Spondylolysis. A common injury in young cricketers.

Many sports fans are currently staying up late into the night watching in hope as England loses momentum in The Ashes. This event is perhaps the most important fixture in the cricket calender and will inevitably inspire many younger fans to give the sport a try for themselves. Cricket as with all sports comes with the risk of injury; common injuries include rotator cuff tears, contusions, ankle sprains and low back pain. I wanted to take this opportunity to write about a common cricket injury which is particularly common to the young bowler; Spondylolysis. In the general population the prevalence of this injury is around 8% but in throwing sports such as cricket this more than trebles to 27%.¹

 Spondylolysis is a stress fracture to the Pars Interarticularis of the vertebrae and it is the repetitive rotation, extension and side flexion of the spine in bowling that can cause this fracture. The most commonly involved vertebrae is L5 but L3 and L 4 can also be fractured. Symptoms of this injury may include unilateral (although sometimes bilateral) low back pain which is aggravated by extending the spine, particularly when standing on one leg, and tenderness over the fracture site.² It is important I point out that not all low back pain in young cricketers will be caused by Spondylolysis and the condition can also be asymptomatic so it is important to see a Sports Therapist or other medical professional for an assessment.

Prevention is always better than cure, so can this injury be prevented? Thankfully, there are things you can do to prevent this injury. As with many overuse injuries correct technique can help in avoiding them so ask your coach if you feel your bowling technique could be improved. If the spine is functional in a ‘normal’ manner you will be at a lower risk because the forces acting on the spine are lower. Having good posture is therefore important so make sure your posture is optimal and avoid slouching. You are at particular risk if you have excessive lordosis (curve) in your lower spine. Some research has found people suffering from Spondylolysis have tight hamstrings, so make sure your flexibility and range of motion is good; again ask a Sports Therapist or other medical professional for help with stretches to improve hamstring flexibility if this is a problem for you. ³ Tying in nicely with posture is core stability. Having good core stability will improve your posture and allow the muscles to support more of the spine’s movement; exercises such as the plank will help.

 If you do have Spondylolysis your Therapist is likely to initially rest you to allow the fracture to heal and to prevent the condition from progressing. Core Stability will be used to strengthen the stabilising muscles of the lower back and hydrotherapy may be used to maintain cardiovascular fitness during the rehab programme. When the fracture heals you will make a slow and controlled return back to sport, paying particular attention to rectifying any possible causes of the injury. This is where communication with your coach becomes of greater importance. Return to full sport could take 3 – 6 months but symptom resolution and healing is a far better indicator than time. ⁴  

Normally, this injury occurs unilaterally (on one side) but sometimes it can be bilateral (both sides) and this may take longer to recover from and carries the further risk of developing into Spondylolisthesis, which is another topic altogether.

Cricket is a fun sport enjoyed by many across the country and the globe. All sport carries the risk of injury but the benefits of sport far outweigh the negatives and when injury does occur most players make a full return to the sport they enjoy. The key is correct diagnosis and proper treatment and rehabilitation.   

Alex Dexter BSc (Hons) MSST

Graduate Sports Therapist

1 Soler, T. Calderón, C. 2000. The Prevelance of Spondylolysis in the elite Spanish athlete. American Journal of Sports Medicine. 28(1):57-62.  

2 MacAuley, D. 2007. Oxford Handbook of Sport and Exercise Medicine. Oxford University Press pp506-507

3 McCleary, M.  Congeni, J. 2007. Current Concepts in the diagnosis and treatment of Spondylolysis in young athletes. Current Sports Medicine Reports. 6(1): 62-66

4  Iwamoto, J. Sato, Y. Takeda, T. Matsumoto, H. 2010. Return to sports activity by athelets after treatment of Spondylolysis. World Journal of Orthopedics. 18(1): 26-30