Original research

International Journal of Sports Science

& Coaching
The kinematics of pace bowling associated 2024, Vol. 19(5) 2136–2143
© The Author(s) 2024
with lumbar bone stress injuries:
Article reuse guidelines:
Disparities observed in elite male and sagepub.com/journals-permissions
DOI: 10.1177/17479541241249814
female cricketers journals.sagepub.com/home/spo

Simon Andrew Feros1,2 , Michael H Gerhardy1,2,

Jackson J Fyfe2 , and Dan B Dwyer1,2

Abstract
Elite cricket pace bowlers commonly sustain debilitating bone stress injuries. Lumbar bone stress injuries are more prom-
inent in males, while lower limb bone stress injuries are more common in females. Bone stress injuries are partly attrib-
utable to bowling technique; however, scant research exists comparing bowling techniques of males and females as to
better understand why males are more susceptible to lumbar bone stress injury. Three-dimensional pace bowling kine-
matics previously linked with lumbar bone stress injury were compared between 59 male and 19 female elite pace bow-
lers. Participants bowled 18 match-intensity deliveries indoors from a full run-up, whereby the mean of six deliveries was
analyzed. Compared to females, males exhibited: a more extended thoraco-pelvic segment at back foot contact (p =
0.039, g = 0.46), larger shoulder counter-rotation from back foot contact to front foot flat (p = 0.021, g = 0.64), greater
thoraco-pelvic lateral flexion at front foot flat (p = 0.001, g = 0.95), larger front knee flexion at ball release (p = 0.046, g =
0.57), and greater maximum front knee flexion from front foot flat to ball release (p = 0.009, g = 0.57). Australian elite
male pace bowlers performed techniques linked to lumbar bone stress injury to a much greater extent than their female
counterparts. A straighter front leg technique observed in elite Australian females may be why they more commonly
experience lower limb bone stress injuries via possibly higher vertical loading rates. This information may assist in devel-
oping sex-specific bone stress injury risk mitigation approaches.

Keywords
Ball release, biomechanics, front-leg technique, knee flexion, sex differences

Introduction balls in a 28-day period, and 1097 and 1410 balls over
90 days.6
The ability of a pace bowler to bowl faster is beneficial for
cricket performance.1,2 Faster pace bowlers require less
deliveries to take a wicket (i.e. have a lower “strike
rate”) and concede fewer runs per wicket acquired (i.e.
Reviewers: Aaron Beach (Macquarie University, Australia)
have a lower “economy”) compared to their slower coun- Paul Felton (Nottingham Trent University, UK)
terparts.2 Pace bowling is a physically demanding task;
peak vertical and horizontal ground reaction forces upon 1
Centre for Sport Research (CSR), School of Exercise and Nutrition
front foot landing can range between 3.99 and 8.63 body Sciences, Deakin University - Geelong Waurn Ponds Campus, Geelong,
weight (BW) and 2.55 and 6.05 BW, respectively, per VIC, Australia
2
Institute for Physical Activity and Nutrition (IPAN), School of Exercise
delivery in elite male pace bowlers.3 Compared with tread- and Nutrition Sciences, Deakin University - Melbourne Burwood Campus,
mill running, a delivery from a pace bowler can involve Geelong, VIC, Australia
40–50 times greater lumbar shear forces, 100 times
larger peak lumbar lateral flexion moments, 25 times Corresponding author:
greater peak lumbar rotation moments, and six times Simon Andrew Feros, Centre for Sport Research (CSR), School of
Exercise and Nutrition Sciences, Deakin University - Geelong Waurn
larger peak lumbar flexion-extension moments.4,5 Match Ponds Campus, 75 Pigdons Road, Waurn Ponds VIC 3216, Geelong,
workload data indicates professional pace bowlers deliver Australia.
between 238 and 289 balls in a 7-day span, 554 and 664 Email: [email protected]
Feros et al. 2137

Elite male pace bowlers have the highest injury preva- bowling deliveries may help to explain why particular
lence (% of players unavailable through injury) of 17% bone stress injuries are more common in one sex than
compared to other specialist roles such as spin bowlers another. Such information can be used to develop sex-
(4.2%), batters (6.5%) and wicketkeepers (3.4%).7 specific bone stress injury risk management approaches.
Although the overall injury prevalence of elite female Therefore, the purpose of this study was to compare pace
pace bowlers is lower than their male counterparts (6.4% bowling kinematics previously associated with lumbar
vs. 10.4%, respectively),7 female pace bowlers still have bone stress injury between elite male and female cricketers.
the highest injury prevalence of 7.6% followed by spin Observations from prior research14 formed the hypothesis
bowlers (7.5%), batters (4.9%), and wicketkeepers that some kinematic differences will be evident between
(2.6%).7 Lumbar bone stress injuries are commonly experi- elite male and female pace bowlers.
enced by males (prevalence of 2.6%, incidence of 4.3 new
injuries per 100 players per season), while females more
frequently experience lower limb bone stress injuries Method
(prevalence of 0.9%, incidence of two new injuries per
Study design and setting
100 players per season).7 Lumbar bone stress injuries in
particular can result in more than 8 months of time lost This study involved a retrospective cross-sectional design.
from cricket,6 which is likely to have a negative impact Non-identifiable data was provided in-kind by Cricket
on the development of a pace bowler. Due to the varied Australia. The data was collected indoors at the BUPA
bone stress injury locations between elite male and female National Cricket Centre (Brisbane, Australia). The indoor
pace bowlers, sex-specific injury risk mitigation strategies center housed an artificial cricket pitch and permitted a full-
have been advocated.7 length run-up (Figure 1).
Although ground reaction forces do not significantly
differ between elite male pace bowlers who sustain a
lumbar bone stress injury versus those who do not,8 peak
Participants
lumbar flexion-extension and lateral flexion moments are A total of 59 male and 19 female state- or national-level
discriminatory.9 It is likely that these lumbar kinetics com- contracted pace bowlers (over 18 years) within Australia
bined with particular lumbar kinematics increase the stress from 2014 to 2019 cricket seasons were included in this
on the neural arch of the vertebrae.10 Lumbar bone stress study. An ethics exemption was approved by Deakin
injury is associated with other pace bowling kinematics University’s Human Ethics Advisory Committee (project
such as an increase in rear hip flexion angle at back foot number HEAG-H 153-2020).
contact,8 an increase in lumbo-pelvic extension angle at
front foot contact,8 shoulder counter-rotation from back
foot contact to front foot contact,11 and greater contralateral Procedures
thoracic lateral flexion at front foot contact and at ball Three-dimensional motion data (250 Hz) was captured via a
release.9 Lower limb bone stress injuries (e.g. tibial or meta- 20-camera (T40-S) Vicon motion analysis system (Oxford
tarsal stress fracture) are not influenced by the magnitude of Metrics Ltd, Oxford, UK) over 18 trials (Figure 1). The
ground reaction forces as often suspected, but rather, are cameras surrounded the bowling crease in a circular
partly explained by greater vertical loading rates.12 manner, covering a 20 m3 volume (width = 2 m, length =
Kinematic parameters such as reduced knee flexion and 5 m, height = 2 m). This capture space was first calibrated
faster gait speed increase vertical loading rates,13 which via a calibration wand that collected 5000 frames with a tol-
may in-turn heighten the risk of sustaining a lower limb erance of 0.2. A high-speed camera (125 Hz; Vicon Bonita
bone stress injury. 720c, Vicon Motion Systems Ltd, Oxford, UK), was placed
Given the importance of kinematics in understanding the in line with the popping crease to provide a sagittal plane
etiology of bone stress injuries, it is surprising how little view of the bowling action for purposes of identifying the
research has been conducted on comparing kinematics moment of back foot contact and ball release.
between elite male and female pace bowlers. Just one Each participant wore sixty-three 14-mm spherical retro-
study to date has explored these differences and observed reflective markers. The plug-in gait marker set, which has
elite female pace bowlers to develop less whole-body been used in prior cricket pace bowling research,18,19
linear momentum than males, but are able to make use of accounted for 57 of these markers, while six additional
whole-body angular momentum in the delivery sequence.14 markers were used. Of the 57 markers that formed the
However, that study did not investigate variables that are plug-in gait marker set, four markers were positioned on
associated with lumbar bone stress injury in male pace the head, five markers were situated about the thorax (C7
bowlers such as shoulder counter-rotation and contralateral spinous process, T10 spinous process, right scapula,
thoracic lateral flexion.9,11,15–17 Knowledge of the kine- xiphoid process, and suprasternal notch), six markers
matic differences between elite male and female pace were located around the pelvis and sacrum (left and right
2138 International Journal of Sports Science & Coaching 19(5)

Figure 1. The data collection environment.

side anterior superior iliac spine, and a cluster of four

markers about the sacrum), seven markers were situated Table 1. The delivery sequence in the pace bowling assessment.
on each arm (one at the acromion, upper arm, and elbow, Delivery no. Over 1 Over 2 Over 3
with a marker positioned either side of the wrist, and a
marker placed just proximal to the middle knuckle of the 1 Good length Good length Good length
2 Good length Bouncer Yorker
hand), and 14 markers were located on each leg (a cluster
3 Bouncer Yorker Bouncer
of four markers on the thigh, a marker on the medial and
4 Bouncer Yorker Good length
lateral epicondyles of the femur, a cluster of four markers 5 Yorker Bouncer Bouncer
on the tibia cluster, a marker on the medial and lateral mal- 6 Yorker Good length Yorker
leoli, a heel and forefoot marker). Of the six additional
markers, two were located on either side of the forefoot
and an additional heel marker was used per foot. This cus- red/white cricket ball (Kookaburra Turf, Kookaburra, Sport,
tomized marker set allowed full body motion to be deter- Melbourne, Australia), while females bowled with a 4-piece
mined using Vicon BodyBuilder (Version 3.6.1, Oxford 142 g half red/white cricket ball (Kookaburra Turf,
Metrics Group, Oxford, UK) software. Kookaburra, Sport, Melbourne, Australia). A high-
One static and one dynamic calibration capture were per- performance cricket coach (i.e. a coach with the Level 3
formed. Participants stood in the anatomical position and Cricket Australia Coach Accreditation) assessed bowling
held this for the static calibration. A set of five squats accuracy performance across the 18 deliveries. Time-discrete
were used in the dynamic trial to define the knee joint angular outputs were generated from the first six useable
flexion-extension axis.20 After the dynamic calibration, trials (two of each delivery length with minimal marker loss).
joint center markers at the hip, knee, and ankle were Motion capture data were smoothed using a fourth-order
removed as they were virtually stored in the thigh and low-pass Butterworth filter with a cut-off frequency of
shank clusters. 10 Hz.21 Pace bowling biomechanics do not appear to be influ-
Following the static and dynamic calibration, subjects enced by the length of delivery22; thereby the selection of trials
performed their own warm-up that included several at each delivery length for analysis was deemed acceptable.
warm-up balls. Once completed, participants delivered 18 Note that the dataset only contained the mean data of the six
balls (three overs of six deliveries each) at match intensity. trials, not trial-by-trial data for each participant.
These deliveries were bowled in a pre-determined order Thirteen bowling kinematic parameters were analyzed
(Table 1), with six balls each at the following delivery (Table 2). Reference frames were defined using three
lengths: “full” (0–4 m from batter’s stumps), “good” (4– markers on each segment, allowing segment orientations
7 m from batter’s stumps), and “short” (7–10 m from and joint angles to be calculated. The thorax reference
batter’s stumps). Males bowled with a 4-piece 156 g half frame was defined by the C7 spinous process, T10
Feros et al. 2139

Table 2. Pace bowling kinematic parameters and their definitions.

Kinematic parameter Definition

Pelvis orientation at BFC (°) The angle of the long axis of the pelvis in relation to the global coordinate system and measured
in the transverse plane at back foot contact. The zero point was defined as the pelvis facing
forwards in an anatomical position straight down the pitch.
Shoulder orientation at BFC (°) The angle of the shoulder segment (segment represented one acromion to the other acromion)
was measured in the transverse plane in relation to the global coordinate system at back foot
contact.11 The zero point was defined as the shoulders facing forwards in an anatomical
position straight down the pitch.
Pelvis-shoulder separation at BFC (°) The difference between the pelvis orientation and shoulder orientation angle at back foot
contact, measured in the transverse plane. A positive angle represented the shoulder segment
being more front-on to the pelvis, while a negative angle represented the shoulder segment
being more side-on to the pelvis. The zero point was defined as the pelvis and shoulder
orientations in complete alignment in the transverse plane.
Shoulder counter-rotation from BFC The difference between the shoulder orientation angle at back foot contact and the maximum
to FFF (°) shoulder orientation angle observed between back foot contact and front foot flat, measured
in the transverse plane. A value of zero indicated no “clockwise” shoulder rotation in the
transverse plane for a right-handed bowler from back foot contact.
Thoraco-pelvic extension at BFC (°) The angular difference between the thorax and the pelvis in the sagittal plane at back foot
contact. The zero point was defined as the thorax and pelvis segment orientations in complete
alignment in the sagittal plane.
Thoraco-pelvic extension at FFF (°) The angular difference between the thorax and the pelvis in the sagittal plane at the front foot is
flat. The zero point was defined as the thorax and pelvis segment orientations in complete
alignment in the sagittal plane.
Thoraco-pelvic lateral flexion at FFF The angular difference between the thorax and the pelvis in the frontal plane at the front foot is
(°) flat. The zero point was defined as the thorax and pelvis segment orientations in complete
alignment in the frontal plane.
Thoraco-pelvic lateral flexion at BR (°) The angular difference between the thorax and the pelvis in the frontal plane at ball release. The
zero point was defined as the thorax and pelvis segment orientations in complete alignment in
the frontal plane.
Rear knee flexion at BFC (°) The sagittal plane angle between the rear thigh and shank segments at back foot contact, using a
previously defined model.20 The zero point was defined as the thigh and shank segment in
complete alignment along the longitudinal axis.
Maximum rear knee flexion from BFC The maximum amount of rear knee flexion from back foot contact to ball release. The zero
to BR (°) point was defined as the thigh and shank segments in complete alignment along the
longitudinal axis.
Front knee flexion at FFF (°) The sagittal plane angle between the front thigh and shank segments at the front foot is flat using
a previously defined model.20 The zero point was defined as the thigh and shank segment in
complete alignment along the longitudinal axis.
Maximum front knee flexion from FFF The maximum amount of front knee flexion from front foot flat to ball release. The zero point
to BR (°) was defined as the thigh and shank segments in complete alignment along the longitudinal axis.
Front knee flexion at BR (°) The sagittal plane angle between the front thigh and shank segments at ball release using a
previously defined model.20 The zero point was defined as the thigh and shank segment in
complete alignment along the longitudinal axis.
BFC: back foot contact; FFF: front foot flat; BR: ball release.

spinous process, xiphoid process, and suprasternal notch x-axis pointed towards the participant’s right, and the
markers. The pelvis reference frame was defined by the z-axis pointed upwards along the longitudinal axis of the
bilateral anterior superior iliac spine markers and the segment. For the global orientation, the xyz rotations corre-
cluster of four markers on the sacrum. Thoraco-pelvic sponded to tilt, drop, and twist, respectively, with orienta-
segment orientations and joint angles could be calculated tions described relative to the anatomical position and the
based on the thorax and pelvis local reference frames. A bowling side (anatomical position = 0°, flexion > 0°); a
global coordinate system was defined with the y-axis point- bowler that was in a “side-on” position was in 90° of rota-
ing down the cricket pitch, with the x-axis pointing to the tion. For the joint angles, the xyz rotations corresponded to
right of the cricket pitch for a right-handed bowler, and flexion–extension, abduction–adduction, and longitudinal
the z-axis pointing vertically upwards. The local coordinate rotation, respectively, with angles described relative to the
system was defined with the y-axis pointing forwards, the anatomical position (anatomical position, 0°; flexion > 0°).
2140 International Journal of Sports Science & Coaching 19(5)

Data for left-handed bowlers was transformed into the (< 0.20), small (≥ 0.20), medium (≥ 0.50), and large (≥
coordinate system of a right-handed bowler. 0.80). Effect sizes were defined as “unclear” if the 95% confi-
Each kinematic parameter was calculated at either back dence intervals overlapped thresholds for both small positive (>
foot contact, front foot flat, or ball release. Back foot 0.2) and small negative effects (< 0.2).24 All statistical analyses
contact represented the time point when the heel markers involved pairwise deletion due to a low sample size of female
reached their lowest point. The front foot flat was depicted data. Inferential analyses were performed using IBM SPSS
as the first visible frame from the high-speed camera Statistics (version 27.0, IBM Corp, Armonk, NY). Statistical
whereby the foot was flat. The first visible frame from the significance was accepted at p < 0.05.
high-speed camera whereby the ball was not in contact
with any part of the bowling hand was defined as the
moment of ball release. Due to the differences in sampling Results
rates between the high-speed camera (125 Hz) and Vicon Elite male pace bowlers exhibited significantly greater thoraco-
cameras (250 Hz), the three-dimensional analysis involved pelvic extension at back foot contact (mean difference ± 95%
going backwards by one frame compared to the high-speed CI: 4.3 ± 4.1°, p = 0.039), shoulder counter-rotation from
camera to accurately determine and analyze the kinematics back foot contact to front foot flat (mean difference ± 95%
at front foot flat and ball release. CI: 8.9 ± 7.4°, p = 0.021), and thoraco-pelvic lateral flexion
The mean of the six deliveries for each variable (and not the at front foot flat (mean difference ± 95% CI: 8.7 ± 5.1°, p =
individual trial data) was included in the dataset provided by 0.001) compared to their female counterparts (Table 3,
Cricket Australia. Some kinematic data were missing com- Figure 2). Elite female pace bowlers exhibited significantly
pletely at random. Imputation for missing data was not per- less front knee flexion at ball release (mean difference ± 95%
formed. All dependent variables met the normal distribution, CI: −11.9 ± 11.6°, p = 0.046), and less maximum front knee
assessed via the Shapiro-Wilk test (i.e. p > 0.05). Independent flexion from front foot flat to ball release (mean difference ±
samples t-tests were conducted to examine differences in 95% CI: −10.0 ± 7.4°, p = 0.009) compared to their male
pace bowling kinematics between males and females. peers (Table 3, Figure 2).
Unequal variances were assumed when a statistically signifi-
cant p-value (p < 0.05) was determined via the Levene’s test.
Hedges’ g effect sizes and 95% confidence intervals were cal- Discussion
culated using a purpose-made Microsoft Excel (version 2016; The purpose of this study was to investigate the differences
Microsoft Corp.) spreadsheet23 to account for the large differ- in pace bowling kinematics between elite male and female
ence in sample size between males and females and to correct pace bowlers. In agreement with the hypothesis, this study
the positive bias in Cohen’s d effect sizes associated with observed several novel kinematic differences between
smaller samples. Qualitative descriptors of standardized effect males and females that could partly explain why males
sizes (Cohen’s d) were assessed using these criteria: trivial are more likely to sustain lumbar bone stress injuries and

Table 3. Descriptive data and differences in pace bowling kinematics between elite male and female pace bowlers.

Mean difference Effect size

Male Female (male–female) (male–female)

Kinematic parameter n Mean SD n Mean SD Mean ± 95% CI p g ± 95% CI

a a
Pelvis orientation at BFC (°) 53 56.6 13.9 12 56.5 5.5 0.1 5.0 0.952 0.01 0.63
Shoulder orientation at BFC (°) 55 38.9 18.5 19 39.4 16.7 −0.5 9.6 0.919 −0.03 0.52
Pelvis-shoulder separation at BFC (°) 54 19.6 14.4 18 12.7 11.2 6.9 7.5 0.068 0.50 0.54
Shoulder counter-rotation from BFC to FFF (°) 55 36.4 14.3 18 27.5 11.9 8.9 7.4 0.021* 0.64 0.54
Thoraco-pelvic extension at BFC (°) 51 8.3 10.1 16 4.0 5.7 4.2 4.1a 0.039*,a 0.46 0.57
Thoraco-pelvic extension at FFF (°) 53 −5.6 10.9 19 −5.8 7.7 0.2 5.4 0.939 0.02 0.52
Thoraco-pelvic lateral flexion at FFF (°) 54 7.4 9.4 16 −1.3 7.8 8.7 5.1 0.001* 0.95 0.58
Thoraco-pelvic lateral flexion at BR (°) 54 34.0 7.9 19 31.2 10.0 2.8 4.5 0.220 0.33 0.53
Rear knee flexion at BFC (°) 52 45.6 11.7 18 43.2 8.2 2.4 6.0 0.418 0.22 0.54
Maximum rear knee flexion from BFC to BR (°) 50 61.4 12.2 18 64.4 7.7 −2.9 5.1a 0.246a −0.26 0.54
Front knee flexion at FFF (°) 48 12.3 8.9 19 8.8 6.5 3.5 4.5 0.125 0.42 0.54
Maximum front knee flexion from FFF to BR (°) 45 30.0 19.3 16 20.0 9.3 10.0 7.4a 0.009*,a 0.57 0.58
Front knee flexion at BR (°) 41 23.2 21.3 18 11.3 19.0 11.9 11.6 0.046* 0.57 0.56
BFC: back foot contact; FFF: front foot flat; BR: ball release; SD: standard deviation; CI: confidence interval.
a
Equal variances not assumed (Levene’s test), p < 0.05.
*Significant difference between males and females, p < 0.05.
Feros et al. 2141

Figure 2. Hedges’ g effect sizes (male–female) ± 95% confidence intervals of each pace bowling kinematic parameter. The following
symbols were used to assist in the qualitative interpretation of the effect size: ×, unclear; •, small; ▪, medium; ▴, large. BFC: back foot
contact; FFF: front foot flat; BR: ball release.

why females are more likely to sustain lower limb bone not statistically significant), and achieved greater maximum
stress injuries. The findings from this investigation may values of extension in their lower thoraco-pelvic region from
have practical implications for designing sex-specific inter- back foot contact to ball release (medium effect size, not stat-
ventions to mitigate the risk of bone stress injuries. istically significant), compared with their uninjured counter-
Males counter-rotated their shoulders more than their female parts.8 Extension, lateral flexion, and rotation of the lumbar
counterparts. Earlier research associated excessive shoulder spine in conjunction with compression forces have been
counter-rotation and the “mixed” bowling action with lumbar shown to place the pars interarticularis under the greatest
bone stress injury in elite male pace bowlers.11,15–17 However, amount of stress.10 Lumbar bone stress injuries typically ori-
more recent conflicting evidence exists surrounding this associ- ginate in the distal–ventral region of the pars interarticularis,
ation.8,9 Discrepancies in studies can be attributed to the limita- and it is the ventral aspect that can experience double the
tion in projecting a three-dimensional segment orientation onto stress during lumbar extension compared to the dorsal compo-
the horizontal plane. This two-dimensional kinematic parameter nent.26 Although speculative, the elite male pace bowlers in
is a modest proxy of three-dimensional spinal kinematics.25 this study may have adopted a technique that elevated their
Nevertheless, after applying the technique classification system risk of lumbar bone stress injury by adopting greater lumbo-
with respect to the global coordinate system used by Portus pelvic extension upon back foot contact.
et al.,11 71% of males (n = 37) were categorized to have Pace bowlers perform contralateral thoraco-pelvic lateral
bowled with a “mixed” bowling action compared to 47% for flexion to maximize the height of ball release and subsequent
females (n = 8). Despite previous studies highlighting a bounce off the cricket pitch.8 In this study, males were in
concern with excessive counter-rotation, this data indicates greater contralateral thoraco-pelvic lateral flexion at the front
excessive shoulder counter-rotation remains prevalent in elite foot flat, which may place them at greater risk of lumbar
male pace bowlers and is also potentially problematic for elite bone stress injury compared to their female counterparts.
female pace bowlers too. However, this result contrasts observations from prior research
Males displayed greater thoraco-pelvic extension at back that compared pace bowling kinematics in elite male and
foot contact than females. This finding agrees with prior female pace bowlers.14 The discrepancy between findings
research.14 Recent evidence has shown elite male pace may be due to differences in the measurement of front foot
bowlers who sustain a lumbar bone stress injury are positioned landing; this study measured kinematics at front foot flat
in greater lumbo-pelvic extension at front foot contact than which typically occurs a little later than front foot contact.
their uninjured counterparts.8 Bowlers who sustained a Nevertheless, adolescent male pace bowlers with low back
lumbar bone stress injury in that study were also observed to injury demonstrate excessive contralateral thoracic lateral
be in greater extension of the lower thoraco-pelvic region at flexion at both front foot contact and ball release, but also
back foot contact and front foot contact (medium effect size, experience greater peak lumbar lateral flexion moments
2142 International Journal of Sports Science & Coaching 19(5)

compared to their uninjured counterparts.9 Excessive contra- instant of back foot contact in this study was defined as
lateral lower thoracic lateral flexion from front foot contact when the heel markers reached their lowest point; the true
to ball release combined with the external ground reaction instant of back foot contact may have occurred a few
forces increases the stress on the neural arch of the lumbar ver- frames earlier than measured in this study as pace bowlers
tebrae,10,27 and thereby heightens the risk of lumbar bone typically land their back foot in a plantarflexed position
stress injury. Recent evidence has shown shoulder counter- (midfoot or forefoot) with their heel off the ground. The
rotation to be linked with contralateral thoracic lateral flexion instants of the front foot flat and ball release were identified
and contralateral thoraco-lumbar lateral flexion,25 therefore, from high-speed camera footage operating at 125 Hz; this
interventions to reduce shoulder counter-rotation may also sampling rate is not as precise as the three-dimensional
assist in limiting contralateral thoracic lateral flexion and motion analysis system that operated at 250 Hz. The calcu-
contralateral thoraco-lumbar lateral flexion. A two-year coach- lation of time-discrete kinematic data at front foot flat made
ing intervention study that used a constraints-led approach it difficult to compare across other studies that investigated
with the aim of reducing contralateral lower thoracic lateral kinematics at front foot contact. Additional research could focus
flexion was shown to be ineffective28; however, an eight-week on analyzing the kinematics at when peak vertical ground reac-
exercise-based intervention program was effective in reducing tion forces are experienced during the front leg landing of each
contralateral trunk lateral flexion relative to the pelvic pos- bowler. It should be noted, however, that the analysis of time-
ition.29 This research highlights contralateral trunk lateral discrete kinematic data as conducted in this study is an inferior
flexion (relative to the pelvis) to perhaps be more influenced approach compared to the analysis of continuous wave-form
by insufficient dynamic neuromuscular control of the kinematic data; the latter can better portray “how” pace
lumbo-pelvic-hip complex.9,29 bowlers attained positions of increased injury risk.1 Finally,
Compared to males, elite female pace bowlers were able the dataset provided for the secondary data analysis only com-
to maintain a straighter front leg technique from front foot prised the mean kinematic data from the six trials per participant
flat to ball release, as indicated by a lower maximum (with two useable trials of each delivery length). While there are
front knee flexion angle during this phase, and a lesser some kinematic parameters that do not significantly alter with
front knee flexion angle at ball release. Gait research con- respect to the length of delivery bowled,22 other kinematic para-
ducted on healthy male subjects has shown that a more meters could have been sensitive to changes in delivery length,
extended front knee throughout the gait cycle increases ver- and thus the averaging of the six trials to provide representative
tical loading rates compared to a more flexed knee.13 While data for each bowler would not have been appropriate due to
kinetic data was not collected as part of this study, and that expected lower between-trial repeatability.
human gait differs from the front leg landing mechanics of a
cricket pace bowler, a straighter front leg landing technique
may be positively associated with increased vertical loading Conclusion
rates. A systematic review and meta-analysis indicate lower This investigation has shown elite Australian male pace
limb bone stress injuries cannot be explained by the magni- bowlers use techniques that could explain why they suffer
tude of ground reaction forces, but rather, by vertical more lumbar bone stress injuries than their female counter-
loading rates.12 Given elite Australian female cricketers parts. These techniques involve greater shoulder counter-
sustain two new lower limb bone stress injuries per 100 rotation, thoraco-pelvic extension at back foot contact,
players annually,7 interventions to reduce the vertical and contralateral thoraco-pelvic lateral flexion at front
loading rate upon front foot landing may be helpful to foot flat. On the other hand, elite Australian female pace
reduce the incidence of this debilitating injury. Previous bowlers bowl with a straighter front leg technique, which
research in elite male pace bowlers reveals that a more dor- may partly explain why they experience more lower limb
siflexed ankle at the front foot upon landing to increase the bone stress injuries, possibly through increased vertical
time to reach vertical peak force,30 which may have positive loading rates. These findings are likely to influence sex-
implications for reducing vertical loading rates. specific mitigation approaches to reduce the incidence of
There were several limitations to this study. As this bone stress injury. Future experimental research is encour-
investigation involved a secondary data analysis, conducted aged to adopt a multi-disciplinary approach involving bio-
retrospectively, several kinematic variables linked with mechanics, strength and conditioning, and physiology in
lumbar bone stress injury (e.g. rear hip flexion angle at the mitigation of biomechanical risk factors linked to
back foot contact, lumbo-pelvic extension angle at front lumbar and lower limb bone stress injury in elite cricketers.
foot contact, lumbo-pelvic lateral flexion angle to the oppos-
ite side at front foot contact) or potentially associated with Acknowledgements
lower limb bone stress injury (front foot dorsiflexion angle The authors would like to thank Cricket Australia for providing the
at front foot contact) were not included in the dataset.3,8 data in-kind and for Rian Crowther’s assistance regarding the pro-
Kinetic data was not captured, thus front-leg vertical tocols for the collection of three-dimensional pace bowling kine-
loading rates and kinematics could not be explored. The matics and ball release speed data.
Feros et al. 2143

Authors’ contributions 11. Portus MR, Portus MR, Mason BR, et al. Cricket: technique
SA Feros: conceptualization, methodology, formal analysis, factors related to ball release speed and trunk injuries in high per-
writing–original draft, and writing–review and editing, formance cricket fast bowlers. Sports Biomech 2004; 3: 263–284.
Visualization, supervision, and project administration. MH 12. Zadpoor AA and Nikooyan AA. The relationship between
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