South Africa in Australia 2012-13

The plague of the back injury stalls Cummins, de Lange

If you are young and bowl quick, you stand prone to stress factors of the back; the promising, fast-bowling duo of Pat Cummins and Marchant de Lange is a case in point

Firdose Moonda

November 6, 2012

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Dale Steyn signals the end of Pat Cummins, South Africa v Australia, 2nd Test, Johannesburg, 2nd day, November 18, 2011
Quicks under-23 are more prone to stress fractures of the back than say a Dale Steyn because 'their bodies are still developing' © AFP
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When the series between South Africa and Australia drew to an abrupt close last summer - they played just two Test matches instead of the originally planned three - the consolation was that two fast-bowling seedlings had been planted. And the hope was they would have grown into something resembling flowering trees by the next time the two sides met.

That time has come and neither Marchant de Lange nor Pat Cummins will participate in a series that has been dubbed the battle of the pacers. De Lange, who came to prominence with his five-wicket haul for South Africa A against Australia last year, has not played cricket since June. His last first-class match was a Test in Wellington in March. Cummins was in action a little over a week ago for Sydney Sixers in the Champions League T20 but has now been ruled out of the rest of the summer. The last red-ball game - and the only Test - he played in was the Wanderers Test in November 2011.

Both have stress fractures of the lower back, although Cummins has also had one in his foot, and both have had their recovery period lengthened and their return delayed.

De Lange was due to play in South Africa's domestic one-day competition that started on Friday, but is still not fully fit. His return has been put back to early next year, which means he will probably miss out on the home series' against New Zealand and Pakistan. Cummins is targeting next year's Ashes for his return but nothing can be certain, especially because stress fractures are such nasty injuries with such lingering tendencies that so few really understand.

"The best way to explain it would be to say it is a bony reaction," Mohammed Moosajee, South African team manager who is also a medical doctor, told ESPNcricnfo. "The spine is made up of vertebrae and the muscles that join each vertebrae act as stabilisers for the spine. When those muscles are affected and can no longer perform their function properly, it affects the bone, which has to carry a greater load. It is not a complete break but if it is left untreated it could turn into a complete break."

Bowlers are particularly at risk of straining the muscles in their back because of the task they perform. "The physical act of bowling causes this. There is hypertension when they arch the back, the rotation of the side and flexing. Even when you land, you put a force of 10 times your body weight onto your foot," Moosajee explained.

Those who are under-23 are even more prone to the condition. "Young people have a growth spurt, which only ends around that age," Moosajee said. "Before that, their bodies are still developing." Cummins is only 19, de Lange 21 and both have had more injuries than the likes of Dale Steyn or Morne Morkel, who debuted much later and played much less cricket.

It may sound like nothing more than a curmudgeons' curse to blame 20-overs cricket for the overload but to some degree it is responsible. Even though bowlers are only allowed four overs in the match, it's the work they do before hand in the nets that adds to their delivery count. De Lange was part of the Kolkata Knight Riders squad and bowled extensively there, then he went to Zimbabwe on an unofficial 20-overs tournament and got injured. To say it was simply coincidence is wishful. "Things like being in training every day, day in, day out, has an impact," Moosajee said.

Even just those four match-time overs can take their toll. Because it's just 24 deliveries, bowlers will throw all their efforts into it and the exertion could result in injury. "It's short, sharp bursts and could be too much all at once," Moosajee said.

 
 
"I spoke to Pat for about an hour on the phone the other night and told him that I have been through the same thing ... Pat's body is maybe not mature enough for what he is doing. It's disappointing for Pat, at his age you don't look to the future, you want everything there and then." Australia fast bowler James Pattinson
 

Twenty-overs cricket is not the only format that is played more frequently and the amount, overall, is a concern. Something as simple as switching between formats has caused Cummins to wonder whether that has hurt his back. While he strives for correctness with the red ball, he looks for variation with the white and the slight changes in action could be doing him in harm.

It could mean that cricketers have to be more selective about how much they play and what they format they choose to play in. James Pattinson, another Australia quick, is an example. Pattinson suffered two stress fractures at the ages of 16 and 18 and was suspected of having a third during the tour of the West Indies. He has since chosen to focus on the longer game, evident in that he has only played one List A game so far this summer, and had had a word with Cummins about the issue.

"I spoke to Pat for about an hour on the phone the other night and told him that I have been through the same thing," Pattinson said. "I said to him that if you bowl at 150 [kph] you are bound to get some injuries. Look at someone like Glenn McGrath, he made his debut at 23 and those years make a big difference. Pat's body is maybe not mature enough for what he is doing. It's disappointing for Pat, at his age you don't look to the future, you want everything there and then."

Pattinson has empathy for his situation. He said he understands that It is difficult trying to cherry pick when you are young, enthusiastic and want to be involved everywhere you can. "It's tough mentally and physically to play in all formats but even I want to play in all three. It's tough to try and work it out but you have to."

For Moosajee too, the management of young bowlers is becoming increasingly important, because there is only so much the medical staff can do. Stress fractures can be tricky to diagnose and only when that has been achieved properly can the rehabilitation process start. Some bowlers go weeks without knowing exactly what the problem is.

"At first you feel discomfort and bowlers sometimes want to and can bowl through that," Moosajee said. "It's not always pain. Pain is something that restricts you, discomfort you can live with." Moosajee said it's up to team management to act quickly as soon as they suspect something is wrong. "When bowlers feel discomfort we immediately do investigations and usually an MRI will detect a stress fracture. As soon as that happens, the bowler will need a back brace. After that, rehabilitation starts with work on the core to strengthen the muscles there. Even after all of that, the injury could recur."

That has already happened with both de Lange and Cummins and the cricketing world can only wait in uncertainty for the exciting pair's return. Cummins' won't be for at least six months but de Lange's could be sooner, although it is likely to be limited to domestic matches because of the schedule - South Africa only play Test cricket again in October next year but the IPL along with a few other 20-overs leagues, the Champions Trophy and a limited-overs tour of Sri Lanka will all take place before that.

If the management chooses the smart route, they will not rush him back for any of that but save him for later so he can fulfil the promise he showed 12 months ago.

Firdose Moonda is ESPNcricinfo's South Africa correspondent

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© ESPN Sports Media Ltd.

Posted by Bonehead_maz on (November 8, 2012, 2:19 GMT)

Posted by Hammond on (November 07 2012, 12:06 PM GMT)

Agree with this ! Only way to get fit to bowl is to bowl". lol a quote from the "first bowler since Francis Drake to get a Knighthood" (and was also the one bowling all the hard overs for Statham, Trueman etc)................

Posted by Meety on (November 8, 2012, 1:06 GMT)

@OzzyHammond on (November 07 2012, 12:06 PM GMT) - perhaps I didn't explain myself, I was making exactly THAT point! They played less "games" but bowled many multiples more over than our current crop. I honestly do not believe that they were necessarily supermen - as heaps of other county bowlers had similar workloads. What I was saying is that the mix of bowling that was done years ago - was more likely to toughen a frame up to the rigours of International cricket. Whereas a diet of one over spells for weeks on end is the opposite of what a bowler should be doing! I know exactly how "do-gooders" stuff things up in Sport. I have personal experience in Rugby where the U19s laws in the scrums & grade involvement retard player development. I have the same suspicions about tampering with how many overs a kid can bowl - well meaning but counter productive. I will clarify - Trueman & others obviously bowled '000s of more overs than current internationals -& it did them GOOD!

Posted by SurlyCynic on (November 7, 2012, 20:22 GMT)

Dale Steyn did not debut 'much later', he played his first test at 21 and was bowling quick as a teenager. The difference is he has a lighter, more athletic build whereas Cummins and De Lange are taller and heavier.

Posted by Hammond on (November 7, 2012, 12:06 GMT)

@Meety- I think you are completely ignoring the fact that in the days of Trueman and Statham, these blokes were playing far more cricket full stop as they were regularly playing for their counties in three day cricket. There was less international cricket in those days, but over a season Tyson would have bowled 5 times as many overs in match conditions as Mitchell Starc would today. Hence the body was conditioned for long spells of bowling. The cricket Australia initiative in the late 90's to stop young blokes bowling long spells has backfired tremendously.

Posted by Meety on (November 7, 2012, 10:39 GMT)

@ OzzyHammond on (November 07 2012, 02:52 AM GMT) - there is no comparison in overs, yet the current crop play more games. I bet Typhoon & Trueman would of had a hell of lot more injuries (than what they did), if they had the schedule these guys have. Also - I bet in the "good old days" a large % of fast bowlers probably had stress fractures they never knew about! All I can say about Hadlee is, (apart from great bowler), is that as a Kiwi, it wasn't like they played that many Tests/ODIs in a season. He would of had a fair bit of downtime in any given year & also in his later years I'd say he was no faster than McGrath. On the topic of speed - look at the insane workload that Copeland delivers - via his 125kph medium pace!

Posted by Hammond on (November 7, 2012, 2:52 GMT)

@Moppa- I actually was referring to his age when he cracked the big time, not what happened to him 13 years later in the Great War. @Meety- McGrath was pretty chest on, you may have a point, but then Hadlee was the classic side on bowler.. who knows, I think comparing the number of deliveries say a Statham delivered per year at the age of 21 and compare that with the young Aussie bowlers are delivering at the same age is where this argument should be heading.

Posted by Meety on (November 7, 2012, 1:32 GMT)

@Moppa on (November 07 2012, 00:49 AM GMT) - re: McGrath - I think it is a combination of the two! Didn't see much of Bishop pre-injury, but I had it in my mind he was more side on. Pretty sure Patterson was always front on - but it was hard to tell he was such a big unit!

Posted by   on (November 7, 2012, 1:22 GMT)

Why these guys are not doing yoga is incomprehensible to me.

Posted by Moppa on (November 7, 2012, 0:49 GMT)

@Hammond, Tibby Cotter was killed in a cavalry charge on Beersheeba in WWI, is he really the most relevant example for whether Cummins and de Lange will survive modern cricket? @RoJayao and Meety, agree broadly with what you're saying, Bishop was initially side-on/mixed (not unlike James Pattinson, incidentally) and then came back more front on. McGrath is an interesting case - yes, his bowling workload came later in life (I heard he couldn't even get a bowl in Narromine when he was 16), and he was also very front-on. Not sure which of these factors explains his durability.

Posted by Meety on (November 7, 2012, 0:34 GMT)

@RoJayao on (November 06 2012, 22:00 PM GMT) - I would say the "rule" to avoid back injuries is obviously a front on style - particularly in your youth. Courtney Walsh had longevity & he was quite front on. Unless you are Malcolm Marshall it used to be thought you can't bowl outswingers with a front on action. So there'll be some temptation to always be side on, but maybe that is something a bowler can do more of when they are over 25?

Posted by   on (November 6, 2012, 23:52 GMT)

Excellent and insightful article..I know there is plenty of research going on this field of biomechanics when it comes to fast bowlers with the crazy amount of limited overs cricket..Has to be upto management to be able to deal with these issues..

I am not fully convinced by the side arm vs Front on action argument..I think its more what Moosajee says about the strength of muscles and bones

Posted by RoJayao on (November 6, 2012, 22:00 GMT)

Absolutely agree Meety. Holding was classic side on, Garner and Marshall front on, Patterson and Bishop a bit each way. Who got the injuries? Not incidentally Bishop was only 20 or 21 when he cracked the big time and then cracked his back, big time! There'll always be exceptions Hammo but it seems the rule is obvious.

Posted by Meety on (November 6, 2012, 20:23 GMT)

@OzzyHammond on (November 06 2012, 14:30 PM GMT) - WIndies pace bowlers were in the main - front on bowlers, they were taught that way to avoid back problems. Didn't help Patterson or Bishop much - although I think when they returned from injury they were more front on.

Posted by Hammond on (November 6, 2012, 14:30 GMT)

Lindwall was 25 when he cracked the big time so there may be an argument. However Tibby Cotter was 21 and he had no dramas. The West Indies bowlers may be a way to destroy the argument.

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