Both too little and too much load are linked to illness and injury in athletes
PainSci summary of Soligard 2016?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This is the first of a pair of papers (with Schwellnus) about the risks of athletic training and competition intensity (load). Is load a risk for injury and illness? How much is too much? Is too little a problem? These papers were prepared by a panel of experts for the International Olympic Committee, and both them use many words to say the same things formally — but they are good points. Here they are in plain English:
- There’s not enough research, surprise surprise, and what we do know is mostly from limited data about a few specific sports. But there’s enough to be confident that “load management” overall is definitely important.
- Both illness and injury seem to have a similar relationship to load — lots of overlap.
- Too much and not enough load probably increase the risk of both injury and illness. You want to be in the goldilocks zone! But the devil is in the details …
- Not everyone is vulnerable to high load, and elite athletes are the most notable exception: they are relatively immune to the risks of overload, probably because of genetic gifts. Everyone else gets weeded out!
- Big load changes — dialing intensity up or down too fast — are much bigger risks than absolute load. If you methodically work your way up to a high load, it may even be protective.
- “Load” can also refer to non-sport stressors and “internal” loads, which are legion. Psychology, for instance, probably does matter: anything from daily hassles to major emotional challenges, as well as stresses related to sport itself.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.
related content
- “How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness,” Martin Schwellnus, Torbjørn Soligard, Juan-Manuel Alonso, Roald Bahr, Ben Clarsen, H Paul Dijkstra, Tim J Gabbett, Michael Gleeson, Martin Hägglund, Mark R Hutchinson, Christa Janse Van Rensburg, Romain Meeusen, John W Orchard, Babette M Pluim, Martin Raftery, Richard Budgett, and Lars Engebretsen, British Journal of Sports Medicine, 2016.
These seven articles on PainScience.com cite Soligard 2016 as a source:
- Sports Injury Prevention Tips — A few evidence-based ways to reduce your risk of injury
- Anxiety & Chronic Pain — A self-help guide for people who worry and hurt
- Save Yourself from IT Band Syndrome! — All your treatment options for Iliotibial Band Syndrome reviewed in great detail, with clear explanations of recent scientific research supporting every key point
- Save Yourself from Patellofemoral Pain Syndrome! — Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
- Save Yourself from Shin Splints! — Causes and treatment options for shin splints explained and discussed in great detail, especially shin pain caused by myofascial trigger points, compartment syndrome, medial tibial stress syndrome, and stress fracture
- The Art of Rest — The finer points of resting strategy when recovering from injury and chronic pain (hint: it’s a bit trickier than you might think)
- Achilles Tendinitis Treatment Science — Evidence-based guidelines for recovering as fast as possible
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.