The training—injury prevention paradox: should athletes be training smarter and harder?

By Tim J. Gabbett. British Journal of Sports Medicine, 2016

1,559 citations recorded by the source corpus.

Background There is dogma that higher training load causes higher injury rates. However, there is also evidence that training has a protective effect against injury. For example, team sport athletes who performed more than 18 weeks of training before sustaining their initial injuries were at reduced risk of sustaining a subsequent injury, while high chronic workloads have been shown to decrease the risk of injury. Second, across a wide range of sports, well-developed physical qualities are associated with a reduced risk of injury. Clearly, for athletes to develop the physical capacities required to provide a protective effect against injury, they must be prepared to train hard. Finally, there is also evidence that under-training may increase injury risk. Collectively, these results emphasise that reductions in workloads may not always be the best approach to protect against injury. Main thesis This paper describes the ‘Training-Injury Prevention Paradox’ model; a phenomenon whereby athletes accustomed to high training loads have fewer injuries than athletes training at lower workloads. The Model is based on evidence that non-contact injuries are not caused by training per se, but more likely by an inappropriate training programme. Excessive and rapid increases in training loads are likely responsible for a large proportion of non-contact, soft-tissue injuries. If training load is an important determinant of injury, it must be accurately measured up to twice daily and over periods of weeks and months (a season). This paper outlines ways of monitoring training load (‘internal’ and ‘external’ loads) and suggests capturing both recent (‘acute’) training loads and more medium-term (‘chronic’) training loads to best capture the player's training burden. I describe the critical variable—acute:chronic workload ratio—as a best practice predictor of training-related injuries. This provides the foundation for interventions to reduce players risk, and thus, time-loss injuries. Summary The appropriately graded prescription of high training loads should improve players’ fitness, which in turn may protect against injury, ultimately leading to (1) greater physical outputs and resilience in competition, and (2) a greater proportion of the squad available for selection each week.

Subfields: Developmental and Educational Psychology, Orthopedics and Sports Medicine

View Paper: https://www.semanticscholar.org/paper/1b3c65610ab961a54fec99fd92fbb5154594f6cc

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In Developmental and Educational Psychology

M. Hägglund

In Orthopedics and Sports Medicine

Citations in the corpus

Training Load Monitoring in Team Sports: A Novel Framework Separating Physiological and Biomechanical Load-Adaptation Pathways (2017, background): “While a recent editorial [66] and review [54] have already alluded to this, we believe that with more detailed biomechanical understanding the distinct biomechanical load-adaptation pathway in the proposed framework can be further justified.”
Load monitoring system in top-level basketball team: Relationship between external and internal training load (2018, background): “Successful training monitoring in team sports results in better performance (Akenhad & Nassis, 2015; Drew & Finch, 2016; Gabbett, 2004, 2016) and fewer injuries, especially non-contact and soft tissue injuries (Akenhad & Nassis, 2015; Drew & Finch, 2016; Gabbett, 2004, 2016; Halson, 2014).”
Wearable sensors for monitoring the internal and external workload of the athlete (2019, background): “The product can be thought of as the athletes’ “exertional minutes”.(46) Advancements in MEMS fabrication techniques and device packaging have allowed for the detection of multi-axial movement to calculate an external training load (e.”
Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study (2016, background): “…such as player load, match frequency, playing style, team management, continuity of club medical and technical staff, etc, could be important underlying external risk factors for hamstring injury, and should be considered in future hamstring injury prevention initiatives and injury management.”