Leading spinal specialist cites ongoing misdiagnosis as problem with Australia's bowlers PAT Howard has defended Cricket Australia's injury management record, as a leading spinal specialist cites ongoing misdiagnosis of back stress fractures grounding Test tyros including James Pattinson, Mitchell Starc and Pat Cummins. CA general manager, team performance, Howard insists Australia isn't in the grip of an injury crisis but CA's treatment of young fast bowlers is under the microscope ahead of a critical Ashes series. Former head of spinal injuries unit at Royal Adelaide Hospital, Professor Robert Fraser, says it is time to blow the whistle on a decade of back injury analysis. If Fraser is correct, the fundamentals driving CA's injury protocols could have been hindering rather than helping a cohort of fast bowlers from Brett Lee to Pattinson. "There is no convincing evidence that new stress fractures develop in adults after skeletal maturity," said Professor Fraser, who helped solve Shane Watson's back issues in 2009 - against CA protocols. "Given the repeated loads on the lower back of fast bowlers it is not surprising that a bone scan will show evidence of a "stress reaction" or "arthritic inflammation" in the region of the facet joints or in an old stress fracture but this does not indicate a serious injury, certainly not one that requires prolonged rest and lay-off from bowling." Australia's Ashes preparations have been rocked with express trio Cummins, Starc, Pattinson sidelined, while seamer Jackson Bird also returned from Australia's tour of England with back pain. Cummins will miss his third home summer in a row with a back injury. Skipper Michael Clarke will be deprived this Ashes summer of the variety provided by 197cm left-armer Starc who can swing both ways and averages 30 with the bat. A hat-trick to fast bowler Clint McKay was not enough for Australia, with a sub-par batting effort seeing them go down by three wickets to England in the fourth ODI. Fraser says the "prolonged" rest will hurt the bowler and fans without benefit - arguing there's no basis for months in the stands. Howard says CA is open to new scientific evidence but backs the expertise of head physiotherapist Alex Kountouris, one of two professionals with a PhD in bowling-related back stress fractures. "We have a team who study science journals, we are absolutely open to new ideas," Howard told The Advertiser. There's some thought that when the players are rested they have the pipe and slippers, that is not the case. There is a period of rest then they are slowly built up, like marathon runners. Howard pointed to the success of CA preparation in assembling a fleet of fast men - Pattinson, Starc, Ryan Harris, Peter Siddle, Bird and James Faulkner for the 2013 winter Ashes campaign. Starc (1379) and Pattinson (1254) are in a group with Craig McDermott (3035) and Dennis Lillee (1471), Bruce Reid (1407) and Jason Gillespie (1370) who have bowled the most Test deliveries before aged 23. Kountouris says high early workload can place bowlers at risk of a premature retirement like McDermott at 31 in 1996 after 291 wickets in 71 Tests. Starc featured in consecutive Tests in his debut series against New Zealand in 2011 but hasn't done so again much to his frustration. Ryan Harris has been one of the most affected by Australia's bowler rotations. It is a ploy that did not prevent his back stress fracture diagnosis last week during the one-day series in England. Howard maintains CA's cautious approach is justified. "We do agree if you bowl a lot to get into good condition that is fine, it is just that spike in a Test or in back to back matches that sets you off," said Howard. Fraser believes it is a self-fulfilling prophecy telling fast bowlers they will break down continually until physical maturation at 24. Allrounder Watson was diagnosed with back stress fractures in 2008 and told to rest for six months but sought Fraser's opinion and returned to bowling by following a pilates program to make the 2009 Ashes tour. Howard says experienced reinforcements like Mitchell Johnson and Ben Hilfenhaus and youngster Josh Hazlewood can do the business against the Old Enemy this summer. We have bowlers like (Johnson) in the one-dayers, Ben Hilfenhaus who is bowling at state camp, Ryan Harris, Peter Siddle. We have real depth and real competition for places," he said. The caravan doesn't stop. We have the Champions League, India ODI's so it is possible we will have another injury between here and there but we are working hard to minimise that.