Australian cricket icon Pat Cummins first displayed symptoms of a lumbar stress injury in his lower back in mid-December. Recognising the risk, Australia quickly withdrew their prized player from Ashes duty with the T20 World Cup in mind. Although scans in January were reportedly positive, Cricket Australia stated that Cummins "needs more time" to fully recover.
On Saturday, it was confirmed that Australia will be without their premier pacer for the T20 World Cup, forcing the national selectors to pick Ben Dwarshuis in his place within the 15-member squad.
What is Lumbar bone stress injuries?
Lumbar bone stress injuries (LBSI) have been recognised as a common cause of back pain in cricket fast bowlers and other athletes for at least 40 years. It is a broad category referring to any injury caused by repetitive stress to the bones in the lower back or the lumbar spine. Simply put, it occurs when the rate of micro-damage exceeds the bone’s ability to remodel and heal.
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According to available medical information, these injuries happen when the bone is overworked and begins to swell. This can initially lead to microscopic cracks forming in the bone, which may later progress to 'spondylolysis'—a complete "break" or defect in a specific part of the vertebra.
Symptoms and prevalence in seamers
Lumbar stress fractures occur mainly in young athletes who rotate and extend their spine, particularly during weight-bearing activities. The Australia-based website Clinical Physio St Ives noted in a report that fast bowlers have up to a 67% lifetime prevalence of LBSI.
"The main symptom of a lumbar stress fracture is low back pain that worsens with activity and improves by avoiding sports that require repeated back bending. Additional symptoms can include back stiffness, muscle spasms, tight hamstrings, trouble standing or walking, and pain radiating down one or both legs. Patients can also experience weakness, tingling, and numbness in their legs. Symptoms can progress to interfere with normal daily activities," the report added.
Recovery
The recovery from LSBI typically relies on the bone remodelling cycle, which takes between 120 to 200 days on average, according to the Clinical Physio St Ives report. Genetics, hormones, nutrition, and physical activity can all significantly affect the duration of the recovery period.
