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

Gabbett, Tim J. (2016) The training-injury prevention paradox: should athletes be training smarter and harder?. British Journal of Sports Medicine, 50 5: 273-280. doi:10.1136/bjsports-2015-095788


Author Gabbett, Tim J.
Title The training-injury prevention paradox: should athletes be training smarter and harder?
Formatted title
The training-injury prevention paradox: should athletes be training smarter and harder?
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 1473-0480
0306-3674
Publication date 2016-03
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/bjsports-2015-095788
Open Access Status DOI
Volume 50
Issue 5
Start page 273
End page 280
Total pages 9
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2017
Language eng
Formatted abstract
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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
School of Human Movement and Nutrition Sciences Publications
 
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