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Why are so many of England’s young fast bowlers getting stress fractures?

Yas Rana by Yas Rana
@Yas_Wisden 5 minute read

The past week has seen three England bowlers in their mid-twenties ruled out for the remainder of the season.

Jofra Archer, Saqib Mahmood and Matt Fisher – aged 27, 25 and 24 respectively – have all been robbed of an English summer in what should be the prime of their respective fast bowling careers.

In all three cases, the cause for their spell on the sidelines is the same – stress fractures of the back. So prevalent are stress fractures for young, English fast bowlers, they have almost become a sort of bleak badge of honour.

As well as the aforementioned injured trio, of England’s squad for the first two Tests of the summer, Craig Overton, Matty Potts and James Anderson have all previously suffered from stress fractures, as have Olly Stone and Sam Curran, two more England quicks who have recently spent time on the treatment table.

So, why do they happen? Dr Pete Alway is an expert in the field, having researched for a PhD determining the risk factors for lumbar stress fractures in elite fast bowlers.

“A stress fracture is quite similar to a chip you get on your windscreen on your car,” Alway explained to Wisden.com. “To begin with, it’s like nothing, but as you keep driving on it, as you keep hitting potholes or speed bumps, that crack gets longer and longer, until the windscreen fails. In the case of the bone, it starts to crack all the way through or to a significant length that then needs to be stabilised.”

Given the proliferation of recent stress fractures, it would be tempting to lay the blame at management for not adequately minimising the risk for players but as Alway points out, both over-bowling and under-bowling increase the likelihood of developing them; it is a difficult balance to get right, and in some cases it’s unavoidable.

“One of the challenges with stress fractures in fast bowlers is that there’s not just one risk factor,” said Alway. “It’s likely that every individual player will have a different risk factor that has led to their stress fracture. The most obvious one which most people look towards is workload. We know that short-term workload, whether that’s seven-day, 30-day, or 90-day workload, if those are excessively high or there is a spike in them, that significantly increases the risk of a player sustaining a stress fracture in the next three to six weeks.

“Technique is another big one. We can generally predict around 88 per cent of all future stress fractures from a person’s technique. Players who have a lot of hip flexion at back-foot contact, as well as lumbar spine extension at front-foot contact, those are the two big red flags when it comes to stress fractures in fast bowlers. There are stress fractures which are preventable but then there are others where there are factors that are beyond the individuals’ control.”

After the news of Fisher’s stress fracture was announced, a set of numbers posted by statistician Andrew Samson did the rounds on Twitter. His tweet showed that between the ages of 20-24, Anderson and Broad bowled significantly more than their younger teammates Stone, Fisher and Mahmood. According to Alway, there is a level of bowling that helps a player build resistance to the possibility of a future stress fracture.

“It’s difficult to pinpoint,” he said. “Firstly, what you have in Jimmy and Broady, are two players who have had a remarkable career in terms of the injuries that they’ve had, in that there’s been very few. With Jimmy, he’s been blessed with a career where there’s been very few stress fractures, whereas most of the fast bowlers we see in that list have had a few injuries which then limits their appearances. There’s research to suggest that until a player has bowled at least 1,200 overs in matches it is unlikely that they’re going to be resilient to stress fractures. You’ve got a group of players here coming through who are extremely talented but haven’t reached that threshold of overs that is protective to stress fractures.

“By 24, the fast bowler should have enough strength built up from the repetitive nature of fast bowling. You then have the resilience to resist the forces which accumulate on the spine. They’ve got a much bigger ceiling to withstand much bigger workloads, so hopefully they can avoid getting stress fractures.”

Fisher and Mahmood are both below that 1,200-over threshold and Archer had gone 10 months without a professional appearance prior to his diagnosis. A lack of cricket can also be a hindrance. As can the relentlessness of the modern schedule. For elite fast bowlers who play all three (or four) formats, there are now very few periods of rest available to them.

“Compared to the 1970s and 80s, players have 10-30 per cent more matches in a year,” said Alway. “The frequency of games is huge so players are getting much less rest than previously, just adding to the multitude of factors and why we might be seeing more stress fractures these days.”

In a later tweet, Alway expanded on his earlier comments, saying: “The relentless rise of T20 has turned cricket into a year round sport without an off-season. This has led to an increase in match days. Lumbar stress fractures are complex as often they manifest without pain or similar to non-specific low back pain – players in the 70s/80s may have had lumbar bone stress at the end of the season without realising, but would recover over winter while they rested.”

The long-term impact of stress fractures can also vary. Potts, who suffered from stress fractures earlier on in his career, is a good example of a bowler who has bounced back from the injury and has since not only recovered his pace, but increased it.

“If you look at someone like Matthew Potts, he’s had a couple of stress fractures in his career, and if you look at him now he’s absolutely flying. There are always exceptions to that, there are players who, after getting a stress fracture their performance does decrease, but in a couple of injury-free years there’s no reason that they wouldn’t be back to playing at their best.”

In a week that has seen the English game lose three of its most exciting young fast bowlers for the summer, that at least offers a glimmer of hope that we will see all three fit and firing at their absolute best one day in the not-too-distant future.

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