title: Risk factors and successful interventions for cricket-related low back pain: a systematic review.
abstract: BACKGROUND
  Low back pain (LBP) is highly prevalent in cricketers, particularly in adolescent fast bowlers. Numerous modifiable risk factors for and interventions to address LBP in cricketers have been proposed in the literature.
  
  
  OBJECTIVE
  Summarise and critique studies evaluating LBP risk factors in cricketers, and evaluate the effectiveness of interventions designed to prevent or treat such LBP.
  
  
  METHODS
  Systematic literature review.
  
  
  METHODS
  MEDLINE, ISI Web of Knowledge, CINAHL, SportDiscus and the Cochrane Library were searched from inception using key terms relating to risk factors and interventions in LBP in cricketers. Quality of included studies was assessed using the Downs and Black Quality Index, data were extracted to complete the effect size and OR calculations and evidence levels were established using van Tulder's criteria.
  
  
  RESULTS
  12 studies (6 of high quality) investigating the factors associated with LBP in cricketers and 5 low-quality studies evaluating the interventions for the treatment/prevention of LBP in cricketers were identified. Moderate evidence indicates the presence of acute MRI bone stress as a risk factor for developing lumbar stress fractures. Additionally, moderate evidence indicates increased shoulder counter rotation (associated with mixed bowling actions) and decreased anterior abdominal fascial slide may be associated with LBP in cricketers.
  
  
  CONCLUSIONS
  Screening for bone stress on MRI should be considered by clinicians managing developing cricketers to identify the risk of lumbar stress fracture development. Numerous associative factors were outlined, although causality needs establishing to further guide interventions in cricketers with LBP. Intervention studies were of insufficient quality to generate concrete conclusions and these research failings require rapid attention.
authors.affiliation: Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, , London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Morton
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Barton
authors.forename: Simon
authors.initials: S
authors.lastname: Rice
authors.forename: Dylan
authors.initials: D
authors.lastname: Morrissey
mesh_terms: D000293:Adolescent; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009135:Muscular Diseases / Q000473:pathology; D012307:Risk Factors; D014142:Track and Field; D055815:Young Adult
keywords: Back injuries; Cricket