Expert reveals why Australia’s fast bowlers suffer stress fractures, and the keys to mitigating the risk

Expert reveals why Australia’s fast bowlers suffer stress fractures, and the keys to mitigating the risk

While the latter duo both sustained hamstring concerns, Cummins – who dealt with stress fractures early in his career – is fighting to return from a lumbar bone stress injury, which Sims described as a “hotspot”.

Sims, now Tennis Australia’s national physiotherapy manager and lecturer at the University of Queensland, said athletes were most susceptible to stress fractures from ages 15 to 19, with the bone not fully developing until about the age of 22.

Suffering such a setback in those ages increases the risk of later injury.

He said a gamut of factors made the issue difficult to mitigate across a career.

“You can modify your technique to some extent, but it’s not that easy because you might have someone who bowls a certain way, and they’re very effective – fast and can swing the ball – so it’s hard to change if it then reduces their effectiveness,” Sims said.

“There are anatomical things that are genetic, the way you’re put together, the shape of the vertebrae, the angle of how one vertebrae sits relative to another, and the angle of the joints relative to each other can contribute.

“I think the data would tell you it’s probably not that avoidable.

“Everyone has a ceiling, so it’s putting a lot of strain on your spine when you bowl – the forces being transmitted through the body and up into the back are high forces.”

Australia’s longstanding reliance on Cummins, Hazlewood, Mitchell Starc and Scott Boland has exposed a perceived lack of bowling depth.

Brendan Doggett is tipped to become the first quick to make a Test debut since Boland on Boxing Day in 2021, while only four others have earned a baggy green since Hazlewood’s maiden appearance in 2014.

It is why Sims believed spinner Nathan Lyon had been crucial to their longevity, given how he could effectively tie up one end to afford the spearheads time to recover.

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The key to mitigating the risks of stress fractures later in a bowler’s career, however, was in the way they were managed in their junior days, with Sims outlining the “one, three, five” guidelines: one day before a rest day, three days a week, and five-over spells. This method increases to “two, four, six” from an under-19s level.

“That idea of small increments over time is how you get to the resilience of Test cricket. If you spent your junior career in cotton wool … you’re not going to succeed because you won’t develop the resilience to tolerate the higher loads,” Sims said.

“You’ve got to bowl enough to stipulate the changes you need to see to get the bone strong … but equally, if you do too much when you’re more at risk and get one, you’re also more at risk [later].

“It requires a lot of patience to become a Test bowler. It’s very rare you would get a 19-year-old bowler able to bowl in Test cricket safely without having a problem because it takes four or five years to get those adaptations to tolerate the volumes a Test bowler would bowl.”

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