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Overuse injury is a ‘training load error’
Inappropriately high training loads cause overuse injuries.1 However, it has recently been proposed that overuse injuries should be considered in terms of both ‘overloading’ and ‘underloading’.2 The rationale is that increased injury risk is associated with ‘spikes’ in workload (ie, overloading) and low chronic workloads (ie, underloading), which may leave an athlete predisposed to a ‘spike’ in workload.3 Given that workload is both modifiable and controllable, it has been suggested that ‘overuse injuries’ be considered as ‘training load errors’.2 ,4
Who ‘owns’ the injury?
Anecdotally, strength and conditioning staff are viewed as the practitioners who ‘break’ the athlete, while medical staff ‘fix’ them. Conversely, conditioning staff may indeed decrease the probability of athletes sustaining an injury by increasing chronic workloads, whereas medical staff may inadvertently increase injury risk by reducing workloads. Given that all coaching staff as well as the performance team (eg, strength and conditioning, sport scientists and physiotherapists) are involved to varying degrees in the training process, an effective solution needs to be multidisciplinary in nature. Periods of underloading and overloading can occur anywhere, from rehabilitation through to game-specific skills and competition, hence communication between athlete, manager …
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