A structural approach to management emphasising bone healing as a critical outcome is applicable for young fast bowlers with lumbar bone stress injuries (LBSI). Clinical management strategies are dictated by radiological and physical assessment findings, player age, skill level, injury history, and bowling speed. Four phases of management are specified: unloading and protection; integrated reloading; return to high-intensity bowling; and return to competition. Progression through phases is based upon criteria related to bone healing, symptom resolution, movement patterns, and tolerance of resistance training and bowling loads. Lumbopelvic stabilisation training is a major focus of early rehabilitation, along with the reduction of lumbar loads to enhance bone healing and prevent LBSI progression. Integrating progressed lumbopelvic stabilisation training into single-plane resistance training is essential, as is subsequent development of multiplanar strength and power within a high-performance training framework and a well-planned return to bowling programme. Bespoke strength and conditioning support, and monitoring of bowling workloads and technique are required to prevent recurrences following return to competition.