Training Load Management for Injury Prevention

Training Load as “Protection” From Injury
Training for high performance requires athletes to strategically alternate between increased training load to stimulate physiological responses and decreased training load to allow for adaptation and increased capacity. Interestingly, research on the effect of training load on injury risk shows that high training loads are not only NOT an injury risk, they have been shown to offer PROTECTION FROM INJURY in athletes. Of course, what IS important is HOW you get to those higher training loads. Ramping up intensity too quickly or inadequately recovering between loading cycles pushes an athlete beyond their current capacity and can result in overload at the tissue level (ie tendon injuries) or fatigue-related changes in motor control that can contribute to injuries (not to mention the effects on motivation, concentration, emotional stability, etc). Training at lower loads is also an injury risk because it results in an athlete’s inability to cope with any increases in load. Our goal is to progressively load our bodies to improve our durability; in doing so, we can withstand higher loads for improved performance and decreased risk of injury.
 
Getting the Whole Picture: Training Load and Wellness
Sport injuries are dependent on a number of factors. Training load management is not just a matter of calculating extrinsic factors such as training volume, duration and speed, but must also consider intrinsic factors such as heart rate or rate of perceived exertion (“how hard was that workout?”). Internal loads can be affected by a number of things: fatigue, emotional disturbance, poor sleep, poor recovery, illness, or recent training loads. This can explain why the same workout done at one point in the season will feel more or less difficult due to factors such as current fitness level, during a stressful school testing, or after several nights of poor sleep. So, by daily tracking of wellness factors as well as training load factors, we are trying to get a real-time picture of the athlete’s current and past training load, his/her ability to cope with that training load, and his/her readiness to train or compete going forward.
 
Identifying Individual Patterns
Research has shown that there is likely an optimal range of load progression to maximize performance and avoid undertraining or overtraining. For example, large week-to-week increases in load have been shown to significantly increase injury risk. Research is showing that an athlete can be at increased risk for injury for 7-28 days following a significant spike in training load! (so, maybe that overuse injury didn’t really come out of nowhere). Another metric used to measure appropriate progressions in load is what is called the acute-to-chronic-workload-ratio (ACWR).

• Acute load is defined as the sum of the load across a 7 day period
• Chronic load is the average of the acute load over a 4 week period
• ACWR is the ratio of the current 7 day period as compared to the average of the previous 28 days

 
A generalized goal is to keep an athlete’s ACWR between 0.8-1.2. An ACWR of less than 0.8 has been associated with a 5-7% increased risk of injury (undertraining), while an ACWR greater than 2.0  (overreaching) can increase injury risk to 15-20%! This range can vary by sport and individual, so by tracking your own training and wellness data, you can fine tune your training plan according to how YOU specifically respond to changes in training loads.
 
Injury Prevention with Enhanced Performance Therapy
 
Functional Movement Screen
Utilizing the Functional Movement Screen and Y-Balance Test (www.functionalmovement.com), we perform functional tests that are used to determine if an athlete is performing at least at a minimal level of “movement competence”. The presence of asymmetries, excessive compensations, painful movements or orthopedic tests, and injury history can indicate an increased risk of a future injury. The results of the screen help to determine what an athlete needs to focus on in their strength training program to improve mobility, stability and motor control with the goal of decreasing compensations that might lead to injury.
 
Training Load and Wellness Tracking
Are you interested in bringing this sport science technology to your training? We use a simple data entry web app that you can use from any mobile device or computer. You simply fill out a quick wellness questionnaire every morning, enter daily training sessions, and report the occurrence of any injuries. Results and reporting can be viewed directly from the app and the daily “Ready to Perform” score is visualized using an easy to interpret “stoplight” system. Over time you accumulate more data and will be able to view your Acute:Chronic Workload ratio in real-time for a more sensitive measurement of your workload progressions and the relationship to your wellness scores and onset of injuries. By tracking patterns, you can then make adjustments to your training and/or your recovery strategies based on your own history. We provide educational resources and exercise/self-care interventions via the application based upon your individual needs.
 
 
Interested in more information?
Go to www.eperformancetherapy.com/sports-wellness.html or contact me at kendal@eperformancetherapy.com.
 
 
References
Blanch P, Gabbett TJ. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury. Br J Sports Med Published Online First: 23 Dec 2015. doi:10.1136/bjsports-2015-095445
 
Gabbett TJ The training-injury prevention paradox: should athletes be training smarter and harder?Br J Sports Med  Published Online First: 12 January 2016. doi: 10.1136/bjsports-2015-095788