Single photon emission computerized tomography and reverse gantry computerized tomography findings in patients with back pain investigated for spondylolysis.

BACKGROUND: Athletes with low back pain may have sustained a bone stress injury in the lumbar neural arch, including spondylolysis. Single photon emission computerized tomography (SPECT) and reverse gantry computerized tomography (rg-CT) help localize bone stress response and spondylolyses. OBJECTIVES: To describe the SPECT and rg-CT findings in those patients suspected of suffering from a spondylolysis. STUDY DESIGN: Large retrospective case series. SETTING: Secondary and tertiary care center in England. PATIENTS: A total of 213 patients presenting to the Spinal Unit and Sports Medicine Clinics between 1995 and 2000 with low back pain and subsequently investigated for spondylolysis by SPECT and rg-CT. METHODS: An experienced consultant musculoskeletal radiologist reported the SPECT and rg-CT, and these results along with data from the patient's medical records were analyzed. MAIN OUTCOME MEASURES: Sites and sides of increased scintigraphic activity in the lumbar neural arch seen on SPECT and complete and incomplete spondylolyses were recorded. RESULTS: Single photon emission computerized tomography scan showed increased scintigraphic uptake in 145 patients, mostly (42.3%) at L5. Marked increase in scintigraphic uptake was noted on the left side of the neural arch in 31 patients and on the right in 17 (chi; P < 0.05). Spondylolysis was identified on rg-CT in 81 patients. Spondylolyses were bilateral on 44 occasions, but unilateral lesions occurred in the left pars 36 times and on the right 16 times (chi; P < 0.01) CONCLUSIONS: Spondylolyses were a frequent finding on rg-CT in young athletes with low back pain. The sports most commonly associated with this stress response in the pars interarticularis were cricket and soccer. The lower lumbar levels are more likely to show abnormalities on SPECT and computerized tomography. Among those investigated for spondylolysis, left-sided lower lumbar pain was more common than right, and a marked increase in scintigraphic uptake was noted on the left more often than the right. Although bilateral spondylolyses were common, left-sided spondylolyses were more common than right. The asymmetric repetitive movements of certain sports may be responsible. In particular, fast bowlers developed spondylolysis on the opposite side of the body to their bowling arm.     

Lumbar lordosis and pars interarticularis fractures: a case–control study

Objective

The aim of this study is to examine the relationship between lumbar lordosis and pars interarticularis fractures.

Materials and methods

In this retrospective case–control study we compare the angle of lumbar lordosis and the angle of the S1 vertebral endplate (as a measure of pelvic tilt) in patients with bilateral L5 pars interarticularis fractures with age- and sex-matched control cases with normal MRI examinations of the lumbar spine. Twenty-nine cases of bilateral L5 pars interarticularis fractures with matched control–cases were identified on MRI (16 male, 13 female, age 9–63?years). The angle of lordosis was measured between the inferior L4 and superior S1 vertebral endplates on a standing lateral lumbar spine radiograph for both groups.

Results

The mean angle of lordosis about the L5 vertebra was 36.9° (SD?=?6.5°) in the pars interarticularis fracture group, and 30.1° (SD?=?6.4°) in the control group. The difference between the two groups was significant (mean difference 6.8°, Student’s?t test: P?P?Conclusion Sacral tilt represented by a steeply angled superior endplate of S1 is associated with a significantly increased angle of lordosis, between L4 and S1, and pars fractures at L5. Steep angulation of the first sacral vertebral segment maybe the predisposing biomechanical factor that leads to pincer-like impingement of the pars interarticularis and then spondylolysis.     

Facet joint arthrography in lumbar spondylolysis: anatomic basis for spread of contrast medium

Facet arthrograms in patients with lumbar spondylolyses show spread of contrast medium through pars interarticularis defects into the adjacent ipsilateral facet joint space and across the midline into the contralateral joint space. Transverse and sagittal sections of facet joints from 141 postmortem lumbar spines were studied. Five examples of spondylolysis were found. Anatomic studies of the relationship of the joint recesses to the pars interarticularis demonstrated the basis for the patterns of spread of contrast medium observed radiographically in this and previous series. The pars interarticularis forms the only boundary between the inferior recess of one facet joint and the superior recess of the adjacent joint. Fracture through the pars interarticularis establishes communication between adjacent ipsilateral joints and opens a communication to the retrodural space, through which contrast medium can track to the contralateral joint.     

Sports related maxillofacial injuries: the first maxillofacial trauma database in Switzerland

Background: With the increase in the amount of medical data handled by emergency units, advances in computerisation have become necessary. New computer technology should have a major influence on accident analysis and prevention and the quality of research in the future.

Objectives: To investigate the occurrence of sports related maxillofacial injuries using a newly installed relational database. To establish the first sports trauma database in Switzerland.

Methods: The Qualicare databank was used to prospectively review 57 248 case histories of patients treated in the Department of Emergency Medicine between January 2000 and December 2002. Pre-defined key words were used to collect data on sports related maxillofacial injuries.

Results: A total of 750 patients with maxillofacial injuries were identified. Ninety (12%) were sports related maxillofacial fractures. Most (27%) were sustained during skiing and snowboarding, 22% during team sports such as soccer or ice hockey, and 21% were from cycling accidents. Sixty eight per cent of the cyclists, 50% of the ice hockey players and soccer players, and 48% of the skiers and snowboarders had isolated fractures of the midface. Fractures of the mandible were noted predominantly in contact sports.

Conclusions: Computerisation of trauma and emergency units and the introduction of customised software can significantly reduce the workload of researchers and doctors. The effective use of new computer technology should have a considerable influence on research and the quality of future prospective and retrospective studies.

     

Differences in sole arch indices in various sports

Background: There are controversial data about the relation between foot morphology and athletic injuries of the lower extremity. Studies in soldiers have shown some relationship, whereas those involving athletes have not shown any significant relationship. The reason for these differences is not clear.

Objective: To determine the effect of various sports on sole arch indices (AIs).

Method: A total of 116 elite male athletes (24 soccer players, 23 wrestlers, 19 weightlifters, 30 handball players, and 20 gymnasts) and 30 non-athletic men were included in this cross sectional study. Images of both soles were taken in a podoscope and transferred to a computer using a digital still camera. AIs were calculated from the stored images.

Results: The AI of the right sole of the gymnasts was significantly lower than that of the soccer players, wrestlers, and non-athletic controls (p<0.01). The AI of the right sole of the wrestlers was significantly higher than that of the soccer players, handball players, weightlifters, gymnasts, and non-athletic controls (p<0.03). The AI of the left sole of the gymnasts was significantly lower than that of the wrestlers and non-athletic controls (p<0.001). The AI of the left sole of the wrestlers was significantly higher than that of the soccer players, handball players, and gymnasts (p<0.007). The AI of both soles in handball players was significantly lower than those of the non-athletic subjects (p = 0.049). The correlation between the AI of the left and right foot was poor in the soccer players, handball players, and wrestlers (r = 0.31, 0.69, and 0.56 respectively), but was high in the gymnasts, weightlifters, and non-athletic controls (r = 0.96, 0.88, and 0.80 respectively).

Conclusion: The AIs of the gymnasts and wrestlers were significantly different from those of other sportsmen studied, and those of the gymnasts and handball players were significantly different from those of non-athletic controls.

     

Quadratus lumborum asymmetry and L4 pars injury in fast bowlers: a prospective MR study

PURPOSE: This prospective study examined the association between quadratus lumborum (QL) asymmetry and the development of symptomatic pars interarticularis lesions in the lumbar spine of adolescent cricket fast bowlers. METHODS: Annual magnetic resonance imaging was used to measure QL volume asymmetry and for identifying pars lesions of the lumbar vertebrae in fast bowlers (N=51) and a control group of swimmers (N=18). Manual segmentation of axial images spanning the lumbar spine was performed to calculate percent QL asymmetry relative to the bowling- or throwing- (swimmers) arm side. Asymmetry above 100% indicated a larger QL volume on the bowling- (throwing) arm side. RESULTS: The mean QL asymmetry in bowlers of 110.5% (SD=12.1%) was significantly different from the 96.6% (SD=5.0%) asymmetry in swimmers (t=6.75, P相似文献   

Epidural fat interposition between dura mater and spinous process: a new sign for the diagnosis of spondylolysis on MR imaging of the lumbar spine

The purpose of this study was to assess the diagnostic value of epidural fat interposition between the dura mater and spinous process of L5 as an indirect sign of spondylolysis on mid-sagittal MR imaging of the lumbar spine. Mid-sagittal T1-weighted MR images of the lumbar spine of 85 patients with spondylolysis and 93 patients without pars interarticularis fractures were randomized and evaluated by a masked reader. After a training sample of five cases, the reader was asked to note the presence or absence of epidural fat interposition between the dura mater and spinous process of L5 on the randomized images. The epidural fat interposition between the dura mater and spinous process of L5 was noted in 67 out of the 85 patients with spondylolysis (78.8%) and three of the patients without pars interarticularis fracture (3.2%). The difference was statistically significant (P<0.01). This sign has a specificity of 96.7%, sensitivity of 78.8%, positive predictive value of 95.7%, negative predictive value of 83.3% and accuracy of 88.2% for diagnosis of spondylolysis. Epidural fat interposition between the dura mater and spinous process may be a helpful sign for the diagnosis of spondylolysis on mid-sagittal MR imaging of the lumbar spine.     

Injury history as a risk factor for incident injury in youth soccer

Objectives: To determine if athletes with a self reported history of previous injury have a higher incident injury rate than athletes without a self reported injury history.

Methods: A prospective cohort study of Classic League soccer players playing at the level under 12 through under 18. Injury history forms were mailed to all registering Classic League soccer players in the North Carolina Youth Soccer Association during 1997–2000 (n = 7000); 1483 (19%) returned the baseline questionnaire and were followed up for injuries.

Results: There were 5139 player-seasons of follow up and an estimated 171 957 athlete-exposures. More than half self reported an injury history (59.7%). Overall, the unadjusted incidence rate was 4.6 (95% confidence interval (CI) 4.3 to 4.9) incident injuries per 1000 athlete-exposures. Multivariate generalised Poisson regression modelling indicated that players with one previous injury had a twofold greater risk of incident injury (IRR = 2.6; 95% CI 2.0 to 3.3), and those with two or more previous injuries had a threefold greater risk of incident injury (IRR = 3.0; 95% CI 2.3 to 3.8) compared with athletes with no previous injuries.

Conclusions: Injury history was associated with an increased injury rate. This suggests that, even in these youth soccer players, those with an injury history may be at higher risk.

     

Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis

Objective The objective was to retrospectively record the CT and MRI features and healing patterns of acute, incomplete stress fractures of the pars interarticularis. Method The CT scans of 156 adolescents referred with suspected pars interarticularis stress fractures were reviewed. Patients with incomplete (grade 2) pars fractures were included in the study. Fractures were assessed on CT according to vertebral level, location of cortical involvement and direction of fracture propagation. MRI was also performed in 72 of the 156 cases. MRI images of incomplete fractures were assessed for the presence of marrow oedema and cortical integrity. Fracture healing patterns were characterised on follow-up CT imaging. Results Twenty-five incomplete fractures were identified in 23 patients on CT. All fractures involved the inferior or infero-medial cortex of the pars and propagated superiorly or superolaterally. Ninety-two percent of incomplete fractures demonstrated either complete or partial healing on follow-up imaging. Two (8%) cases progressed to complete fractures. Thirteen incomplete fractures in 11 patients confirmed on CT also had MRI, and 92% demonstrated oedema in the pars. Ten out of thirteen fractures (77%) showed a break in the infero-medial cortex with intact supero-lateral cortex, which correlated with the CT findings. MRI incorrectly graded one case as a complete (grade 3) fracture, and 2 cases as (grade 1) stress reaction. Six fractures had follow-up MRI, 67% showed partial or complete cortical healing, and the same number showed persistent marrow oedema. Conclusions Incomplete fracture of the pars interarticularis represents a stage of the evolution of a complete stress fracture. The direction of fracture propagation is consistent, and complete healing can be achieved in most cases with appropriate clinical management. CT best demonstrates fracture size and extent, and is the most appropriate modality for follow-up. MRI is limited in its ability to fully depict the cortical integrity of incomplete fractures of the pars, but the presence of marrow oedema on fat-saturated T2-weighted sequences is a useful means of detecting acute spondylolysis.     

Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players

Background: A high level of strength is inherent in elite soccer play, but the relation between maximal strength and sprint and jumping performance has not been studied thoroughly.

Objective: To determine whether maximal strength correlates with sprint and vertical jump height in elite male soccer players.

Methods: Seventeen international male soccer players (mean (SD) age 25.8 (2.9) years, height 177.3 (4.1) cm, weight 76.5 (7.6) kg, and maximal oxygen uptake 65.7 (4.3) ml/kg/min) were tested for maximal strength in half squats and sprinting ability (0–30 m and 10 m shuttle run sprint) and vertical jumping height.

Result: There was a strong correlation between maximal strength in half squats and sprint performance and jumping height.

Conclusions: Maximal strength in half squats determines sprint performance and jumping height in high level soccer players. High squat strength did not imply reduced maximal oxygen consumption. Elite soccer players should focus on maximal strength training, with emphasis on maximal mobilisation of concentric movements, which may improve their sprinting and jumping performance.

     

Endurance training and testing with the ball in young elite soccer players

Background: The aerobic capacity of soccer players substantially influences their technical performance and tactical choices. Thus, the assessment of soccer players' aerobic performance should be of interest for soccer coaches in order to evaluate and improve their endurance training sessions. In this study, we present a new test to assess aerobic performance in soccer by means of a specific dribbling track: the Hoff test. We further determined whether improvement in maximal oxygen uptake was reflected in increased distance covered in the Hoff test.

Methods: We tested 18 male soccer players (14 years old) both in the laboratory and using the Hoff test before and after 8 weeks of soccer training.

Results: The distance covered in the Hoff test correlated significantly with maximum oxygen uptake, and improved by 9.6% during the 8 week training period, while maximum oxygen uptake and running economy improved by 12 and 10%, respectively. Backward multiple regression showed maximum oxygen uptake to be the main explanatory variable for the distance covered in the Hoff test.

Conclusion: The present study demonstrated a significant correlation between laboratory testing of VO_2max and performance in the Hoff test. Furthermore, training induced improvements in VO_2max were reflected in improved performance in the Hoff test. We suggest that it should be a goal for active U-15 soccer players to cover more than 2100 metres in the Hoff test, as this requires a VO_2max of above 200 ml/kg^0.75/min, which should serve as a minimum in modern soccer.

     

The lumbar spine of the young cricket fast bowler: An MRI study

ObjectivesTo describe the prevalence and nature of lumbar spinal abnormalities in adolescent cricket fast bowlers.DesignObservational study.Methods46 asymptomatic fast bowlers aged 13–18 years participated in the study and were grouped into under-15 (U15), under-17 (U17) and under-19 (U19) classifications. All participants underwent magnetic resonance imaging of the lumbar spine and abnormalities of the pars interarticularis and intervertebral discs were graded according to type and severity. Other abnormalities were also noted.ResultsFifteen bowlers (33%) had at least one pars interarticularis abnormality. Six bilateral and 10 unilateral defects were identified. Of the 10 unilateral pars abnormalities, 6 occurred on the non-dominant side. Nineteen of the abnormalities occurred at the L5 vertebral level, 2 at L4 and 1 at L3. The most common type of pars abnormality was the subtotal stress fracture, which was found in 38% of bowlers aged 16 years and under. Sixteen participants (35%) were found to have degeneration of at least 1 lumbar disc and the prevalence increased with each successive age group (29% U15, 33% U17 and 43% U19). Of the 25 discs with signs of degeneration, 9 occurred at L4/5 and 7 at L5/S1. Eleven of these were classified as mild degeneration, 13 as moderate, and 1 as severe. Disc bulges were found in 33% of participants.ConclusionsLumbar radiological abnormalities are common in asymptomatic adolescent fast bowlers. Acute bone stress reactions of the lumbar pars interarticularis are visible on magnetic resonance imaging and, in some instances, occur before the onset of activity-related pain.     

Physiological adaptations to soccer specific endurance training in professional youth soccer players

Background: Improved oxygen uptake improves soccer performance as regards distance covered, involvements with the ball, and number of sprints. Large improvements in oxygen uptake have been shown using interval running. A similar physiological load arising from interval running could be obtained using the soccer ball in training.

Objectives: The main aim was to study physiological adaptations to a 10 week high intensity aerobic interval training program performed by professional youth soccer players, using a soccer specific ball dribbling track.

Methods: Eleven youth soccer players with a mean (SD) age of 16.9 (0.4) years performed high intensity aerobic interval training sessions twice per week for 10 weeks in addition to normal soccer training. The specific aerobic training consisted of four sets of 4 min work periods dribbling a soccer ball around a specially designed track at 90–95% of maximal heart frequency, with a 3 min recovery jog at 70% of maximal heart frequency between intervals.

Results: Mean Vo_2max improved significantly from 63.4 (5.6) to 69.8 (6.6) ml kg^–1 min^–1, or 183.3 (13.2) to 201.5 (16.2) ml kg^–0.75 min^–1 (p<0.001). Squat jump and counter movement jump height increased significantly from 37.7 (6.2) to 40.3 (6.1) cm and 52.0 (4.0) to 53.4 (4.2) cm, respectively (p<0.05). No significant changes in body mass, running economy, rate of force development, or 10 m sprint times occurred.

Conclusion: Performing high intensity 4 min intervals dribbling a soccer ball around a specially designed track together with regular soccer training is effective for improving the Vo_2max of soccer players, with no negative interference effects on strength, jumping ability, and sprinting performance.

     

Les activités posturales de footballeurs de niveau national diffèrent-elles entre les attaquants et les défenseurs ?

Summary. – The aim was to compare the postural activities between offensive and defensive soccer players at the same competitive level.Methods. – Postural regulation was evaluated in nine defensive soccer players (group DEF) and six offensive players (group OFF) with a force platform. Static and dynamic (anteroposterior or A–P, mediolateral or M–L) balance tests were performed with eyes open (EO) and eyes closed (EC). The analysis of A-P dynamic balance in EO condition differed between the DEF and OFF groups.Conclusions. – The postural adaptations would differ between the offensive and defensive soccer players in a non-lived previously standardized balance task.     

No acute changes in postural control after soccer heading

Background: Soccer heading has been proposed as a potential cause of cerebral dysfunction.

Objective: To examine the acute effects of two types of soccer heading on postural control.

Methods: Collegiate soccer players were randomly assigned to one of four groups: control, linear heading, simulated rotational heading, or rotational heading. Each subject completed a baseline postural stability assessment on day 1. On day 2 the same assessment was completed for the control subjects. The simulated rotational heading group completed a simulated heading drill before postural stability testing. The linear and rotational heading groups performed a heading drill with 20 balls at 88.71 km/h (55 mph), before postural stability testing. Separate one between (group), three within (surface, eyes, and day), mixed model, repeated measures analyses of variance were conducted on values for total sway and mean centre of pressure.

Results: The mixed model analysis of variance of results showed no significant differences (p>0.05) for the interactions of interest for either variable. Results suggest no acute changes in measures of postural control in soccer players completing either a linear or rotational soccer heading drill of 20 balls at a fixed speed.

Conclusion: Non-significant interactions between surface, eyes, day, and group indicate that sensory interaction of the balance mechanism components are not be compromised by the heading drill. This research supports previous studies suggesting that there are no acute risks associated with routine soccer heading. A direct comparison between these findings and those suggesting long term chronic deficits, however, cannot be made. Other studies that report chronic cerebral deficits in soccer players may have resulted from factors other than soccer heading and warrant further examination.

     

Routine thin slice MRI effectively demonstrates the lumbar pars interarticularis.

AIM: To confirm that routine thin slice sagittal magnetic resonance imaging (MRI) of the lumbar spine effectively demonstrates the lumbar pars interarticularis. METHOD: A retrospective review of 100 MRI examinations was carried out and the appearance of the pars interarticularis at L4 and L5 bilaterally was assessed and classified as Type 1 - normal, Type 2 - sclerotic pars, Type 3 - not assessable and Type 4 - pars defect. A total of 400 pars were assessed. Those with known or obvious lytic spondylolysis were excluded from the study. All MRI examinations had both sagittal T1- and T2- weighted sequences and both were assessed. Sagittal T1 sequences were carried out with a 3 mm slice thickness and T2 image sequences with a 4 mm slice thickness. RESULTS: The total number of pars assessed as normal (Type 1) was 299 (75%) of the T1-weighted images; 80 (20%) were classified Type 2. On T2-weighted imaging 290 (72.5%) were Type 1 and 66 (16.5%) were Type 2. Both of these types of appearances correlate well with the finding of a normal pars interarticularis. Thus, 379 (95%) of the pars appeared normal on T1-weighting and 356 (89%) on T2-weighting. CONCLUSION: Contrary to previous findings with 5 mm thick slices, routine thin slice sagittal T1 and T2 images effectively demonstrate the pars interarticularis, with acceptable data acquisition times and image quality. We believe this is mainly due to the thinner slices obtained in our series.     

MRI findings in the lumbar spines of asymptomatic elite junior tennis players

Objective

To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis players.

Materials and Methods

The lumbar spine MRI studies of 98 asymptomatic junior elite tennis players (51 male, 47 female) with a mean age of 18 years (age range 11.2–26.3 years; standard deviation 3.1) was reviewed by two consultant musculoskeletal radiologists using consensus opinion. Images were assessed using accepted classification systems.

Results

Four players (4 %) had no abnormality. Facet joint arthropathy occurred in 89.7 % of the players, being mild in 84.5 % of cases. There were 41 synovial cysts in 22.4 % of the cohort all occurring in the presence of facet arthropathy. Disc degeneration was noted in 62.2 % of players, being mild in 76.2 % of those affected. Disc herniation was noted in 30.6 % of players, with 86.1 % of these being broad based and 13.9 % being focal. There was nerve root compression in 2 %. There were 41 pars interarticularis abnormalities in 29.6 % of patients, 63.4 % of these being grades 1–3. There was grade 1 spondylolisthesis in 5.1 % of players. The prevalence of facet joint arthropathy, disc degeneration, disc herniation and pars interarticularis fracture was lower in female players than in male and lower in the under 16-year-olds compared with the over 20-year-olds.

Conclusion

There is a significant amount of underlying pathology that would normally go undetected in this group of asymptomatic elite athletes. Whilst these findings cannot be detected clinically, their relevance is in facilitating appropriate prehabilitation to prevent loss of playing time and potentially career-ending injuries.     

A comparison of the physiological profiles of elite Gaelic footballers, hurlers, and soccer players

Background: Gaelic football, soccer, and hurling are prominent field games in Ireland and involve participants undertaking a variety of playing tasks and skills which place various physiological demands on the participants. The aim of this study was to evaluate and compare the mid-season physiological profiles of elite players.

Methods: Physiological assessment was carried out on 29 inter-county Gaelic footballers, 30 inter-county hurlers, and 21 League of Ireland soccer players.

Results: Significant differences were reported for % body fat (p<0.05), aerobic capacity (p<0.05), flexibility (p<0.05), upper body strength (p<0.05), upper body strength endurance (p<0.05), abdominal endurance (p<0.05), and speed endurance (p<0.05), while there were no differences recorded for height, weight, or speed levels. A relatively heterogeneous body size is evident for all three sports. Soccer players had lower body fat levels, greater aerobic capacity, greater strength endurance, and greater flexibility compared to both Gaelic footballers and hurlers, possibly due to specific training and conditioning programmes or physical adaptation to match play The greater strength of both Gaelic footballers and hurlers and the superior speed endurance levels of Gaelic footballers also reflect the physical nature of the sports. Similar speed levels amongst all three sports reflect the importance of speed for performance.

Conclusions: The various physiological attributes for Gaelic football, soccer, and hurling reflect the physical requirements for success and participation in each of these field games.

     

Radionuclide Imaging of Musculoskeletal Injuries in Athletes with Negative Radiographs

In brief: Radionuclide bone scans can be useful in the diagnostic evaluation of musculoskeletal injuries in athletes. Bone scans can detect shinsplints, stress fractures, and muscle injuries before they are detectable on radiographs. Prognosis can be accurately assessed, allowing appropriate treatment to proceed without delay. The authors discuss the use of bone scans and identify musculoskeletal injuries that are associated with specific sports, such as stress fracture of the femur (soccer), tibia (running), scapula (gymnastics), and pars interarticularis (football or lacrosse).     

Lumbar vertebral stress injuries in fast bowlers: A review of prevalence and risk factors

ObjectivesTo provide a concise overview of the prevalence and risk factors in the development of lumbar vertebral stress injuries in cricketers who are fast bowlers.MethodsA search of Medline, SPORTDiscus and CINAHL databases was conducted to find relevant studies pertaining to: cricket, cricket biomechanics and lumbar vertebral stress injuries. Narrative review methods were used to synthesise the data.ResultsThe prevalence of lumbar vertebral stress injuries in fast bowlers is high, with figures up to 67% reported. Potential risk factors identified include bowling action, overuse, age, lumbar muscle asymmetry and physical characteristics. While prospective studies provide evidence that bowling action and overuse are risk factors for developing lumbar vertebral stress injuries, to date there is limited evidence, largely from cross-sectional studies, regarding the other factors.ConclusionsThis study provides an up-to-date overview of the current literature on prevalence and risk factors for lumbar vertebral stress injuries in fast bowlers. This information may assist clinicians to prevent injury through early identification of risk factors. Recommendations for future research directions include further prospective investigation of the role of age, physical characteristics and muscle asymmetry in the development of such injuries as well as gender specific risk factors.