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We read the recent systematic review on the prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes and agree with the conclusion that age and early specialisation (early training commencement) are risk factors for injury.1 The study highlighted training intensity as a risk factor for overuse injuries. Given changes in training loads precede the onset of injury in cricket,2 football (soccer)3 and Australian football,4 we consider that overuse injuries can be considered errors in training load prescription and labelled as such. Care should also be taken with broadly labelling training intensity as a risk factor as moderate training loads are protective against injury Gabbett's ‘training injury prevention paradox’.5 ,6 High training loads may predispose to …