To Couple or not to Couple? For Acute:Chronic Workload Ratios and Injury Risk, Does it Really Matter?

Abstract

We examined the association between coupled and uncoupled acute:chronic workload ratios (ACWR) and injury risk in a cohort of 28 elite cricket fast bowlers (mean±SD age, 26±5 yr). Workloads were estimated using the session rating of perceived exertion (session-RPE). Coupled ACWRs were calculated using a 1-week acute workload and 4-week chronic workload (acute workload was included in the chronic workload calculation), whereas uncoupled ACWRs used the most recent 1-week acute workload and the prior 3-week chronic workload (acute workload was not included in the chronic workload calculation). A nearly perfect relationship (R²=0.99) was found between coupled and uncoupled ACWRs. Using a percentile rank method, no significant differences in injury risk were found between the coupled and uncoupled ACWR. Higher ACWRs were associated with increased injury likelihood for both coupled and uncoupled methods, however there were no significant differences in injury risk between coupled and uncoupled ACWRs. Our data demonstrates that both coupled and uncoupled ACWRs produce the same injury likelihoods. Furthermore, our results are consistent with previous studies: higher ACWRs are associated with greater risk, irrespective of whether acute and chronic workloads are coupled or uncoupled.

Key words

workload - load management - injury likelihood

• References

• 1 Lolli L, Batterham AM, Hawkins R, Kelly DM, Strudwick AJ, Thorpe R, Gregson W, Atkinson G. Mathematical coupling causes spurious correlation within the conventional acute-to-chronic workload ratio calculations. Br J Sports Med 2017; Nov 3. pii: bjsports-2017-098110. [Epub ahead of print]
• 2 Windt J, Gabbett TJ. Is it all for naught? What does mathematical coupling mean for acute:chronic workload ratios?. Br J Sports Med 2018; May 28. pii: bjsports-2017-098925. [Epub ahead of print]
• 3 Hulin BT, Gabbett TJ, Blanch P, Chapman P, Bailey D, Orchard JW. Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med 2014; 48: 708-712
• 4 World Medical Association . Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA 2013; 310: 2191-2194
• 5 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
• 6 Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, Doleshal P, Dodge C. A new approach to monitoring exercise training. J Strength Cond Res 2001; 15: 109-115
• 7 Foster C. Monitoring training in athletes with special reference to overtraining syndrome. Med Sci Sports Exerc 1998; 30: 1164-1168
• 8 Haddad M, Stylianides G, Djaoui L, Dellal A, Chamari K. Session-RPE method for training load monitoring: Validity, ecological usefulness, and influencing factors. Front Neurosci 2017; 11: 1-14
• 9 Bowen L, Gross AS, Gimpel M, Bruce-Low S, Li FX. Spikes in acute:chronic workload ratio (ACWR) associated with a 5–7 times greater injury rate in English Premier League football players: A comprehensive 3-year study. Br J Sports Med 2019; Feb 21. pii: bjsports-2018-099422. [Epub ahead of print]
• 10 Bowen L, Gross AS, Gimpel M, Li FX. Accumulated workloads and the acute:chronic workload ratio relate to injury risk in elite youth football players. Br J Sports Med 2017; 51: 452-459
• 11 Hulin BT, Gabbett TJ, Caputi P, Lawson DW, Sampson JA. Low chronic workload and the acute: chronic workload ratio are more predictive of injury than between-match recovery time: A two-season prospective cohort study in elite rugby league players. Br J Sports Med 2016; 50: 1008-1012
• 12 Jaspers A, Kuyvenhoven JP, Staes F, Frencken WGP, Helsen WF, Brink MS. Examination of the external and internal load indicators' association with overuse injuries in professional soccer players. J Sci Med Sport 2018; 21: 579-585
• 13 Malone S, Owen A, Newton M, Mendes B, Collins K, Gabbett TJ. The acute:chronic workload ratio in relation to injury risk in professional soccer. J Sci Med Sport 2017; 20: 561-565
• 14 Malone S, Roe M, Doran DA, Gabbett TJ, Collins K. High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football. J Sci Med Sport 2017; 20: 250-254
• 15 Malone S, Owen A, Mendes B, Hughes B, Collins K, Gabbett TJ. High-speed running and sprinting as an injury risk factor in football: Do well-developed physical qualities reduce the risk?. J Sci Med Sport 2018; 21: 257-262
• 16 Malone S, Roe M, Doran A, Gabbett TJ, Collins KD. Protection against spikes in workload with aerobic fitness and playing experience: The role of the acute:chronic workload ratio on injury risk in elite Gaelic football. Int J Sports Physiol Perform 2017; 12: 393-401
• 17 Malone S, Hughes B, Doran DA, Collins K, Gabbett TJ. Can the workload-injury relationship be moderated by improved strength, speed and repeated-sprint qualities?. J Sci Med Sport 2019; 22: 29-34
• 18 Ivarrson A, Johnson U, Andersen MB, Tranaeus U, Stenling A, Lindwall M. Psychosocial factors and sports injuries: Meta-analyses for prediction and prevention. Sports Med 2017; 47: 353-365
• 19 Mann JB, Bryant KR, Johnstone B, Ivey PA, Sayers SP. Effect of physical and academic stress on illness and injury in division 1 college football players. J Strength Cond Res 2016; 30: 20-25
• 20 Milewski MD, Skaggs DL, Bishop GA, Pace JL, Ibrahim DA, Wren TA, Barzdukas A. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Petriatr Orthop 2014; 34: 129-133
• 21 von Rosen P, Frohm A, Kottorp A, Friden C, Heijne A. Multiple factors explain injury risk in adolescent athletes: Applying a biopsychosocial perspective. Scand J Med Sci Sports 2017; 27: 2059-2069
• 22 Gabbett TJ. Debunking the myths about training load, injury and performance: Empirical evidence, hot topics and recommendations for practitioners. Br J Sports Med 2018; Oct 26. pii: bjsports-2018-099784. [Epub ahead of print]
• 23 Hulin BT, Gabbett TJ. Indeed association does not equal prediction: The never-ending search for the perfect acute:chronic workload ratio. Br J Sports Med 2019; 53: 144-145
• 24 Carey DA, Crossely KM, Whitely R, Mosler A, Ong KL, Crow J, Morris ME. Modelling training loads and injuries: The dangers of discretization. Med Sci Sports Exerc 2018; 50: 2267-2276
• 25 Carey DL, Blanch P, Ong KL, Crossley KM, Crow J, Morris ME. Training loads and injury risk in Australian football-differing acute:chronic workload ratios influence match injury risk. Br J Sports Med 2017; 51: 1215-1220
• 26 Stares J, Dawson B, Peeling P, Heasman J, Rogalski B, Drew M, Colby M, Dupont G, Lester L. Identifying high risk loading conditions for in-season injury in elite Australian football players. J Sci Med Sport 2018; 21: 46-51
• 27 Williams S, West S, Cross MJ, Stokes KA. Better way to determine the acute:chronic workload ratio?. Br J Sports Med 2017; 51: 209-210
• 28 Gabbett TJ, Hulin BT, Blanch P, Whiteley R. High training loads alone do not cause sports injuries: How you get there is the real issue. Br J Sports Med 2016; 50: 444-445
• 29 Gabbett TJ. The training—injury prevention paradox: Should athletes be training smarter and harder?. Br J Sports Med 2016; 50: 273-280