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15 January, 2025

BUMRAH AND BACK INJURY- AN INSIGHT INTO THE INTRICACY OF THE CONUNDRUM

BGT is over, Australia regained it after a decade, India for the first time lost chance to play in WTC final. But among all these demoralizing lows, there is only one glimpse of sheer brilliance- JASPRIT BUMRAH. 32 wickets at an average of 13.06 is unreal. But in the process, came inevitable breakdown in the last innings of the test series.

Lumbar bone stress injury (LBSI), is an overuse injury resulting from microdamage accumulation and propagation in bone and can be career ending. This injury differs in severity, based on the bone stress continuum from stress reactions to incomplete or complete lumbar stress fracture. Fast bowling has been associated with asymmetrical bone stress response with injuries occurring more commonly on the contralateral side to the bowling arm (93% of injuries), at sites like pedicle (23%) and pars interarticularis (77%), and specifically on lower lumbar vertebrae. Risk factors of LBSI in fast bowlers are multifactorial like young age, reduced trunk or pelvic flexibility, bowling technique related and most importantly increased bowling volume and frequency.

In case of Bumrah, he is more of a product of white ball cricket with an unique action which is difficult to replicate. His approach speed and stride length are very less compared to other fast bowlers but he generates pace from hyperextended knee braced at delivery stride. Moreover because of the hyperextended elbow and back he releases ball a bit later, giving the batsman that microsecond less time to react. The whiplash release of ball creates a Reverse Magnus Effect which actually helps ball to dip pretty fast. All these patterns generated by the hyperextension posture at release point, actually put the lower lumbar area under lot of stress. Another interesting stat is the number of overs he has bowled (192 overs) in BGT and last NZ series at home, which is higher than the independent risk factor threshold of match overs accumulated in last 3 months.

What we have seen in the last innings of BGT, was always on the card specially after the workload for him throughout the series. Being a sports medicine practitioner, it was obvious from the visual that it might not be a simple muscle spasm specially for a fast bowler having history of surgery for same injury. Hence it is that much important to consider whether it is at the same level or not, whether it is an early stress reaction or a complete/incomplete fracture. Choice of investigation is also very important for staging and grading. Since the investigation reports are unknown  (for obvious reason), any comment on this particular injury will be speculation but it can be safely assumed that we should be braced for another long hiatus for him.

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1 Comment

  • Dr. Sumedh Magar

    What analysis would you do in clinic and in lab? What would be the best way to manage in the season for such injuries?

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