At least two-thirds of fast bowlers in cricket are likely to experience a lumbar stress injury during their careers, most often in the early years, missing an average of 274 days per injury. Professor Nick Peirce and Dr Peter Alway will present the ECB research programme and their clinical experience, including MRI and DXA annual screening over more than 15 years and involving more than 200 fast bowlers. They will describe the extraordinary spinal adaptations, including bone mineral density changes, that continue throughout bowlers' junior and senior careers. Further research presented will include an understanding of the workload, technique, and physical characteristics required for the safe development of fast bowlers. This knowledge could potentially translate into lessons for any sport challenged with safe athlete development.

Central to the management of pars injuries is radiology expertise, with Dr Adam Mitchell, Lead MSK Radiologist with Fortius, describing the nuances and current concepts in imaging. This includes leading research and experiences from developing the novel imaging techniques of VIBE sequences. This work underpins the ECB's identification and management of PARs lesions.

Finally, Dr Jon Houghton will discuss the challenges and limitations of conservative strategies for managing PARs lesions, drawing on significant experience in cricket. He will cover bone health and Vitamin D guidelines, the lack of clear guidelines/rehab protocols, the use of bone agents like teriparatide, and the challenges of determining when to consider surgery.

This will be followed by a panel discussion with audience participation in some illustrative cases.