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Johnston R1, Cahalan R1, Bonnett L2, Maguire M3, Neville A4, Glasgow P5, O'Sullivan K1,6, Comyns T7
1University of Limerick, School of Allied Health, Limerick, Ireland, 2University of Liverpool, Department of Biostatistics, Liverpool, United Kingdom, 3Ulster Rugby, Belfast, United Kingdom, 4University of Wolverhampton, Wolverhampton, United Kingdom, 5Irish Rugby Football Union, Dublin, Ireland, 6Aspetar Orthopaedic and Sports Medicine Hospital, Sports Spine Centre, Doha, Qatar, 7University of Limerick, Physical Education and Sports Sciences, Limerick, Ireland
Background: The incidence of injury and/or pain (IP) in endurance sport populations (ESPs) is high, yet there have been no previously published prospective studies of internal training load factors and IP risk within ESPs.
Purpose: The aim of this prospective study was to determine the association between TL factors, baseline characteristics (i.e. age, sex, history of previous IP) and new IP risk within an ESP.
Methods: Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Participants initially completed a questionnaire capturing baseline characteristics. TL and IP data was submitted weekly over a 52-week study period. Cumulative TL factors, Acute:Chronic Workload Ratios (ACWR) and Exponentially Weighted Moving Averages (EWMA) were calculated. A shared frailty model was used to explore time to new IP and association to TL factors and baseline characteristics.
Results: 92.6% of the ESP completed all 52 weeks of TL and IP data. The following factors were associated with the lowest risk of a new IP episode; (a) a low to moderate 7-day lag EWMA (0.8-1.3: HR=1.21, 95% CI 1.01-1.44, p=0.04) (b) a low to moderate 7-day lag weekly training load (WL) (1200-1700AU: HR=1.38, 95% CI=1.15-1.65, p 0.001) (c) a moderate to high 14-day lag 4-weekly cumulative training load (CL) (5200-8000AU: HR=0.33, 95% CI=0.21-0.50, p 0.001) and (d) a low number of previous IP episodes in the preceding 12 months (1 previous IP episode: HR=1.11, 95% CI=1.04-1.17, p=0.04).
Conclusion(s): Training consistently, while avodiing sudden spikes in activity, was associated with the lowest risk of IP among ESPs. The risk was also increased among those with a previous history of IP.
Implications: To minimise new IP risk an ESP should avoid high spikes in acute TL whilst maintaining moderate to high chronic TLs. A history of previous IP should be considered when prescribing TLs. The demonstration of a lag between a TL factor and its impact on new IP risk may have important implications for future ESP TL analysis.
Keywords: Injury, athlete, predict
Funding acknowledgements: The faculty of education and health sciences at the university of limerick supported this work with a phd shcolarship.
Purpose: The aim of this prospective study was to determine the association between TL factors, baseline characteristics (i.e. age, sex, history of previous IP) and new IP risk within an ESP.
Methods: Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Participants initially completed a questionnaire capturing baseline characteristics. TL and IP data was submitted weekly over a 52-week study period. Cumulative TL factors, Acute:Chronic Workload Ratios (ACWR) and Exponentially Weighted Moving Averages (EWMA) were calculated. A shared frailty model was used to explore time to new IP and association to TL factors and baseline characteristics.
Results: 92.6% of the ESP completed all 52 weeks of TL and IP data. The following factors were associated with the lowest risk of a new IP episode; (a) a low to moderate 7-day lag EWMA (0.8-1.3: HR=1.21, 95% CI 1.01-1.44, p=0.04) (b) a low to moderate 7-day lag weekly training load (WL) (1200-1700AU: HR=1.38, 95% CI=1.15-1.65, p 0.001) (c) a moderate to high 14-day lag 4-weekly cumulative training load (CL) (5200-8000AU: HR=0.33, 95% CI=0.21-0.50, p 0.001) and (d) a low number of previous IP episodes in the preceding 12 months (1 previous IP episode: HR=1.11, 95% CI=1.04-1.17, p=0.04).
Conclusion(s): Training consistently, while avodiing sudden spikes in activity, was associated with the lowest risk of IP among ESPs. The risk was also increased among those with a previous history of IP.
Implications: To minimise new IP risk an ESP should avoid high spikes in acute TL whilst maintaining moderate to high chronic TLs. A history of previous IP should be considered when prescribing TLs. The demonstration of a lag between a TL factor and its impact on new IP risk may have important implications for future ESP TL analysis.
Keywords: Injury, athlete, predict
Funding acknowledgements: The faculty of education and health sciences at the university of limerick supported this work with a phd shcolarship.
Topic: Sport & sports injuries; Musculoskeletal; Musculoskeletal: lower limb
Ethics approval required: Yes
Institution: university of limerick
Ethics committee: faculty of education and health sciences
Ethics number: EHSREC:0017
All authors, affiliations and abstracts have been published as submitted.
