On the captain's back

Among the most revealing passages of Opening Up, Mike Atherton's autobiography, is his depiction of the compounding problems stemming from a back condition he carried into cricket. The cycle of misdiagnosis, treatment, medication, side effects and excruciating days robbed of all reasonable movement is told frankly and graphically, providing ample justification for why his batting seemed less than supple at various times, and how his career was shortened. Atherton retired at 33, and concludes he was lucky to get that far.

Tellingly, the years in which Atherton was least hindered by his back were from 1993 to 1998. In that time he went from the age of 25 to 30, now widely regarded as the period most likely to represent an international cricketer's physical peak. They also happened to be the years in which he was England captain, when the pressures and dramas of the job might have cracked a lesser man.

The weight of expectation on Atherton, as England's captain and most reliable batsman, and the nagging doubt created by a bad back, are feelings to which Australia's captain Michael Clarke can easily relate. Clarke is also humbugged by a degenerative back condition dealt to him in his youth - believed to be the lingering cost of early attempts to bowl fast before he resorted to the gentler arts of batting and left-arm spin.

He is also now leading a team that is set to rely on his batting as heavily as England leaned on Atherton's - his wicket the one most valued by opponents who recognised the brittleness beneath. While Atherton was appointed captain early on and left the job before his body began to fail him, Clarke is entering the most vexing phase of his captaincy at an age when his physical durability is going to be increasingly tested. The imminent Test series against India, and those that follow against England away and at home, will be an examination of his batting, his captaincy and his physique - if the body fails, the other skills will be rendered useless.

Few achievements in the game give Clarke more pride than never missing a Test match through injury. For all the handicaps presented by his back, which once confined him to bed for a day of the 2005 Old Trafford Ashes Test and has also forced him to miss numerous limited-overs engagements, his meticulous preparatory efforts have so far meant he has always been deemed fit enough, not only to walk out onto the field on day one but to still be thriving on day five.

"I've been lucky throughout my career, to be honest, with the degeneration I have in my back, to have played 80-odd Test matches and not missed one is something I'm very proud of, but I certainly couldn't do that on my own," Clarke said recently. Alex Kountouris is the physio he has spent most of his career with around the Australian team; he also has a physio at home, and his trainer, Duncan Kerr. "I've been lucky to have so many people around me who know my body and have been able to get me up and continually get me on the park. It is something I'm very proud of."

Kountouris has been working with the national side since 2003, Clarke's first year of international cricket. Over that time they have established a relationship of trust and honest judgement, making calculated gambles at various times along the way that have so far paid off handsomely in the Test match arena. Initially, Kountouris says, there was little indication to him of the back trouble that he had researched before working directly with Clarke.

"When I came in I knew Michael had this history, and you do your homework on everyone, what they've got," Kountouris said. "When I saw [Clarke's first episode of back pain] I realised how much it affected him and how hard it was to do what he wanted to do. But he's incredibly tough - tough mentally more than anything, getting himself up for games.

"One thing he does do is work incredibly hard. He's as professional as any athlete I've ever seen. He crosses every 't' and dots every 'i', and that's the key for him. He has his treatment he needs to, he does his rehab every day. If you tell him, 'This is what you need to do', he'll do it. He doesn't accept second-best as an option when it comes to his preparation. He wants to be the fittest, he wants to be the strongest.

"He's got a set-up at home to do his rehab as well - he does it in the clinic, he does it when he's on tour. He's up every morning, having treatment or whatever he needs to get done."

The maintenance work Clarke has done almost continually since his international career began has been focused on keeping his core as strong as possible, while also maintaining flexibility for his back. Conditioning has been vital too, and there is always a balance to be struck around training intensely to ensure he is able not only to bat but dive around in the field. He has also needed to avoid an excess of the sort of activity that might cause his back to lock up at the wrong moment. Clarke's habit of standing up for long stretches of team bus or plane trips to save his back is well known.

Just as Atherton's batting form ebbed away on the 1998-99 Ashes tour of Australia, when his troublesome discs flared badly, and Mark Taylor's infamous drought of Test runs was preluded by his own bout of back trouble, Clarke's lowest series as an Australian cricketer followed one of his most unfortunately timed relapses. In the Sheffield Shield match immediately before the first Test against England in 2010, he felt the familiar pain, and hobbled through the latter stages of the match in obvious discomfort.

By the time the Gabba match rolled around, his condition had improved, but there was ample evidence of restricted movement in one of his least characteristic innings, a tortured 9 from 50 balls that ended with a pained half-pull shot and an edge behind. It was an innings that more or less defined his series. Looking back, Kountouris remembers a race to get Clarke fit enough to play, though he denies he was still struggling with movement when he was cleared to play.

"It was a race around the clock. He had the Shield game and then it was only a week before the first Test in a massive series and he was keen to play and the team was keen for him to play," Kountouris says. "But by the time it got to the Test, he was pretty good. Once you've had an injury, you're a bit ginger and a bit hesitant to throw yourself around and it's a natural process to be protective and look after yourself. If he'd made a hundred, everyone would have said fantastic, but because he didn't make runs and they bounced him, everyone said, 'He's restricted.'

"We wouldn't have played him if he was carrying back pain. One thing about Test cricket is how tough a game it is. It goes for five days, and you don't want to bring people in with things like that because over the five days they'll be exposed. That's one of the hardest parts of the job, trying to predict what's going to happen over five days. If the game goes for two hours, a different story, you can cope. But six hours, five days in a row, it's pretty tough.

"Conversations with the players are along the lines of, 'Can you do this? Can you bowl 40 or 30 overs in the second innings?' We work on the worst-case scenario in the game. When Michael Clarke goes into a game I expect him to be fit to make 150… although now I have to be sure he's fit to make 200. We literally have that conversation: 'Can you make 150 with how you are?' And that's the expectation."

It will be no tougher than over the next five weeks in India, where Clarke's fitness will be central to his team's chances. Towards the conclusion of each of the past two summers, Clarke has battled hamstring trouble, linked to his back, and the stubborn nature of the problems has forced him to miss numerous limited-overs matches, though not yet a Test. Kountouris is aware that Clarke is no longer the young man who burst into the side in 2004, and the captain's management must reflect his advancing years.

"You'll say to him, 'Yeah, you want to do that but we need to get there a different way than you used to when you were 23-24,'" Kountouris says. "With him it's been more tinkering with what he does now, the way he goes about training. He's 31 now, not 21 anymore, so we adjust that and then hope he gets through. He knows he's had these injuries in the past, so because of that he does his rehabilitation or pre-habilitation, or strength training to make sure he remains strong.

"There's always times when there's something he can go down with, like the hamstring injury in the Melbourne Test match - it happened seven days before the Boxing Day Test [against Sri Lanka]. There was concern he wasn't going to get up for that game, and when you play someone that soon after a hamstring injury there's a risk of re-injury. But it's an informed decision. He's a senior player and he's comfortable, he understands his body. If he says he's confident he can do it then you trust him. Fortunately we manage him on a constant level, try to be as regular as we can with his strength and his treatment and stuff like that, and we don't get into those scenarios very often."

There will be times ahead when Clarke may need to manage himself extra carefully. The IPL that follows the India Tests is a period of particular concern. Other moments may arise when self-preservation precludes him from taking part in training, or he may disappear from the team's inner sanctum for a visit to a clinic. Clarke's longevity in the game is as much about his desire to continue doing all the extra work that has become a part of his career, doubly so since he became captain. After ten years there will be times when it becomes tiresome.

In 1998, with England on the brink of their much-celebrated victory over South Africa at Headingley, Atherton was not in the field, nor the dressing room. He was in a cab scuttling through Leeds, having gone to hospital for a check-up on stomach problems related to his back treatment. His oblivious driver listened to Test Match Special, and at the moment of the final wicket exclaimed: "I knew we'd win something, now that Atherton's not in charge." For Clarke, the physical ailment is familiar, but the team scenario quite different - right now, no one can imagine Australia winning a series without him.