Training load and injury part 1: The devil is in the detail – challenges to applying the current research in the training load and injury field

Review written by Robin Kerr info

Key Points

  1. The idea that manipulation of workload can reduce injury risk is a common assumption amongst clinicians.
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BACKGROUND & OBJECTIVE

There is a common clinical assumption amongst therapists that training load issues are a major contributor to injury. This commentary paper is introductory to Part 2, setting the scene for critique of the research practices and the subsequent overinterpretation of results in the training load and injury research. Clinicians are alerted to the risk of questionable research influencing their clinical practice. These papers follow a controversial request of retraction to the British Journal of Sports Medicine in 2019, regarding workload research in which a now much utilized but erroneous diagram was published (1,2,3).

The authors ask and address the clinical questions of whether the research has been designed and conducted well enough to answer the questions of:

  • What is the relationship between training workload and sports injury risk?
  • Can the metrics based on training workload be used to decrease injury risk?

Interestingly (or perturbingly), already ubiquitous in daily physiotherapy practice are two common clinical assumptions:

(1) Training workload is a key factor influencing sports injury risk. (2) Training workload can be manipulated to reduce injury risk.

There is a common clinical assumption amongst therapists that training load issues are a major contributor to injury.
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Questionable research practices and over-interpretation of research results undermines the trustworthiness of research in the training load-injury field.

WORKLOAD METRICS:

In sports medicine the metrics of exposure to training workload are commonly used. One metric used prognostically to predict injury risk is acute:chronic workload ratio (ACWR). This is an evolution of Banister’s original model (4). The most common metrics currently

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