A fast bowler came to me with lower back pain that kept returning. He had seen multiple physiotherapists. Every one of them had treated his back. Back strengthening exercises, passive treatment, rest. He would feel better. He would start bowling again. The pain would come back.
When I assessed him properly, I found the problem was not in his back at all.
His left hip, the same side as his pain, had significantly restricted internal rotation. His hip extension was limited. His glutes were weak. Every time he bowled, his lumbar spine was compensating for the range his hip could not produce. It was extending further and rotating more than it should, just to get the ball down the pitch.
We worked on his hip. Mobilisation, glute strengthening, pelvic control. The back pain resolved. He returned to bowling and it did not come back.
His back had been treated for months. Nobody had looked at his hip.
What actually happens to a cricketer’s body during a long season
Cricket injuries are rarely the result of one bad movement. They are almost always the result of accumulated load over a long season without adequate recovery.
A fast bowler runs in at high speed, plants the front foot with significant ground reaction force, then simultaneously produces lumbar extension, rotation, lateral flexion, and trunk flexion in a fraction of a second. This happens delivery after delivery, session after session, match after match. If there is no recovery between matches, if sleep is poor, if one segment of the kinetic chain is not moving properly, the load transfers to whatever joint is next in the chain.
This is why cricket back and shoulder injuries keep coming back. The treatment addresses the symptom. The underlying load pattern and the movement compensation causing it are never corrected.
The most common injuries I see in cricketers are rotator cuff tendinopathy from repetitive throwing and overhead catching, shoulder impingement, labral injuries from repetitive overhead load, AC joint problems in bowlers, and mechanical lower back pain in fast bowlers from the thoracolumbar load generated at ball release.
All of these have one thing in common. They are not isolated injuries. They are the result of a chain that has broken down somewhere, and the pain appears at the weakest link.
The fast bowler whose back pain came from his hip
When that fast bowler came to me, I did not start with his back. I assessed his full movement chain.
The finding was clear. Left hip internal rotation was significantly restricted. Left hip extension was limited. Glute strength was reduced on the bowling side.
In fast bowling, the hip has to produce and absorb enormous forces at the crease. When the hip cannot move through its full range, the lumbar spine compensates. It extends further. It rotates more. It does the work the hip was supposed to do. Over a season of bowling, that compensation accumulates into pain.
Previous physiotherapists had treated the back because that was where the pain was. But the back was not the problem. The back was the victim of a hip that was not doing its job.
Hip mobilisation and strengthening resolved the back pain because we treated the cause, not the symptom.
This is the pattern I see repeatedly in cricket. The pain is in one place. The problem is somewhere else in the chain. Until the chain is assessed fully, the injury will keep returning.
Why generic rehabilitation fails cricketers
A cricketer cannot be rehabilitated with generic back or shoulder exercises. The demands of the sport are too specific.
A fast bowler needs to produce force from ankle to shoulder in a coordinated sequence. The ankle absorbs the impact of the run-up. The knee transfers it upward. The hip generates rotation and extension. The thoracic spine adds rotation. The shoulder produces the throw. If any segment in that chain is restricted, weak, or compensating, the delivery breaks down and the injury returns.
Rehabilitation for a cricketer has to train the entire chain. Not just the area that hurts. Back extension with rotation. Throwing mechanics. Pelvic control during high-speed movements. Thoracic mobility. Hip strength and range. All of these need to be addressed and then progressively loaded in a way that replicates the bowling or batting action.
A generic shoulder programme or generic back strengthening programme does not do this. It treats a structure. It does not train the movement.
What a cricketer needs to demonstrate before returning to play
Pain free is not the standard. Movement quality is the standard.
Before I clear a cricketer to bowl or bat at full intensity, I check the entire kinetic chain under load. Throwing mechanics. Whether the athlete is using the full chain or compensating through a single joint. Rotational control through the trunk and pelvis. The T-test for directional movement in batters and fielders.
If the throwing mechanics show compensation. If the shoulder is doing work that the hip or thoracic spine should be producing, that compensation will lead to re-injury under the loads of actual match play. The athlete has to demonstrate clean movement through the full chain before they return.
Pain going away is the beginning of recovery. Demonstrating correct movement under sport-specific load is the end of it.
What this means for your cricket injury
If your shoulder or back pain keeps returning after treatment, ask one question: has anyone assessed your full movement chain, or has every session focused only on the area that hurts?
Cricket injuries that keep coming back are almost always a chain problem, not a local problem. Finding where in the chain the breakdown is happening, correcting it, and then loading the full chain progressively is the only approach that produces lasting results.
I see cricket players in Saket, South Delhi, including bowlers and batters dealing with recurring shoulder and back pain. WhatsApp me at +91 92893 03555. The first session is a full assessment of the movement chain, not a treatment of the symptom.
For how shoulder conditions are diagnosed and treated differently: Frozen Shoulder, Rotator Cuff, Impingement. How I Actually Tell Them Apart
The same root cause pattern in a different sport: What I Look for When Lower Back Pain Keeps Coming Back
If your cricket injury treatment has not worked before: Why Physiotherapy Stopped Working for You and What I Look for Instead
Dr. Manvi Dhyani, PT holds an MPT in Sports Physiotherapy from Jamia Millia Islamia and is a registered physiotherapist with the Delhi Council for Physiotherapy and Occupational Therapy (Reg. TPR-2666). She has worked as a team physiotherapist with the Central Reserve Police Force, completed international field postings with ProHealth Asia across four countries, and served as physiotherapist for India’s national archery team at the 2021 World Archery Youth Championships in Wroclaw, Poland. She practices in Saket, New Delhi.
Dr. Manvi Dhyani is a qualified physiotherapist (MPT Sports Physiotherapy, Jamia Millia Islamia; Registered Physiotherapist, Delhi Council for Physiotherapy and Occupational Therapy, Reg. TPR-2666). The title Dr. is used in accordance with her doctoral-level physiotherapy qualification and does not denote a registered medical practitioner under the NMC Act, 2020.
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