The associations between training load and baseline characteristics on musculoskeletal injury and pain in endurance sport populations: A systematic review

Abstract

Objective: To determine the associations between training load, baseline characteristics (e.g. age or previous injury) and rate of musculoskeletal injury and/or pain specifically within an Endurance Sporting Population (ESP). Design: Prospectively registered systematic review. 3 Methods: Eight electronic databases were searched by two independent reviewers. Studies were required to prospectively monitor both (i) training loads and (ii) musculoskeletal injury and/or pain for >3 months. Methodological quality and risk of bias were determined utilising the Critical Skills Appraisal Program (CASP). Reported effect sizes were categorised as small, medium or large. Results: Twelve endurance sport studies were eligible (running, triathlon, rowing). Increased injury and/or pain risk was associated with: (i) high total training distances per week/month (medium effect size) (ii) training frequency <2 sessions/week (medium effect size) and (iii) both low weekly (<2 hours/week) and high monthly (large effect size) training durations. None of the studies reported internal training load data or acute:chronic workload ratios. Baseline characteristics found to increase the rate of injury and/or pain included: (i) a history of previous injury (medium effect size), (ii) age >45 years (small effect size), (iii) non-musculoskeletal comorbidities (large effect size), (iv) using older running shoes (small effect size) and (v) non-competitive behaviour. Conclusions: This review identifies a range of external training load factors and baseline characteristics associated with an increased rate of injury and/or pain within ESPs. There is an absence of research relating to internal training loads and acute:chronic workload ratios in relation to rate of injury and/or pain within ESPs.

Debunking the myths about training load, injury and performance: empirical evidence, hot topics and recommendations for practitioners

“…The relationship between training, performance and injury has been of interest to researchers and practitioners for considerable time 1 5–15. Both individual16 and team17–19 performance can be explained, at least in part by training load, with higher training loads generally associated with better performance.…”

Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review

“…Workloads and injuries in rugby, running, and soccer athletes have been examined. [94][95][96] However, the literature is not nearly as comprehensive for overhead-throwing athletes (adolescent and adult); some of the research involved cricket bowlers and handballers. 30,77,92 Studies of baseball and softball pitchers relied primarily on throwing volume and velocity and hours of training and competition as the workload measures.…”

Increase in the Acute:Chronic Workload Ratio relates to Injury Risk in Competitive Runners

“…Although applying sRPE in combination with the acute:chronic workload ratio (ACWR) may be promising for identification of the impact of workload on injury risk [24], there is an absence of studies that relates sRPE based ACWR with injury risk in running. Previous studies in running on workload and injury risk defined workload as a single nonrelative factor, like duration, distance or frequency [6,7,11].…”