Pars Stress Fracture, RED-S & Young Athlete Development with Elite Sports Physio Vishal Kanji

Bone stress injuries are becoming an increasingly important issue in young and high-performance athletes. From sudden increases in training load to rapid growth, poor recovery and low energy availability, a combination of factors can leave developing athletes vulnerable to injury. In this episode, we sit down with Vishal Kanji , Specialist Physiotherapist at Mayfair Health, with extensive experience across the NHS and elite sport, including work with Arsenal FC, Middlesex County Cricket Club, Essex County Cricket Club and Brentford FC. Vish specialises in spinal rehabilitation, lumbar spine stress fractures, movement control and return to play, and shares his experience managing one of the more challenging injuries seen in young athletes: Pars stress fractures . We explore why these injuries are particularly common in adolescent athletes and fast bowlers, how repeated spinal extension and rotation can place stress on the pars, and why early symptoms are often mistaken for simple muscular back pain. A key focus of the conversation is load management . We discuss how sudden changes in training volume, year-round competition, early sport specialisation and inadequate recovery can influence injury risk, and why successful rehabilitation requires balancing temporary unloading with progressive strength and capacity building. We also explore the role of RED-S, nutrition and bone health , including how low energy availability, hormonal changes, sleep and recovery can influence bone adaptation and healing. Vish explains why treating the injury alone may not be enough if the underlying biological factors aren't addressed. Using fast bowling as a case study, we dive into biomechanics, including front-on, side-on and mixed bowling actions, counter-rotation, hip–shoulder separation and the role of the front-foot block. We discuss how technique, workload and physical capacity interact, and whether biomechanics can be modified without compromising performance. Finally, we look beyond rehabilitation towards prevention and long-term athlete development . From strength training and bone loading to better communication between coaches, parents and clinicians, Vish explains how we can build stronger, more resilient athletes before injury occurs. 🎙️ In This Episode, We Cover • Why bone stress injuries may be increasing in young athletes • Pars stress fractures and why they occur • How to recognise the early warning signs of lumbar stress injury • MRI, CT and SPECT imaging and when they may be used • The impact of growth and adolescence on injury risk • RED-S, nutrition and hormonal health • Why fast bowlers are particularly vulnerable to lumbar stress injuries • Front-on, side-on and mixed bowling biomechanics • The relationship between technique, workload and injury risk • How to safely manage training loads in young athletes • Staged rehabilitation and return-to-bowling • The role of strength training in prevention and recovery • How bone adapts to resistance training and impact loading • Building long-term skeletal resilience in young athletes • Practical strategies for preventing bone stress injuries 🎯 Who This Episode Is For • Young athletes and aspiring elite performers • Cricket players, particularly fast bowlers • Parents and coaches involved in youth sport • Athletes recovering from a pars stress fracture or bone stress injury • Physiotherapists, sports physicians and strength & conditioning coaches • Anyone interested in injury prevention, bone health and long-term athletic development 🎙️ Powered by Mayfair Health At Mayfair Health, we specialise in recovery, performance and proactive wellness. Our multidisciplinary team works with athletes and active individuals to manage injury, build physical capacity and develop the foundations for long-term performance and resilience. 🔗 Website: https://www.mayfairhealth.co.uk 📩 Contact: info@mayfairhealth.co.uk 📞 Phone: 020 3985 1500 📱 Instagram: @mayfairhealth