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If overuse injury is a ‘training load error’, should undertraining be viewed the same way?
  1. Tim J Gabbett1,2,
  2. Steve Kennelly3,
  3. Joe Sheehan4,
  4. Richard Hawkins5,
  5. Jordan Milsom6,
  6. Enda King7,8,
  7. Rod Whiteley9,
  8. Jan Ekstrand10,11,12
  1. 1School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia
  2. 2School of Exercise Science, Australian Catholic University, Brisbane, Queensland, Australia
  3. 3New York Football Giants, New Jersey, USA
  4. 4Cleveland Browns, Ohio, USA
  5. 5Manchester United Football Club, Manchester, UK
  6. 6Liverpool Football Club, Liverpool, UK
  7. 7Department of Life Sciences, University of Roehampton, London, UK
  8. 8Sports Surgery Clinic, Dublin, Ireland
  9. 9Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  10. 10Football Research Group, Linkoping University, Linkoping, Sweden
  11. 11Division of Community Medicine, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
  12. 12UEFA Medical Committee, Nyon, Switzerland
  1. Correspondence to Dr Tim J Gabbett, School of Exercise Science, Australian Catholic University, Brisbane, QLD 4014, Australia; tim_gabbett{at}yahoo.com.au

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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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