{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T05:41:42Z","timestamp":1782538902254,"version":"3.54.5"},"reference-count":49,"publisher":"BMJ","issue":"24","funder":[{"name":"England and Wales Cricket Board","award":["Not Applicable."],"award-info":[{"award-number":["Not Applicable."]}]},{"DOI":"10.13039\/501100000857","name":"Loughborough University","doi-asserted-by":"publisher","award":["Not Applicable."],"award-info":[{"award-number":["Not Applicable."]}],"id":[{"id":"10.13039\/501100000857","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,9,16]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>MRI screening is increasingly used in elite cricket to support the early detection of lumbar bone stress injuries (LBSIs). However, its impact on injury outcomes and career trajectories remains unclear. This study evaluated short-term and long-term outcomes from LBSI in young male fast bowlers, comparing injuries detected through MRI screening with those detected clinically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analysed 15 years (2009\u20132024) of injury surveillance data from the England and Wales Cricket Board. LBSIs in male fast bowlers (aged 16\u201324) were classified as screening-detected (via routine MRI) or clinically-detected (imaging-confirmed following symptom onset). Outcomes were evaluated across short-term (diagnosis to return-to-play (RTP)) and long-term (5-year post-RTP) timeframes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>197 LBSIs (44 screening-detected, 153 clinically-detected) were detected in 142 bowlers (mean age at injury: 19.4\u00b12.1 years). Screening-detected injuries were more likely to be stress reactions (p=0.002), while complete fractures were exclusively clinically-detected. Screening-detected injuries had shorter RTP times (p&lt;0.001) and were managed conservatively with 100% RTP success. Bowlers with screening-detected injuries had greater in-season availability (p&lt;0.001) and returned to preinjury playing standards post-RTP. Over 5 years, 51%\u201367% of bowlers remained reinjury-free, with comparable probabilities between detection methods (p\u22650.536); 5-year playing standard trajectories showed improvement in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRI screening may facilitate earlier detection of LBSIs compared with symptom-based pathways, enabling conservative management, shorter RTP times and greater availability, while allowing for continued career progression. However, the observed risk of reinjury highlights the need for improved preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110221","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:25:36Z","timestamp":1759307136000},"page":"1718-1725","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["MRI Screening for lumbar bone stress injuries in young male cricket fast bowlers: a 15-year retrospective cohort study"],"prefix":"10.1136","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4874-0054","authenticated-orcid":false,"given":"Tom","family":"White","sequence":"first","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4062-665X","authenticated-orcid":false,"given":"Peter","family":"Alway","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"},{"name":"National Cricket Performance Centre, England and Wales Cricket Board, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3708-4346","authenticated-orcid":false,"given":"Katherine","family":"Brooke-Wavell","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2160-7739","authenticated-orcid":false,"given":"Thamindu","family":"Wedatilake","sequence":"additional","affiliation":[{"name":"National Cricket Performance Centre, England and Wales Cricket Board, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2587-9117","authenticated-orcid":false,"given":"Mark","family":"King","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-5060","authenticated-orcid":false,"given":"Nicholas","family":"Peirce","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK"},{"name":"National Cricket Performance Centre, England and Wales Cricket Board, Loughborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"2026022501151594000_59.24.1718.1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.jsams.2025.01.001","article-title":"The financial cost of injuries and their association with team success in professional men\u2019s cricket","volume":"28","author":"Williams","year":"2025","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.2147\/OAJSM.S117497","article-title":"Incidence and prevalence of elite male cricket injuries using updated consensus definitions","volume":"7","author":"Orchard","year":"2016","journal-title":"Open Access J Sports Med"},{"key":"2026022501151594000_59.24.1718.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2020.03.009"},{"key":"2026022501151594000_59.24.1718.4","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/JSM.0000000000001132","article-title":"Lumbar Bone Stress Injuries and Nonunited Defects in Elite Australian Cricket Players","volume":"34","author":"Saw","year":"2024","journal-title":"Clin J Sport Med"},{"key":"2026022501151594000_59.24.1718.5","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1016\/j.jsams.2022.09.103","article-title":"Lumbar bone stress injuries in elite Australian cricket players: A comprehensive case series","volume":"25","author":"Eales","year":"2022","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2019-000529","article-title":"Incidence and prevalence of lumbar stress fracture in English County Cricket fast bowlers, association with bowling workload and seasonal variation","volume":"5","author":"Alway","year":"2019","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2026022501151594000_59.24.1718.7","doi-asserted-by":"crossref","unstructured":"Warden SJ , Burr DB . Bone stress injuries. In: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 2018: 450\u20138.","DOI":"10.1002\/9781119266594.ch57"},{"key":"2026022501151594000_59.24.1718.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-008-0449-0"},{"key":"2026022501151594000_59.24.1718.9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ejrad.2018.08.029","article-title":"Pars interarticularis injury in elite athletes - The role of imaging in diagnosis and management","volume":"108","author":"Cheung","year":"2018","journal-title":"Eur J Radiol"},{"key":"2026022501151594000_59.24.1718.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2003.006585"},{"key":"2026022501151594000_59.24.1718.11","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509332430"},{"key":"2026022501151594000_59.24.1718.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2014.09.002"},{"key":"2026022501151594000_59.24.1718.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097930"},{"key":"2026022501151594000_59.24.1718.14","doi-asserted-by":"crossref","first-page":"E1166","DOI":"10.1097\/BRS.0000000000003277","article-title":"MRI Bone Marrow Edema Signal Intensity","volume":"45","author":"Sims","year":"2020","journal-title":"Spine (Phila Pa 1986)"},{"key":"2026022501151594000_59.24.1718.15","doi-asserted-by":"crossref","first-page":"E1166","DOI":"10.1097\/BRS.0000000000003277","article-title":"MRI Bone Marrow Edema Signal Intensity: A Reliable and Valid Measure of Lumbar Bone Stress Injury in Elite Junior Fast Bowlers","volume":"45","author":"Sims","year":"2020","journal-title":"Spine (Phila Pa 1976)"},{"key":"2026022501151594000_59.24.1718.16","doi-asserted-by":"crossref","unstructured":"Taylor J , Saw AE , Saw R , et al . Presence of bone marrow oedema in asymptomatic elite fast bowlers: Implications for management. Bone 2021;143. doi:10.1016\/j.bone.2020.115626","DOI":"10.1016\/j.bone.2020.115626"},{"key":"2026022501151594000_59.24.1718.17","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.jsams.2023.06.013","article-title":"Is MRI screening for bone marrow oedema useful in predicting lumbar bone stress injuries in adult male professional cricketers? A New Zealand pilot study","volume":"26","author":"Bell","year":"2023","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40134-018-0299-z","article-title":"Management of Lumbar Spondylolysis in Athletes: Role of Imaging","volume":"6","author":"Kountouris","year":"2018","journal-title":"Curr Radiol Rep"},{"key":"2026022501151594000_59.24.1718.19","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2019-000304"},{"key":"2026022501151594000_59.24.1718.20","doi-asserted-by":"crossref","DOI":"10.1177\/2325967118818413","article-title":"Magnetic Resonance Imaging Findings of the Asymptomatic Elbow Predict Injuries and Surgery in Major League Baseball Pitchers","volume":"7","author":"Garcia","year":"2019","journal-title":"Orthop J Sports Med"},{"key":"2026022501151594000_59.24.1718.21","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2023-107942"},{"key":"2026022501151594000_59.24.1718.22","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jsams.2023.10.012","article-title":"Clinical outcomes of 10\u202fyears of cardiac screening in elite New Zealand athletes","volume":"26","author":"Orchard","year":"2023","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.23","doi-asserted-by":"publisher","DOI":"10.1159\/000509119"},{"key":"2026022501151594000_59.24.1718.24","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1080\/02640414.2022.2080161","article-title":"Lumbar bone stress injuries and risk factors in adolescent cricket fast bowlers","volume":"40","author":"Keylock","year":"2022","journal-title":"J Sports Sci"},{"key":"2026022501151594000_59.24.1718.25","doi-asserted-by":"publisher","DOI":"10.1123\/ijspp.2021-0451"},{"key":"2026022501151594000_59.24.1718.26","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-106328"},{"key":"2026022501151594000_59.24.1718.27","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jsams.2020.06.018","article-title":"Radiological healing of lumbar spine stress fractures in elite cricket fast bowlers","volume":"24","author":"Singh","year":"2021","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.28","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1177\/2192568217734520","article-title":"Return to Play in Adolescent Athletes With Symptomatic Spondylolysis Without Listhesis: A Meta-Analysis","volume":"8","author":"Overley","year":"2018","journal-title":"Global Spine J"},{"key":"2026022501151594000_59.24.1718.29","doi-asserted-by":"crossref","DOI":"10.17159\/2078-516X\/2023\/v35i1a15172","article-title":"Management of lumbar bone stress injury in cricket fast bowlers and other athletes","volume":"35","author":"Orchard","year":"2023","journal-title":"S Afr J Sports Med"},{"key":"2026022501151594000_59.24.1718.30","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.jsams.2017.08.007","article-title":"Does player unavailability affect football teams\u2019 match physical outputs? A two-season study of the UEFA champions league","volume":"21","author":"Windt","year":"2018","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.31","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096731"},{"key":"2026022501151594000_59.24.1718.32","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jsams.2020.07.007","article-title":"Negative association between injuries and team success in professional cricket: A 9-year prospective cohort analysis","volume":"24","author":"Goggins","year":"2021","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.33","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1177\/15563316241234843","article-title":"Return to Sports Following Spondylolysis Surgery in Children and Adolescents: A Systematic Review","volume":"20","author":"Gross","year":"2024","journal-title":"HSS J"},{"key":"2026022501151594000_59.24.1718.34","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ptsp.2019.02.005","article-title":"Return to play after conservative and surgical treatment in athletes with spondylolysis: A systematic review","volume":"37","author":"Grazina","year":"2019","journal-title":"Phys Ther Sport"},{"key":"2026022501151594000_59.24.1718.35","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-07884-z","article-title":"Characteristics of recurrent cases after conservative therapy in adolescent lumbar spondylolysis","volume":"12","author":"Tatsumura","year":"2022","journal-title":"Sci Rep"},{"key":"2026022501151594000_59.24.1718.36","doi-asserted-by":"crossref","first-page":"540","DOI":"10.22603\/ssrr.2021-0242","article-title":"Rates of Return to Sports and Recurrence in Pediatric Athletes after Conservative Treatment for Lumbar Spondylolysis","volume":"6","author":"Kasamasu","year":"2022","journal-title":"Spine Surg Relat Res"},{"key":"2026022501151594000_59.24.1718.37","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1249\/MSS.0000000000002512","article-title":"Cricket Fast Bowling Technique and Lumbar Bone Stress Injury","volume":"53","author":"Alway","year":"2021","journal-title":"Med Sci Sports Exerc"},{"key":"2026022501151594000_59.24.1718.38","doi-asserted-by":"crossref","DOI":"10.3390\/sports9040052","article-title":"Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review","volume":"9","author":"Beck","year":"2021","journal-title":"Sports (Basel)"},{"key":"2026022501151594000_59.24.1718.39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jsams.2017.07.009","article-title":"High acute:chronic workloads are associated with injury in England & Wales Cricket Board Development Programme fast bowlers","volume":"21","author":"Warren","year":"2018","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.40","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092524"},{"key":"2026022501151594000_59.24.1718.41","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093683"},{"key":"2026022501151594000_59.24.1718.42","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.jsams.2022.08.006","article-title":"Activity specific areal bone mineral density is reduced in athletes with stress fracture and requires profound recovery time: A study of lumbar stress fracture in elite cricket fast bowlers","volume":"25","author":"Alway","year":"2022","journal-title":"J Sci Med Sport"},{"key":"2026022501151594000_59.24.1718.43","doi-asserted-by":"crossref","DOI":"10.1186\/s40798-020-00285-4","article-title":"Lumbar spine abnormalities and facet joint angles in asymptomatic elite junior tennis players","volume":"6","author":"Connolly","year":"2020","journal-title":"Sports Med Open"},{"key":"2026022501151594000_59.24.1718.44","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2023-001545","article-title":"Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners","volume":"9","author":"Fredericson","year":"2023","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2026022501151594000_59.24.1718.45","doi-asserted-by":"crossref","first-page":"2847","DOI":"10.1016\/j.acra.2024.12.065","article-title":"Overview of Radiological Classification Systems for Pars Interarticularis Stress Injuries-and Proposal of the BROPI Classification","volume":"32","author":"Henderson","year":"2025","journal-title":"Acad Radiol"},{"key":"2026022501151594000_59.24.1718.46","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s00256-023-04437-x","article-title":"T1-VIBE and STIR MRI of lumbar pars interarticularis injuries in elite athletes: fracture characterisation and potential prognostic indicators","volume":"53","author":"Watura","year":"2024","journal-title":"Skeletal Radiol"},{"key":"2026022501151594000_59.24.1718.47","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/s00256-016-2475-7","article-title":"Diagnostic accuracy of 3-T magnetic resonance imaging with 3D T1 VIBE versus computer tomography in pars stress fracture of the lumbar spine","volume":"45","author":"Ang","year":"2016","journal-title":"Skeletal Radiol"},{"key":"2026022501151594000_59.24.1718.48","doi-asserted-by":"crossref","first-page":"E641","DOI":"10.1097\/BRS.0b013e3181c9f2a2","article-title":"Significance of Magnetic Resonance Imaging Signal Change in the Pedicle in the Management of Pediatric Lumbar Spondylolysis","volume":"35","author":"Sakai","year":"2010","journal-title":"Spine (Phila Pa 1986)"},{"key":"2026022501151594000_59.24.1718.49","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2024-108616"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2025-110221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:15:34Z","timestamp":1772010934000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2025-110221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":49,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2026,2,24]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bjsports-2025-110221"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2025-110221","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}