Bowling back pain usually affects the lumbar region, but might also be expressed in the upper back or neck in less common circumstances. Bowling is a sport with a bad reputation for causing and exacerbating back pain problems and understandably, many bowlers cease participation in their beloved sport as soon as they develop serious dorsalgia. Even the few who decide to hold out and continue to bowl are often eventually told to stop by their care providers, giving them little choice but to comply or risk injury and aggravated pain.
We have been actively studying bowling and back pain for nearly 15 years now and were fortunate enough to participate in a prestigious research project on the subject which finished a couple of years back. The results of this research and the collective clinical experience that we bring to the table has provided us with shocking (to some, at least) conclusions about the real relationship between bowling and back pain.
This article explores bowling lower back pain and the other location-specific symptoms of dorsopathy often linked to bowlers. We will discuss why bowling might be bad of the back in the traditional view of Cartesian medicine, as well as the actual outcomes we have witnessed in people who continue to bowl, despite having a diversity of diagnosed back issues. If you are a bowler with back pain, or a healthcare clinician who is interested in this vital topic, this essay is a must-read for you.
Traditionally, doctors tend to take a very negative stance on bowling and back pain. We have heard all manner of warnings sternly given to patients who bowled, such as all of the following cautions:
Bowling puts tremendous pressure on the lower back and is a major cause of lumbar injury, such as herniated discs.
Bowling involves bending and lifting, which are inherently bad activities for the lumbar spine.
Bowling also places strain on the neck and upper back regions, especially when lining up the shot and during ball release.
Doctors will typically be quick to tell how bowling will hasten degenerative disc disease in the lumbar region, incite herniated discs, exacerbate spinal arthritis and generally have very negative effects on the spine. Of course, since bowling does have some degree of risk of falling, doctors will also mention that a fall under such circumstances of bending and lifting inherent to bowling could be catastrophic.
We really can not argue that all of these cautions have at least some degree of merit and that bowling does have certain inherent negative anatomical consequences to consider. However, then we began to look at the sport more objectively and compared it to many other common activities that humans perform on a daily basis. This is what led us to desire to study the topic in greater detail than it had previously been subjected to before.
We followed a large number of bowlers with back pain over the years. We charted how they fared, depending on their choices to continue bowling or cease bowling and what types of treatment they decided upon during this time. Our findings are incredibly interesting and defy the traditional view of both treatment recommendations (no surprise there) and activity avoidance recommendations.
The first category of bowlers, and the largest number of the group all around, chose to stop bowling completely and pursued active care for their lower back pain. The vast majority continued to have pain, despite treatment using a wide range of conservative traditional and complementary practices. In fact, the type of conservative treatment chosen had virtually no impact on its efficacy. Of this large patient sample, the majority cites unsatisfactory therapeutic outcomes and almost half eventually sought surgery for mostly disc diagnoses in the lumbar spine. Of these surgeries, only a very small number are reported by recipients as being successful in ending pain. This group is judged as being the worst off in their treatment efforts and completely lost out on participating in an activity that was meaningful to them. Most also developed the inability to do more mundane physical tasks with time.
The next largest group consisted of people who continued to bowl, although often less actively or rigorously. These people also sought out treatment following the parameters outlined in the group above, using a selection of conservative methods of care. About 50% cited poor results, while about 50% said that they were able to resume bowling, despite having an occasional flare-up of pain in some select patient profiles. Of the half who did not enjoy good outcomes, only about 25% decided on back surgery, while the rest simply managed, but kept bowling, regardless of their pain. Very few patients lost additional physical abilities or endured activity restrictions, regardless of their pain.
The second smallest group consisted of people who gave up bowling, but did not seek active care for their back pain or gave up when initial treatment efforts failed. These people reported missing bowling, but felt that it was a bad idea to continue due to their pain. About 20% eventually sought surgery, while the rest pressed onwards in life without seeking any additional treatment for their back pain. About half of these people reported time made things better, while almost the entire other half cited no change in their pain over time, for the better or worse. About 65% experienced additional activity restrictions with time.
The best faring group is also the smallest in number. These people did not pursue conservative back pain treatment or gave up their treatment attempts quickly upon initial unsatisfying results. These people continued to bowl and some even escalated their participation in bowling over time. Only about 2% of these people eventually had surgery for back pain and most of these were many years down the line. Of the remaining 98%, about three quarters reported pain improving with time, although they might or might not have occasional flare-ups. Only 25% of these people reported pain remaining the same, whether they bowled or not, but they decided to press onward anyway, even with their persistent pain. Virtually none of this group suffered a reduction in ability to perform other physical activities. This group obviously fared the very best of the entire patient sample.
It should be noted that of all these patients, none were using mindbody medicine as a treatment choice. Therefore, poor efficacy of traditional treatment was not created by embracing any alternate view on the causative nature of symptomology.
Based on the results of the study, as well as our clinical and research experience, we feel confident that bowling is not inherently bad for the back. Patients must make up their own minds about whether to run from activities they enjoy, until they can do nothing at all in fear of pain, or simply choose to live and follow their ambitions in the face of potential pain. It is certainly a very personal choice to make. However, we can provide a very balanced view on preventing bowling back pain using these simple tips:
Always use good technique and economy of motion when bowling and performing all related tasks, such as lifting and carrying a ball, retrieving a ball from the return and even changing into your bowling shoes. Do not place inordinate stress on any part of your body, including your spine.
Use the right size and weight ball for your needs.
Do not throw from the shoulder or arm, but instead, use the entire body to deliver the ball.