Side strains in fast bowlers

A side strain is a tear of the muscles on the side of the trunk, most often where the internal oblique attaches to the lower ribs, on the side opposite the bowling arm. Bowlers describe a sudden sharp pain in the side during delivery, often on a specific ball, then pain with bowling, coughing, sneezing or rolling over in bed.

Why bowlers get them

At back-foot contact the trunk is side-bent and rotated away from the target. Through delivery it whips forward and across. The non-bowling side stretches under load and then contracts hard in a fraction of a second. Add fatigue late in a spell, a jump in bowling volume, or a return after a break, and that side of the trunk is where the tissue fails.

What it is usually not

Rib fractures, rib stress injuries and pain referred from the spine all sit in the same area. So do problems that are not muscle at all. Pain after a blow, pain with breathing at rest, or pain that is getting worse rather than settling needs a medical review.

What to do in the first week

1. Stop bowling. A side strain that is bowled through turns a short absence into a long one.
2. Keep moving. Walking, lower-body training and often batting are fine if they do not provoke the side. Check with whoever assesses you.
3. Get it assessed. Where it hurts, how much, what provokes it, and sometimes imaging decide how big the injury is and how to plan the return.
4. Write down the last four to six weeks of bowling, nets included.

How long it takes

That depends on the size of the tear, where it is, and whether it is the first one. In published case series many bowlers took several weeks to return to match bowling, and recurrences often took longer. Those are ranges from other players, not a promise for your side: the plan follows how the tissue responds, not the calendar.

Rehabilitation

The goal is not a pain-free side at rest. It is a side that tolerates a full spell at match intensity, late in a long day.

• Early: settle the pain, keep the rest of the body training, and begin gentle trunk loading in positions that do not provoke it.
• Middle: progressively heavier trunk work in rotation and side-bending, then fast, elastic work that looks like the delivery stride.
• Late: a return to bowling that builds volume before intensity, one variable at a time, each step judged by how the side feels the next day.

The return to bowling progression in detail

Why they come back

The common thread is a return that tested the side at low intensity only, then asked it to bowl a match spell. The other is load: long gaps followed by heavy weeks. A graded bowling return and steady weekly loads reduce avoidable recurrences. They do not guarantee against one.

Where I fit

An assessment works out whether this is a side strain and how big it is, rules out what mimics it, and sets a return plan built around your fixtures. In Melbourne that is an appointment in Richmond. Elsewhere, start by video, and I will say if you need imaging or an examination locally.

Common questions

Further reading