Load management is a hot topic right now in the sporting world. What’s too much? What’s too little? From a physiotherapy perspective, one of the trickier things when working with athletes is to decide when is the right time to return to competition after injury and have they earned the right to return to their desired activity?
A great example of correctly managing training load, is the magical journey of Leicester City winning the English Premier League in football soccer. Behind the scenes, the work of their sports science/physiotherapy department was top class, and more importantly they had a coach who took everything they said on board. If a player worked his socks off at the weekend, his training would be altered for the coming week, so to have the body right for the next game. They had one of the lowest injury rates in the league last year, which proves how injury rates can affect team performance. They utilised this to great effect, and climbed to the top of the ladder against teams that had spent millions of more pounds. This is a nice newspaper article on how they did it and well worth the read if you get the chance, even if you have very little interest in the sport.
Unfortunately, most of us don’t have access to a full sports science department, where our heart rate is monitored daily, GPS software and blood lactate etc. are watched to determine training load. However, Gabbett (2016) has designed the acute:chronic workload ratio (ACWR) to monitor loading. In a nutshell, the higher (or lower) the acute training load (1 week) is compared to the chronic training load (4 weeks), the greater the risk of injury occurring. So this is not saying high workloads are bad. A chronic high workload, can make an athlete more resistant to injury if managed correctly.
To measure this we take the session time and multiply it by the rate of perceived exertion (RPE). The RPE is a scale of 0-10 rated out of difficulty/intensity of the session. So a 70 minute session at a rating of 7/10 on the RPE will result in 490 units (70 X 7 = 490). So for each session add up the units for the week, and this is the acute workload for the week.
The chronic workload is the average of the past four weeks. So if the chronic ratio for the last 4 weeks was 2000, and the acute workload was 3000, the ACWR is 1.5. (3000/2000). If the acute workload was 4000, and the chronic workload was 2000, then the ACWR would be 2.0, resulting in a higher risk of injury to the athlete. The magic number or ‘sweet spot’ as it is termed is between 0.8 and 1.3. The further you drift away from these figures, whether its above or below, you increase your chances of injury occurring. Realistically we are going to drift over these numbers from time to time and that’s not a bad thing. It is something to keep an eye on and adapt your training and recovery when needed.
If you want to return to sport after injury, you need to mimick the actions and demands of the sport as much as possible. For instance, if a footy player pulls their hamstring, lets say a grade 2 strain, after 6 weeks, physiological healing of the tear has most likely occurred. However, if little to no rehab has been done, the body is not physically capable to match the demands of the sport, and more than likely a recurrence of the injury will happen. Likewise, after the 6 weeks the player is running comfortably at a low pace for 90 minutes painfree.
Does this mean he can return for the game at the weekend? Hell no! The person has not trained for the game situation and as a result they increase their chance of aggravating the injury. I’m new to footy, but the demands are quiet similar to a sport I’m familiar with in Gaelic football, so I’m pretty confident that if you run around at a low pace for 90 minutes you won’t have much of an impact when playing and will be getting the curly finger from management to sit on the bench.
It’s not just in field sports we see this. We commonly hear people in the gym take a sabbatical from it for whatever reason. When they decide to get back to it again, they try and pick up from where they left off, and needless to say, it doesn’t end well.
The key to all of this is good communication between the coaches, physios, and the sport science crew. So if you have an injury and you want to get back doing what you love, whether it’s a field sport, lifting heavy things or just running, come down to us here at Evolutio Sports Physio in Richmond. We will get you back doing what you love, keep your coaches up to date on whats happening and work together to make sure your body is capable of handling whatever your sport throws at you when you return.
Sean is the newest team member, from that place where Conor Mcgregor comes from. The one with Guinness on tap, where the sun rarely shines and where whiskey is found in barrels a plenty. Sean has worked with American football D2, Gaelic, Hurling and is working the Melbourne high old boys footy club. You can book in with Sean here