Load Management

I started writing this blog about 2 months ago as Winter Sports pre-seasons started to ramp up. What a difference 2 months can make right? Back then, my purpose was to focus on the consequences of increasing physical activity (too much load) too quickly. However, on further reflection, the focus can also be on not enough physical activity (under-loading) which is probably more topical.

 What is Load Management in sport?

Very basically it is the balance of physical activity and rest for an individual athlete.

This has two main purposes:

1.     Reduce injury risk

2.     Allow for Optimal Performance

From a physiotherapists perspective, we focus primarily on the first point whereas the coaching staff, club personnel and athletes are more involved with the second point. However, both groups work together to monitor an athletes load “ceiling” and “floor”.

 What is the ceiling and the floor?

This refers to the max load an athlete can tolerate (the ceiling) and the minimum load an athlete should be maintaining (floor). Very basically, if you don’t continue to load your body, it’s capacity/resilience will drop which means it will tolerate less and less load over time (lower the ceiling). If an athlete then tries to increase their physical activity (eg pre-season) then they are at risk of overload injuries like stress fractures and tendinopathies. The ceiling is important because that informs the coaching staff of an athletes current limitations so they can plan for that in their trainings/gym sessions. Luckily, the ceiling can be increased with pre-planned and monitored loading over time.  The main way this is monitored is through the Acute-Chronic Workload Ratio (ACWR).

What is the Acute-Chronic Workload Ratio?

Acute workload refers to the amount of loading over a week. Chronic workload refers to the average of loading over four weeks. Loading can be a number of factors eg kilometres per week which is applicable for marathon runner.

Optimal ratio is 1-1.25 so anything above or below can mean a large spike in injury risk.

Equation: (Acute workload) / (Chronic workload)

Eg week 1 40km, week 2 40km, week 3 50km, week 4 55km

So Acute workload is 55km (the latest week kms)

Chronic workload is average of four weeks ((40+40+50+55)/4) = 46.25

55/46.25= 1.2 (reduced injury risk)

As mentioned, ACWR can be built up over time. For example, the reason marathon runners can do 180km+ per week is because they have painstakingly built up their distance (and therefore ACWR) over years of training.

 How to monitor relative load:

• RPE Scale: Rate of perceived exertion times minutes per session

• Smart watch that monitors distance, speed etc

• GPS: electronic unit that calculates distance, speed, collisions etc

• Subjective Questionnaires (eg Smartabase)

How is Load Management applicable to Elite Athletes?

You may see that every now and again an AFL player is ruled out of a game with “general soreness”, this is most likely because a players load is too high and they are at a high risk of injury so to reduce the risk, they won’t play the game. The same goes with NBA players (eg Kawhi Leonard in the 2018/2019 season) and high profile soccer players. Usually this is done during the season to make sure the player doesn’t get injured before the important part of the season (finals). It also serves to make sure they are “peaking” performance wise. The focus is on winning and the teams chances infinitely increases if their best players are;

A - able to play (no injuries) 

B - optimally performing

How is it applicable to the everyday athlete?

Pretty much the same as above, just because they don’t get paid to play doesn’t mean they don’t want to perform well, remain injury free and win. However, it can be harder for everyday individuals to be able to monitor their loading as intensely as sporting clubs/elite athletes. So here are my top tips for monitoring loading if you don’t have a GPS etc:

• Record each exercise session in terms of duration and RPE 

• Monitor your ACWR (as explained above) by reviewing and planning your training 4 weeks at a

  time (at a minimum)

• Keep an eye on types of physical activity and alternate if possible (eg running/jumping, weights, swimming, bike)

• Apply the 10% rule: don’t increase distance, speed or weights more than 10% on your last session (especially if you can’t calculate your ACWR)

•  Lastly, listen to your body as it will most likely tell you when you need to “de-load”

Main points from this blog:

• You need to load (even if you’re in isolation) otherwise you lose capacity

•  Load a bit more each week if you want to increase your capacity (not more than 10% is a good start)

• Structure your physical activity to load manage which can reduce injury risk as well as improve performance 

• Listen to your body!

 A big thanks to Glenn Stewart, Tim Gabbett and Lauren Shelley for all their work thus far in understanding load management.

If you would like some help load managing, make an appointment (call us on 9361 3777 or click the Book Now button) and any one of our highly trained physiotherapists will be able to assist you.

Busting Running Myths

Are you a seasoned runner or just starting out? Training for your first marathon or just enjoy your Sunday jog? Check out these commonly assumed running myths to know what is and isn’t important for improving performance and reducing injury!

Myth #1

‘The wrong shoe type can cause injury’

• There is some largely subjective and unreliable evidence claiming barefoot running reduced injury by 2.6x compared to running in shoes

• More recent research shows runners who change from a ‘bulkier’ shoe to a minimalistic shoe have a huge varied response in how their running style is affected from this change (with no correlation to injury)

• There is a common belief that shoes should be fitted for a person’s foot type (i.e. pronated feet require more arch support). There is actually no evidence that this type of shoe ‘prescription’ affects performance or injury risk 

Myth #2

‘Changing running style or becoming a forefoot runner is more efficient and reduces injury’

• Forefoot strikers place more force through their ankles and calves, while rearfoot (heel) strikers place more force through their knees and hips

• Despite the differing biomechanics, no running style has proved to enhance performance or reduce injury risk

• There are large variations in the running styles of national 10K runners, with zero correlation to injury or finishing position

• The biomechanical changes that occur when transitioning between running styles changes force distribution to certain muscles and joints, in fact INCREASING injury risk due to this shift in load

• Forcing a running style that feels unnatural uses more energy when you run 

Myth #3

‘Running will damage your knees’

• Evidence is continuing to prove recreational runners are less likely to develop knee osteoarthritis (OA) than non-runners. It appears elite athletes who compete at an international level have the same risk of developing knee OA as non-runners.

• Although further evidence is needed for a conclusive answer, a recent study has shown running does not speed the progression of existing OA and may even help to reduce symptoms. 

• There is strong evidence to suggest resistance training reduces the risk of OA, and slows progression of existing OA

Myth #4

‘You will get sore/injured if you don’t stretch’ 

• Static stretching post run has no positive or negative influence on delayed onset muscle soreness, injury risk or running performance. That being said, as there are no detrimental effects and it can psychologically help runners ‘relax’ after a big training, stretching is still warranted if it feels beneficial for you.

• It is well proven that sleep is one of the best forms of recovery. Athletes who sleep for less than 8 hours increase their injury risk by 1.7x compared to those getting 8 hours or more. 

• Re-fuelling your body with appropriate food will provide your cells with adequate nutrients to recover and grow muscle tissue. Low GI carbohydrates gives your body sustainable energy while you run, and High GI carbohydrates and protein are necessary for filling energy stores and muscle growth

• An active warm-up including dynamic stretching (eg walking lunges, leg swings) and easy jogging is commonly used prior to exercise, but has not been proven to have an effect on injury risk.

Myth #5

‘The only thing that will improve running, is more running!’

• The biggest injury predictor for runners is overload (doing too much too quickly). Total running load or volume should increase by no more than 10% per week to give your body time to recover and adapt.

• Twice weekly strength training has been shown to improve performance, improve fitness or running efficiency and reduce injury risk.

• There is no benefit to running performance by training low weight, high rep endurance exercises, nor circuit training.

• Have a look at our ‘Basic Guide to Resistance Training’ blog for an explanation between different types of gym training

What does this all mean? 

• The number one biggest predictor of injury is a significant load increase of more than 10% per week (Running too much too quickly)

• Choose a shoe you are comfortable in – there are more effective strategies to help your running than changing shoes 

• The body is adaptable and resilient, and there is no ‘perfect’ running style

• Well thought out recovery (diet, sleep) is one of the most effective ways of reducing injury 

• Twice weekly strength training will reduce your injury risk and improve your running performance. 

Our physiotherapists at East Vic Park Physiotherapy can answer all your running questions and can help review your running program to get you the best possible results

Injury Prevention: Part ONE – Groin Injuries

Prevention is the best cure - Desiderius Erasmus

Prevention of an injury can be difficult as injury occurrence is usually multi-modal. Extensive research has gone into the development of programs designed to address contributing factors of common injuries. Two common injury sites in sport are; groin and hamstring and both have been the subject of research articles investigating the efficacy of specific exercise intervention on prevention of injury.  

 GROIN

Groin injuries are a common occurrence in change of direction sports like soccer, basketball (e.g Lebron James recent injury) and Australian rules football. With the highest paid player in soccer earning $111 million per year, you can see why prevention of these injuries becomes very important. 

 Haroy et al (2017) looked at the inclusion of the Copenhagen exercise in the FIFA 11+ program (used as a warm up for soccer players) on improving hip adduction strength. 

The Copenhagen Adductor (CA) exercise is a partner exercise where the player lies on the side with one forearm as support on the floor and the other arm placed along the body. The upper leg is held at approximately hip height of the partner, who holds the leg with one arm supporting the ankle and the other supporting the knee (position A in figure 1). The player then raises the body from the field and the lower leg is adducted so that the feet touch each other and the body is in a straight line (position B in figure 1). The body is then lowered halfway to the ground while the foot of the lower leg is lowered so that it just touches the floor without using it for support. It is performed on both sides. 

Figure 1 The Copenhagen Adduction exercise. A start/end-position. B mid-position. 

The article found that the CA exercise delivered in the below protocol (figure 2) resulted in an increase in hip adduction strength and as this is a risk factor for groin injuries, should be included in the FIFA 11+ to try to reduce the incidences of these injuries. 

 Figure 2 The prescription parameters for the CA exercise.

The CA is a fairly safe and easy exercise to self- integrate into the pre-existing FIFA 11+ protocol. However, even with the diligent performance of the protocol, groin injuries can still occur. It is always best to be assessed by a physiotherapist to ascertain a correct diagnosis so you can receive the best treatment possible for your specific condition. Here at East Vic Park Physiotherapy, our physiotherapists are very experienced in assessing and treating groin pain. Additionally, if you would like to know more about the CA exercise or the FIFA 11+ program then click the link at the top of the webpage to book an appointment or call us on 9361 3777. Below is a quick link to review:

https://www.fifamedicinediploma.com/lessons/prevention-fifa-11/