscular soft tissue injury. For example, the average incidence of spondylolysis in the population is 5% , where research suggests amongst fast bowlers incidence is as high as 11-55%.
What is more concerning is that all the research so far has been with junior cricket players, indicating that these injuries are occurring very early in their careers. This fact, however, is perhaps not so surprising. Gray et al discuss how adolescents have thinner pars interarticularis and the ossification of the neural arches in the vertebrae is not complete until 20-30 years of age. This structural immaturity will place the young bowler at great risk of stress and injury.
Bowling technique is also related to injury risks. Various research has identified that what is classified as the mixed action is associated with higher low back injury risks. If a bowler lands on the back foot with the foot parallel to the crease and an upper body aligned straight down the wicket, this is a 'side on' action. If a bowler lands with his back foot pointing down the wicket and the upper body aligned obliquely down the wicket, this is called 'front on' action.
Alternatively, if a bowler lands on the back foot in a 'front on' style and then rotates his trunk into a 'side on' position by the time the front foot lands, this is called a 'mixed' action. The extra rotation involved in this mixed action may place extra stress on the low back and mean that this technique is more likely to cause injury
The amount of bowling performed may also be a factor that coaches and therapists need to consider. This review of the research cites studies which suggest that for young bowlers more than 10 overs may increase risk of back pain and that playing a greater than average number of games per season will also predispose to injury.