Prehab to avoid rehab

In part one of injury prevention to a fast bowler's lower back, I wrote that the body works as a whole, and that tightness, stiffness, or restricted movement in one structure will result in compensatory loading elsewhere. Over time or with sudden overload, this compensating structure(s) will reach a critical limit beyond which structural failure (injury) occurs.

Early investigations of pain and stiffness can prevent such injury but it helps to maintain a good range of joint movement and soft tissue mobility. If you combine these with suitable and progressive bowling workload, development of excellent core/pelvic control, endurance and functional strength, then most bases are covered to minimise or prevent injury.

But there is one more thing a fast bowler can add to his preparation - bowling prehabilitation.

Bowling prehabilitation involves a series of loaded and coordinated movements designed to mimic/warm-up/facilitate/load the bowling action without actually bowling. This is probably the closest to conditioning the bowling technique when compared with any other functional training tool. It allows power development and core stability in the specific bowling muscles whilst challenging the bowler's unique body positioning and balance. It is also great for filling that transitional phase in injury rehab between gym, functional training and return to bowling.

Credit must go to Troy Cooley for developing this concept a few years ago with his work within Cricket Australia. It has now become routine for elite bowlers to perform a few sets of a variety of drills prior to picking up a cricket ball.

The minimum equipment required is a medicine ball of approximately 3kgs, preferably one that bounces. Ideally, have a big (soccer ball size) ball and a lighter, smaller (softball size) ball in the kit bag to use for double-arm and single-arm variations.

As with any exercise, however, the principles of overload need to be followed, so don't go too heavy too soon. Also Also, start slowly with control and on a stable surface to begin with - even use the crease on a side or practice wicket. The following are an introduction to the bowling prehabilitation concept, and for variations and progressions speak to your team trainer, physio or bowling coach since each will want to do things slightly differently.

Trunk forward flexion Use this drill to warm up the upper back, shoulders, trunk and hip flexors.

Start by standing with feet placed shoulder-width apart and arms fully extended above the head. It's important to initiate the movement from the trunk/abdominals after rocking back as far as possible and stabilising. As you flex forward by bending the back, throw the med ball downwards and forward with arms still straight (as in bowling) onto the ground a couple of metres directly in front. Use a partner to either catch the ball and pass it back gently or progress the challenge by having them throw the ball back above your head - catch it, rock back, stabilise then repeat the throw as described.

Side to side Use this drill to warm up the intercostal (rib) and oblique abdominal muscles. Again, start by holding the medicine ball above the head and have the feet shoulder-width apart. Rock or stretch slightly to one side, then throw the ball down to the outside of the opposite foot using a flexion/rotation movement. Catch the ball on the bounce then repeat. Some players prefer to alternate the throws to the other side.

Back foot to front foot Position your back foot as it would be during your delivery (i.e. pointing straighter for a front-on bowler or out to the side for a more open bowler) and position the body accordingly (i.e. front-on, side-on or semi-open). Balance on this leg with the front leg raised, and arms holding the medicine ball above your head. Rock back slightly and stabilise in this position - this should simulate your bowling position. Then throw the medicine ball forward as if you were bowling and step onto the front leg. Again, initiate the movement with trunk flexion, keeping the arms straight, and throw the ball in the line of the off stump down the wicket. After the ball is released, maintain your balance on the front leg for two counts to emphasise balance and control. Progress by having a partner throw (gently at first) the ball above your head whilst you balance in the start position on the back leg. You should be able to feel how your body needs to work hard to maintain balance and control as you catch it.

Front foot to follow-through This is similar to the previous, but the start position is on the front foot. Again, position the foot as you would place it on the crease. Balance and rock back with the arms raised and stabilise briefly. Throw or deliver the ball down and forward and step into the follow-through. Hold the end position for three counts to emphasise the balance and control and to switch on the necessary stabilising mechanisms. Progress this as above by using a partner.

Typically, a bowler will perform two sets of six to ten repetitions of each exercise as a warm-up. One of the things which may become evident once these drills are attempted is the identification of areas of weakness or poor control. Performing the drills in an unstable environment such as on a foam mat or a mini-trampoline will only amplify areas of weakness. You may then be able to really feel where control is impaired as this really loads the balance systems of the body. An experienced coach, trainer or sports physio can help to identify these areas.

Variations of these drills can also be performed with the smaller medicine ball held solely in the bowling arm.

Performing these exercises considerably changes the loading on the body, and they can easily be incorporated in the session. However, care must be taken as the leverage effect of the arm significantly increases the stabilising forces needed at the shoulder.