Lumbar stress fractures or lumbar bone stress injury in cricket fast blowers: Risk factors, diagnosis, management, and rehabilitation.

Fast bowling is a distinct and high-powered movement pattern used in the sport of cricket that is characterized by vigorous trunk actions, strong vertical ground reaction forces, and high workloads. Due to their intense play, fast blowers are more vulnerable than other players to suffer significant injuries. lumbar stress fracture (LSF) is the type of such injuries that occurs as a result of such vigorous activity. LSF accounts for 3% to 12% of all cricket injuries. These injuries develop as a result of overuse injuries caused by microdamage accumulation and propagation in bone, and their severity varies according to the bone stress continuum, resulting in stress responses to partial and complete lumbar stress fractures (LSF) . In a study by Alway et al., the incidence of lumbar stress fractures among English county cricket fast bowlers was 1.67% (57 lumbar stress fractures) all over the entire squad of 368 fast blowers, with match incidence of 0.13 per 10,000 balls, yearly incidence of 2.46 per 100 fast bowlers, and match incidence of 0.13 per 10,000 balls between 2010 and 2016. They further, found that fast bowling has been linked to an asymmetrical bone stress response, with injuries occurring more frequently on the bowling arm's contralateral side (93% of injuries), in the pedicle (23%), the pars inter articularis (77%), and the L4 (35% and L5 (32%) 11. Another study found that fast bowlers had significant lumbar bone mineral despite the high frequency of Lumbar bone stress injuries (LBSI), with up to 14.6% and 18.1% more bone mineral density (BMD) and bone mineral content (BMC) on the side opposite and the bowling arm, respectively. Such an injury usually results in pain, time loss from sporting events, and activity constraints