Training Load Management for Injury Risk

Question 1

state what it is meant by the key term - ‘training load’

Answer 1

can be described as a higher-order construct reflecting the amount of PA that is actually done and experienced by the athletes and not what was planned, which is training prescription

Question 2

what is the ‘Theoretical Basis for Movement’ stated by (Banister et al., 1975)

Answer 2

the basis of training monitoring us based on the ‘dose-response relationship’ - the response of an athlete to one ‘dose’ of training

(Banister et al., 1975)

Question 3

what is the ‘theoretical basis for monitoring’ stated by (Soligard et al., 2016)

Answer 3

• we want to look at the green line
• we want to avoid the red line - if you load an athlete before they fully recover, then you could overtrain the athlete, and their capacity to perform will decrease

Question 4

what is the overall ‘theoretical basis for monitoring’ by (Winds & Gabbett., 2016)

Answer 4

• monitoring is essential to see adaptation, illness, injury, etc…
• modifiable factors change due to fitness and fatigue factors
• take point: the likelihood of injury changes day-to-day which is why coaches do daily training monitoring

Question 5

what 3 fats are highlighted in the ‘Theoretical Framework of the Training Process’ (Jeffries et al., 2021)

Answer 5

1. functional overreaching
2. non-functional overreaching
3. overtraining

Question 6

state what it is meant by the key term - functional overreaching (Jeffries et al., 2021)

Answer 6

short term; after rest and recovery, the athlete is then at a higher performance level

Question 7

state what it is meant by the key term - no-functional overreaching (Jeffries et al., 2021)

Answer 7

where the athlete doesn’t get a performance re-bound after a huge training load - the training stimulus was too great

Question 8

state what it is meant by the key term - overtraining (Jeffries et al., 2021)

Answer 8

weeks/months/years of a performance deficit due to a workload being applied which is greater than the athlete’s capacity to deal with that load

Question 9

state what it is meant by the key term - ‘external load measures’

Answer 9

the work completed by the athlete; measured independently of their internal characteristics

Question 10

state 4 external work load measures

Answer 10

1. frequency/time
2. power, speed, acceleration
3. Global Positioning System (GPS)
4. micro-sensor technology (e.g. - accelerometers)

Question 11

state what it is meant by the key term - ‘internal load measures’

Answer 11

the relative psychophysiological stress elicited by an external workload

Question 12

state an issue with GPS monitoring

Answer 12

the reliability is influenced by factors such as sample rate, velocity and duration, and type of task. increased velocity = reduced reliability

Question 13

state 4 internal work load measures

Answer 13

1. session RPE
2. blood lactate
3. biochemical/hormonal/immunological assessments
4. HR measures (more weight given to higher HR zones)

Question 14

what is the formula for sRPE/tRIMP (session RPE)

Answer 14

sRPE load = Duration x sRPE

e.g. - 45 mins x RPE 7 = 315 AU

Question 15

what is recommended when measuring RPE?

Answer 15

recommended you wait 30 minutes (10 mins at least) post session before you fill it out

Question 16

state 4 benefits of using RPE

Answer 16

1) can be used for different training styles
2) is valid (HR r = 0.89 and lactate 0.96) and reliable (ICC = 0.99, TE = 4%) - Gabbett., 2007
3) easy and cheap to collect
4) captures both physiological and psychological stress

Question 17

state 3 issues with the use of RPE

Answer 17

1) compliance/collection issues (e.g. - less likely to be honest if your mates say different scores)
2) doesn’t measure diff components of training stress (e.g. - breathlessness, leg muscle exhaustion, etc…)
3) intensity and duration are merged (10 mins at RPE 10 does not equal 100 mins at RPE 2)

Question 18

what tools do practitioners use?

Answer 18

• shift to examining external rather than internal load
• caution should be taken (internal adaptation ultimately determines external capacity)
• advantage of external load measuring is that is can allow for better prescription of external load

Question 19

what did Carl Foster come up with ?

Answer 19

he came up with a ‘Load Injury Relationship’ graph which looked at the loads which athletes performed when/just before they got injured

Question 20

explain Carl Foster’s graph (2 points)

Answer 20

• he drew a threshold line where, if you went above it, your likelihood of injury increased drastically
• did not predict injury every time, people were still getting injured far below the threshold

Question 21

what was Tim Gabbet’s graph on injuries in different parts of the season ? (2 points)

Answer 21

• he saw that different phases in the season changed the likelihood of getting injured
• this changed due to the cumulative effect of performing every single week in rugby

Question 22

what was Tim Gabbett’s graph on loads and injury (3 points)

Answer 22

• saw injury can be due to changes in loads
• saw low load increases have lower chances of injury (10% rule)
• as you increase the change in load, the risk of getting injured increases

Question 23

explain the difference between ‘acute’ and ‘chronic’ work loads

Answer 23

acute: recent loads (e.g. - one week), analogous to state of ‘fatigue’
chronic: average loads over last 3-6 weeks, analogous to state of ‘fitness’ - 4 weeks used in most literature

Question 24

how do you work out the ACWR?

Answer 24

• acute = most recent week load AU)
• chronic = average over last 4 weeks (AU)
• acute / chronic = ACWR
  e. g. - 200 AU / 125 AU = 1.6 ACWR

Question 25

what did Gabbett do with regards to the ACWR

Answer 25

did a summary of studies that looked at ACWR. he found a ‘sweet spot’ between 0.8 and 1.3 where injury risk is low. when ratio gets to 1.5 and above (50% or more increase in one week), then the chance of injury increases

this theory has been used by a lot of coaches because it is easy to do and makes a lot of sense

Question 26

what did (Windt & Gabbett., 2016) do ?

Answer 26

did a study to look at - ‘does fatigue negatively affect risk factors of the lower extremity injury risk profile? a systematic and critical review’

Question 27

what were the findings to the following study:

‘does fatigue negatively affect risk factors of the lower extremity injury risk profile? a systematic and critical review’ (Windt & Gabbett., 2016)

Answer 27

• reviewed study of fitness in Gaelic football and found that the fitter the athlete, the better they can deal with larger increases in load
• found the stronger the athlete, the better they can deal with larger increases in load

Question 28

who came up with the following study:

‘Has the athlete trained enough to return to play safely’

Answer 28

‘Has the athlete trained enough to return to play safely’ (Blanch & Gabbett., 2016)

Question 29

state 4 facts from the following study:

‘Has the athlete trained enough to return to play safely’ (Blanch & Gabbett., 2016)

Answer 29

1. a measure of ACWR in high-speed runners
2. ever time their injury ent above 1.5, they’d get injured
3. when injured, the workload must go down to zero
4. if they go back to their previous workload, their ratio goes a lot higher, and therefore will become injured again

Question 30

what is more reliable, and why:

1) exponentially weighted moving average
2) rolling average

Answer 30

1) exponentially weigher moving average
2) gives more weighting to the more recent training day
3) rolling average takes past 7 days and divides by 7. this means that it doesn’t give more weighting to most recent session, and some days they may not train so their ACWR is 0 - does not mean that they are fully recovered to perform again

Question 31

state 3 issues with using ACWR research

Answer 31

1. mathematical coupling/scaling issues (Lolli et al., 2017)
2. optimal time-constraints (Carey et al., 2017)
3. categorisation (Carey et al., 2017)
4. inappropriate statistical methods (Windt et al., 2018)
5. multiple comparisons (Tostein Dalen-Lorenstel et al., 2021)

Question 32

why is the following an issue with using ACWR research:

mathematical coupling/scaling issues (Lolli et al., 2017)

Answer 32

need to check that it is appropriate to divide numbers by each other which it may not be appropriate to do so with ACWR

Question 33

why is the following an issue with using ACWR research:

optimal time-constraints (Carey et al., 2017)

Answer 33

commonly use 7 days and 28 days - no reason why you cant be using 5 days and x days etc… you ca tweak that as much as you want until you get a significant effect

Question 34

why is the following an issue with using ACWR research:

categorisation (Carey et al., 2017)

Answer 34

lots of different was to split into low, moderate, and high data sets. this causes comparison problems

Question 35

why is the following an issue with using ACWR research:

inappropriate statistical methods (Windt et al., 2018)

Answer 35

some used in research are not appropriate for modelling injury risk

Question 36

explain the study design to:

‘does load management using the ACWR prevent health problems?’

Answer 36

• randomised cluster trial of 482 elite youth footballers of both sexes
• intervention group had all sessions planned by ACWR
• control group trained as normal
• outcome determined via ‘Also Sports Trauma Research Centre Questionnaire on `health Problems’

Question 37

what were the findings to:

‘does load management using the ACWR prevent health problems?’

Answer 37

1. ACWR works and doesn’t work
2. no - results how’s no difference in injuries between the 2 groups
3. if you look at serious injuries, the chances are lower in the intervention group (PR = 0.99. p = 0.17) - p value is signifiant so there is potentially something going on

Question 38

explain the problems of the following study:

‘does load management using the ACWR prevent health problems?’

Answer 38

• control didn’t measure loads at all - may not have had any spikes above 1.5 ACWR
• compliance issues: 10 month study with compliance around 62%

Question 39

Planning optimal workloads:

Answer 39

• we want to get an athlete from point A to point B
• must do in a safe way (ACWR can be a useful guide)
• adjust loads based on subjective wellness measures
• can use heart rate variability (HRV)

Question 40

what’s considered a healthy HRV, why?

Answer 40

• variation relents current state of autonomic NS
• greater aviation = parasympathetic NS in control - relaxed state - more able to adjust to environmental changes
• structured = sympathetic NS in control - ridged and less able to respond to changes in the environment

Question 41

‘Mediators in workload-injury investigations’ (Williams et al., 2017) - explain findings

Answer 41

• injury risk was elevated when HRV was low and workloads were high (unable to cope with increases in work loads)
• people with high HRV and high work loads are able to cope with those higher work loads

Question 42

who’s study on HRV training did we look at?

Answer 42

(Manresa-Rocamora et al., 2021)

Question 43

what was the study design to:

‘HRV Guided Training’ (Manresa-Rocamora et al., 2021)

Answer 43

measure HRV every morning and if in normal range = normal training

surpassed HRV - rest day or low intensity/volume day

study did a meta-analysis of multiple athletes training when using HRV

Question 44

what are the future directions of Training Load Management for Injury management ?

Answer 44

tech improving to measure many more biological factors that are wearable

this will give us a key insight to the integration of both training and match loads as its difficult to measure together right now

tech will also aid out analysis s we don’t have to deal with so many numbers - machine learning methods