Do you know the most common cause of low back pain in junior cricketers?
Most low back pain in young cricketers is the result of a bone stress injury. The lower back bones (vertebrae) do not fully mature until the child is around 23 years of age so the bone is more vulnerable to injury in adolescence than it is during adulthood. If the volume or intensity of cricket exceeds the current capacity of the body, the body takes steps to try and protect itself. When bones are exposed to sudden spikes in activity, they lay down new bone to try and reinforce the existing bone. This new bone takes several weeks to get strong enough to withstand receptive loads and during that time, it is more susceptible to injury.
At the start of the season, the sudden opportunity to play in multiple games and training sessions may prove too tempting. If children have not done sufficient training before the season starts, this sudden increase in activity can overload the immature bones and create a bone “bruise”. Often the child complains of intermittent low back pain on activities like bowling, kicking, and sprinting. Initially, the pain is usually felt on the opposite side to their bowling arm. A right arm bowler would commonly get left sided low back pain.
If the bone is giving time to adapt and become stronger, this bone bruise will settle and given time become more robust and better able to tolerate more load. If managed incorrectly, these injuries can result in a stress fracture in the lower back bones which although rarely serious take many months to heal and can result in a season lost. The season is over before it begins!
How do we prevent low back pain in young cricketers?
Bowling too much is not the biggest injury risk to young bowlers, bowling too much, too soon is. If the bone is given time to adapt, it gets stronger so by planning ahead the bone can be given time to gradual be exposed to greater loads and develop the resilience it needs at the start of the season. It is not just bowlers who get low back pain. Many children are still playing other sports that stress the lower back bones such as kicking in soccer, netball, tennis, rugby and athletics, so be aware as they start the new season, however well prepared that there will often be a pike in load as the season overlap. The key is preparation.
To prepare effectively we need to consider how much the child wants to play.
Let’s look at an example:
Player A is playing in the u14 age group.
The England and Wales Cricket Board have directives for junior pace bowlers that limits how many balls they can bowl in a spell and per day for each age group. They also suggest that pace bowlers, bowl no more than 4 times in every 7 days and no more than 2 days in a row. Avoiding too many back to back days of high intensity activity helps bones have time to adapt.
An u14 player can bowl 6 overs in a spell and up to 12 overs in a day. That’s 72 balls a day up to 4 x in a 7 day period which adds up to nearly 300 balls a week.
This level is safe to bowl, but only if the training has been completed.
So, how much has Player A done in preparation for that level of bowling?
Most winter net sessions are in groups and facilitate kids bowling around 30-50 balls on average per session and they are usually limited to 1-2 net sessions per week. We need to look at the most recent training done.
Player A has bowled:
Week 1: 30 balls
Week 2 35 balls
Week 3: 0 (he was ill)
Week 4: 35 balls
Total balls bowled: 100 over 4 weeks so average 25 balls a week.
He has trained to bowl 25 balls a week plus most kids can cope with around a 10% increase depending on whether they are in a growth spurt, eating and sleeping well and have been bowling for several years.
Over the next few weeks, providing Player A continues to remain pain free and is coping with the current load, he can gradually add more volume and build up the intensity gradually in preparation for the start of the season.
How to prepare for the season if you are not currently bowling.
If you decide you want to run a marathon, most people would follow a graduated training plan. It starts slowly and builds up week on week. This approach is a sensible way to prepare a junior bowler for the season. Just like running, if you are new to it, or haven’t bowled since last season, you shouldn’t start hard and fast. It is not just about volume. The intensity of the session is also relevant. Bowling at half pace in those early sessions can ease the pressure on the tissues and allow them to adapt.
Most players tolerate around 3-4 overs at half pace in the early weeks.
I usually recommend doing some running training to replicating the length of their run up in intervals. Poor running technique and in particular crossing over the feet as you approach the crease has been associated with injury.
Gradually build up the volume and intensity adding around 10% more each week and monitor for any signs of low back or shoulder pain.
It is important to remember, that whilst kids build up their training load over the winter, many then take 2 weeks off over the easter holidays and their average training load drops.
If the child has only done 100 balls a week in winter nets, that is the level trained for and prepared for. Just because they are excited to play, shouldn’t mean abandoning the graduated training programme. Easing in to the season, adding a little more over the first few weeks is a safer approach to ensure a successful, injury free season.
HELP! I didn’t do winter nets, so what do I do?
Start slowly, avoiding bowling at pace on back to back days. Focus on accuracy and technique not pace in those early sessions, allowing the body to get used to the new exercise. Even the fittest kids need time to adapt to a bowling action if they have not done it for several months.
They are better to start slowly, than get injured in those first few weeks of the season.
How can they boost their capacity to do more?
Children are just like mobile phones. They need to be recharged each night to perform well in the day. They need adequate energy for optimal performance. If they don’t eat enough for what they do, they will prioritise where the remaining energy is spent and that rarely includes bone health, immunity and building new muscles. Focus on getting good quality sleep, good nutrition and adequate recovery days. If they are ill, stressed, going through a growth spurt, or very tired, they may not have the same capacity as a child who is achieving a better activity:recovery balance. This explains why given the same volume of activity, some kids get injured when others don’t.
If your child develops low back pain when playing sport, then remove them from all activities involving arching their back (kicking, throwing, twisting, not just bowling) for a minimum of 2 weeks to allow the bone to adapt.
As they return to sport, add one new activity in every other day at low intensity. Assess the reaction. If they start to get pain again, it is important to see a health professional with experience in youth athletes. This condition is rarely seen in adults so most clinicians are not aware of the diagnosis and management. Check the Kids Back 2 Sport website to find a clinician near you or contact Angela Jackson at info@kidsback2sport.com for a 121 consultation.
