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Last Updated: Tuesday, 2 May 2006, 18:58 GMT 19:58 UK
All stressed out
By Bryn Palmer

James Anderson looks downcast during England's recent tour of India
Anderson had recently rediscovered some of his best form
While Wayne Rooney ruminates on football's curse of the metatarsal, James Anderson has the cricketing equivalent to contend with.

The Lancashire seamer has become the latest in a long line of fast bowlers to succumb to a stress fracture of the back.

While Lancashire hope he will be fit again in two months, recent precedents suggest England should not pencil him into their summer plans just yet.

The most serious case of recent years involved New Zealand spearhead Shane Bond, who only returned to action last summer after 28 months out.

He eventually required an operation that grafted hip bone into a vertebra, secured with bolts and wire.

It can take weeks or months and it can be as much a psychological as physiological process
Notts and former SA physio Craig Smith
After surgery Bond was unable to walk for six weeks, took another four months to regain fitness and, even after adapting his bowling style, plays under the fear "it could go at any time".

Pakistan's Umar Gul spent a year on the sidelines with three stress fractures in his spine, while West Indian Fidel Edwards took eight months to recover from a back injury.

Closer to home, former England fast bowler Alex Tudor endured two injury-ruined seasons at Surrey before a visit to a Munich-based specialist diagnosed collagen damage within his spine.

And Andrew Flintoff recently revealed his fears that his career could be cut short if the persistent back injuries of his early career - caused by a slight curvature of the spine - return.

"Every day I bowl I wonder how much longer (my back) is going to last," Flintoff said. "The fear of those old problems returning is always at the back of my mind."

So how certain can Anderson, already ruled out of England's forthcoming Test series with Sri Lanka, be about a prompt recovery?

Craig Smith, the former South Africa physiotherapist who now works with Nottinghamshire after a spell at Lancashire, warns the comeback trail may be fraught with difficulties.

"Stress fractures are not like metatarsal injuries, which you can be back from in six-to-eight weeks," he told BBC Sport. "It varies from bowler to bowler, and where in the spine the injury is.

"It also varies in terms of whether rest and rehabilitation are going to be sufficient or whether they need surgery.

"A screw is normally put in when conservative treatment has failed. It is deemed to have failed if a player has not come back in a four-to-six or 12-month period.

"It's still early days for Jimmy (Anderson), but even at the comeback stage there is a difference between conditioning and settling in to bowling at full tilt.

"It can take weeks or months and it can be as much a psychological as physiological process."

I didn't have a perfect action but I compensated with upper-body strength
Former England paceman Devon Malcolm
While every case is different, Smith says most stress fractures in fast bowlers arise from "overload, technique, or a muscular weakness".

With Anderson, he says it might have occurred by "not playing much, then playing a lot".

The 23-year-old enjoyed a full season for Lancashire last summer before a winter featuring five one-dayers for England in Pakistan, a match on the England A tour to the West Indies, England's final Test in India and all six one-dayers that followed.

"Stress tends to be caused by repetitiveness but a large part of it is just luck," said former England bowler Angus Fraser, who missed a summer with a stress fracture of the back when he was 19.

"Some bowlers have bodies that cope with the workload, and others don't. The action is very unnatural, but it is part and parcel of being a fast bowler."

Devon Malcolm, another former England paceman, suffered back problems early in his career, before advice from an orthopaedic surgeon changed his approach.

"'The surgeon said to me: 'If you want to play this game for a long time you are going to need a strong back, strong legs and extremely strong abdominal muscles'," Malcolm recalled.

"After that I worked religiously on my 'abs' and it worked wonders. I didn't have a perfect action but I compensated with my upper-body strength. I never had any more back trouble."

State-of-the-art technology devised by former England bowling coach Troy Cooley has already helped Liam Plunkett change his action to avoid possible injury.

But not everyone in the fast-bowling fraternity believes altering bowling actions is the way forward.

Former England bowler Phil DeFreitas recalls coaches trying to change his action in his early days, only to suffer more injuries as a result.

"I was fortunate, back problems were probably the only thing I never had," DeFreitas told BBC Sport.

"But I am a great believer that you learn to bowl and that is your natural action. You might be able to change one or two things but in the long run, you are either lucky or unlucky."




SEE ALSO
Techno tools
03 Nov 05 |  England
Flintoff reveals injury worries
22 Sep 05 |  Cricket
Bond delight at return to action
18 Aug 05 |  Cricket
Gul faces long lay-off
25 Aug 04 |  Cricket
Injury worry for bowlers
15 Jan 04 |  Cricket


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